Research ArticleTraditional Therapies Used to ManageDiabetes and Related Complications in MauritiusA Comparative Ethnoreligious Study
M Fawzi Mahomoodally1 A Mootoosamy1 and S Wambugu2
1Department of Health Sciences Faculty of Science University of Mauritius 230 Reduit Mauritius2Department of Veterinary Anatomy and Physiology University of Nairobi Nairobi 30197 00100 Kenya
Correspondence should be addressed to M Fawzi Mahomoodally fmahomoodallyuomacmu
Received 29 December 2015 Revised 11 February 2016 Accepted 14 February 2016
Academic Editor Andrea Pieroni
Copyright copy 2016 M Fawzi Mahomoodally et al This is an open access article distributed under the Creative CommonsAttribution License which permits unrestricted use distribution and reproduction in any medium provided the original work isproperly cited
Religious communities from Mauritius still rely on traditional therapies (TT) for primary healthcare Nonetheless there is still adearth of scientific information on TT used by the different religious groups to manage diabetes and related complications (DRC)This study aimed to gather ethnomedicinal knowledge on TT used by the different religious groups against DRC Diabetic patients(119899 = 95) and traditional healers (119899 = 5) were interviewed Fifty-two plant species belonging to 33 families and 26 polyherbalformulations were documented to manage DRC The most reported DRC was hypertension (119899 = 36) Leaves (452) and juice(36) were themost citedmode of preparation of herbal recipes Plants which scored high relative frequency of citation wereCitrusaurantifolia (055) andMorinda citrifolia (054) The cultural importance index showed that Ocimum tenuiflorum Cardiospermumhalicacabum Camellia sinensis and Ophiopogon japonicas were the most culturally important plants among Hindu MuslimChristian and Buddhist community respectively Hindu andMuslim community showed the highest similarity of medicinal plantsusage (Jaccard index = 958) Seven animal species distributed over 4 classes were recorded for the management of DRC Plants andanimals recorded as TT should be submitted to scientific studies to confirm safety and efficacy in clinical practice and to identifypharmacologically active metabolites
1 Background
Diabetes mellitus generally termed as diabetes is a chronicmetabolic disorder of the endocrine system characterised byabnormalities in carbohydrates protein and fat metabolism[1ndash3] The incidence of diabetes mellitus continues to soarexponentially in both developed and developing countriesleading to an increase in the cost of managementtreatmentof the disease and its related complications Diabetes mellitusis a global epidemic currently affecting more than 371 millionpeople and the death toll from the disease rose to 15 millionin 2012 [4 5]TheWorldHealth Organisation has argued thatdiabetes will be the 7th leading cause of death in 2030 [6]
Diabetes mellitus is one of the most important healthissues inMauritius with a prevalence of 245 in 2015 [7]TheInternational Diabetes Federation reported that in 2015 there
were 220000 cases of diabetes in Mauritius and the numberof cases of diabetes in adults that are undiagnosed was foundto be 113100 [7] Alterations in carbohydrates protein and fatmetabolism entail an increase in blood glucose level whichcauses long-term devastating complications in many organsof the body [8] Prolonged uncontrolled hyperglycemic levelleads to macrovascular complications (coronary artery dis-ease peripheral arterial disease and stroke) and to microvas-cular complications (diabetic nephropathy neuropathy andretinopathy) [9] Complications related to diabetes are themajor cause of disability and mortality among the Mauritiandiabetic population
Nowadays diabetes is managed with oral hypoglycemicagents and insulin Though the efficacy of these treat-ments is irrefutable they have to be given throughoutthe lifetime of the patient and entail numerous potential
Hindawi Publishing CorporationEvidence-Based Complementary and Alternative MedicineVolume 2016 Article ID 4523828 25 pageshttpdxdoiorg10115520164523828
2 Evidence-Based Complementary and Alternative Medicine
Republic of Mauritius
Agalega Islands
Cargados Carajos
Rodrigues
Mauritius
Mauritius
Rivi ere duRempart
Pamplemousses
Port Louis
Ile drsquoAmbre
Ile de lrsquoEst
Ile aux Cerfs
Ilot Flamants
Ile MarianneIle aux Fouquets
Ile aux Aigrettes
FlacqMoka
Rivi ereNoire
PlainesWilhems
Grand PortIle aux Benitiers
Ilot Fourneau
Savanne
Figure 1 Map of Mauritius indicting the study area (spread over 9 main districts)
side effects namely hypoglycemic coma and hepatorenaldisturbances [10 11] Hence there is a growing interest intraditional therapies mostly because of the less frequent sideeffects associated with them as compared to conventionalmedicines
Mauritius is a tropical island located in the southernhemisphere in the middle of the Indian Ocean Mauritius isbestowed with a rich variety of medicinal flora fauna andcultural diversity The volcanic island of Mauritius lies in themiddle of the IndianOcean (Figure 1) with coordinates 57∘301015840east and 20∘201015840 south Mauritius has an area of 1865 km2 and
about 43 of the area is allocated to agriculture Mauritiusenjoys a mild tropical climate characterised by a warmhumid summer between November and April and a cool drywinter between June and September whereby October andMay are the transition months Mean summer temperatureis 247∘C and mean winter temperature is 204∘C [12]Mauritius has a rich heritage of indigenous and endemicplants During the past allopathic medicine was not easilyavailable for the local population and the use of traditionalmedicine was therefore necessary in order to alleviate signsand symptoms of diseases Nowadays healthcare facilities
Evidence-Based Complementary and Alternative Medicine 3
are within the reach of everybody nonetheless traditionalmedicine continues to remain active in the lives of the localpopulation
The multicultural society of Mauritius encompassesdescendants of Indian indentured labourers Chinese shop-keepers African slaves and British and French colonisersThe Indo-Mauritians community (Hindus and Muslims)represents the majority of the population followed by theChristian community and the Sino-Mauritians communityThe Hindu community is subdivided into several distinctreligious and sociocultural groupsThemain religious groupsare theHindi or Bhojpuri speaking people constituting 402of the total population and 765of allHindusTheTamils arethe second largest ethnic community (139) while Telugus(56) andMarathis (4) represent smallerminoritieswithinthe overall Hindu community The Hindus have a commonlanguage (Bhojpuri) the same regional origin (Uttar PradeshandBihar) and religious practices and rituals [13]The officiallanguage in Mauritius is the English language but ldquoCreolerdquo isthe native language of the island and is mostly used in infor-mal settings Mauritius is reputed worldwide for the peacefulharmony which prevails in the island among the differentgreat religions of the world namely Hinduism ChristianityIslam and Buddhism In Mauritius traditional therapies areparamount to panoply of ailments treatmentmanagementoffering profound therapeutic benefits and the indigenouscommunities rely heavily on them to meet their medicalneeds Though allopathic medicine is the primary form ofhealthcare in Mauritius some patients prefer traditionalmedicine for the treatmentmanagement of a number ofhuman diseases The rising costs of synthetic drugs havefueled the interest of the local population in traditionalmedicine usage thereby reintroducing such therapies as anovel emerging formof health aidMauritius is endowedwitha number of tropical rainforests which are rich repositoriesof a diverse range of invaluable medicinal plants and animalspecies Recently Mauritius has become the arena of anumber of ethnopharmacological field studies conducted byvarious workers which have emphasised mostly medicinalplants and animals among the Mauritian population andhave led to several publications [14 15] Nonetheless noneof these studies have addressed the patterns of similarityand dissimilarity of medicinal plants and animals usageamong the different religious communities present in theisland Heinrich et al [16] reported that most studies onmedicinal plants focus on the role of these plants withinone particular ethnic group and little emphasis has beengiven to the comparison of medicinal plant species amongvarious cultures Moreover an analysis of medicinal plantsusage must be carried out in order to understand thepatterns of use intra- and interculturally However studieson cross-cultural analysis of medicinal plants usage arelacking inMauritiusTherefore the current study specificallyseeks to bring in the limelight of the scientific communitythe documentation of traditional remedies used amongthe diabetic patients in Mauritius We also attempted toidentify the most culturally important medicinal plants andanimals in each religious group compare the use of plantand animal species interculturally and examine how the
different religious groups present in the island value tradi-tional remedies in their daily lives in their quest for soundhealth
2 Methods
21 Data Collection The project was approved by the Facultyof Science University of Mauritius Mauritius A total of100 key informants (27 Hindus 24 Muslims 26 Christiansand 23 Buddhists) were interviewed from June to August2015 Data was collected from key informants throughface-to-face interviews using a semistructured questionnaire(supplementary file in Supplementary Material availableonline at httpdxdoiorg10115520164523828) Traditionalinformation was sought from diabetic patients older than 30years based on the assumption that the mature populationis better versed in traditional knowledge Moreover partic-ipants should be users of traditional medicine and formallydiagnosed to be diabetic by their treating physician Duringthe course of the study 12 field trips were carried out indifferent regions of the island The interview was performedin ldquoCreolerdquo the native language of the Mauritian populationThe questionnaire developed for the survey consisted of bothclose- and open-ended questions Participants were informedabout the purpose of the survey and a prior informed consentformwas dully signed by the participants before the interviewwas carried out The traditional healers were interviewedusing the same questionnaireThe interviewswere performedin health centers home visits markets and Chinese shops(Figure 2) Figure 1 illustrates the different regions where thesurvey was carried out
The questionnaire comprised three main parts PartsA B and C Part A consisted of demographic data whichincluded age gender level of education occupation incomeand religious belief Part B of the questionnaire consistedof information about the herbal remedies used to managediabetes and related complications the local vernacular nameof the plant the method of preparation the dosage theroute of administration and the duration of treatmentPart C was based on animal-based remedy used to man-age diabetes and related complications the local vernac-ular name of the animal the method of preparation thedosage the route of administration and the duration oftreatment
22 Collection and Identification of Medicinal Plants Duringthe field visits when a remedy was mentioned by thetraditional healer or diabetic patient where possible theparticipant was encouraged to show us a sample of theremedy which was collected in situ and photographed Thecollected sample was then identified by local botanist Ourlocal repository database was updated whereby plant sampleswere assigned a collection number for future reference anddata mining Data obtained during the survey was cross-checked (local namesscientific names) according to a locallypublished book by Gurib-Fakim and Brendler [17] Scientificnames of plant species were identified according to the Inter-national Plant Name Index (IPNI httpwwwipniorg)
4 Evidence-Based Complementary and Alternative Medicine
Figure 2 Interview with traditional healers
23 Ailments Categories Based on the information obtainedfrom the key informants in the study area all the reportedailments were classified into 9 categories based on publishedscientific literature fromRiaz [18] ADA [19] Yadav et al [20]Ginsberg et al [21] and Bodansky et al [22] The categorieswere diabetic angiopathy diabetic nephropathy eye diseasesdiabetic neuropathy infections and wounds hypertensionskin complications diabetic dyslipidemia and diabetes
24 Data Analysis and Ethnobotanical Indexes The indige-nous medicinal information of plant and animal species wasanalyzed using different quantitative indexes
241 Relative Frequency of Citation Relative frequency ofcitation is calculated as follows relative frequency of citation= FCN where FC is the number of informants mentioningthe use of the species and 119873 is the number of informantsparticipating in the survey This index theoretically variesfrom 0 to 1 According to Sharma et al [23] when relativefrequency of citation is 0 it means that nobody refers tothe plantanimal as useful and when relative frequency ofcitation is 1 it means that all informants in the survey referto the plantanimal as useful
242 Cultural Importance Index Culturally importantspecies as medicines are identified by the cultural importanceindex (CII) [24] The CII was used to determine the most
culturally important plantanimal species in each religiousgroup It can be calculated by the following formula
CII =119906NC
sum
119906=1199061
119894119899
sum
119894=1198941
UR119906119894
119873
(1)
where NC is the total number of different illness categories(of each 119894 species) UR is the total number of use reportsfor each species and 119873 is the total number of informantsin each religious group The cultural importance index is thesum of the proportion of informants that mention each ofthe use-categories for a given species Themaximum value ofthe index equals the total number of different use-categories(NC) whichwould occur if all informants in a religious groupwould mention the use of a species in all use-categories Thisindex was used to estimate the cultural significance of eachplantanimal species [24] and to determine to what extenteach plantanimal species is present in the memory of theinformants belonging to each religious group
243 Jaccard Similarity Index The Jaccard similarity indexadapted from Guzel et al [25] was used to determine thedegree of similarity of medicinal plantsrsquo use among thedifferent religious groups The Jaccard similarity index iscalculated as follows Jaccard similarity index = 119862 times 100119860 +119861 minus 119862 where 119860 is the number of plant species reported byreligious group A 119861 is the number of plant species reportedby the religious group B and119862 is the number of plant speciesreported by both A and B [25]
Evidence-Based Complementary and Alternative Medicine 5
Table 1 Demographic data of the informants (119873 = 100)
Variable Categories Frequency (119899 = 100)
Age (years)
30ndash39 240ndash49 1750ndash59 2760ndash69 4170ndash79 8ge80 5
Sex Male 38Female 62
Level of education
No formal education 7Primary 64Secondary 20Tertiary 9
Occupation
Retired 36Nongovernment officer 25Housewife 18Government officer 16Traditional healer 2Ayurvedic medicine practitioner 2Traditional Chinese medicine practitioner 1
Monthly household income
ltRs 5000 2Rs 5001ndash10000 48Rs 10001ndash20000 40Rs 20001ndash30000 8gtRs 30001 2
Religion
Hindu 27Muslim 24Christian 26Buddhist 23
Diabetes related complications
Hypertension 36High level of cholesterol 27Neuropathic pain 25Cardiovascular diseases 12Cataracts 9Urinary tract infections 7Renal failure 5Foot ulcers 4Gangrene 3Infected wounds 3Stress 2Dry skin 2Erectile dysfunction 1Hearing loss 1Memory loss 1Depression 1
3 Results and Discussion
31 Demographic Profile of the Participants The demo-graphic characteristics of the participants were determinedand documented through face-to-face interviews usingsemistructured questionnaire (Tables 1 and 2) A total of 100
randomly selected informants (38males and 62 females) wereinterviewed as summarized in Tables 1 and 2 Our findingresembled the study of Ishola et al [26] where the majorityof traditional medicine users were female since they weretypically in charge of preparing herbal preparations in thedomestic setting According to Hardy [27] women are the
6 Evidence-Based Complementary and Alternative Medicine
Table 2 Age and gender distribution within each religious commu-nity
Religiouscommunity Age Number of
participants Gender Number ofparticipants
Hindu
30ndash39 1 Male 1240ndash49 3 Female 1550ndash59 860ndash69 770ndash79 6ge80 2
Muslim
30ndash39 0 Male 1140ndash49 4 Female 1350ndash59 360ndash69 1470ndash79 2ge80 1
Christian
30ndash39 1 Male 1040ndash49 4 Female 1650ndash59 760ndash69 1370ndash79 0ge80 1
Buddhist
30ndash39 0 Male 540ndash49 6 Female 1850ndash59 960ndash69 770ndash79 0ge80 1
main source of conservation and dissemination of traditionalknowledge Ethnographic investigations revealed that thegreatest contribution in terms of traditional information wasprovided by interviewees belonging to the age group 60ndash69 years old (119873 = 41) They were followed by informantsbelonging to the age category 50ndash59 years old (119873 = 27)This information implies that the young generation neglectstraditional medicine practice which might lead to the rapidloss of valuable traditional knowledge regarding the useof medicinal plants [28] There exist several reasons whichmight account for the loss of traditional knowledge in thestudy area (1) holders of empirical knowledge have diedbefore passing on this knowledge to the younger generation(2) the younger generation believes more in the efficacy ofallopathic medicine and (3) given the free cost of healthcarefacilities provided by the Mauritian government in publichospitals allopathic medicine is more accessible to thepopulation
Moreover the results revealed that the majority of theparticipants studied till the primary level only (119873 = 64) Ourfinding is in accordance with the work of Gakuya et al [29]where elder people with little formal education possess moreknowledge concerning the use of medicinal plants It wasalso noted that the majority of the informants were retired
(119873 = 36) and had a monthly household income of Rs 5001ndash10000 (1 US$ asymp Rs 3600) (119873 = 48) The retirement agein Mauritius is 60 years and above Nonetheless some ofthe participants were found to continue working thoughthey reached the retirement age The traditional healthpractitioners (119873 = 5) were found to play vital roles in thestudy area whereby the indigenous communities rely on themfor the provision of herbal medicines The traditional healthpractitioners were found to be key custodians of traditionalinformation on themedicinal use of plant and animal speciesTheir practice of healing involved panoply of methodologieswhich are considered trustworthy among the indigenouscommunity in the study area Traditional health practitionersin Mauritius were willing to share their valuable traditionalknowledge in order to prevent extinction of this culturalheritage
In order to allow better comparison of medicinal plantsand animals use among the four religious groups presentin the study area the number of participants surveyed ineach religious group was approximately equal 27 24 26and 23 for the Hindu Muslim Christian and Buddhistreligious group respectively The most common diabetesrelated complications reported by the informants were hyper-tension (119873 = 36) followed by high level of cholesterol (27)neuropathic pain (119873 = 25) and cardiovascular diseases(119873 = 12) According to the American Diabetes Associationin type 2 diabetes hypertension is often present as part ofthe metabolic syndrome of insulin resistance while in type1 diabetes hypertension may reflect the onset of diabeticnephropathy [30]
32 Herbal Remedies Used to Manage Diabetes and RelatedComplications The present research revealed the ethnob-otanical use of 52 plant species belonging to 33 familiesused to manage diabetes and related complications Infor-mation on medicinal plants obtained from the four religiousgroups namelyHinduMuslimChristian andBuddhist wasarranged alphabetically according to their botanical familiesalong with their ethnomedicinal uses (Table 3)
33 Source of Medicinal Plants Informants obtained themedicinal plants from three main sources gathering fromthe wild (39) harvesting from home gardens (37) andpurchasing from the herbalistsrsquo store (24) Our result isin agreement with the work of Singh et al [31] where themajority ofmedicinal plants used in the preparation of herbalremedies are obtained from the wild Indigenous people alsocultivate medicinal plants in home garden where medicinalplants are grown in small areas surrounding the houseMoreover medicinal plants are also grown in clay potsOne informant reported that effective medicinal plants arecultivated close to the house to allow easy accessibility On theother handmedicinal plants which are considered rare by theinformants and which are not easily available are purchasedfrom the herbalistsrsquo store
34 Forms of Medicinal Plants It was found that the infor-mants showed no particular preference for using either fresh
Evidence-Based Complementary and Alternative Medicine 7
Table3Listof
medicinalplantsandpo
lyherbalform
ulations
with
theirrelated
inform
ationused
againstd
iabetesa
ndrelated
complications
repo
rtedby
theinformants
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Acanthaceae
Graptophyllum
pictum
(L)Griff
(A
M15)
Laitde
vierge
Type
2diabetes
LPreparea
decoctionwith
3leaves
anddrink2cups
daily
for1
week
016
002
004
010
000
Alismataceae
Alism
aplantago-aquatica
subsp
orientale(Sam)S
am
(AM09)
mdashHighlevelofcho
leste
rol
mdash
Sold
asaC
hinese
teaa
gainstcholesterolPreparea
ninfusio
nwith
the
teabagsw
hich
containAlism
aorien
talis
(Rhizomaalism
atis)R
adix
angelicae
sinensisH
erba
artemisiae
capillarisH
awthornberryRh
izom
aatractylodismacrocephalaeSem
enzizip
hispinosaeand
ChineseteaD
rink
1cup
daily
012
000
000
003
009
Type
1diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Highlevelofcho
leste
rol
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Renalfailure
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Alliu
mcepa
L(A
M04)
Zoiyon
oigno
nHearin
gloss
BCr
ushandpressthe
bulbto
obtain
thejuice
andmix30
gof
thejuice
with
30gof
waterH
eatand
instill3-4drop
sinthea
ffected
ear
048
028
012
017
003
Amaryllid
aceae
Erectiled
ysfunctio
nB
Preparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Cataract
BPreparea
decoctionwith
theb
ulbandadd2teaspo
onso
fhon
eyA
llowitto
coolanduseitasa
neyebathdaily
Type
2diabetes
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Cataract
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Renalfailure
BCon
sume2
-3rawclo
vesd
ailyfor1
week
Alliu
msativ
umL
(AM39)
Lrsquoail
Hypertension
BSw
allow2sm
allclovesw
ithac
upof
water
thric
eper
week
042
024
009
022
006
Wou
ndB
Crushandpressthe
bulbto
obtain
juicea
ndapplythejuice
onthew
ound
daily
tillh
ealin
g
Ulcer
BCr
ushandpressthe
bulbto
obtain
juicea
ndapplythejuice
ontheu
lcer
daily
tillh
ealin
g
Anacardiaceae
Mangifer
aindica
L(A
M20)
Mangue
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
031
017
003
010
001
Ann
onaceae
Annona
murica
taL
(AM29)
Coron
sol
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
016
007
003
006
000
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
2 Evidence-Based Complementary and Alternative Medicine
Republic of Mauritius
Agalega Islands
Cargados Carajos
Rodrigues
Mauritius
Mauritius
Rivi ere duRempart
Pamplemousses
Port Louis
Ile drsquoAmbre
Ile de lrsquoEst
Ile aux Cerfs
Ilot Flamants
Ile MarianneIle aux Fouquets
Ile aux Aigrettes
FlacqMoka
Rivi ereNoire
PlainesWilhems
Grand PortIle aux Benitiers
Ilot Fourneau
Savanne
Figure 1 Map of Mauritius indicting the study area (spread over 9 main districts)
side effects namely hypoglycemic coma and hepatorenaldisturbances [10 11] Hence there is a growing interest intraditional therapies mostly because of the less frequent sideeffects associated with them as compared to conventionalmedicines
Mauritius is a tropical island located in the southernhemisphere in the middle of the Indian Ocean Mauritius isbestowed with a rich variety of medicinal flora fauna andcultural diversity The volcanic island of Mauritius lies in themiddle of the IndianOcean (Figure 1) with coordinates 57∘301015840east and 20∘201015840 south Mauritius has an area of 1865 km2 and
about 43 of the area is allocated to agriculture Mauritiusenjoys a mild tropical climate characterised by a warmhumid summer between November and April and a cool drywinter between June and September whereby October andMay are the transition months Mean summer temperatureis 247∘C and mean winter temperature is 204∘C [12]Mauritius has a rich heritage of indigenous and endemicplants During the past allopathic medicine was not easilyavailable for the local population and the use of traditionalmedicine was therefore necessary in order to alleviate signsand symptoms of diseases Nowadays healthcare facilities
Evidence-Based Complementary and Alternative Medicine 3
are within the reach of everybody nonetheless traditionalmedicine continues to remain active in the lives of the localpopulation
The multicultural society of Mauritius encompassesdescendants of Indian indentured labourers Chinese shop-keepers African slaves and British and French colonisersThe Indo-Mauritians community (Hindus and Muslims)represents the majority of the population followed by theChristian community and the Sino-Mauritians communityThe Hindu community is subdivided into several distinctreligious and sociocultural groupsThemain religious groupsare theHindi or Bhojpuri speaking people constituting 402of the total population and 765of allHindusTheTamils arethe second largest ethnic community (139) while Telugus(56) andMarathis (4) represent smallerminoritieswithinthe overall Hindu community The Hindus have a commonlanguage (Bhojpuri) the same regional origin (Uttar PradeshandBihar) and religious practices and rituals [13]The officiallanguage in Mauritius is the English language but ldquoCreolerdquo isthe native language of the island and is mostly used in infor-mal settings Mauritius is reputed worldwide for the peacefulharmony which prevails in the island among the differentgreat religions of the world namely Hinduism ChristianityIslam and Buddhism In Mauritius traditional therapies areparamount to panoply of ailments treatmentmanagementoffering profound therapeutic benefits and the indigenouscommunities rely heavily on them to meet their medicalneeds Though allopathic medicine is the primary form ofhealthcare in Mauritius some patients prefer traditionalmedicine for the treatmentmanagement of a number ofhuman diseases The rising costs of synthetic drugs havefueled the interest of the local population in traditionalmedicine usage thereby reintroducing such therapies as anovel emerging formof health aidMauritius is endowedwitha number of tropical rainforests which are rich repositoriesof a diverse range of invaluable medicinal plants and animalspecies Recently Mauritius has become the arena of anumber of ethnopharmacological field studies conducted byvarious workers which have emphasised mostly medicinalplants and animals among the Mauritian population andhave led to several publications [14 15] Nonetheless noneof these studies have addressed the patterns of similarityand dissimilarity of medicinal plants and animals usageamong the different religious communities present in theisland Heinrich et al [16] reported that most studies onmedicinal plants focus on the role of these plants withinone particular ethnic group and little emphasis has beengiven to the comparison of medicinal plant species amongvarious cultures Moreover an analysis of medicinal plantsusage must be carried out in order to understand thepatterns of use intra- and interculturally However studieson cross-cultural analysis of medicinal plants usage arelacking inMauritiusTherefore the current study specificallyseeks to bring in the limelight of the scientific communitythe documentation of traditional remedies used amongthe diabetic patients in Mauritius We also attempted toidentify the most culturally important medicinal plants andanimals in each religious group compare the use of plantand animal species interculturally and examine how the
different religious groups present in the island value tradi-tional remedies in their daily lives in their quest for soundhealth
2 Methods
21 Data Collection The project was approved by the Facultyof Science University of Mauritius Mauritius A total of100 key informants (27 Hindus 24 Muslims 26 Christiansand 23 Buddhists) were interviewed from June to August2015 Data was collected from key informants throughface-to-face interviews using a semistructured questionnaire(supplementary file in Supplementary Material availableonline at httpdxdoiorg10115520164523828) Traditionalinformation was sought from diabetic patients older than 30years based on the assumption that the mature populationis better versed in traditional knowledge Moreover partic-ipants should be users of traditional medicine and formallydiagnosed to be diabetic by their treating physician Duringthe course of the study 12 field trips were carried out indifferent regions of the island The interview was performedin ldquoCreolerdquo the native language of the Mauritian populationThe questionnaire developed for the survey consisted of bothclose- and open-ended questions Participants were informedabout the purpose of the survey and a prior informed consentformwas dully signed by the participants before the interviewwas carried out The traditional healers were interviewedusing the same questionnaireThe interviewswere performedin health centers home visits markets and Chinese shops(Figure 2) Figure 1 illustrates the different regions where thesurvey was carried out
The questionnaire comprised three main parts PartsA B and C Part A consisted of demographic data whichincluded age gender level of education occupation incomeand religious belief Part B of the questionnaire consistedof information about the herbal remedies used to managediabetes and related complications the local vernacular nameof the plant the method of preparation the dosage theroute of administration and the duration of treatmentPart C was based on animal-based remedy used to man-age diabetes and related complications the local vernac-ular name of the animal the method of preparation thedosage the route of administration and the duration oftreatment
22 Collection and Identification of Medicinal Plants Duringthe field visits when a remedy was mentioned by thetraditional healer or diabetic patient where possible theparticipant was encouraged to show us a sample of theremedy which was collected in situ and photographed Thecollected sample was then identified by local botanist Ourlocal repository database was updated whereby plant sampleswere assigned a collection number for future reference anddata mining Data obtained during the survey was cross-checked (local namesscientific names) according to a locallypublished book by Gurib-Fakim and Brendler [17] Scientificnames of plant species were identified according to the Inter-national Plant Name Index (IPNI httpwwwipniorg)
4 Evidence-Based Complementary and Alternative Medicine
Figure 2 Interview with traditional healers
23 Ailments Categories Based on the information obtainedfrom the key informants in the study area all the reportedailments were classified into 9 categories based on publishedscientific literature fromRiaz [18] ADA [19] Yadav et al [20]Ginsberg et al [21] and Bodansky et al [22] The categorieswere diabetic angiopathy diabetic nephropathy eye diseasesdiabetic neuropathy infections and wounds hypertensionskin complications diabetic dyslipidemia and diabetes
24 Data Analysis and Ethnobotanical Indexes The indige-nous medicinal information of plant and animal species wasanalyzed using different quantitative indexes
241 Relative Frequency of Citation Relative frequency ofcitation is calculated as follows relative frequency of citation= FCN where FC is the number of informants mentioningthe use of the species and 119873 is the number of informantsparticipating in the survey This index theoretically variesfrom 0 to 1 According to Sharma et al [23] when relativefrequency of citation is 0 it means that nobody refers tothe plantanimal as useful and when relative frequency ofcitation is 1 it means that all informants in the survey referto the plantanimal as useful
242 Cultural Importance Index Culturally importantspecies as medicines are identified by the cultural importanceindex (CII) [24] The CII was used to determine the most
culturally important plantanimal species in each religiousgroup It can be calculated by the following formula
CII =119906NC
sum
119906=1199061
119894119899
sum
119894=1198941
UR119906119894
119873
(1)
where NC is the total number of different illness categories(of each 119894 species) UR is the total number of use reportsfor each species and 119873 is the total number of informantsin each religious group The cultural importance index is thesum of the proportion of informants that mention each ofthe use-categories for a given species Themaximum value ofthe index equals the total number of different use-categories(NC) whichwould occur if all informants in a religious groupwould mention the use of a species in all use-categories Thisindex was used to estimate the cultural significance of eachplantanimal species [24] and to determine to what extenteach plantanimal species is present in the memory of theinformants belonging to each religious group
243 Jaccard Similarity Index The Jaccard similarity indexadapted from Guzel et al [25] was used to determine thedegree of similarity of medicinal plantsrsquo use among thedifferent religious groups The Jaccard similarity index iscalculated as follows Jaccard similarity index = 119862 times 100119860 +119861 minus 119862 where 119860 is the number of plant species reported byreligious group A 119861 is the number of plant species reportedby the religious group B and119862 is the number of plant speciesreported by both A and B [25]
Evidence-Based Complementary and Alternative Medicine 5
Table 1 Demographic data of the informants (119873 = 100)
Variable Categories Frequency (119899 = 100)
Age (years)
30ndash39 240ndash49 1750ndash59 2760ndash69 4170ndash79 8ge80 5
Sex Male 38Female 62
Level of education
No formal education 7Primary 64Secondary 20Tertiary 9
Occupation
Retired 36Nongovernment officer 25Housewife 18Government officer 16Traditional healer 2Ayurvedic medicine practitioner 2Traditional Chinese medicine practitioner 1
Monthly household income
ltRs 5000 2Rs 5001ndash10000 48Rs 10001ndash20000 40Rs 20001ndash30000 8gtRs 30001 2
Religion
Hindu 27Muslim 24Christian 26Buddhist 23
Diabetes related complications
Hypertension 36High level of cholesterol 27Neuropathic pain 25Cardiovascular diseases 12Cataracts 9Urinary tract infections 7Renal failure 5Foot ulcers 4Gangrene 3Infected wounds 3Stress 2Dry skin 2Erectile dysfunction 1Hearing loss 1Memory loss 1Depression 1
3 Results and Discussion
31 Demographic Profile of the Participants The demo-graphic characteristics of the participants were determinedand documented through face-to-face interviews usingsemistructured questionnaire (Tables 1 and 2) A total of 100
randomly selected informants (38males and 62 females) wereinterviewed as summarized in Tables 1 and 2 Our findingresembled the study of Ishola et al [26] where the majorityof traditional medicine users were female since they weretypically in charge of preparing herbal preparations in thedomestic setting According to Hardy [27] women are the
6 Evidence-Based Complementary and Alternative Medicine
Table 2 Age and gender distribution within each religious commu-nity
Religiouscommunity Age Number of
participants Gender Number ofparticipants
Hindu
30ndash39 1 Male 1240ndash49 3 Female 1550ndash59 860ndash69 770ndash79 6ge80 2
Muslim
30ndash39 0 Male 1140ndash49 4 Female 1350ndash59 360ndash69 1470ndash79 2ge80 1
Christian
30ndash39 1 Male 1040ndash49 4 Female 1650ndash59 760ndash69 1370ndash79 0ge80 1
Buddhist
30ndash39 0 Male 540ndash49 6 Female 1850ndash59 960ndash69 770ndash79 0ge80 1
main source of conservation and dissemination of traditionalknowledge Ethnographic investigations revealed that thegreatest contribution in terms of traditional information wasprovided by interviewees belonging to the age group 60ndash69 years old (119873 = 41) They were followed by informantsbelonging to the age category 50ndash59 years old (119873 = 27)This information implies that the young generation neglectstraditional medicine practice which might lead to the rapidloss of valuable traditional knowledge regarding the useof medicinal plants [28] There exist several reasons whichmight account for the loss of traditional knowledge in thestudy area (1) holders of empirical knowledge have diedbefore passing on this knowledge to the younger generation(2) the younger generation believes more in the efficacy ofallopathic medicine and (3) given the free cost of healthcarefacilities provided by the Mauritian government in publichospitals allopathic medicine is more accessible to thepopulation
Moreover the results revealed that the majority of theparticipants studied till the primary level only (119873 = 64) Ourfinding is in accordance with the work of Gakuya et al [29]where elder people with little formal education possess moreknowledge concerning the use of medicinal plants It wasalso noted that the majority of the informants were retired
(119873 = 36) and had a monthly household income of Rs 5001ndash10000 (1 US$ asymp Rs 3600) (119873 = 48) The retirement agein Mauritius is 60 years and above Nonetheless some ofthe participants were found to continue working thoughthey reached the retirement age The traditional healthpractitioners (119873 = 5) were found to play vital roles in thestudy area whereby the indigenous communities rely on themfor the provision of herbal medicines The traditional healthpractitioners were found to be key custodians of traditionalinformation on themedicinal use of plant and animal speciesTheir practice of healing involved panoply of methodologieswhich are considered trustworthy among the indigenouscommunity in the study area Traditional health practitionersin Mauritius were willing to share their valuable traditionalknowledge in order to prevent extinction of this culturalheritage
In order to allow better comparison of medicinal plantsand animals use among the four religious groups presentin the study area the number of participants surveyed ineach religious group was approximately equal 27 24 26and 23 for the Hindu Muslim Christian and Buddhistreligious group respectively The most common diabetesrelated complications reported by the informants were hyper-tension (119873 = 36) followed by high level of cholesterol (27)neuropathic pain (119873 = 25) and cardiovascular diseases(119873 = 12) According to the American Diabetes Associationin type 2 diabetes hypertension is often present as part ofthe metabolic syndrome of insulin resistance while in type1 diabetes hypertension may reflect the onset of diabeticnephropathy [30]
32 Herbal Remedies Used to Manage Diabetes and RelatedComplications The present research revealed the ethnob-otanical use of 52 plant species belonging to 33 familiesused to manage diabetes and related complications Infor-mation on medicinal plants obtained from the four religiousgroups namelyHinduMuslimChristian andBuddhist wasarranged alphabetically according to their botanical familiesalong with their ethnomedicinal uses (Table 3)
33 Source of Medicinal Plants Informants obtained themedicinal plants from three main sources gathering fromthe wild (39) harvesting from home gardens (37) andpurchasing from the herbalistsrsquo store (24) Our result isin agreement with the work of Singh et al [31] where themajority ofmedicinal plants used in the preparation of herbalremedies are obtained from the wild Indigenous people alsocultivate medicinal plants in home garden where medicinalplants are grown in small areas surrounding the houseMoreover medicinal plants are also grown in clay potsOne informant reported that effective medicinal plants arecultivated close to the house to allow easy accessibility On theother handmedicinal plants which are considered rare by theinformants and which are not easily available are purchasedfrom the herbalistsrsquo store
34 Forms of Medicinal Plants It was found that the infor-mants showed no particular preference for using either fresh
Evidence-Based Complementary and Alternative Medicine 7
Table3Listof
medicinalplantsandpo
lyherbalform
ulations
with
theirrelated
inform
ationused
againstd
iabetesa
ndrelated
complications
repo
rtedby
theinformants
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Acanthaceae
Graptophyllum
pictum
(L)Griff
(A
M15)
Laitde
vierge
Type
2diabetes
LPreparea
decoctionwith
3leaves
anddrink2cups
daily
for1
week
016
002
004
010
000
Alismataceae
Alism
aplantago-aquatica
subsp
orientale(Sam)S
am
(AM09)
mdashHighlevelofcho
leste
rol
mdash
Sold
asaC
hinese
teaa
gainstcholesterolPreparea
ninfusio
nwith
the
teabagsw
hich
containAlism
aorien
talis
(Rhizomaalism
atis)R
adix
angelicae
sinensisH
erba
artemisiae
capillarisH
awthornberryRh
izom
aatractylodismacrocephalaeSem
enzizip
hispinosaeand
ChineseteaD
rink
1cup
daily
012
000
000
003
009
Type
1diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Highlevelofcho
leste
rol
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Renalfailure
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Alliu
mcepa
L(A
M04)
Zoiyon
oigno
nHearin
gloss
BCr
ushandpressthe
bulbto
obtain
thejuice
andmix30
gof
thejuice
with
30gof
waterH
eatand
instill3-4drop
sinthea
ffected
ear
048
028
012
017
003
Amaryllid
aceae
Erectiled
ysfunctio
nB
Preparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Cataract
BPreparea
decoctionwith
theb
ulbandadd2teaspo
onso
fhon
eyA
llowitto
coolanduseitasa
neyebathdaily
Type
2diabetes
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Cataract
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Renalfailure
BCon
sume2
-3rawclo
vesd
ailyfor1
week
Alliu
msativ
umL
(AM39)
Lrsquoail
Hypertension
BSw
allow2sm
allclovesw
ithac
upof
water
thric
eper
week
042
024
009
022
006
Wou
ndB
Crushandpressthe
bulbto
obtain
juicea
ndapplythejuice
onthew
ound
daily
tillh
ealin
g
Ulcer
BCr
ushandpressthe
bulbto
obtain
juicea
ndapplythejuice
ontheu
lcer
daily
tillh
ealin
g
Anacardiaceae
Mangifer
aindica
L(A
M20)
Mangue
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
031
017
003
010
001
Ann
onaceae
Annona
murica
taL
(AM29)
Coron
sol
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
016
007
003
006
000
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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OncologyJournal of
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The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
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Evidence-Based Complementary and Alternative Medicine
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Evidence-Based Complementary and Alternative Medicine 3
are within the reach of everybody nonetheless traditionalmedicine continues to remain active in the lives of the localpopulation
The multicultural society of Mauritius encompassesdescendants of Indian indentured labourers Chinese shop-keepers African slaves and British and French colonisersThe Indo-Mauritians community (Hindus and Muslims)represents the majority of the population followed by theChristian community and the Sino-Mauritians communityThe Hindu community is subdivided into several distinctreligious and sociocultural groupsThemain religious groupsare theHindi or Bhojpuri speaking people constituting 402of the total population and 765of allHindusTheTamils arethe second largest ethnic community (139) while Telugus(56) andMarathis (4) represent smallerminoritieswithinthe overall Hindu community The Hindus have a commonlanguage (Bhojpuri) the same regional origin (Uttar PradeshandBihar) and religious practices and rituals [13]The officiallanguage in Mauritius is the English language but ldquoCreolerdquo isthe native language of the island and is mostly used in infor-mal settings Mauritius is reputed worldwide for the peacefulharmony which prevails in the island among the differentgreat religions of the world namely Hinduism ChristianityIslam and Buddhism In Mauritius traditional therapies areparamount to panoply of ailments treatmentmanagementoffering profound therapeutic benefits and the indigenouscommunities rely heavily on them to meet their medicalneeds Though allopathic medicine is the primary form ofhealthcare in Mauritius some patients prefer traditionalmedicine for the treatmentmanagement of a number ofhuman diseases The rising costs of synthetic drugs havefueled the interest of the local population in traditionalmedicine usage thereby reintroducing such therapies as anovel emerging formof health aidMauritius is endowedwitha number of tropical rainforests which are rich repositoriesof a diverse range of invaluable medicinal plants and animalspecies Recently Mauritius has become the arena of anumber of ethnopharmacological field studies conducted byvarious workers which have emphasised mostly medicinalplants and animals among the Mauritian population andhave led to several publications [14 15] Nonetheless noneof these studies have addressed the patterns of similarityand dissimilarity of medicinal plants and animals usageamong the different religious communities present in theisland Heinrich et al [16] reported that most studies onmedicinal plants focus on the role of these plants withinone particular ethnic group and little emphasis has beengiven to the comparison of medicinal plant species amongvarious cultures Moreover an analysis of medicinal plantsusage must be carried out in order to understand thepatterns of use intra- and interculturally However studieson cross-cultural analysis of medicinal plants usage arelacking inMauritiusTherefore the current study specificallyseeks to bring in the limelight of the scientific communitythe documentation of traditional remedies used amongthe diabetic patients in Mauritius We also attempted toidentify the most culturally important medicinal plants andanimals in each religious group compare the use of plantand animal species interculturally and examine how the
different religious groups present in the island value tradi-tional remedies in their daily lives in their quest for soundhealth
2 Methods
21 Data Collection The project was approved by the Facultyof Science University of Mauritius Mauritius A total of100 key informants (27 Hindus 24 Muslims 26 Christiansand 23 Buddhists) were interviewed from June to August2015 Data was collected from key informants throughface-to-face interviews using a semistructured questionnaire(supplementary file in Supplementary Material availableonline at httpdxdoiorg10115520164523828) Traditionalinformation was sought from diabetic patients older than 30years based on the assumption that the mature populationis better versed in traditional knowledge Moreover partic-ipants should be users of traditional medicine and formallydiagnosed to be diabetic by their treating physician Duringthe course of the study 12 field trips were carried out indifferent regions of the island The interview was performedin ldquoCreolerdquo the native language of the Mauritian populationThe questionnaire developed for the survey consisted of bothclose- and open-ended questions Participants were informedabout the purpose of the survey and a prior informed consentformwas dully signed by the participants before the interviewwas carried out The traditional healers were interviewedusing the same questionnaireThe interviewswere performedin health centers home visits markets and Chinese shops(Figure 2) Figure 1 illustrates the different regions where thesurvey was carried out
The questionnaire comprised three main parts PartsA B and C Part A consisted of demographic data whichincluded age gender level of education occupation incomeand religious belief Part B of the questionnaire consistedof information about the herbal remedies used to managediabetes and related complications the local vernacular nameof the plant the method of preparation the dosage theroute of administration and the duration of treatmentPart C was based on animal-based remedy used to man-age diabetes and related complications the local vernac-ular name of the animal the method of preparation thedosage the route of administration and the duration oftreatment
22 Collection and Identification of Medicinal Plants Duringthe field visits when a remedy was mentioned by thetraditional healer or diabetic patient where possible theparticipant was encouraged to show us a sample of theremedy which was collected in situ and photographed Thecollected sample was then identified by local botanist Ourlocal repository database was updated whereby plant sampleswere assigned a collection number for future reference anddata mining Data obtained during the survey was cross-checked (local namesscientific names) according to a locallypublished book by Gurib-Fakim and Brendler [17] Scientificnames of plant species were identified according to the Inter-national Plant Name Index (IPNI httpwwwipniorg)
4 Evidence-Based Complementary and Alternative Medicine
Figure 2 Interview with traditional healers
23 Ailments Categories Based on the information obtainedfrom the key informants in the study area all the reportedailments were classified into 9 categories based on publishedscientific literature fromRiaz [18] ADA [19] Yadav et al [20]Ginsberg et al [21] and Bodansky et al [22] The categorieswere diabetic angiopathy diabetic nephropathy eye diseasesdiabetic neuropathy infections and wounds hypertensionskin complications diabetic dyslipidemia and diabetes
24 Data Analysis and Ethnobotanical Indexes The indige-nous medicinal information of plant and animal species wasanalyzed using different quantitative indexes
241 Relative Frequency of Citation Relative frequency ofcitation is calculated as follows relative frequency of citation= FCN where FC is the number of informants mentioningthe use of the species and 119873 is the number of informantsparticipating in the survey This index theoretically variesfrom 0 to 1 According to Sharma et al [23] when relativefrequency of citation is 0 it means that nobody refers tothe plantanimal as useful and when relative frequency ofcitation is 1 it means that all informants in the survey referto the plantanimal as useful
242 Cultural Importance Index Culturally importantspecies as medicines are identified by the cultural importanceindex (CII) [24] The CII was used to determine the most
culturally important plantanimal species in each religiousgroup It can be calculated by the following formula
CII =119906NC
sum
119906=1199061
119894119899
sum
119894=1198941
UR119906119894
119873
(1)
where NC is the total number of different illness categories(of each 119894 species) UR is the total number of use reportsfor each species and 119873 is the total number of informantsin each religious group The cultural importance index is thesum of the proportion of informants that mention each ofthe use-categories for a given species Themaximum value ofthe index equals the total number of different use-categories(NC) whichwould occur if all informants in a religious groupwould mention the use of a species in all use-categories Thisindex was used to estimate the cultural significance of eachplantanimal species [24] and to determine to what extenteach plantanimal species is present in the memory of theinformants belonging to each religious group
243 Jaccard Similarity Index The Jaccard similarity indexadapted from Guzel et al [25] was used to determine thedegree of similarity of medicinal plantsrsquo use among thedifferent religious groups The Jaccard similarity index iscalculated as follows Jaccard similarity index = 119862 times 100119860 +119861 minus 119862 where 119860 is the number of plant species reported byreligious group A 119861 is the number of plant species reportedby the religious group B and119862 is the number of plant speciesreported by both A and B [25]
Evidence-Based Complementary and Alternative Medicine 5
Table 1 Demographic data of the informants (119873 = 100)
Variable Categories Frequency (119899 = 100)
Age (years)
30ndash39 240ndash49 1750ndash59 2760ndash69 4170ndash79 8ge80 5
Sex Male 38Female 62
Level of education
No formal education 7Primary 64Secondary 20Tertiary 9
Occupation
Retired 36Nongovernment officer 25Housewife 18Government officer 16Traditional healer 2Ayurvedic medicine practitioner 2Traditional Chinese medicine practitioner 1
Monthly household income
ltRs 5000 2Rs 5001ndash10000 48Rs 10001ndash20000 40Rs 20001ndash30000 8gtRs 30001 2
Religion
Hindu 27Muslim 24Christian 26Buddhist 23
Diabetes related complications
Hypertension 36High level of cholesterol 27Neuropathic pain 25Cardiovascular diseases 12Cataracts 9Urinary tract infections 7Renal failure 5Foot ulcers 4Gangrene 3Infected wounds 3Stress 2Dry skin 2Erectile dysfunction 1Hearing loss 1Memory loss 1Depression 1
3 Results and Discussion
31 Demographic Profile of the Participants The demo-graphic characteristics of the participants were determinedand documented through face-to-face interviews usingsemistructured questionnaire (Tables 1 and 2) A total of 100
randomly selected informants (38males and 62 females) wereinterviewed as summarized in Tables 1 and 2 Our findingresembled the study of Ishola et al [26] where the majorityof traditional medicine users were female since they weretypically in charge of preparing herbal preparations in thedomestic setting According to Hardy [27] women are the
6 Evidence-Based Complementary and Alternative Medicine
Table 2 Age and gender distribution within each religious commu-nity
Religiouscommunity Age Number of
participants Gender Number ofparticipants
Hindu
30ndash39 1 Male 1240ndash49 3 Female 1550ndash59 860ndash69 770ndash79 6ge80 2
Muslim
30ndash39 0 Male 1140ndash49 4 Female 1350ndash59 360ndash69 1470ndash79 2ge80 1
Christian
30ndash39 1 Male 1040ndash49 4 Female 1650ndash59 760ndash69 1370ndash79 0ge80 1
Buddhist
30ndash39 0 Male 540ndash49 6 Female 1850ndash59 960ndash69 770ndash79 0ge80 1
main source of conservation and dissemination of traditionalknowledge Ethnographic investigations revealed that thegreatest contribution in terms of traditional information wasprovided by interviewees belonging to the age group 60ndash69 years old (119873 = 41) They were followed by informantsbelonging to the age category 50ndash59 years old (119873 = 27)This information implies that the young generation neglectstraditional medicine practice which might lead to the rapidloss of valuable traditional knowledge regarding the useof medicinal plants [28] There exist several reasons whichmight account for the loss of traditional knowledge in thestudy area (1) holders of empirical knowledge have diedbefore passing on this knowledge to the younger generation(2) the younger generation believes more in the efficacy ofallopathic medicine and (3) given the free cost of healthcarefacilities provided by the Mauritian government in publichospitals allopathic medicine is more accessible to thepopulation
Moreover the results revealed that the majority of theparticipants studied till the primary level only (119873 = 64) Ourfinding is in accordance with the work of Gakuya et al [29]where elder people with little formal education possess moreknowledge concerning the use of medicinal plants It wasalso noted that the majority of the informants were retired
(119873 = 36) and had a monthly household income of Rs 5001ndash10000 (1 US$ asymp Rs 3600) (119873 = 48) The retirement agein Mauritius is 60 years and above Nonetheless some ofthe participants were found to continue working thoughthey reached the retirement age The traditional healthpractitioners (119873 = 5) were found to play vital roles in thestudy area whereby the indigenous communities rely on themfor the provision of herbal medicines The traditional healthpractitioners were found to be key custodians of traditionalinformation on themedicinal use of plant and animal speciesTheir practice of healing involved panoply of methodologieswhich are considered trustworthy among the indigenouscommunity in the study area Traditional health practitionersin Mauritius were willing to share their valuable traditionalknowledge in order to prevent extinction of this culturalheritage
In order to allow better comparison of medicinal plantsand animals use among the four religious groups presentin the study area the number of participants surveyed ineach religious group was approximately equal 27 24 26and 23 for the Hindu Muslim Christian and Buddhistreligious group respectively The most common diabetesrelated complications reported by the informants were hyper-tension (119873 = 36) followed by high level of cholesterol (27)neuropathic pain (119873 = 25) and cardiovascular diseases(119873 = 12) According to the American Diabetes Associationin type 2 diabetes hypertension is often present as part ofthe metabolic syndrome of insulin resistance while in type1 diabetes hypertension may reflect the onset of diabeticnephropathy [30]
32 Herbal Remedies Used to Manage Diabetes and RelatedComplications The present research revealed the ethnob-otanical use of 52 plant species belonging to 33 familiesused to manage diabetes and related complications Infor-mation on medicinal plants obtained from the four religiousgroups namelyHinduMuslimChristian andBuddhist wasarranged alphabetically according to their botanical familiesalong with their ethnomedicinal uses (Table 3)
33 Source of Medicinal Plants Informants obtained themedicinal plants from three main sources gathering fromthe wild (39) harvesting from home gardens (37) andpurchasing from the herbalistsrsquo store (24) Our result isin agreement with the work of Singh et al [31] where themajority ofmedicinal plants used in the preparation of herbalremedies are obtained from the wild Indigenous people alsocultivate medicinal plants in home garden where medicinalplants are grown in small areas surrounding the houseMoreover medicinal plants are also grown in clay potsOne informant reported that effective medicinal plants arecultivated close to the house to allow easy accessibility On theother handmedicinal plants which are considered rare by theinformants and which are not easily available are purchasedfrom the herbalistsrsquo store
34 Forms of Medicinal Plants It was found that the infor-mants showed no particular preference for using either fresh
Evidence-Based Complementary and Alternative Medicine 7
Table3Listof
medicinalplantsandpo
lyherbalform
ulations
with
theirrelated
inform
ationused
againstd
iabetesa
ndrelated
complications
repo
rtedby
theinformants
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Acanthaceae
Graptophyllum
pictum
(L)Griff
(A
M15)
Laitde
vierge
Type
2diabetes
LPreparea
decoctionwith
3leaves
anddrink2cups
daily
for1
week
016
002
004
010
000
Alismataceae
Alism
aplantago-aquatica
subsp
orientale(Sam)S
am
(AM09)
mdashHighlevelofcho
leste
rol
mdash
Sold
asaC
hinese
teaa
gainstcholesterolPreparea
ninfusio
nwith
the
teabagsw
hich
containAlism
aorien
talis
(Rhizomaalism
atis)R
adix
angelicae
sinensisH
erba
artemisiae
capillarisH
awthornberryRh
izom
aatractylodismacrocephalaeSem
enzizip
hispinosaeand
ChineseteaD
rink
1cup
daily
012
000
000
003
009
Type
1diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Highlevelofcho
leste
rol
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Renalfailure
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Alliu
mcepa
L(A
M04)
Zoiyon
oigno
nHearin
gloss
BCr
ushandpressthe
bulbto
obtain
thejuice
andmix30
gof
thejuice
with
30gof
waterH
eatand
instill3-4drop
sinthea
ffected
ear
048
028
012
017
003
Amaryllid
aceae
Erectiled
ysfunctio
nB
Preparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Cataract
BPreparea
decoctionwith
theb
ulbandadd2teaspo
onso
fhon
eyA
llowitto
coolanduseitasa
neyebathdaily
Type
2diabetes
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Cataract
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Renalfailure
BCon
sume2
-3rawclo
vesd
ailyfor1
week
Alliu
msativ
umL
(AM39)
Lrsquoail
Hypertension
BSw
allow2sm
allclovesw
ithac
upof
water
thric
eper
week
042
024
009
022
006
Wou
ndB
Crushandpressthe
bulbto
obtain
juicea
ndapplythejuice
onthew
ound
daily
tillh
ealin
g
Ulcer
BCr
ushandpressthe
bulbto
obtain
juicea
ndapplythejuice
ontheu
lcer
daily
tillh
ealin
g
Anacardiaceae
Mangifer
aindica
L(A
M20)
Mangue
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
031
017
003
010
001
Ann
onaceae
Annona
murica
taL
(AM29)
Coron
sol
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
016
007
003
006
000
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
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Behavioural Neurology
EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
4 Evidence-Based Complementary and Alternative Medicine
Figure 2 Interview with traditional healers
23 Ailments Categories Based on the information obtainedfrom the key informants in the study area all the reportedailments were classified into 9 categories based on publishedscientific literature fromRiaz [18] ADA [19] Yadav et al [20]Ginsberg et al [21] and Bodansky et al [22] The categorieswere diabetic angiopathy diabetic nephropathy eye diseasesdiabetic neuropathy infections and wounds hypertensionskin complications diabetic dyslipidemia and diabetes
24 Data Analysis and Ethnobotanical Indexes The indige-nous medicinal information of plant and animal species wasanalyzed using different quantitative indexes
241 Relative Frequency of Citation Relative frequency ofcitation is calculated as follows relative frequency of citation= FCN where FC is the number of informants mentioningthe use of the species and 119873 is the number of informantsparticipating in the survey This index theoretically variesfrom 0 to 1 According to Sharma et al [23] when relativefrequency of citation is 0 it means that nobody refers tothe plantanimal as useful and when relative frequency ofcitation is 1 it means that all informants in the survey referto the plantanimal as useful
242 Cultural Importance Index Culturally importantspecies as medicines are identified by the cultural importanceindex (CII) [24] The CII was used to determine the most
culturally important plantanimal species in each religiousgroup It can be calculated by the following formula
CII =119906NC
sum
119906=1199061
119894119899
sum
119894=1198941
UR119906119894
119873
(1)
where NC is the total number of different illness categories(of each 119894 species) UR is the total number of use reportsfor each species and 119873 is the total number of informantsin each religious group The cultural importance index is thesum of the proportion of informants that mention each ofthe use-categories for a given species Themaximum value ofthe index equals the total number of different use-categories(NC) whichwould occur if all informants in a religious groupwould mention the use of a species in all use-categories Thisindex was used to estimate the cultural significance of eachplantanimal species [24] and to determine to what extenteach plantanimal species is present in the memory of theinformants belonging to each religious group
243 Jaccard Similarity Index The Jaccard similarity indexadapted from Guzel et al [25] was used to determine thedegree of similarity of medicinal plantsrsquo use among thedifferent religious groups The Jaccard similarity index iscalculated as follows Jaccard similarity index = 119862 times 100119860 +119861 minus 119862 where 119860 is the number of plant species reported byreligious group A 119861 is the number of plant species reportedby the religious group B and119862 is the number of plant speciesreported by both A and B [25]
Evidence-Based Complementary and Alternative Medicine 5
Table 1 Demographic data of the informants (119873 = 100)
Variable Categories Frequency (119899 = 100)
Age (years)
30ndash39 240ndash49 1750ndash59 2760ndash69 4170ndash79 8ge80 5
Sex Male 38Female 62
Level of education
No formal education 7Primary 64Secondary 20Tertiary 9
Occupation
Retired 36Nongovernment officer 25Housewife 18Government officer 16Traditional healer 2Ayurvedic medicine practitioner 2Traditional Chinese medicine practitioner 1
Monthly household income
ltRs 5000 2Rs 5001ndash10000 48Rs 10001ndash20000 40Rs 20001ndash30000 8gtRs 30001 2
Religion
Hindu 27Muslim 24Christian 26Buddhist 23
Diabetes related complications
Hypertension 36High level of cholesterol 27Neuropathic pain 25Cardiovascular diseases 12Cataracts 9Urinary tract infections 7Renal failure 5Foot ulcers 4Gangrene 3Infected wounds 3Stress 2Dry skin 2Erectile dysfunction 1Hearing loss 1Memory loss 1Depression 1
3 Results and Discussion
31 Demographic Profile of the Participants The demo-graphic characteristics of the participants were determinedand documented through face-to-face interviews usingsemistructured questionnaire (Tables 1 and 2) A total of 100
randomly selected informants (38males and 62 females) wereinterviewed as summarized in Tables 1 and 2 Our findingresembled the study of Ishola et al [26] where the majorityof traditional medicine users were female since they weretypically in charge of preparing herbal preparations in thedomestic setting According to Hardy [27] women are the
6 Evidence-Based Complementary and Alternative Medicine
Table 2 Age and gender distribution within each religious commu-nity
Religiouscommunity Age Number of
participants Gender Number ofparticipants
Hindu
30ndash39 1 Male 1240ndash49 3 Female 1550ndash59 860ndash69 770ndash79 6ge80 2
Muslim
30ndash39 0 Male 1140ndash49 4 Female 1350ndash59 360ndash69 1470ndash79 2ge80 1
Christian
30ndash39 1 Male 1040ndash49 4 Female 1650ndash59 760ndash69 1370ndash79 0ge80 1
Buddhist
30ndash39 0 Male 540ndash49 6 Female 1850ndash59 960ndash69 770ndash79 0ge80 1
main source of conservation and dissemination of traditionalknowledge Ethnographic investigations revealed that thegreatest contribution in terms of traditional information wasprovided by interviewees belonging to the age group 60ndash69 years old (119873 = 41) They were followed by informantsbelonging to the age category 50ndash59 years old (119873 = 27)This information implies that the young generation neglectstraditional medicine practice which might lead to the rapidloss of valuable traditional knowledge regarding the useof medicinal plants [28] There exist several reasons whichmight account for the loss of traditional knowledge in thestudy area (1) holders of empirical knowledge have diedbefore passing on this knowledge to the younger generation(2) the younger generation believes more in the efficacy ofallopathic medicine and (3) given the free cost of healthcarefacilities provided by the Mauritian government in publichospitals allopathic medicine is more accessible to thepopulation
Moreover the results revealed that the majority of theparticipants studied till the primary level only (119873 = 64) Ourfinding is in accordance with the work of Gakuya et al [29]where elder people with little formal education possess moreknowledge concerning the use of medicinal plants It wasalso noted that the majority of the informants were retired
(119873 = 36) and had a monthly household income of Rs 5001ndash10000 (1 US$ asymp Rs 3600) (119873 = 48) The retirement agein Mauritius is 60 years and above Nonetheless some ofthe participants were found to continue working thoughthey reached the retirement age The traditional healthpractitioners (119873 = 5) were found to play vital roles in thestudy area whereby the indigenous communities rely on themfor the provision of herbal medicines The traditional healthpractitioners were found to be key custodians of traditionalinformation on themedicinal use of plant and animal speciesTheir practice of healing involved panoply of methodologieswhich are considered trustworthy among the indigenouscommunity in the study area Traditional health practitionersin Mauritius were willing to share their valuable traditionalknowledge in order to prevent extinction of this culturalheritage
In order to allow better comparison of medicinal plantsand animals use among the four religious groups presentin the study area the number of participants surveyed ineach religious group was approximately equal 27 24 26and 23 for the Hindu Muslim Christian and Buddhistreligious group respectively The most common diabetesrelated complications reported by the informants were hyper-tension (119873 = 36) followed by high level of cholesterol (27)neuropathic pain (119873 = 25) and cardiovascular diseases(119873 = 12) According to the American Diabetes Associationin type 2 diabetes hypertension is often present as part ofthe metabolic syndrome of insulin resistance while in type1 diabetes hypertension may reflect the onset of diabeticnephropathy [30]
32 Herbal Remedies Used to Manage Diabetes and RelatedComplications The present research revealed the ethnob-otanical use of 52 plant species belonging to 33 familiesused to manage diabetes and related complications Infor-mation on medicinal plants obtained from the four religiousgroups namelyHinduMuslimChristian andBuddhist wasarranged alphabetically according to their botanical familiesalong with their ethnomedicinal uses (Table 3)
33 Source of Medicinal Plants Informants obtained themedicinal plants from three main sources gathering fromthe wild (39) harvesting from home gardens (37) andpurchasing from the herbalistsrsquo store (24) Our result isin agreement with the work of Singh et al [31] where themajority ofmedicinal plants used in the preparation of herbalremedies are obtained from the wild Indigenous people alsocultivate medicinal plants in home garden where medicinalplants are grown in small areas surrounding the houseMoreover medicinal plants are also grown in clay potsOne informant reported that effective medicinal plants arecultivated close to the house to allow easy accessibility On theother handmedicinal plants which are considered rare by theinformants and which are not easily available are purchasedfrom the herbalistsrsquo store
34 Forms of Medicinal Plants It was found that the infor-mants showed no particular preference for using either fresh
Evidence-Based Complementary and Alternative Medicine 7
Table3Listof
medicinalplantsandpo
lyherbalform
ulations
with
theirrelated
inform
ationused
againstd
iabetesa
ndrelated
complications
repo
rtedby
theinformants
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Acanthaceae
Graptophyllum
pictum
(L)Griff
(A
M15)
Laitde
vierge
Type
2diabetes
LPreparea
decoctionwith
3leaves
anddrink2cups
daily
for1
week
016
002
004
010
000
Alismataceae
Alism
aplantago-aquatica
subsp
orientale(Sam)S
am
(AM09)
mdashHighlevelofcho
leste
rol
mdash
Sold
asaC
hinese
teaa
gainstcholesterolPreparea
ninfusio
nwith
the
teabagsw
hich
containAlism
aorien
talis
(Rhizomaalism
atis)R
adix
angelicae
sinensisH
erba
artemisiae
capillarisH
awthornberryRh
izom
aatractylodismacrocephalaeSem
enzizip
hispinosaeand
ChineseteaD
rink
1cup
daily
012
000
000
003
009
Type
1diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Highlevelofcho
leste
rol
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Renalfailure
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Alliu
mcepa
L(A
M04)
Zoiyon
oigno
nHearin
gloss
BCr
ushandpressthe
bulbto
obtain
thejuice
andmix30
gof
thejuice
with
30gof
waterH
eatand
instill3-4drop
sinthea
ffected
ear
048
028
012
017
003
Amaryllid
aceae
Erectiled
ysfunctio
nB
Preparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Cataract
BPreparea
decoctionwith
theb
ulbandadd2teaspo
onso
fhon
eyA
llowitto
coolanduseitasa
neyebathdaily
Type
2diabetes
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Cataract
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Renalfailure
BCon
sume2
-3rawclo
vesd
ailyfor1
week
Alliu
msativ
umL
(AM39)
Lrsquoail
Hypertension
BSw
allow2sm
allclovesw
ithac
upof
water
thric
eper
week
042
024
009
022
006
Wou
ndB
Crushandpressthe
bulbto
obtain
juicea
ndapplythejuice
onthew
ound
daily
tillh
ealin
g
Ulcer
BCr
ushandpressthe
bulbto
obtain
juicea
ndapplythejuice
ontheu
lcer
daily
tillh
ealin
g
Anacardiaceae
Mangifer
aindica
L(A
M20)
Mangue
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
031
017
003
010
001
Ann
onaceae
Annona
murica
taL
(AM29)
Coron
sol
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
016
007
003
006
000
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Computational and Mathematical Methods in Medicine
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 5
Table 1 Demographic data of the informants (119873 = 100)
Variable Categories Frequency (119899 = 100)
Age (years)
30ndash39 240ndash49 1750ndash59 2760ndash69 4170ndash79 8ge80 5
Sex Male 38Female 62
Level of education
No formal education 7Primary 64Secondary 20Tertiary 9
Occupation
Retired 36Nongovernment officer 25Housewife 18Government officer 16Traditional healer 2Ayurvedic medicine practitioner 2Traditional Chinese medicine practitioner 1
Monthly household income
ltRs 5000 2Rs 5001ndash10000 48Rs 10001ndash20000 40Rs 20001ndash30000 8gtRs 30001 2
Religion
Hindu 27Muslim 24Christian 26Buddhist 23
Diabetes related complications
Hypertension 36High level of cholesterol 27Neuropathic pain 25Cardiovascular diseases 12Cataracts 9Urinary tract infections 7Renal failure 5Foot ulcers 4Gangrene 3Infected wounds 3Stress 2Dry skin 2Erectile dysfunction 1Hearing loss 1Memory loss 1Depression 1
3 Results and Discussion
31 Demographic Profile of the Participants The demo-graphic characteristics of the participants were determinedand documented through face-to-face interviews usingsemistructured questionnaire (Tables 1 and 2) A total of 100
randomly selected informants (38males and 62 females) wereinterviewed as summarized in Tables 1 and 2 Our findingresembled the study of Ishola et al [26] where the majorityof traditional medicine users were female since they weretypically in charge of preparing herbal preparations in thedomestic setting According to Hardy [27] women are the
6 Evidence-Based Complementary and Alternative Medicine
Table 2 Age and gender distribution within each religious commu-nity
Religiouscommunity Age Number of
participants Gender Number ofparticipants
Hindu
30ndash39 1 Male 1240ndash49 3 Female 1550ndash59 860ndash69 770ndash79 6ge80 2
Muslim
30ndash39 0 Male 1140ndash49 4 Female 1350ndash59 360ndash69 1470ndash79 2ge80 1
Christian
30ndash39 1 Male 1040ndash49 4 Female 1650ndash59 760ndash69 1370ndash79 0ge80 1
Buddhist
30ndash39 0 Male 540ndash49 6 Female 1850ndash59 960ndash69 770ndash79 0ge80 1
main source of conservation and dissemination of traditionalknowledge Ethnographic investigations revealed that thegreatest contribution in terms of traditional information wasprovided by interviewees belonging to the age group 60ndash69 years old (119873 = 41) They were followed by informantsbelonging to the age category 50ndash59 years old (119873 = 27)This information implies that the young generation neglectstraditional medicine practice which might lead to the rapidloss of valuable traditional knowledge regarding the useof medicinal plants [28] There exist several reasons whichmight account for the loss of traditional knowledge in thestudy area (1) holders of empirical knowledge have diedbefore passing on this knowledge to the younger generation(2) the younger generation believes more in the efficacy ofallopathic medicine and (3) given the free cost of healthcarefacilities provided by the Mauritian government in publichospitals allopathic medicine is more accessible to thepopulation
Moreover the results revealed that the majority of theparticipants studied till the primary level only (119873 = 64) Ourfinding is in accordance with the work of Gakuya et al [29]where elder people with little formal education possess moreknowledge concerning the use of medicinal plants It wasalso noted that the majority of the informants were retired
(119873 = 36) and had a monthly household income of Rs 5001ndash10000 (1 US$ asymp Rs 3600) (119873 = 48) The retirement agein Mauritius is 60 years and above Nonetheless some ofthe participants were found to continue working thoughthey reached the retirement age The traditional healthpractitioners (119873 = 5) were found to play vital roles in thestudy area whereby the indigenous communities rely on themfor the provision of herbal medicines The traditional healthpractitioners were found to be key custodians of traditionalinformation on themedicinal use of plant and animal speciesTheir practice of healing involved panoply of methodologieswhich are considered trustworthy among the indigenouscommunity in the study area Traditional health practitionersin Mauritius were willing to share their valuable traditionalknowledge in order to prevent extinction of this culturalheritage
In order to allow better comparison of medicinal plantsand animals use among the four religious groups presentin the study area the number of participants surveyed ineach religious group was approximately equal 27 24 26and 23 for the Hindu Muslim Christian and Buddhistreligious group respectively The most common diabetesrelated complications reported by the informants were hyper-tension (119873 = 36) followed by high level of cholesterol (27)neuropathic pain (119873 = 25) and cardiovascular diseases(119873 = 12) According to the American Diabetes Associationin type 2 diabetes hypertension is often present as part ofthe metabolic syndrome of insulin resistance while in type1 diabetes hypertension may reflect the onset of diabeticnephropathy [30]
32 Herbal Remedies Used to Manage Diabetes and RelatedComplications The present research revealed the ethnob-otanical use of 52 plant species belonging to 33 familiesused to manage diabetes and related complications Infor-mation on medicinal plants obtained from the four religiousgroups namelyHinduMuslimChristian andBuddhist wasarranged alphabetically according to their botanical familiesalong with their ethnomedicinal uses (Table 3)
33 Source of Medicinal Plants Informants obtained themedicinal plants from three main sources gathering fromthe wild (39) harvesting from home gardens (37) andpurchasing from the herbalistsrsquo store (24) Our result isin agreement with the work of Singh et al [31] where themajority ofmedicinal plants used in the preparation of herbalremedies are obtained from the wild Indigenous people alsocultivate medicinal plants in home garden where medicinalplants are grown in small areas surrounding the houseMoreover medicinal plants are also grown in clay potsOne informant reported that effective medicinal plants arecultivated close to the house to allow easy accessibility On theother handmedicinal plants which are considered rare by theinformants and which are not easily available are purchasedfrom the herbalistsrsquo store
34 Forms of Medicinal Plants It was found that the infor-mants showed no particular preference for using either fresh
Evidence-Based Complementary and Alternative Medicine 7
Table3Listof
medicinalplantsandpo
lyherbalform
ulations
with
theirrelated
inform
ationused
againstd
iabetesa
ndrelated
complications
repo
rtedby
theinformants
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Acanthaceae
Graptophyllum
pictum
(L)Griff
(A
M15)
Laitde
vierge
Type
2diabetes
LPreparea
decoctionwith
3leaves
anddrink2cups
daily
for1
week
016
002
004
010
000
Alismataceae
Alism
aplantago-aquatica
subsp
orientale(Sam)S
am
(AM09)
mdashHighlevelofcho
leste
rol
mdash
Sold
asaC
hinese
teaa
gainstcholesterolPreparea
ninfusio
nwith
the
teabagsw
hich
containAlism
aorien
talis
(Rhizomaalism
atis)R
adix
angelicae
sinensisH
erba
artemisiae
capillarisH
awthornberryRh
izom
aatractylodismacrocephalaeSem
enzizip
hispinosaeand
ChineseteaD
rink
1cup
daily
012
000
000
003
009
Type
1diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Highlevelofcho
leste
rol
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Renalfailure
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Alliu
mcepa
L(A
M04)
Zoiyon
oigno
nHearin
gloss
BCr
ushandpressthe
bulbto
obtain
thejuice
andmix30
gof
thejuice
with
30gof
waterH
eatand
instill3-4drop
sinthea
ffected
ear
048
028
012
017
003
Amaryllid
aceae
Erectiled
ysfunctio
nB
Preparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Cataract
BPreparea
decoctionwith
theb
ulbandadd2teaspo
onso
fhon
eyA
llowitto
coolanduseitasa
neyebathdaily
Type
2diabetes
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Cataract
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Renalfailure
BCon
sume2
-3rawclo
vesd
ailyfor1
week
Alliu
msativ
umL
(AM39)
Lrsquoail
Hypertension
BSw
allow2sm
allclovesw
ithac
upof
water
thric
eper
week
042
024
009
022
006
Wou
ndB
Crushandpressthe
bulbto
obtain
juicea
ndapplythejuice
onthew
ound
daily
tillh
ealin
g
Ulcer
BCr
ushandpressthe
bulbto
obtain
juicea
ndapplythejuice
ontheu
lcer
daily
tillh
ealin
g
Anacardiaceae
Mangifer
aindica
L(A
M20)
Mangue
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
031
017
003
010
001
Ann
onaceae
Annona
murica
taL
(AM29)
Coron
sol
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
016
007
003
006
000
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
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EndocrinologyInternational Journal of
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Disease Markers
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
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The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
6 Evidence-Based Complementary and Alternative Medicine
Table 2 Age and gender distribution within each religious commu-nity
Religiouscommunity Age Number of
participants Gender Number ofparticipants
Hindu
30ndash39 1 Male 1240ndash49 3 Female 1550ndash59 860ndash69 770ndash79 6ge80 2
Muslim
30ndash39 0 Male 1140ndash49 4 Female 1350ndash59 360ndash69 1470ndash79 2ge80 1
Christian
30ndash39 1 Male 1040ndash49 4 Female 1650ndash59 760ndash69 1370ndash79 0ge80 1
Buddhist
30ndash39 0 Male 540ndash49 6 Female 1850ndash59 960ndash69 770ndash79 0ge80 1
main source of conservation and dissemination of traditionalknowledge Ethnographic investigations revealed that thegreatest contribution in terms of traditional information wasprovided by interviewees belonging to the age group 60ndash69 years old (119873 = 41) They were followed by informantsbelonging to the age category 50ndash59 years old (119873 = 27)This information implies that the young generation neglectstraditional medicine practice which might lead to the rapidloss of valuable traditional knowledge regarding the useof medicinal plants [28] There exist several reasons whichmight account for the loss of traditional knowledge in thestudy area (1) holders of empirical knowledge have diedbefore passing on this knowledge to the younger generation(2) the younger generation believes more in the efficacy ofallopathic medicine and (3) given the free cost of healthcarefacilities provided by the Mauritian government in publichospitals allopathic medicine is more accessible to thepopulation
Moreover the results revealed that the majority of theparticipants studied till the primary level only (119873 = 64) Ourfinding is in accordance with the work of Gakuya et al [29]where elder people with little formal education possess moreknowledge concerning the use of medicinal plants It wasalso noted that the majority of the informants were retired
(119873 = 36) and had a monthly household income of Rs 5001ndash10000 (1 US$ asymp Rs 3600) (119873 = 48) The retirement agein Mauritius is 60 years and above Nonetheless some ofthe participants were found to continue working thoughthey reached the retirement age The traditional healthpractitioners (119873 = 5) were found to play vital roles in thestudy area whereby the indigenous communities rely on themfor the provision of herbal medicines The traditional healthpractitioners were found to be key custodians of traditionalinformation on themedicinal use of plant and animal speciesTheir practice of healing involved panoply of methodologieswhich are considered trustworthy among the indigenouscommunity in the study area Traditional health practitionersin Mauritius were willing to share their valuable traditionalknowledge in order to prevent extinction of this culturalheritage
In order to allow better comparison of medicinal plantsand animals use among the four religious groups presentin the study area the number of participants surveyed ineach religious group was approximately equal 27 24 26and 23 for the Hindu Muslim Christian and Buddhistreligious group respectively The most common diabetesrelated complications reported by the informants were hyper-tension (119873 = 36) followed by high level of cholesterol (27)neuropathic pain (119873 = 25) and cardiovascular diseases(119873 = 12) According to the American Diabetes Associationin type 2 diabetes hypertension is often present as part ofthe metabolic syndrome of insulin resistance while in type1 diabetes hypertension may reflect the onset of diabeticnephropathy [30]
32 Herbal Remedies Used to Manage Diabetes and RelatedComplications The present research revealed the ethnob-otanical use of 52 plant species belonging to 33 familiesused to manage diabetes and related complications Infor-mation on medicinal plants obtained from the four religiousgroups namelyHinduMuslimChristian andBuddhist wasarranged alphabetically according to their botanical familiesalong with their ethnomedicinal uses (Table 3)
33 Source of Medicinal Plants Informants obtained themedicinal plants from three main sources gathering fromthe wild (39) harvesting from home gardens (37) andpurchasing from the herbalistsrsquo store (24) Our result isin agreement with the work of Singh et al [31] where themajority ofmedicinal plants used in the preparation of herbalremedies are obtained from the wild Indigenous people alsocultivate medicinal plants in home garden where medicinalplants are grown in small areas surrounding the houseMoreover medicinal plants are also grown in clay potsOne informant reported that effective medicinal plants arecultivated close to the house to allow easy accessibility On theother handmedicinal plants which are considered rare by theinformants and which are not easily available are purchasedfrom the herbalistsrsquo store
34 Forms of Medicinal Plants It was found that the infor-mants showed no particular preference for using either fresh
Evidence-Based Complementary and Alternative Medicine 7
Table3Listof
medicinalplantsandpo
lyherbalform
ulations
with
theirrelated
inform
ationused
againstd
iabetesa
ndrelated
complications
repo
rtedby
theinformants
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Acanthaceae
Graptophyllum
pictum
(L)Griff
(A
M15)
Laitde
vierge
Type
2diabetes
LPreparea
decoctionwith
3leaves
anddrink2cups
daily
for1
week
016
002
004
010
000
Alismataceae
Alism
aplantago-aquatica
subsp
orientale(Sam)S
am
(AM09)
mdashHighlevelofcho
leste
rol
mdash
Sold
asaC
hinese
teaa
gainstcholesterolPreparea
ninfusio
nwith
the
teabagsw
hich
containAlism
aorien
talis
(Rhizomaalism
atis)R
adix
angelicae
sinensisH
erba
artemisiae
capillarisH
awthornberryRh
izom
aatractylodismacrocephalaeSem
enzizip
hispinosaeand
ChineseteaD
rink
1cup
daily
012
000
000
003
009
Type
1diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Highlevelofcho
leste
rol
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Renalfailure
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Alliu
mcepa
L(A
M04)
Zoiyon
oigno
nHearin
gloss
BCr
ushandpressthe
bulbto
obtain
thejuice
andmix30
gof
thejuice
with
30gof
waterH
eatand
instill3-4drop
sinthea
ffected
ear
048
028
012
017
003
Amaryllid
aceae
Erectiled
ysfunctio
nB
Preparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Cataract
BPreparea
decoctionwith
theb
ulbandadd2teaspo
onso
fhon
eyA
llowitto
coolanduseitasa
neyebathdaily
Type
2diabetes
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Cataract
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Renalfailure
BCon
sume2
-3rawclo
vesd
ailyfor1
week
Alliu
msativ
umL
(AM39)
Lrsquoail
Hypertension
BSw
allow2sm
allclovesw
ithac
upof
water
thric
eper
week
042
024
009
022
006
Wou
ndB
Crushandpressthe
bulbto
obtain
juicea
ndapplythejuice
onthew
ound
daily
tillh
ealin
g
Ulcer
BCr
ushandpressthe
bulbto
obtain
juicea
ndapplythejuice
ontheu
lcer
daily
tillh
ealin
g
Anacardiaceae
Mangifer
aindica
L(A
M20)
Mangue
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
031
017
003
010
001
Ann
onaceae
Annona
murica
taL
(AM29)
Coron
sol
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
016
007
003
006
000
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 7
Table3Listof
medicinalplantsandpo
lyherbalform
ulations
with
theirrelated
inform
ationused
againstd
iabetesa
ndrelated
complications
repo
rtedby
theinformants
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Acanthaceae
Graptophyllum
pictum
(L)Griff
(A
M15)
Laitde
vierge
Type
2diabetes
LPreparea
decoctionwith
3leaves
anddrink2cups
daily
for1
week
016
002
004
010
000
Alismataceae
Alism
aplantago-aquatica
subsp
orientale(Sam)S
am
(AM09)
mdashHighlevelofcho
leste
rol
mdash
Sold
asaC
hinese
teaa
gainstcholesterolPreparea
ninfusio
nwith
the
teabagsw
hich
containAlism
aorien
talis
(Rhizomaalism
atis)R
adix
angelicae
sinensisH
erba
artemisiae
capillarisH
awthornberryRh
izom
aatractylodismacrocephalaeSem
enzizip
hispinosaeand
ChineseteaD
rink
1cup
daily
012
000
000
003
009
Type
1diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Type
2diabetes
BPreparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Highlevelofcho
leste
rol
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Renalfailure
BPreparea
decoctionwith
theb
ulbanddrink1cup
daily
for1
week
Alliu
mcepa
L(A
M04)
Zoiyon
oigno
nHearin
gloss
BCr
ushandpressthe
bulbto
obtain
thejuice
andmix30
gof
thejuice
with
30gof
waterH
eatand
instill3-4drop
sinthea
ffected
ear
048
028
012
017
003
Amaryllid
aceae
Erectiled
ysfunctio
nB
Preparejuice
with
theb
ulbandadd1teaspoo
nof
honeyDrin
k1cup
daily
for3
mon
ths
Cataract
BPreparea
decoctionwith
theb
ulbandadd2teaspo
onso
fhon
eyA
llowitto
coolanduseitasa
neyebathdaily
Type
2diabetes
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Cataract
BPreparea
decoctionwith
2-3clo
vesa
nddrink1cup
thric
eper
week
Renalfailure
BCon
sume2
-3rawclo
vesd
ailyfor1
week
Alliu
msativ
umL
(AM39)
Lrsquoail
Hypertension
BSw
allow2sm
allclovesw
ithac
upof
water
thric
eper
week
042
024
009
022
006
Wou
ndB
Crushandpressthe
bulbto
obtain
juicea
ndapplythejuice
onthew
ound
daily
tillh
ealin
g
Ulcer
BCr
ushandpressthe
bulbto
obtain
juicea
ndapplythejuice
ontheu
lcer
daily
tillh
ealin
g
Anacardiaceae
Mangifer
aindica
L(A
M20)
Mangue
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
031
017
003
010
001
Ann
onaceae
Annona
murica
taL
(AM29)
Coron
sol
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
016
007
003
006
000
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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OphthalmologyJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
8 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aphloiaceae
Aphloiatheiformislowast
(Vahl)Be
nn
(AM51)
Fand
amane
Cataract
LPreparea
ninfusio
nwith
theleavesa
ndwashthee
yesw
ithitdaily
018
008
002
010
000
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Apiaceae
Apium
graveolen
sL
(AM07)
Celeri
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
003
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Coria
ndrum
sativ
umL
(AM11)
Cotom
iliTy
pe2diabetes
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
018
005
002
011
000
Petro
selin
umcrisp
um(M
ill)
Nym
anexAWH
ill
(AM52)
Persil
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
027
012
007
016
001
Highlevelofcho
leste
rol
LPreparea
soup
with
theleavestogetherw
ithAp
ium
graveolen
sLand
Alliu
mam
peloprasum
varporrum
Con
sumeittwicep
erweek
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Renalfailure
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparejuice
with
theleavestogetherw
ithDau
cuscarotaandAp
ium
graveolen
sLD
rink1cup
twicep
erweek
Apocyn
aceae
Catharanthus
roseus
LGDon
(AM17)
Sapo
nnaire
(blanc)
Type
2diabetes
LPreparea
ninfusio
nwith
7leaves
in2cups
ofho
twaterD
rink1cup
thric
eperw
eek
018
004
005
008
001
Arecaceae
Cocosn
ucifera
L(A
M21)
Coco
Cataract
FrInstill2drop
sofo
ilin
thee
yetw
icep
erday
023
008
002
012
000
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
thric
eper
week
Renalfailure
FrDrin
k1cup
ofthefruitwater
four
times
perw
eek
Renalfailure
RPreparea
decoctionof
ther
ootand
drink1cup
twicep
erweek
Asparagaceae
Ophiopogonjaponicus(Th
unb)K
erGrawl
(AM22)
mdashTy
pe2diabetes
mdash
Sold
asCh
inesea
ntidiabetic
teaPreparea
ninfusio
nwith
thetea
bags
which
containOphiopogonjaponicas(Ra
dixop
hiop
ogon
is)fragrant
solomon
sealrhizom
eCh
inesey
amH
awthornberryRa
dixpu
erariaeand
whiteteaDrin
k1cup
daily
013
000
000
002
011
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 9
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Aste
raceae
Bidens
pilosa
L(A
M31)
Lavilbag
Type
2diabetes
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
028
014
007
010
004
Hypertension
LPreparea
decoctionof
3leaves
anddrink1cup
twicep
erweek
Type
2diabetes
LPreparea
ninfusio
nwith
10gof
leaves
in1L
ofwater
anddrink1cup
twicethric
eper
week
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Cyna
racardun
culusL
(A
M24)
Artichaut
Highlevelofcho
leste
rol
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
031
010
006
015
007
Atherosclerosis
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erdayfor1
week
Atherosclerosis
LPreparejuice
with
theleavesa
nddrink1cup
twicep
erdayfor1
week
Sigesbeckiaorien
talis
L(A
M05)
Herbe
deflacq
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
034
017
009
008
000
Type
2diabetes
LPreparea
decoctionof
theleavestogetherw
ithAp
hloiatheiformis
Faujasiopsisflexu
osaRu
busa
lceifoliu
sRa
vena
lamadagascarie
nsis
and
Rhizophora
mucronataD
rink1cup
twicep
erweek
Brassic
aceae
Brassicaoleracea
L(A
M33)
Lichou
Cardiovascular
disease
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
037
013
011
017
002
Type
2diabetes
LPreparejuice
with
theleavesa
nddrink1cup
daily
for1
week
Wou
ndL
Applytheleavesa
sacataplasm
onthew
ound
Cataract
LCr
ushandpressthe
leaves
toob
tain
juicea
ndinstill3-4drop
sineach
eye2
hoursd
ailytillh
ealin
g
Hearin
gloss
LPreparejuice
with
theleavesa
ndmixequalamou
ntof
thejuice
with
equal
amou
ntof
thejuice
ofCitru
smedica
LfruitInstill2drop
sinthee
arsd
aily
before
goingto
bed
Brom
eliaceae
Anan
ascomosus
(L)Merr
(AM30)
Anana
Renalfailure
FrCon
sumer
ipefruittwicep
erweek
015
003
001
013
000
Cardiovascular
disease
FrPreparejuice
with
thefruitandwater
anddrink1cup
twicep
erweek
Caric
aceae
Caric
apapaya
L(A
M45)
Papaya
Hypertension
FrCon
sumer
ipefruithalfan
hour
before
breakfastthricep
erweek
021
007
008
005
002
Highlevelofcho
leste
rol
FrCr
ushandpressthe
rawfruittoob
tain
milk
yliq
uidanddrink1teaspoo
ntwicep
erweek
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaDrin
k1cup
thric
eperw
eek
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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EndocrinologyInternational Journal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
10 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Cucurbita
ceae
Cucumissativ
usL
(AM10)
Con
combre
Type
1diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
014
002
001
012
001
Type
2diabetes
FrPreparejuice
with
thefruitandwater
anddrink1cup
onalternatived
ays
Cucurbita
maxim
aDuchesne
(AM01)
Giro
mon
Type
2diabetes
FrPreparea
decoctionwith
thep
eelsin
water
anddrink1cup
daily
for1
week
023
002
007
014
001
Cataract
FlCr
ushandpressthe
flower
toob
tain
juiceAp
plyjuicea
scom
press
externallyon
thee
yes
Renalfailure
SeSeedsa
redriedin
bright
sunlight
for1
dayandeatenrawthefollowingday
Seedssho
uldbe
consum
edthric
eper
week
Wou
ndFr
Preparejuice
with
thefruitandapplyiton
wou
ndtillh
ealin
g
Lagena
riasiceraria(M
olina)
Standl
(AM41)
Calebasse
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
byallowingitto
boilfor2
0minutesD
rink1cup
for3
days
032
014
009
009
007
Highlevelofcho
leste
rol
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Hypertension
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
Luffa
acutangula(L)Ro
xb
(AM08)
Patole
Hypertension
LCr
ushandpress3
ndash5leaves
toob
tain
juicea
nddrinkittwicep
erweek
017
003
005
011
000
Cardiovascular
disease
LPreparejuice
with
theleavestogetherw
ithSw
ertia
chira
yita
andho
ney
Drin
k1cup
twicep
erweek
Type
2diabetes
LEa
t2-3
leaves
twicep
erweek
Type
2diabetes
LEx
tractthe
liquidby
crushing
theleavesa
nddrink1teaspoo
ntwicep
erweek
Type
2diabetes
FrEx
tractthe
liquidby
crushing
thefruitanddrink1-2
teaspo
onstwicep
erweek
Type
2diabetes
SeDry
thes
eeds
inbright
sunlight
durin
gthed
ayandatnightallo
wthem
tosoak
inac
upof
water
anddrinkitthen
extm
orning
onan
emptysto
mach
Type
2diabetes
LPreparejuice
with
3leaves
andaddPipern
igrumD
rinkiton
ceperw
eek
Mom
ordica
charantia
L(A
M03)
Margose
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
LM
alus
domesticaandAloe
barbadensisD
rink1cup
once
perw
eek
046
023
009
011
005
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Phaseolusv
ulgaris
Landdrink1
cuptwicep
erweek
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
Cucumissativ
usanddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
thefruitof
Phyllanthus
emblica
andthefruitof
Syzygium
cuminiDrin
k1cup
twicep
erweek
Fabaceae
Tamarindu
sind
icaL
(AM37)
Tamarin
Hypertension
FrPreparejuice
with
thep
ulpandwater
anddrink1cup
twicep
erdayfor1
day
039
012
009
018
002
Pain
LPreparea
foot
bath
with
adecoctio
nof
theleavesm
ixed
with
1teaspoo
nof
salt
Type
2diabetes
SePreparea
decoctionwith
thes
eeds
anddrink1cup
thric
eper
week
Trigo
nella
foenum
-graecum
L(A
M18)
Methi
Highlevelofcho
leste
rol
SeSo
akthes
eeds
in1g
lassof
water
for1
nightand
drinkitthen
extm
orning
onan
emptysto
mach
043
023
006
022
001
Erectiled
ysfunctio
nSe
Preparea
decoctionwith
1teaspoo
nof
seedsa
nd2cups
ofwaterD
rink1
cupon
anem
ptysto
machin
them
orning
daily
for1
week
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 11
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Type
2diabetes
LCon
sume2
rawleaves
twicep
erweek
Hypertension
LCr
ushandpressthe
leaves
toob
tain
juicea
nddrink2teaspo
onstwicep
erweek
Cataract
LCr
ush2leaves
andpresstoob
tain
juicea
ndtake
1dropof
thejuice
inthe
eyed
aily
Ocim
umtenu
iflorum
L(A
M26)
Tulsi
Cataract
LCr
ushandpress3
-4leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
ey
Instill
2drop
softhe
mixture
inthee
yeeach
nightfor
5days
048
039
015
016
002
Lamiaceae
Erectiled
ysfunctio
nL
Preparea
decoctionwith
3leaves
together
with
3leaves
ofPiperb
etleand
drink1cup
twicep
erweek
Wou
ndL
Crushandpressthe
leaves
toob
tain
juicea
ndmixthejuice
with
theo
ilof
Cocosn
ucifera
thathasp
reviou
slybeen
heated
andapplyiton
thew
ound
Highlevelofcho
leste
rol
LCr
ushandpress3
leaves
toob
tain
juicea
ndadd2teaspo
onso
fhon
eyand
drinktwicep
erweek
Prun
ellavulga
risL
(AM28)
mdashHypertension
mdashSold
asCh
inesea
ntihypertensiveteaP
repare
aninfusio
nwith
thetea
bags
which
containPrun
ellavulga
risL(Selfhealspike)Ra
mulus
uncaria
ecumun
cisFructus
leonu
riandCh
ineseo
olon
gteaDrin
k1cup
daily
009
000
000
001
008
Lauraceae
Persea
america
naMill
(AM34)
Avocat
Cataract
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
021
008
004
011
000
Highlevelofcho
leste
rol
FrPreparejuice
with
2cups
ofyoghurt12
acup
ofthefruit
and12
acup
ofwater
anddrink1cup
once
perw
eek
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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OncologyJournal of
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Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
12 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Linaceae
Linu
musita
tissim
umLinn
aeus
(AM40
)Grain
delin
Type
2diabetes
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
034
016
013
008
001
Renalfailure
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Highlevelofcho
leste
rol
SeSo
akthes
eeds
inac
upof
water
atnightand
drinkitthen
extm
orning
onan
emptysto
machDrin
kitthric
eper
week
Meliaceae
Azadira
chta
indica
AJuss
(AM16)
Neemlila
perche
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
046
021
012
009
004
Type
2diabetes
LCr
ushtheleavesa
ndmakes
mallballswith
them
andallowthem
todryin
thes
unTh
efollowingdaysw
allow2balls
with
1glassof
water
twicep
erweek
Moraceae
Artocarpus
heterophyllus
Lam
(AM36)
Zack
Type
2diabetes
FrPreparea
decoctionwith
they
oung
fruitsanddrink1cup
daily
for1
week
019
007
002
008
002
Moringaceae
Moringa
oleiferaLam
(AM42)
Brede
mou
roun
gue
Type
2diabetes
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
026
012
006
016
000
Highlevelofcho
leste
rol
LCr
ushandpressthe
leaves
toob
tain
juiceMixitwith
milk
anddrink1cup
twicep
erweek
Hypertension
RPreparea
decoctionwith
ther
ootand
drink1cup
twicep
erweek
Hypertension
StPreparea
decoctionwith
thes
tem
anddrink1cup
twicep
erweek
Myrtaceae
Eucalyptus
globu
lusL
abill
(AM32)
Eucalyptus
Type
2diabetes
LPreparea
ninfusio
nwith
2-3leaves
anddrink1cup
twicep
erweek
013
005
000
008
000
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
daily
for1
week
Psidium
guajavaL
(AM50)
Goyave
Type
2diabetes
FrCon
sumer
ipfruitthricep
erweek
038
017
004
015
002
FrPreparea
juiceo
fthe
fruitand
drink1cup
daily
for1
week
Syzygium
cuminiL
Skeels
(AM06)
Jamblon
Type
2
LPreparea
decoctionwith
theleavesa
nddrink1cup
daily
for1
week
049
019
014
013
003
FrCon
sume10rip
efruits
thric
eper
week
FrPreparejuice
with
1cup
ofthefruits
and2cups
ofwaterD
rink1cup
twice
perw
eek
SePreparea
decoctionwith
thes
eeds
anddrink1cup
twicep
erweek
FrSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoKarela
jamun
rdquowhich
contains
Syzygium
cuminiand
Mom
ordica
charantia
Drin
k5ndash10mlofthe
preparationwith
12ag
lassof
water
twicep
erday
Fr
Sold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoYesakardquo
which
contains
Phyllanthus
emblica
TerminaliachebulaTerm
inaliabelleric
aSyzygium
cuminiPicrorhiza
kurroaSwe
rtiachira
taT
inospora
cordifoliaG
ymnema
sylve
streMom
ordica
charantia
CuraumalongaSalacia
chinensis
Linn
and
Meliaazadira
chtaD
rink1tablespoo
ntwicep
erday
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 13
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Oleaceae
Olea
europaea
L(A
M02)
Zolive
Hypertension
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
024
010
004
013
002
Cardiovascular
disease
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Type
2diabetes
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
daily
for1
week
Phyllanthaceae
Phyllanthus
emblica
L(A
M13)
Amla
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
ncalledldquoTrip
halardquoc
ontainingPh
yllanthu
sem
blica
Bellirica
myrobalan
and
Chebulicmyrobalan
Drin
k1tablespoo
ndaily
052
025
014
016
006
Type
2diabetes
mdashSold
asan
Ayurvedicp
reparatio
nkn
ownas
ldquoAmlakarelardquow
hich
contains
Phyllanthus
emblica
andMom
ordica
charantia
Drin
k10ndash30m
lofthe
preparationdaily
in100m
lofw
ater
Type
2diabetes
FrCon
sumer
awfruitsthric
eper
week
Type
2diabetes
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
andadd1teaspoo
nof
honeyto
thejuice
(optional)
Drin
k1cup
thric
eper
week
Highlevelofcho
leste
rol
FrPreparejuice
with
1cup
offruitsand1cup
ofwater
anddrink1cup
thric
eperw
eek
Poaceae
AvenasativaL
(AM35)
Oatmeal
Type
2diabetes
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
032
019
008
013
002
Highlevelofcho
leste
rol
Gr
Theg
rainsa
resoaked
in1cup
ofwater
durin
gthen
ight
anddrun
kin
the
morning
onan
emptysto
mach
Dry
skin
Gr
Theg
rainsa
recrushedinto
fined
powdersandmixed
with
1tablespoo
nof
almon
doiltoform
apasteandappliedon
wetskin
after
bathLeave
itfor10
minutes
then
rinse
itwith
water
Prim
ulaceae
Lysim
achiachristin
aeHance
(AM19)
mdashUrin
arytractinfectio
nL
Preparea
decoctionof
theleavesa
nddrink1cup
daily
for1
week
005
000
000
000
005
Rhizop
horaceae
Rhizophora
mucronatalowastLam
(AM25)
Manglier
Type
2diabetes
RPreparea
ninfusio
nof
ther
ootsanddrink1cup
twicep
erweek
039
016
004
019
000
Rosaceae
Crataeguslaevigata
Poir
DC
(AM38)
Aubepine
Cataract
LPreparea
ninfusio
nof
theleavesa
ndwashthee
yewith
it
032
014
006
017
000
Highlevelofcho
leste
rol
LPreparea
ninfusio
nof
theleavesa
nddrink1cup
twicep
erweek
Hypertension
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Atherosclerosis
FlPreparea
ninfusio
nwith
1teaspoo
nof
flower
anddrink2cups
perd
aytwicep
erweek
Rubu
salce
ifoliu
sPoir
(AM14)
Piqu
antlou
lou
Type
2diabetes
LPreparea
decoctionwith
theleavesa
nddrink1cup
twicep
erweek
036
011
009
014
002
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
14 Evidence-Based Complementary and Alternative Medicine
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Rubiaceae
Morinda
citrifoliaL
(AM12)
Non
i
Type
2diabetes
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
054
024
019
025
007
Highlevelofcho
leste
rol
FrTh
efruitispeele
dcrushedandpressedto
obtain
thejuiceD
rink1cup
thric
eper
week
Hypertension
LPreparea
ninfusio
nwith
theleavesa
nddrink1cup
twicep
erweek
Pain
LAp
plywarm
oilonthep
ainful
area
andbind
itwith
theleaves
Vangueria
madagascarie
nsis
JFGmel
(AM27)
Vavang
ueTy
pe2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
037
012
008
019
002
Hypertension
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Rutaceae
Hypertension
FrPeelandpressthe
fruittoob
tain
thejuice
anddrink1cup
Type
2diabetes
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
um1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Renalfailure
LPeelandpressthe
fruittoob
tain
juicea
nddrink1cup
twicep
erweek
Citru
saurantifolia(C
hristm)
Swingle
(AM49)
Limon
Renalfailure
FrPeelandpreparejuice
with
thep
ulpandadd1teaspoo
nof
honeyDrin
kthric
eper
weekin
them
orning
055
024
010
023
005
Cardiovascular
disease
LPreparea
ninfusio
nwith
4leaves
anddrink1cup
thric
eper
week
Cardiovascular
disease
FrPreparejuice
with
thefruittogether
with
1clove
ofAlliu
msativ
umL1
teaspo
onof
honeyand1cup
ofwaterD
rink1cup
twicep
erweek
Cataract
FrPreparejuice
with
thep
ulpandadd2teaspo
onso
fhon
eyanduseitasa
neyebathdaily
Type
2diabetes
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
Citru
smaxim
a(Burm)Osbeck
(AM47)
Pamplem
ousse
Highlevelofcho
leste
rol
FrPreparea
decoctionof
thep
eelsin
water
anddrink1cup
thric
eper
week
048
020
018
019
002
Highlevelofcho
leste
rol
FrPreparejuice
with
thefruittogether
with
Dau
cuscarotaand2c
mof
Zingiberoffi
cinaleroo
tDrin
k1cup
once
perw
eek
Murraya
koenigii(L)Spreng
(AM44
)Ca
rripou
let
Hypertension
LPreparea
ninfusio
nwith
3leaves
anddrink1cup
twicep
erweek
018
009
003
005
001
Sapind
aceae
Cardiospermum
halicacabum
L(A
M23)
Pocpoc
Gangrene
LPreparea
ninfusio
nof
theleavestogetherw
ithSenn
aalexan
drinaMilland
Senn
aalataLDrin
k1cup
twicep
erweek
021
008
009
005
000
Wou
ndL
Crushtheleavesa
ndapplythem
onthew
ound
asap
oultice
Type
2diabetes
LPreparea
decoctionof
theleavesa
nddrink1cup
twicep
erweek
Theaceae
Camelliasin
ensis
LKu
ntze
(AM48)
Thev
ert
Cataract
LPreparea
ninfusio
nwith
thetea
bags
andwashthee
yewith
it
045
026
012
027
008
Type
2diabetes
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Hypertension
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
thetea
bags
anddrink1cup
twicep
erweek
Highlevelofcho
leste
rol
LPreparea
ninfusio
nwith
theteabags
together
with
Cinn
amom
umverum
Drin
k1cup
twicep
erweekatnight
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 15
Table3Con
tinued
Family
Scientificn
ameo
fplant
(identifi
catio
nnu
mber)
Localn
ame
ofplant
Indicatio
nPartof
plantu
sed
Metho
dof
preparationandadministratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Verbenaceae
Aloysia
citrio
dora
Palau
(AM45)
Verveine
Cardiovascular
disease
WPreparea
ninfusio
nwith
1teaspoo
nof
thep
lant
in1cup
ofho
twaterA
llow
itto
infuse
for10minutes
anddrink1cup
thric
eper
week
009
002
000
007
000
Xantho
rrho
eaceae
Aloe
vera
(L)Bu
rmf
(AM46
)Aloev
era
Type
2diabetes
LGelisremoved
from
theleafp
ulpand2tablespo
onsa
reeatendaily
inthe
morning
for1
week
053
017
015
023
006
Type
2diabetes
LSold
asan
Ayurvedicjuice10m
ltaken
twiced
ailyaft
ermeal
Highlevelofcho
leste
rol
LPreparea
mixture
with
2tablespo
onso
fthe
gelrem
oved
from
theleafp
ulp
1cup
ofyoghurtand12
acup
ofwaterM
ixallinajuicera
nddrink1cup
ofthejuice
obtained
twicep
erweek
Gangrene
LPreparea
footbath
with
thed
ecoctio
nof
theleafm
ixed
with
1teaspoo
nof
saltand1teaspoo
nof
vinegarSo
akfoot
for3
0ndash45
minutes
daily
for1
week
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexa
mon
gthe
Budd
histcommun
ityPlant
partusedR
roo
tLleafFrfruitSeseedsW
who
leplantBbu
lbStste
mFlfl
owerG
rgrainlowast
Listofendemic
plants
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
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Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
16 Evidence-Based Complementary and Alternative Medicine
452
1300
2810
210 210620
070 210 0700050
100150200250300350400450500
Leaves Bulb Fruit Root Flower Seed Stem Grain Wholeplant
Plan
t par
ts us
ed (
)
Part of the plant used
Figure 3 Plant parts employed in herbal remedies by the partici-pants
or dried plants in the preparation of herbal remedies Theyreported that the use of either fresh or dried plants in herbalrecipes did not make any difference in the efficacy of theherbal remedies However the traditional healers reportedthat they preferred dried plants which should be kept inopen air and not in closed container Furthermore dryingenabled indigenous people to use medicinal plants duringoff season This is supported by the work of Tahraoui et al[32] whereby plant parts are dried in shade and stored in ahouse room free of humidity and sunlight for their use duringunavailability Similarly Lingaraju et al [33] reported that inthe absence of freshmaterials the dried ones were prescribedin the preparation of herbal remedies Previous studies hadshown that there were quantitative and qualitative differencesin the essential oil contents of fresh and dry plant materials[34 35] Ishola et al [26] reported that dry plant materialsmight not be as potent as freshly collected herbs since someof their enzymes may have been denatured or the heat labilecompounds could have been destroyed
35 Parts of Medicinal Plants Used in the Preparation ofHerbal Remedies In the current investigation different partsof medicinal plants were documented in the preparationof indigenous herbal medicines to manage diabetes andrelated complications Whole plant in addition to differentparts of the same plant including leaf bulb fruit rootflower seed stem and grain was used in the preparation ofherbal remedies for the management of diabetes and relatedcomplications (Figure 3) Leaf was the most frequently usedplant parts (452) followed by fruit (281) bulb (13)seed (62) root (21) flower (21) grain (21) stem(07) and whole plant (07) These observations resonatewith finding obtained by Sadeghia and Mahmood [36] inwhich the part of the plant most commonly used was leavesAccording to Tuttolomondo et al [37] greater accessibility ofthe aboveground parts of the plants in natural ecosystems andthe greater abundance of leaves compared to other plant partsmay explain the higher use-frequency of these plant partsin traditional medicine Leaves are the most favored partsin the preparation of herbal medicines since they contain
Decoction26
Infusion20Juice
36
Soup06 Crude form
17
Paste06
Figure 4 Forms of herbal preparations
a high concentration of pharmacologically active secondarymetabolites which are valuable in phytotherapy [38 39]The result of the present study showed that whole plant isnot commonly used in the preparation of herbal remediesbecause its removal will threaten the conservation of theplant species and hence impair sustainability of indigenousflora in the study area The result of the study deviates fromthe work of Cheikhyoussef et al [40] who observed thatroots are mostly used in the preparation of herbal remediesFrom the current study the root of Rhizophora mucronataan endemic plant was reported to be used against type2 diabetes According to Flatie et al [41] roots containhigh concentration of bioactive substances Nonethelessfrequent harvesting of roots has a negative influence on thesurvival of the plant species and is therefore discouragedDifferent parts of a plant species may contain different typesand concentrations of pharmacologically active constituentsresulting in distinct pharmacological activities In the presentwork the fruit of Cucurbita maxima was reported to be usedagainst type 2 diabetes and in wound healing its leaves wereused against cataract while its seeds were used against renalfailure The phytochemical analysis of an ethanolic extract ofCucurbita maxima seeds revealed the presence of tanninscarbohydrates glycosides alkaloids volatile oils saponinsproteins and flavonoids [42]
36 Method of Preparation of Herbal Remedies Variouspreparation modes of herbal medicines like juice decoctioninfusion crude form paste and soup were used by theindigenous community in Mauritius (Figure 4) The mostcommon modes of preparation were juice (36) followedby decoction (26) and infusion (20) Similar findingwas reported by Malla et al [43] in western Nepal wherejuice was the most commonly used preparation method foradministering medicinal plants Most of the reported herbalpreparations are made with water as dilution media Thisfinding is in line with previous work [44] where waterwas mostly used as solvent medium in the preparation ofherbal remedies Decoctions are usually prepared by boilingplant parts in water until the amount of water is reducedto half its original amount According to a study conductedby Zhang et al [45] on heating various biological reactions
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Disease Markers
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
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Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 17
0 1 2 3 4 5 6Acanthaceae
AlismataceaeAmaryllidaceaeAnacardiaceae
AnnonaceaeAphloiaceae
ApiaceaeApocynaceae
ArecaceaeAsparagaceae
AsteraceaeBrassicaceae
BromeliaceaeCaricaceae
CucurbitaceaeFabaceae
LamiaceaeLauraceae
LinaceaeMeliaceaeMoraceae
MoringaceaeMyrtaceae
OleaceaePhyllanthaceae
PoaceaePrimulaceae
RhizophoraceaeRosaceae
RubiaceaeRutaceae
SapindaceaeTheaceae
VerbenaceaeXanthorrhoeaceae
Number of plant species
Fam
ilies
Figure 5 Representative botanical families
are accelerated resulting in many active compounds henceaccounting for the effectiveness of herbal remedies preparedby decoction
37 Administration of Herbal Remedies Regarding themeansof administration oral ingestion (871) was the preferredmode of administration of herbal remedies followed byexternal use (129) This is in agreement with the findingof Sadeghia and Mahmood [36] where herbal remedies aremostly administered orally It was reported that the predom-inance of oral route for administration of herbal remediescan be attributed to the ease of administration without usingcostly and complex accessories [46]
38 Botanical Families Thepredominantly quotedmedicinalplant families were Cucurbitaceae with five species followedby Apiaceae Asteraceae Myrtaceae and Rutaceae withthree species each and Amaryllidaceae Fabaceae LamiaceaeRosaceae and Rubiaceae with two species each The remain-ing 23 families were each represented by one species (Fig-ure 5) The Cucurbitaceae family encompasses 800 speciesdistributed mainly in tropical and subtropical regions of theworld [47] The most plausible reason for the predominanceof the Cucurbitaceae family in the study area could be dueto the large group of plant species belonging to this familywhich are medicinally valuable due to their phytochemicalprofile Moreover the high citations of the Cucurbitaceaefamily may be because of the high availability of plant speciesbelonging to this family in the study area Further plantsbelonging to the Cucurbitaceae family contain a group ofactive secondary metabolites namely triterpenoid which
are well known for their bitterness [47] hence justifyingtheir use in the management of diabetes in the presentstudy It was noted from the current investigation that someof the informants believed that type 2 diabetes is causedby excess sugar in the blood hence bitter plants are usedto neutralise the excess sugar In an ethnopharmacologicalsurvey conducted in Congo by Katemo et al [48] it wasreported that bitter plants are prescribed to control bloodsugar level Some of the bitter plants recorded from thepresent study used to manage diabetes with high relativefrequency of citation include Aloe vera (053) Phyllanthusemblica (052) Azadirachta indica (046) and Momordicacharantia (046) Phyllanthus emblica has been shown tocontain an array of bioactive components like quercetinphyllaemblic compounds gallic acid tannins flavonoidspectin vitamin C terpenoids and alkaloids which possessesuseful biological activities [49ndash51] According to Walia andBoolchandani [52] Phyllanthus emblica contain high vitaminC content which is effective in controlling diabetes andtanninswhich has the capacity to enhance glucose uptake andinhibit adipogenesis The majority of the informants (92)responded that after consumption of the herbal remedy theyfelt an improvement in their health state
39 Relative Frequency of Citation Relative frequency ofcitation was calculated to ascertain the most commonlyoccurring medicinal plants used for the management of dia-betes and related complications and thus aids in the selectionof plants for further phytochemical and pharmacologicalstudies Citrus aurantifolia (055) was the predominant plantspecies which exhibited the highest relative frequency ofcitation demonstrating its importance in indigenous phy-totherapy It is followed by Morinda citrifolia (054) Aloevera (053) Phyllanthus emblica (052) and Syzygium cumini(049) Plant species with high relative frequency of citationreflected their popularity due to their strong healing powerand they were easily available and affordable in the studyarea According to Kpodar et al [46] other reasons why plantspecies are cited frequently might be (1) the trust that theindigenous community have in these plants as medicine and(2) the relatively high cost of synthetic drugs Based on theseresults such plants should be focused on for the investigationof bioactive phytochemical constituents and other pharma-cological activities It is important to note that the plantswith high relative frequency of citation have been previouslyscreened for their pharmacological activities Unripen juicesof Citrus aurantifolia showed antioxidant activities in vitro[53] Moorthy and Reddy [54] reported that the ethanolicextract of the roots ofMorinda citrifolia lowered blood pres-sure in an anesthetized dog An experimental investigationcarried out by Alam et al [55] demonstrated that leaves ofSyzygium cumini contain the bioactive compounds lupeol 12-oleanen-3-ol-3120573-acetate stigmasterol and 120573-sitosterol whichpossess potential antidiabetic activities hence supportingthe traditional use of the leaves for treating diabetes Someof the plant species reported namely Lysimachia christinae(005) Prunella vulgaris (009) and Aloysia citriodora (009)scored low relative frequency of citation since they have
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
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PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Computational and Mathematical Methods in Medicine
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
18 Evidence-Based Complementary and Alternative Medicine
Table 4 Culturally most important plant and animal species used against diabetes and related complications
Religiousgroups Hindu Muslim Christian Buddhist
Plantspecies
Ocimum tenuiflorum (039) Cardiospermum halicacabum (009) Camellia sinensis (027) Ophiopogon japonicas (011)
Allium cepa (028) Carica papaya (008) Morinda citrifolia (025) Alisma plantago-aquatica(009)
Phyllanthus emblica (025) Aloe vera (023) Prunella vulgaris (008)Allium sativum (024) Apium graveolens (019) Lysimachia christinae (005)Citrus aurantifolia (024) Rhizophora mucronata (019)
Momordica charantia (023) Vangueria madagascariensis(019)
Trigonella foenum-graecum(023) Tamarindus indica (018)
Azadirachta indica (021) Brassica oleracea (017)Citrus maxima (020) Crataegus laevigata (017)Avena sativa (019) Moringa oleifera (016)Syzygium cumini (019) Petroselinum crispum (016)Mangifera indica (017) Cynara cardunculus (015)Psidium guajava (017) Cucurbita maxima (014)Sigesbeckia orientalis (017) Rubus alceifolius (014)Linum usitatissimum (016) Ananas comosus (013)Bidens pilosa (014) Olea europaea (013)Lagenaria siceraria (014) Cocos nucifera (012)Murraya koenigii (009) Cucumis sativus (012)Annona muricata (007) Coriandrum sativum (011)
Luffa acutangula (011)Persea americana (011)Aphloia theiformis (010)Graptophyllum pictum (010)Artocarpus heterophyllus(008)Catharanthus roseus (008)Eucalyptus globules (008)Aloysia citriodora (007)
Animalspecies
Anguilla japonica (002) Salmo salar (008) Rattus rattus (002)Apis mellifera (003)Tenrec ecaudatus (003)Helix aspersa (002)Periplaneta americana (002)
been reported by few informants only Low relative frequencyof citation values of these plants imply that traditionalknowledge about their use is on the verge of extinctionFurthermore they were found to be scarce in the studyarea due to deforestation and urbanization Since Lysimachiachristinae is not native to Mauritius many informants wereunaware of this medicinal plant The traditional Chinesemedicine practitioner reported that this plant is importedin its dried form from China Lysimachia christinae containsflavonoid and phenolic compounds which possess promisingpharmacological activities in vivo [56]
310 Cultural Importance Index The cultural importanceindex showed that Ocimum tenuiflorum (039) Cardiosper-mumhalicacabum (009)Camellia sinensis (027) andOphio-pogon japonicas (011) are the most culturally important plantspecies among the Hindu Muslim Christian and Buddhistcommunity respectively (Table 4) The high cultural impor-tance index of these plants indicates their importance in theirrespective culture because of their medicinal properties andversatility These plant species have been used since timeimmemorial and themedicinal knowledge of these plants hasbeen transmitted from one generation to the next within the
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Disease Markers
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Research and TreatmentAIDS
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Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 19
Table 5 Jaccard similarity index for the different religious groups ofMauritius regarding the number of medicinal plants used tomanagediabetes and related complications
Hindu Muslim Christian BuddhistHindu mdash 958 941 635Muslim 958 mdash 902 660Christian 941 902 mdash 692Buddhist 635 660 692 mdash
specific religious group According to Tardıo and Pardo-de-Santayana [57] the cultural importance index is an efficienttool for highlighting those species with a high agreementfor the culture of the study area and hence recognises theshared knowledge of these people From Table 4 it is evidentthat plant species which scored very low cultural importanceindex value in a particular religious group imply that little cul-tural importance is given to these plant species in traditionalmedicine in that particular religious group Tuttolomondoet al [37] reported that plants with low cultural importanceindex value indicate that the local populations had little trustin them concerning their use in the treatment of certainpathologies or indicate a fall in traditional plant knowledgeregarding medicinal uses of these plants which is an evidenceof an ongoing process of cultural erosion Cultural andreligious preferences also influence the use of medicinalplants [58] Some of the documented medicinal plants werefound to play important roles in religious ceremonies amongthe Hindu community Ocimum sanctum is considered assacred by the Hindu community The holy basil worship isdone every morning in every Hindu community householdin order to keep the family members healthy MoreoverAzadirachta indica and Mangifera indica were reported toplay fundamental role in ldquoDurga poojardquo a prayer dedicatedto goddess ldquoDurgardquo
311 Jaccard Similarity Index In the current investigation theChristian community provided us with the highest numberof medicinal plants (51) followed by the Hindu (48) Muslim(46) and the Buddhist (37) community As depicted inTable 5 the Hindu community and the Muslim communityshowed the highest similarity of medicinal plants usage withJaccard similarity index value of 958 The Hindu and Mus-lim community are both descendants of Indian indenturedlabourers who were recruited by the British Empire to workon sugar cane banana tea and coffee plantationsThey camefrom the same village in eastern Uttar Pradesh and westernBihar in northern India and arrived to Mauritius in thesame ships [59] It was observed that the Hindu and Muslimcommunity in Mauritius commonly spoke the ldquoBhojpurirdquodialect which is an amalgam of Creole and Hindi languageMoreover certain traditions were found to be similar amongthese two religious groups For instance the use of hennato decorate womenrsquos hands during weddings was found tobe similar among both religious groups The high degreeof similarity of medicinal plants usage between these two
communities implies that there has been an exchange oftraditional information between these two cultures on theuse of medicinal plant species to manage diabetes and relatedcomplications The Hindu community and the Buddhistcommunity showed the least similarity of medicinal plantsusage with Jaccard similarity index value of 635 The reasonfor this least similarity is most likely because the Buddhistcommunity have their own systemof healingwhich is distinctto that of the Hindu community Moreover the Buddhistcommunity commonly purchased medicinal plants fromherbal stores which are imported from China and some ofplants employed by the Buddhist community are unknownby the other three religious communities Moreover theBuddhist community was observed to be quite reticent toshare their traditional knowledge with people not belongingto their cultural group According toGuzel et al [25] detailedanthropological studies should be carried out in order toidentify factors affecting ethnomedicinal similarities anddifferences amongst different cultural groups
312 Ailment Categories The reported ailments weregrouped into 9 broad categories of diseases (Table 6)The ailment categories treated by the greatest number ofmedicinal plants were diabetes with 40 listed plant speciesfollowed by diabetic dyslipidemia and hypertension with 19plant species each The reasons for this may be due to highprevalence of diabetes in the study area as reported earlierhence the need to search for more hypoglycemic plants Theefficacy demonstrated by some of the antidiabetic plantsidentified in this study has previously been documentedin either in vivo or in vitro studies Ethanolic leaf extractof Azadirachta indica was found to normalize bloodglucose level in streptozotocin-induced diabetic rats [60]Syzygium cumini bark extract lowered blood glucose levelin streptozotocin-induced diabetic albino Wistar rats [61]Aqueous leaf extract of Graptophyllum pictum was found tohave hypoglycemic effect which is comparable to metforminin alloxan-induced diabetic Wistar rats [62] Aqueousalcohol extract of the aerial parts of Bidens pilosa loweredblood glucose in dbdb mice a type 2 diabetes mouse model[63] However herbal medicinal practices may vary amongdifferent groups of people in different parts of the worldFor example Trigonella foenum-graecum was reported tobe used against diabetes high level of cholesterol anderectile dysfunction in Mauritius but in Iran it is usedagainst gynaecological problems [36] The result revealedthat 635 of the plant species enlisted were employed for themanagement of more than one kind of disease This findingis in agreement with previous result described by Yousuf etal [64] and Gupta et al [65] where most plant species usedby indigenous people have multiple uses
313 Cross-Cultural Comparison of Medicinal Plants amongthe Different Religious Groups Though the four religiousgroups in Mauritius possess different cultures and traditionsit was observed that they have common knowledge about themajority of the reportedmedicinal plant speciesThirty-threeplants species were used commonly among the four religious
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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ObesityJournal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
20 Evidence-Based Complementary and Alternative Medicine
Table6Th
euse
ofplant-b
ased
remediesa
ndanim
al-based
remediesb
yillnesscategorie
s
Illnesscategorie
sEthn
omedicinal
applications
Plantspecies
Animalspecies
Diabetic
angiop
athy
Atherosclerosis
cardiovascular
disease
Cynara
cardun
culusBrassicaoleraceaA
nana
scom
osusC
arica
papayaLuff
aacutangulaO
leaeuropaeaC
rataegus
laevigataCitru
saurantifoliaand
Aloysia
citrio
dora
mdash
Diabetic
neph
ropathy
Renalfailure
Alliu
mcepaA
llium
sativ
umPetroselin
umcrisp
umC
ocos
nuciferaAn
anas
comosus
Cucurbita
maxim
aLinu
musita
tissim
umand
Citru
saurantifolia
Tenrec
ecau
datus
Diabetic
neurop
athy
Painerectile
dysfu
nctio
nandhearingloss
Alliu
mcepaB
rassica
oleraceaTam
arindu
sind
icaTrig
onellafoenum
-graecum
Ocim
umtenu
iflorum
and
Morinda
citrifolia
Anguillajaponica
Eyed
iseases
Cataracts
Alliu
mcepaA
llium
sativ
umA
phloiatheiformis
Cocosn
uciferaB
rassica
oleracea
Cucurbita
maxim
aOcim
umtenu
iflorum
Perseaam
erica
naC
rataegus
laevigata
Citru
saurantifoliaand
Camelliasin
ensis
Helixaspersa
Apismellifera
Diabetic
dyslipidemia
Highlevelofcho
lesterol
Alism
aplantago-aquatica
Allium
cepaPetroselin
umcrisp
umC
ynaracardun
culus
Caric
apapayaL
agenariasicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Perseaam
erica
naLinum
usita
tissim
um
Moringa
oleiferaPh
yllanthu
semblica
Avena
sativaCrataeguslaevigata
Morinda
citrifoliaC
itrus
maxim
aCa
melliasin
ensisand
Aloe
vera
mdash
Hypertension
Hypertension
Alliu
msativ
umA
nnonamurica
taA
pium
graveolen
sPetro
selin
umcrisp
umB
idens
pilosaC
arica
papayaL
agenariasicerariaLuff
aacutangulaTam
arindu
sind
ica
Ocim
umtenu
iflorum
Prunella
vulga
risM
oringa
oleiferaOlea
europaeaC
rataegus
laevigataMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifolia
Murraya
koenigiiandCa
melliasin
ensis
mdash
Infections
andwou
nds
Ulce
rsgangreneurinary
tractinfectio
nandwou
ndhealing
Alliu
msativ
umB
rassica
oleraceaC
ucurbita
maxim
aOcim
umtenu
iflorum
Lysim
achiachristin
aeC
ardiosperm
umhalicacabum
and
Aloe
vera
Perip
laneta
america
naRa
ttusrattus
Diabetes
Type
1diabetestype
2diabetes
Graptophyllum
pictum
Allium
cepaA
llium
sativ
umM
angifer
aindicaA
phloia
theiformis
Apium
graveolen
sCo
riand
rum
sativ
umPetroselin
umcrisp
um
Catharanthus
roseusC
ocos
nuciferaOphiopogonjaponicasBidens
pilosaC
ynara
cardun
culusSigesbeckiaorien
talisB
rassica
oleraceaC
ucum
issativ
us
Cucurbita
maxim
aLa
genaria
sicerariaM
omordica
charantia
Trig
onella
foenum
-graecum
Ocim
umtenu
iflorum
Linum
usita
tissim
umA
zadirachta
indica
Artocarpus
heterophyllusMoringa
oleiferaEu
calyptus
globu
lesPsid
ium
guajava
Syzygium
cuminiOlea
europaeaP
hyllanthu
semblica
Avena
sativaRh
izophora
mucronataR
ubus
alceifoliu
sMorinda
citrifoliaV
angueriamadagascarie
nsis
Citru
saurantifoliaC
itrus
maxim
aCa
rdiospermum
halicacabum
Cam
elliasin
ensisand
Aloe
vera
Salm
osalar
Skin
complications
Dry
skin
Avenasativa
mdash
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 21
(A)
Hindu
Christian
Buddhist
Muslim
(B)
(C)
(E)(n = 1)
(D)(n = 3)
(n = 2)
(n = 13)
(n = 33)
Figure 6 Venn diagram representing the overlap of plant speciescited by participants from Hindu Muslim Christian and Chinesecommunities in Mauritius (A) Plant species common to HinduMuslim Christian and Buddhist religious group (Allium cepaAllium sativum Mangifera indica Apium graveolens Petroselinumcrispum Catharanthus roseus Bidens pilosa Cynara carduncu-lus Brassica oleracea Carica papaya Cucumis sativus Cucurbitamaxima Lagenaria siceraria Momordica charantia Tamarindusindica Trigonella foenum-graecum Ocimum tenuiflorum Linumusitatissimum Azadirachta indica Artocarpus heterophyllus Psid-ium guajava Syzygium cumini Olea europaea Phyllanthus emblicaAvena sativa Rubus alceifolius Morinda citrifolia Vangueria mada-gascariensis Citrus aurantifolia Citrus maxima Murraya koenigiiCamellia sinensis and Aloe vera) (B) Plant species common toHindu Muslim and Christian religious group only (Graptophyllumpictum Annona muricata Aphloia theiformis Coriandrum sativumCocos nucifera Sigesbeckia orientalis Ananas comosus Luffa acu-tangula Persea americana Moringa oleifera Rhizophora mucronataCrataegus laevigata and Cardiospermum halicacabum) (C) Plantspecies common to Hindu and Christian religious group only(Eucalyptus globules Aloysia citriodora) (D) Plant species commonto Christian and Buddhist religious group only (Alisma plantago-aquatica Ophiopogon japonicas and Prunella vulgaris) (E) Plantspecies common to Buddhist religious group only (Lysimachiachristinae)
groups whereas 13 plant species were common among theHindu Muslim and Christian religious groups only 2 plantswere common between Hindu and Christian communitiesonly 3 plants were common between the Christian andBuddhist communities only and 1 plant was used exclusivelyby the Buddhist community (Figure 6) A high correspon-dence between the uses of the same medicinal plant speciesamong the four religious groups was surprising The possiblereason accounting for the high similarity of plant speciesused to manage diabetes and related complications amongthe four religious groups might be due to the frequent cross-cultural exchange of traditional knowledge on medicinalplants between them tomanage these ailmentsMoreover thefour religious groups live in close proximity to each other andshare similar flora Lingaraju et al [33] reported that differentethnic groups influence each other in the adoption and usageof certain medicinal plant species According to Masevheet al [66] the use of plant species by different cultural
groups may also indicate their potential pharmacologicalefficacy Medicinal plants are not selected at random butexhibit a considerable degree of patterning within one culture[16] Moreover plants are selected and used in a consistentmanner because of their culturally perceived effectiveness[67 68] According to Heinrich et al [16] the parallel useof plant taxa among different ethnic groups may be due to(1) coincidence (a random selection of similar species) (2)similar criteria for selecting plants and (3) shared infor-mation on the potential usefulness of a plant Thereforemedicinal plant species which are used in parallel amongthe four religious groups require further pharmacologicaltoxicological and phytochemical analysis for the discoveryof potential novel drugs to manage diabetes and relatedcomplications
314 Animal-Based Remedies Used to Manage Diabetes andRelated Complications In this study a total of 7 medicinalanimal species distributed over 4 classeswere recorded for themanagement of diabetes and related complications (Table 7)Among them Actinopterygii Insecta and Mammalia occu-pied themost cited classes with two species each Our presentanalysis reveals that various parts of animal species wereselected as medicinal materials Whole animal (714) wasmostly recorded in the preparation of animal-based remediesfollowed by honey (143) and skin (143) The resultdepicts that animal-based remedies were mainly taken inthe raw form (571) Our finding is comparable to that ofVijayakumar et al [69] where medicinal animal species aremostly taken as raw for the treatment of ailments Basedon relative frequency of citation the most frequently citedmedicinal animal species was Salmo salar (012) Salmo salarwas found to be commonly used against diabetes in thestudy area since it contains a polyunsaturated compoundnamely omega-3Malasanos and Stacpoole [70] reported thatomega-3 fatty acids reduce serum lipids and lipoproteinsimpair platelet aggregation increase cell membrane fluidityand lower blood pressure in diabetic subjects Further studiesare required to confirm the presence of bioactive compoundsin these animal remedies reported in the current studyWith regard to the administration routes of the animal-based remedies external application (571) was the mostcommonly used route of administration It was observed thatcertain animal species were used exclusively in a specificreligious group For instance Tenrec ecaudatus was reportedto be used against renal failure by the Christian communityonly This can be explained by the fact that Tenrec ecaudatusis regarded as impure by the Hindu and Muslim communityand their religious values forbid them from consuming themeat of this animal In addition animal-based remedieswere found to be more prominent among the Christiancommunity as compared to the other three religious groupsIt is fundamental to carry out studies to evaluate the safetyefficacy and optimal dosage of the reported animal-basedremedies in order to validate their traditional use and ensureproper treatment outcomes
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
22 Evidence-Based Complementary and Alternative Medicine
Table7Inventoryof
anim
alspeciesu
sedto
managed
iabetesa
ndrelated
complications
Class
Scientificn
ame
Localn
ame
Indicatio
nPartused
Metho
dof
preparationand
administratio
nRF
CCI
I HCI
I MCI
I CCI
I B
Actin
opterygii
Salm
osalar
Saum
onTy
pe2diabetes
Who
lebo
dyAdish
ofthew
holebo
dyisprepared
and
itistakenon
ceperw
eek
012
004
000
008
000
Anguillajaponica
Ang
uille
Neuropathic
pain
Skin
Thes
kinispeeled
anddriedin
bright
sunlightTh
edrie
dskin
isthen
placed
inab
ottle
ofoilMassage
thep
ainful
area
daily
usingthisoil
003
002
000
001
000
Gastro
poda
Helixaspersa
Cou
rpa
Cataract
Who
lebo
dyTh
ewho
lebo
dyiscrushedto
obtain
whiteliq
uidand2drop
softhe
liquidare
instilled
inthee
ye
002
000
000
002
000
Insecta
Apismellifera
Mou
ched
imiel
Cataract
Hon
eyAsm
allamou
ntisinstilledin
thee
yedaily
004
001
000
003
000
Perip
laneta
america
naCa
ncrela
Gangrene
Who
lebo
dyPreparea
ninfusio
nwith
4cockroaches
and1h
andful
ofPetro
selin
umcrisp
um
Filterinac
loth
anddrink1cup
daily
003
000
000
002
001
Mam
malia
Tenrec
ecau
datus
Tang
Renalfailure
Who
lebo
dy
Adish
oftheb
odyisprepared
using
Cinn
amom
umverumSyzygium
arom
aticu
mM
urraya
koenigiiLand
1cupof
whitewineTh
edish
istakenon
ceperw
eek
003
000
000
003
000
Rattu
srattus
Lerat
Wou
ndWho
lebo
dyTh
eanimalisplaced
inab
ottle
ofcoconu
toilfor1-2
days
andtheo
ilisthen
appliedon
thew
ound
002
000
000
000
002
RFC
relativefre
quency
ofcitatio
nCI
I Hculturalimpo
rtance
indexam
ongtheHindu
commun
ityC
IIMculturalimpo
rtance
indexam
ongtheMuslim
commun
ityC
IICculturalimpo
rtance
indexam
ongthe
Chris
tiancommun
ityand
CII Bculturalimpo
rtance
indexam
ongtheB
uddh
istcommun
ity
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 23
4 Conclusion
To the best of our knowledge this is the first cross-culturalinvestigation on traditional therapies used to manage dia-betes and related complications in Mauritius The panoplyof information gathered in the present study demonstratesthe important recognition of herbal and animal-based reme-dies among diabetic patients and traditional healers for themanagement of diabetes and related complications The highpopularity of Citrus aurantifolia demonstrates its importancein the study area for the management of diabetes andrelated complications However there is a tendency of usingparticular types of plants excessively in traditional medicinefor its therapeutic effects without concerning its vulner-ability to extinction Hence appropriate measures shouldbe taken in order to preserve important plant species andemphasis should be placed on the judicious use of medicinalplants Interviews with individuals from different religiousbackground revealed intra- and interculturally importantmedicinal plants Though cultural divergence exists amongthe 4 religious groups of the island a high degree ofsimilarity of medicinal plants usage among them has beenobserved The possible reason for the high correspondenceof the use of the same medicinal plant species is due to thefrequent cross-cultural exchange of traditional knowledge onmedicinal plants Nonetheless the use of certain medicinalplants and animal species has been found to be confinedin only a particular religious group According to Mustafaet al [71] cross-cultural studies could be important forproposing culturally sensitive ways of using plant naturalresources in future sustainable economic development ini-tiatives Culturally important plant species such as Ocimumtenuiflorum Cardiospermum halicacabum Camellia sinensisand Ophiopogon japonicas should be subjected to detailedscreenings for pharmacologically active metabolites for thediscovery of new therapeutic agents As a concluding notethe present study reflects the rich cultural heritage in termsof ethnomedicinal knowledge possessed by the differentreligious groups in Mauritius However this knowledge is injeopardy due to the lack of interest shown by the youngergeneration Therefore we keenly emphasise the importanceof transmitting this precious knowledge which is vanishing atan alarming rate in order to safeguard our cultural heritage
Competing Interests
The authors declare that they have no competing interests
Authorsrsquo Contributions
M Fawzi Mahomoodally A Mootoosamy and S Wambugudesigned the study and contributed to discussion regardingthe study and to the preparation of the paper AMootoosamyconducted the field work All authors read and approved thefinal paper
Acknowledgments
The authors express their gratefulness to all the participantswho were willing to share their precious knowledge duringthe course of field study and the University of Mauritius forfinancial support
References
[1] M Jung M Park H C Lee Y-H Kan E S Kang and SK Kim ldquoAntidiabetic agents from medicinal plantsrdquo CurrentMedicinal Chemistry vol 13 no 10 pp 1203ndash1218 2006
[2] R M OrsquoBrien and D K Granner ldquoRegulation of gene expres-sion by insulinrdquo Physiological Reviews vol 76 no 4 pp 1109ndash1161 1996
[3] International Diabetes Federation Types of Diabetes Interna-tional Diabetes Federation Brussels Belgium 2011
[4] International Diabetes Federation IDF Diabetes Atlas Update2012 International Diabetes Federation Brussels Belgium2012
[5] World Health Organization Global Health Estimates Deathsby Cause Age Sex and Country 2000ndash2012 World HealthOrganization Geneva Switzerland 2014
[6] C D Mathers and D Loncar ldquoProjections of global mortalityand burden of disease from 2002 to 2030rdquo PLoS Medicine vol3 no 11 pp 2011ndash2030 2006
[7] International Diabetes Federation Mauritius InternationalDiabetes Federation Brussels Belgium 2015
[8] F Qamar S Afroz Z Feroz S Siddiqui andA Ara ldquoEvaluationof hypoglycemic effect of Cassia italicrdquo Journal of Basic andApplied Sciences vol 7 no 1 pp 61ndash64 2011
[9] M J Fowler ldquoMicrovascular and macrovascular complicationsof diabetesrdquo Clinical Diabetes vol 26 no 2 pp 77ndash82 2008
[10] MH Eshrat ldquoEffect ofCoccinia indica (L) andAbroma augusta(L) on glycemia lipid profile and on indicators of end -organdamage in streptozotocin induced diabetic ratsrdquo Indian Journalof Clinical Biochemistry vol 18 no 2 pp 54ndash63 2003
[11] FMustaffa J Indurkar N IM Ali et al ldquoA review ofMalaysianmedicinal plants with potential antidiabetic activityrdquo Journal ofPharmacy Research vol 4 no 11 pp 4217ndash4224 2011
[12] Mauritius Meteorological Services ldquoClimate of MauritiusrdquoMarch 2016 httpmetserviceintnetmuclimate-servicesclimate-of-mauritiusphp
[13] O Hollup ldquoThe disintegration of caste and changing conceptsof Indian ethnic identity in Mauritiusrdquo Ethnology vol 33 no 4pp 297ndash316 1994
[14] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against non-communicable diseases in thetropical island of Mauritiusrdquo Journal of Herbal Medicine vol 2no 4 pp 113ndash125 2012
[15] M FMahomoodally and Z D Hossain ldquoTraditional medicinesfor commondermatological disorders inMauritiusrdquoTANG vol3 no 4 pp 311ndash318 2013
[16] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico Healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998
[17] A Gurib-Fakim and T Brendler Medicinal and AromaticPlants of Indian Ocean Islands Medpharm Scientific StuttgartGermany 2004
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
24 Evidence-Based Complementary and Alternative Medicine
[18] S Riaz ldquoDiabetes mellitusrdquo Scientific Research and Essays vol4 no 5 pp 367ndash373 2009
[19] American Diabetes Association (ADA) ComplicationsJanuary 2014 httpwwwdiabetesorgliving-with-diabetescomplications
[20] R Yadav P Tiwari and E Dhanaraj ldquoRisk factors and compli-cations of type 2 diabetes in Asiansrdquo CRIPS vol 9 no 2 pp8ndash12 2008
[21] H N Ginsberg Y-L Zhang and A Hernandez-Ono ldquoRegula-tion of plasma triglycerides in insulin resistance and diabetesrdquoArchives of Medical Research vol 36 no 3 pp 232ndash240 2005
[22] H J Bodansky A G Cudworth R A F Whitelocke and JH Dobree ldquoDiabetic retinopathy and its relation to type ofdiabetes review of a retinal clinic populationrdquo British Journalof Ophthalmology vol 66 no 8 pp 496ndash499 1982
[23] U K Sharma S Pegu D Hazarika and A Das ldquoMedico-religious plants used by the Hajong community of AssamIndiardquo Journal of Ethnopharmacology vol 143 no 3 pp 787ndash800 2012
[24] C Leto T Tuttolomondo S La Bella and M Licata ldquoEth-nobotanical study in the Madonie Regional Park (CentralSicily Italy) Medicinal use of wild shrub and herbaceous plantspeciesrdquo Journal of Ethnopharmacology vol 146 no 1 pp 90ndash112 2013
[25] Y Guzel M Guzelsemme and M Miski ldquoEthnobotany ofmedicinal plants used in Antakya a multicultural district inHatay Province of Turkeyrdquo Journal of Ethnopharmacology vol174 article 9657 pp 118ndash152 2015
[26] I O Ishola I A Oreagba A A Adeneye C Adirije K AOshikoya and O O Ogunleye ldquoEthnopharmacological surveyof herbal treatment of malaria in Lagos Southwest NigeriardquoJournal of Herbal Medicine vol 4 no 4 pp 224ndash234 2014
[27] M L Hardy ldquoHerbs of special interest to womenrdquo Journal of theAmerican Pharmaceutical Association vol 40 no 2 pp 234ndash242 2000
[28] M F Kadir M S Bin Sayeed N I Setu A Mostafa and MM K Mia ldquoEthnopharmacological survey of medicinal plantsused by traditional health practitioners in Thanchi BandarbanHill Tracts Bangladeshrdquo Journal of Ethnopharmacology vol 155no 1 pp 495ndash508 2014
[29] D W Gakuya S M Itonga J M Mbaria J K Muthee and JK Musau ldquoEthnobotanical survey of biopesticides and othermedicinal plants traditionally used in Meru central district ofKenyardquo Journal of Ethnopharmacology vol 145 no 2 pp 547ndash553 2013
[30] AmericanDiabetesAssociation ldquoHypertensionmanagement inadults with diabetesrdquo Diabetes Care vol 27 supplement 1 ppS65ndashS67 2004
[31] A G Singh A Kumar and D Tewari ldquoAn ethnobotanicalsurvey of medicinal plants used in Terai forest of westernNepalrdquo Journal of Ethnobiology and Ethnomedicine vol 8article 19 2012
[32] A Tahraoui J El-Hilaly Z H Israili and B LyoussildquoEthnopharmacological survey of plants used in the tradi-tional treatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007
[33] D P Lingaraju M S Sudarshana and N RajashekarldquoEthnopharmacological survey of traditional medicinal plantsin tribal areas of Kodagu district Karnataka Indiardquo Journal ofPharmacy Research vol 6 no 2 pp 284ndash297 2013
[34] F Sefidkon K Abbasi and G B Khaniki ldquoInfluence of dryingand extraction methods on yield and chemical composition ofthe essential oil of Satureja hortensisrdquo Food Chemistry vol 99no 1 pp 19ndash23 2006
[35] O O Okoh A P Sadimenko O T Asekun and A J AfolayanldquoThe effects of drying on the chemical components of essentialoils of Calendula officinalis LrdquoAfrican Journal of Biotechnologyvol 7 no 10 pp 1500ndash1502 2008
[36] Z Sadeghia and A Mahmood ldquoEthno-gynecological knowl-edge of medicinal plants used by Baluch tribes southeast ofBaluchistan Iranrdquo Revista Brasileira de Farmacognosia vol 24no 6 pp 706ndash715 2014
[37] T Tuttolomondo M Licata C Leto et al ldquoPopular uses of wildplant species for medicinal purposes in the Nebrodi RegionalPark (North-Eastern Sicily Italy)rdquo Journal of Ethnopharmacol-ogy vol 157 no 18 pp 21ndash37 2014
[38] A Ghorbani ldquoStudies on pharmaceutical ethnobotany in theregion of Turkmen Sahra north of Iran (part 1) general resultsrdquoJournal of Ethnopharmacology vol 102 no 1 pp 58ndash68 2005
[39] S K Ghimire O Gimenez R Pradel D McKey and YAumeeruddy-Thomas ldquoDemographic variation and populationviability in a threatened Himalayan medicinal and aromaticherb Nardostachys grandiflora matrix modelling of harvestingeffects in two contrasting habitatsrdquo Journal of Applied Ecologyvol 45 no 1 pp 41ndash51 2008
[40] A Cheikhyoussef M Shapi K Matengu and H M AshekeleldquoEthnobotanical study of indigenous knowledge on medicinalplant use by traditional healers in Oshikoto region NamibiardquoJournal of Ethnobiology and Ethnomedicine vol 7 no 10 2011
[41] T Flatie T Gedif K Asres and T Gebre-Mariam ldquoEthnomed-ical survey of Berta ethnic group Assosa Zone Benishangul-Gumuz regional state mid-west Ethiopiardquo Journal of Ethnobi-ology and Ethnomedicine vol 5 article 14 2009
[42] R Bajpai N Jain and A K Pathak ldquoStandardization ofethanolic extract of Cucurbita maxima seedrdquo Journal of AppliedPharmaceutical Science vol 2 no 8 pp 92ndash95 2012
[43] B Malla D P Gauchan and R B Chhetri ldquoAn ethnobotanicalstudy of medicinal plants used by ethnic people in Parbatdistrict of western Nepalrdquo Journal of Ethnopharmacology vol165 pp 103ndash117 2015
[44] M Y Paksoy S Selvi and A Savran ldquoEthnopharmacologicalsurvey of medicinal plants in Ulukisla (Nigde-Turkey)rdquo Journalof Herbal Medicine 2014
[45] J-L Zhang M Cui Y He H-L Yu and D-A Guo ldquoChemicalfingerprint and metabolic fingerprint analysis of Dansheninjection by HPLC-UV and HPLC-MS methodsrdquo Journal ofPharmaceutical and Biomedical Analysis vol 36 no 5 pp 1029ndash1035 2005
[46] M S Kpodar P Lawson-Evi B Bakoma et al ldquoEthnophar-macological survey of plants used in the treatment of diabetesmellitus in south of Togo (Maritime Region)rdquo Journal of HerbalMedicine vol 5 no 3 pp 147ndash152 2015
[47] K Dhiman A Gupta D K Sharma N S Gill and A GoyalldquoA review on the medicinally important plants of the familyCucurbitaceaerdquo Asian Journal of Clinical Nutrition vol 4 no1 pp 16ndash26 2012
[48] M Katemo P T Mpiana B M Mbala et al ldquoEthnopharmaco-logical survey of plants used against diabetes in Kisangani city(DR Congo)rdquo Journal of Ethnopharmacology vol 144 no 1 pp39ndash43 2012
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Evidence-Based Complementary and Alternative Medicine 25
[49] E Singh S Sharma A Pareek J Dwivedi S Yadav and SSharma ldquoPhytochemistry traditional uses and cancer chemo-preventive activity of Amla (Phyllanthus emblica) the Sus-tainerrdquo Journal of Applied Pharmaceutical Science vol 2 no 1pp 176ndash183 2012
[50] H J Kim T Yokozawa H Y Kim C Tohda T P Rao and LR Juneja ldquoInfluence of amla (Emblica officinales Gaertn) onhypercholesterolemia and lipid peroxidation in cholesterol-fedratsrdquo Journal of Nutritional Science andVitaminology vol 51 no6 pp 413ndash418 2005
[51] S Arora K Kaur and S Kaur ldquoIndian medicinal plants as areservoir of protective phytochemicalsrdquo Teratogenesis Carcino-genesis and Mutagenesis vol 23 no 1 pp 295ndash300 2003
[52] K Walia and R Boolchandani ldquoRole of amla in type 2 diabetesmellitusmdasha reviewrdquo Research Journal of Recent Sciences vol 4pp 31ndash35 2015
[53] S Kumari N Sarmah and K Handique ldquoAntioxidant activitiesof the unripen and ripen Citrus aurantifolia of Assamrdquo Interna-tional Journal of Innovative Research in Science Engineering andTechnology vol 2 no 9 pp 4811ndash4816 2013
[54] N K Moorthy and G S Reddy ldquoPreliminary phytochemicaland pharmacological study ofMorinda citrifolia LinnrdquoAntisep-tic vol 67 pp 167ndash171 1970
[55] M R Alam A B Rahman M Moniruzzaman et al ldquoEvalu-ation of antidiabetic phytochemicals in Syzygium cumini (L)skeels (Family Myrtaceae)rdquo Journal of Applied PharmaceuticalScience vol 2 no 10 pp 94ndash98 2012
[56] X Yang B-C Wang X Zhang et al ldquoEvaluation of Lysimachiachristinae Hance extracts as anticholecystitis and cholagogicagents in animalsrdquo Journal of Ethnopharmacology vol 137 no1 pp 57ndash63 2011
[57] J Tardıo and M Pardo-de-Santayana ldquoCultural importanceindices a comparative analysis based on the useful wild plantsof southern Cantabria (Northern Spain)rdquo Economic Botany vol62 no 1 pp 24ndash39 2008
[58] A Jusu and A C Sanchez ldquoEconomic Importance of themedicinal plant trade in Sierra Leone1rdquo Economic Botany vol67 no 4 pp 299ndash312 2013
[59] O Hollup ldquoIslamic revivalism and political opposition amongminority Muslims in Mauritiusrdquo 1996 httpsunnirazvinetsocietymauritiushtm
[60] S Bisht and S S Sisodia ldquoAnti-hyperglycemic and antidys-lipidemic potential of Azadirachta indica leaf extract in STZ-induced diabetes mellitusrdquo Journal of Pharmaceutical Sciencesamp Research vol 2 no 10 pp 622ndash627 2010
[61] G Saravanan and P Leelavinothan ldquoEffects of Syzygium cuminibark on blood glucose plasma insulin and C-peptide instreptozotocin -induced diabetic ratsrdquo International Journal ofEndocrinology and Metabolism vol 4 pp 96ndash105 2006
[62] S O Olagbende-Dada S O Ogbonnia H A B Coker andG E Ukpo ldquoBlood Glucose lowering effect of Aqueous extractof Graptophyllum pictum (Linn) Griff on Alloxan-inducedDiabetic Rats and its acute toxicity in Micerdquo African Journal ofBiotechnology vol 10 no 6 pp 1039ndash1043 2011
[63] R PUbillas CDMendez S D Jolad et al ldquoAntihyperglycemicacetylenic glucosides from Bidens pilosardquo Planta Medica vol66 no 1 pp 82ndash83 2000
[64] J Yousuf R K Verma and H Dar ldquoTraditional plant basedtherapy among rural communities of some villages of Baramulladistrict (Jammu and Kashmir)rdquo Journal of Phytology vol 4 no5 pp 46ndash49 2013
[65] S K Gupta O P Sharma N S Raina and S Sehgal ldquoEth-nobotanical study of medicinal plants of Paddar Valley ofJammu and Kashmir Indiardquo African Journal of TraditionalComplementary and Alternative Medicine vol 10 no 4 pp 59ndash65 2013
[66] N AMasevhe L J McGaw and J N Eloff ldquoThe traditional useof plants to manage candidiasis and related infections in VendaSouth Africardquo Journal of Ethnopharmacology vol 168 pp 364ndash372 2015
[67] R T Trotter II ldquoRemedios caseros Mexican American homeremedies and community health problemsrdquo Social Science andMedicine B vol 15 no 2 pp 107ndash114 1981
[68] R Trotter andM Logan ldquoInformant consensus a new approachfor identifying potentially effective medicinal plantsrdquo in Plantsin Indigenous Medicine and Diet Bio-Behavioural ApproachesN L Etkin Ed pp 91ndash112 Redgrave Publishers Bedford HillsNY USA 1986
[69] S Vijayakumar J E M Yabesh S Prabhu M Ayyanar andR Damodaran ldquoEthnozoological study of animals used bytraditional healers in Silent Valley of Kerala Indiardquo Journal ofEthnopharmacology vol 162 pp 296ndash305 2015
[70] T H Malasanos and P W Stacpoole ldquoBiological effects of 120596-3fatty acids in diabetes mellitusrdquoDiabetes Care vol 14 no 12 pp1160ndash1179 1991
[71] B Mustafa A Hajdari A Pieroni B Pulaj X Koro and C LQuave ldquoA cross-cultural comparison of folk plant uses amongAlbanians Bosniaks Gorani and Turks living in south KosovordquoJournal of Ethnobiology and Ethnomedicine vol 11 article 392015
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Submit your manuscripts athttpwwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom