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Background: Ficus sycomorus is one of the recommended antipsoriatic medicinal plants in the traditional Greco-Arab herbal medicine. However, the knowledge on its action mechanisms is limited. Aims: Cytotoxic, cytostatic, and anti-inflammatory effects of water/ethanolic extracts of Ficus sycomorus leaves and fruits were evaluated to test their role in the traditionally known antipsoriatic properties. Place and Duration of Study: All the experiments were done in the Department of Biology and Biotechnology, Arab American University-Palestine in 2020. Plants were collected from the Northern region of the West Bank/Palestine during the fall months in 2019 and given (Voucher code: Pharm-PCT-1030) at An-Najah National University. Methodology: MTT assay was used to evaluate cytostatic and cytotoxic effects of Ficus sycomorus extracts in human skin keratinocyte cell line (HaCaT), human monocytic cell line (THP-1)-derived macrophages, and their co-cultures. Commercial ELISA kits were applied to measure the cytokine levels. Results: Both extracts exhibited cytostatic effects with IC 50 of 656 μg/mL and 886 μg/mL for HaCat and co-culture, respectively. Leaves and fruits extracts significantly reduced dose-dependently the LPS-induced NO production by THP-1-derived macrophages from 65 μM to 19 μM and 16 μM, respectively. The fruit extracts showed higher effects than the leaf extracts and reduced the TNF-α levels from 709 pg/mL to 208 pg/mL. The fruit extracts increased the production levels of IL-10 from 74 pg/mL to 90 pg/mL. Conclusion: Ficus sycomorus extracts probably exert their antipsoriatic effects through cytostatic effects and modulation of the production levels of pro-inflammatory and anti-inflammatory cytokines.

Ever-growing research efforts are demonstrating the potential of medicinal plants and their phytochemicals to prevent and manage obesity, either individually or synergistically. Multiple combinations of phytochemicals can result in a synergistic activity that increases their beneficial effects at molecular, cellular, metabolic, and temporal levels, offering advantages over chemically synthesized drug-based treatments. Herbs and their derived compounds have the potential for controlling appetite, inhibiting pancreatic lipase activity, stimulating thermogenesis and lipid metabolism, increasing satiety, promoting lipolysis, regulating adipogenesis, and inducing apoptosis in adipocytes. Furthermore, targeting adipocyte life cycle using various dietary bioactives that affect different stages of adipocyte life cycle represents also an important target in the development of new antiobesity drugs. In this regard, different stages of adipocyte development that are targeted by antiobesity drugs can include preadipocytes, maturing preadipocytes, and mature adipocytes. Various herbal-derived active compounds, such as capsaicin, genistein, apigenin, luteolin, kaempferol, myricetin, quercetin, docosahexaenoic acid, quercetin, resveratrol, and ajoene, affect adipocytes during specific stages of development, resulting in either inhibition of adipogenesis or induction of apoptosis. Although numerous molecular targets that can be used for both treatment and prevention of obesity have been identified, targeted single cellular receptor or pathway has resulted in limited success. In this review, we discuss the state-of-the-art knowledge about antiobesity medicinal plants and their active compounds and their effects on several cellular, molecular, and metabolic pathways simultaneously with multiple phytochemicals through synergistic functioning which might be an appropriate approach to better management of obesity. In addition, epigenetic mechanisms (acetylation, methylation, miRNAs, ubiquitylation, phosphorylation, and chromatin packaging) of phytochemicals and their preventive and therapeutic perspective are explored in this review.

The present in vitro and randomized, double‐blind, placebo‐controlled trial aims to determine the efficacy and safety of nine Mediterranean antiacne medicinal plants. The antimicrobial, antisebum, and anti-inflammatory activities of the plant extracts were evaluated in cells from the immortalized human keratinocytes (HaCaT) and human monocytic cell line (THP-1) as well as in a double-blind, randomized, and placebo‐controlled trial. Most of the extracts showed no significant cytotoxic effects on HaCaT cells up to 250 μg/ml. Inula helenium (IH) and Saponaria officinalis (SO) inhibited sebum production at 90 μg/ml and 30 μg/ml, respectively. The inhibition effect of SO on the growth of Cutibacterium acnes was 1.2 times higher than that of chloramphenicol. IH and SO extracts significantly inhibited the lipopolysaccharide- (LPS-) induced IL-6 and TNF-α production in THP-1 cells reaching the control levels of untreated cells at a concentration of 250 μg/ml. SO, IH, and Solanum nigrum (SN) extracts inhibited the nitric oxide (NO) production in a dose-dependent manner. Based on these results, an antiacne herbal cream (AHC) was prepared from different portions of extracts from SO, IH, and SN, and its efficacy was evaluated in a double-blind, randomized, and controlled efficacy study with 41 acne patients, ages 18–24, who were asked to apply AHC (n = 27) or a placebo (n = 14) two to three times daily for six weeks. Results obtained indicate that the AHC has unique synergistic effects that halt sebum production, combined with highly antiseptic and anti-inflammatory activity, in which 54.95% (t = 19.37 P<0.001) of acne inflammatory and noninflammatory lesions disappeared after two weeks, 85.3%, after five weeks (t = 14.19 P<0.001), and 91.4%, at the end of the sixth week of application (t = 5.7 P<0.001). In conclusion, SO, IH, and SN as single extracts and in combination as AHC showed significant antimicrobial, antisebum, and anti-inflammatory activities in vitro and in a double-blind, randomized, and controlled antiacne efficacy. Therefore, AHC represents an interesting alternative treatment for acne.

Over the last four decades, the escalation in diabetes and obesity rates has become epidemic all over the world. Diabesity describes the strong link between T2D and obesity. It correlates deeper with the elevated risks of developing cardiovascular disease hypertension, stroke, and several malignancies. Therapeutic usage of medicinal plants and natural products in the treatment of diabetes and obesity has long been known to physicians of Greco-Arab and Islamic medicine. Improved versions of their abundant medicinal plant-based formulations are at present some of the most popular herbal treatments used. Preclinical and clinical data about medicinal plants along with their bioactive constituents are now available, justifying the traditionally known therapeutic uses of products derived from them for the prevention and cure of obesity-related T2D and other health problems. The aim of this review is to systematize published scientific data dealing with the efficiency of active ingredients or extracts from Middle Eastern medicinal plants and diet in the management of diabesity and its complications. Google Scholar, MEDLINE, and PubMed were searched for publications describing the medicinal plants and diet used in the management of T2D, obesity, and their complications. The used keywords were “medicinal plants” or “herbals” in combination with “obesity,” “diabetes,” “diabetes,” or nephropathy. More than 130 medicinal plants were identified to target diabesity and its complications. The antidiabetic and anti-obesity effects and action mechanisms of these plants are discussed here. These include the regulation of appetite, thermogenesis, lipid absorption, and lipolysis; pancreatic lipase activity and adipogenesis; glucose absorption in the intestine, insulin secretion, glucose transporters, gluconeogenesis, and epigenetic mechanisms.

The aim of this in vitro study is to characterize the phenolic compounds of twelve honey samples collected from different locations in Palestine (H1-6) and Morocco (H7-12) and to evaluate their cytotoxic and cytostatic effects in cells from the human colorectal carcinoma cell line HCT-116 and breast cancer cell line MCF-7. Quantitative HPLC analysis revealed nine phenolic compounds in three Moroccan honey samples, namely, syringic acid, tannic acid, caffeic acid, ferulic acid, coumaric acid, gallic acid, rosmarinic acid, epicatechin, and pyrogallol. Syringic acid, abundant in numerous types of honey with strong antioxidant capacities, was present at values ranging between 0.10 mg/100 g and 1.24 mg/100 g of Daghmos (H11) and Kabbar (H10) samples, respectively. No significant reductions in cell viability were observed in both cell lines treated with the Palestinian samples as measured with MTT assay. Significant cytostatic effects were after treatment of HCT cells with Morar honey H1 with IC50 of 1789 μg/ml. Three Moroccan samples, H7 (Zaâtar), H9 (Bochnikha), and H10 (Kabbar), showed slight, but significant cytostatic effects in HCT cells. A strong correlation was observed between cytostatic activity of MCF cells and antioxidant content (phenols, flavonoids, and flavonol). Furthermore, a strong negative correlation was detected between the cytostatic activity in HCT cells and the contents of syringic acid (r= -0.756) and tannic acid (r= -0.610). These results indicate that the traditionally known anticancer effects of honey might be mediated in part through cytostatic effects.

Recent advances in genomics, proteomics, cell biology and biochemistry of tumors have revealed new pathways that are aberrantly activated in numerous cancer types. However, the enormous amount of data available in this field may mislead scientists in focused research. As cancer cell growth and progression is often dependent upon the phosphoinositide 3-kinase (PI3K)/AKT pathway, there has been extensive research into the proteins implicated in the PI3K pathway. Using data available in the Human Protein Atlas database, the current study investigated the expression of 25 key proteins that are known to be involved with PI3K pathway activation in a distinct group of 20 cancer types. These proteins are AKTIP, ARP1, BAD, GSK3A, GSK3B, MERTK-1, PIK3CA, PRR5, PSTPIP2, PTEN, FOX1, RHEB, RPS6KB1, TSC1, TP53, BCL2, CCND1, WFIKKN2, CREBBP, caspase-9, PTK2, EGFR, FAS, CDKN1A and XIAP. The analysis revealed pronounced expression of specific proteins in distinct cancer tissues, which may have the potential to serve as targets for treatments and provide insights into the molecular basis of cancer.

Diabetes is a predominant metabolic disease nowadays due to the off-beam lifestyle of diet and reduced physical activity. Complications of the illness include the gene-environment interactions and the downstream genetic and epigenetic consequences, e.g., cardiovascular diseases, tumor progression, retinopathy, nephropathy, neuropathy, polydipsia, polyphagia, polyuria, and weight loss. This review sheds the light on the mechanistic insights of antidiabetic medicinal plants in targeting key organs and tissues involved in regulating blood glucose homeostasis including the pancreas, liver, muscles, adipose tissues, and glucose absorption in the intestine. Diabetes is also involved in modulating major epigenetic pathways such as DNA methylation and histone modification. In this respect, we will discuss the phytochemicals as current and future epigenetic drugs in the treatment of diabetes. In addition, several proteins are common targets for the treatment of diabetes. Some phytochemicals are expected to directly interact with these targets. We lastly uncover modeling studies that predict such plausible interactions. In conclusion, this review article presents the mechanistic insight of phytochemicals in the treatment of diabetes by combining both the cellular systems biology and molecular modeling.

Propolis is a resin that honeybees produce by mixing saliva and beeswax with exudate gathered from botanical sources. The presentin vitrostudy investigated the potential use of propolis as a multitarget therapeutic product and the physicochemical properties, chemical composition, and immunomodulatory, antioxidant, antibacterial, and anticancer properties of a propolis extract from the northern Morocco region (PNM). Pinocembrin, chrysin, and quercetin were the main phenolic compounds of PNM as measured in HPLC. The PNM showed significant inhibitory effects against all tested Gram-positive and Gram-negative strains and showed high antioxidant activities by scavenging free radicals with IC50 (DPPH = 0.02, ABTS = 0.04, and FRAP = 0.04 mg/ml). In addition, PNM induced a dose-dependent cytostatic effect in MCF-7, HCT, and THP-1 cell lines at noncytotoxic concentrations with IC50 values of 479.22, 108.88, and 50.54 μg/ml, respectively. The production of tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) was decreased in a dose-dependent manner in LPS-stimulated human peripheral blood mononuclear cells (PBMNCs), whereas the production of the anti-inflammatory interleukin-10 (IL-10) was increased in a dose-dependent manner reaching 15-fold compared to the levels measured in untreated PBMNCs. Overall, the results showed that the traditionally known multitarget therapeutic properties of the PNM seem to be mediated, at least in part, through cytostatic, antibacterial, and immunomodulatory effects.

BACKGROUND The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects. METHODS Oncology HCPs from 16 Middle Eastern countries received a 17-item questionnaire asking them to list 5 herbal products in use by their patients with cancer. A literature search (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database) was conducted to identify safety-related concerns associated with the products listed. RESULTS A total of 339 HCPs completed the study questionnaire (response rate of 80.3%), identifying 44 herbal and 3 nonherbal nutritional supplements. Safety-related concerns were associated with 29 products, including herb-drug interactions with altered pharmacodynamics (15 herbs), direct toxic effects (18 herbs), and increased in vitro response of cancer cells to chemotherapy (7 herbs). CONCLUSIONS Herbal medicine use, which is prevalent in Middle Eastern countries, has several potentially negative effects that include direct toxic effects, negative interactions with anticancer drugs, and increased chemosensitivity of cancer cells, requiring a reduction in dosedensity. Oncology HCPs working in countries in which herbal medicine use is prevalent need to better understand the implications of this practice. The presence of integrative physicians with training in complementary and traditional medicine can help patients and their HCPs reach an informed decision regarding the safety and effective use of these products. Cancer 2016;122:598–610. © 2015 American Cancer Society.

In the presentin vitrostudy, we tested the chemical composition, cytotoxicity and antidiabetic activity of two distinct extracts of wild Artichoke-like vegetable,Gundelia tournefortii: methanol and hexane. GC/MS phytochemical analysis ofG. tournefortiimethanol and hexane extracts revealed 39 compounds reported here for the first time inG. tournefortiiout of the 45 detected compounds. Only Stigmasterol was present in both extracts. The efficacy ofG. tournefortiiextracts in enhancing glucose transporter 4 (GLUT4) translocation to the plasma membrane (PM) was tested in L6 muscle cells stably expressing myc-tagged GLUT4 (L6-GLUT4myc) using cell-ELISA test. Results obtained here indicate that methanol and hexane extracts were safe up to 250 μg/ml as measured with MTT and the LDH leakage assays. The methanol extract was the most efficient in GLUT4 translocation enhancement. It increased GLUT4 translocation at 63 μg/ml 1.5- and 2-fold relative to the control in the absence and presence of insulin, respectively. These findings indicate thatG. tournefortiipossesses antidiabetic activity in part by enhancing GLUT4 translocation to the PM in skeletal muscle.

Üzüm tespiti, hasat, ilaçlama ve verim tahmini çiftçiler için zor faaliyetlerdir. Bu işlem zaman alıcıdır ve işgücüne ihtiyaç duymaktadır (bir maliyet artışı) ve üstelik her zaman yeterince başarılı değildir. Bu nedenle, günümüzde akıllı robotlar yardımı ile hasat araştırılmaktadır ve şu anda tarımda kullanımı artmaktadır. Bu çalışmada verim tahmininde kullanmak maksadıyla üzüm meyveleri ve üzüm salkımlarının otomatik olarak tanınabilmesi için bir algoritma önerilmektedir, Tanıma işlemi farklı boyut ve renklerde, doğal ışık ve farklı görüntü kontrastları dahil olmak üzere farklı aydınlatma koşullarında çekilmiş, üzüm meyvelerinin yüksek çözünürlüklü görüntülerinde yapılmaktadır.. Bu tezde, makine öğrenme yöntemlerinden Evrişimsel Sinir Ağı (ESA), Yapay Sinir Ağı (YSA) ve Destek-Vektör-Makine- (DVM) kullanılarak bir üzüm salkımı ve meyvesinin tanınması üzerine bir çalışma sunulmuştur. Yerel İkili Örüntü (YİÖ), Yönlendirilmiş Gradyentlerin Histogramı (YGH) ve her iki özelliğin birleşimi özellik vektörleri olarak kullanılmıştır. Ücretsiz olarak kullanıma açık İzlanda veri seti, tek bir üzüm tanesinin algılama ve sınıflandırma eğitimi için uygulanmıştır. Veriler (üzüm tanesi ve üzüm tanesi olmayan iki sınıf içerir. Üzüm tanesi tanıma işleminde YGH + YİÖ kombinasyonu özellikleri kullanan YSA sınıflandırıcısının ortalama doğruluk, hassasiyet ve duyarlılık ölçütleri sırasıyla % 99,64 ± 0.073, % 99.70 ± 0,094 ve% 99,59 ± 0,117'dir ve elde edilen en başarılı sonuçlardır. Üzüm ağacı görüntülerinde üzüm salkımı ve meyve saptama için önerilen yöntem, Hızlı Radyal Simetri Dönüşümü üzün tanesi merkezini (ilgi noktası) bulmak için kullanır. Önce özellik çıkarımı ve sınıflandırma, her bir ilgi noktasında çok ölçekli bir yaklaşımla hesaplanmaktadır. Daha sonra, DBSCAN (yoğunluk tabanlı tarama) metodu üzüm demetlerini kümeler. Her kümenin uzamsal dağılımı ve gelişmiş bir demet algılaması için uzaklık dönüşümünden faydalanılır. Üzüm salkım tespitinin ortalama doğruluğu % 91,72 ± 2,88 ve meyve saptama için% 89,82 ± 2,58 olarak bulunmuştur. Üzüm salkımının başarı ölçütü piksellerinin üzüm yada üzüm değil olarak elle işaretlenmesiyle hesaplanmıştır. Yöntem farklı aydınlatma ve resim okuma koşuları olan dört farklı renkte üzüm üzerinde test edilmiştir. Ortalama üzüm salkımı belirleme doğruluğu, duyarlılık ve özgüllük ortalamaları sırasıyla % 96,97 ± 0,95, % 97.57 ± 0.969 ve% 89,28 ± 3,83 dır.Anahtar Kelimeler: Üzüm Tespiti, Üzüm Salkımı Tespiti, YGH, YİÖ, DBSCAN, DVM, YSA ve ESA. Grape detection, harvesting, spraying, and yield estimation are difficult activities for farmers. They take time and many workers (cost) and, moreover, are not always accurate. Therefore, harvesting with the aid of smart robots is now being explored and is currently a frontline problem in agriculture. The experiment presents an algorithm for the automatic visible recognition of grape berries and grape bunches so that they can be counted for yield estimation. Recognition is based on high-resolution images of grape berries of different sizes and colors and taken under different illumination conditions, including natural light, and different image contrasts.In this thesis, presented a grape bunch and berry recognition by employing machine learning methods; Convolution Neural Network (CNN), Artificial Neural Network (ANN) and Support-Vector-Machine-(SVM). Histogram of Oriented Gradients (HOG), The Local Binary Pattern-(LBP), and combination of both attributes have been used as feature vectors. The approach has been implemented in the freely available Iceland dataset for single berry detection and classifier train. The data contain two classes (berry and non-berry). ANN classifier with HOG+LBP (combination) features show better results in single berry recognition with an average of accuracy, precision and recall are 99.64±0.073 %, 99.70±0.094%, and 99.59±0.117% respectively. Besides on the time of detection. The proposed method for grape bunch and berry detection in field images uses a Fast Radial Symmetry Transform (FRST) as interest point detector. In the next, feature extraction and classification are computed in each interest point with a multi-scale approach. Afterwards, a DBSCAN method defines the number of grape bunches. Each cluster's spatial distribution and needs to close bunch separation for an improved bunch detection. The average accuracy of grape bunch detection 91.72±2.88% and 89.82±2.58% for berry detection. Grape bunch detection and a comparison of berry and non-berry pixels were studied, using ground-truth the labels are made manually. Four different colors of grape images, with a diversity of illuminations and acquisition protocol, were tested, with an average of the correct rate, sensitivity, and specificity are 96.97±0.95%, 97.57±0.969%, and 89.28±3.83% respectively in pixels of berry classification. Results show good performance with no need for special illumination, not require color feature used which allows recognition for white and red grapes as well as the bunch detection scheme working in varying scenarios.Keywords: Grape detection, grape bunch detection, HOG, LBP, DBSCAN, SVM, ANN and CNN 98

In this multinational Middle-Eastern study, we assessed health-care providers' (HCPs) perspectives on their patients' use of complementary and traditional medicine (CTM) and identified the leading barriers to CTM integration in supportive cancer care.A 17-item questionnaire was developed and administered to HCPs attending palliative medicine workshops conducted across the Middle East by the Middle East Cancer Consortium.339 HCPs from 16 countries across the Middle East completed the questionnaire (80.3 % response rate). Respondents perceived their patients' reasons for CTM use primarily in the context of cancer cure (63 %) and quality of life (QOL) improvement (57 %). Expectation regarding CTM's role in cancer cure/survival was more pronounced in Turkey, Jordan, the Palestinian Authority, and the Persian Gulf area. In contrast, the expectation that CTM would improve QOL was more emphasized in Israel. A mid-position between the cure/survival and QOL poles was observed in Cyprus, Lebanon, and the North African countries. Leading barriers to CTM integration in supportive cancer care included oncologists' skepticism and a gap between patients' expectations and HCP's objectives. Respondents' leading recommendation to HCPs was to communicate integrative care emphasizing well-being and improved functioning in accordance with their patients' health beliefs.CTM integration in supportive cancer care can be facilitated by implementing a platform for Middle Eastern clinical collaborations. HCPs' expectations and experiences with CTM have been positive in the oncology setting. These data need to be corroborated with information of patients' expectations on the provision of CTM over all phases of the oncology treatment.

Aim: Based on knowledge from traditional Greco-Arab herbal medicine, this in vitro study aims to evaluate the cytotoxicity and the anti-inflammatory mechanism of Peganum harmala (P. harmala ) seeds by measuring the expression and release of both anti-inflammatory (IL-10) and proinflammatory (IL-1, IL-2, IL-6 and TNF-α) cytokines in human THP-1-derived macrophages. Methodology: Cells were treated with 1 μg lipopolyssacharide/ml (LPS) in the absence and presence of increasing concentrations of extracts from the P. harmala seeds (PHS-extract). During the entire experimental period, we used extract concentrations (up to 250 μg/ml) that had no cytotoxic effects as measured with MTT and LDH assays. The anti-inflammatory effects were assessed by measuring the levels of secretory proteins and mRNA of IL-1, IL-2, IL-6, IL-10 and TNF-α in LPS-activated (1 μg/ml) human THP-1-derived macrophages.

The recent wave of migration from Middle Eastern countries to Europe presents significant challenges to the European health profession. These include the inevitable communication gap created by differences in health care beliefs between European oncologists, health care practitioners, and refugee patients. This article presents the conclusions of a workshop attended by a group of clinicians and researchers affiliated with the Middle East Cancer Consortium, as well as four European-based health-related organizations. Workshop participants included leading clinicians and medical educators from the field of integrative medicine and supportive cancer care from Italy, Germany, Turkey, Israel, Palestine, Iran, Lebanon, Jordan, Egypt, and Sudan. The workshop illustrated the need for creating a dialogue between European health care professionals and the refugee population in order to overcome the communication barriers to create healing process. The affinity for complementary and traditional medicine (CTM) among many refugee populations was also addressed, directing participants to the mediating role that integrative medicine serves between CTM and conventional medicine health belief models. This is especially relevant to the use of herbal medicine among oncology patients, for whom an open and nonjudgmental (yet evidence-based) dialogue is of utmost importance. The workshop concluded with a recommendation for the creation of a comprehensive health care model, to include bio-psycho-social and cultural-spiritual elements, addressing both acute and chronic medical conditions. These models need to be codesigned by European and Middle Eastern clinicians and researchers, internalizing a culturally sensitive approach and ethical commitment to the refugee population, as well as indigenous groups originating from Middle Eastern and north African countries. Implications for Practice European oncologists face a communication gap with refugee patients who have recently immigrated from Middle Eastern and northern African countries, with their different health belief models and affinity for traditional and herbal medicine. A culturally sensitive approach to care will foster doctor-refugee communication, through the integration of evidence-based medicine within a nonjudgmental, bio-psycho-social-cultural-spiritual agenda, addressing patients' expectation within a supportive and palliative care context. Integrative physicians, who are conventional doctors trained in traditional/complementary medicine, can mediate between conventional and traditional/herbal paradigms of care, facilitating doctor-patient communication through education and by providing clinical consultations within conventional oncology centers.

Traditional Greco-Arab and Islamic medicine continues to be practiced within the Mediterranean as well as most Islamic countries. This medicine was developed during the Golden Age of Arab-Islamic civilization, which spanned from the seventh to fifteenth century and extended from Spain to Central Asia and India. During the Islamic Golden Age, there was a huge enlightenment in the Arab-Islamic world at a time when Europe was in the grip of the Dark Ages, stifled by Church authority. Greco-Arab and Islamic medicine has influenced the fates and fortunes of countless human beings. It also influenced Europe where it formed the roots from which modern Western medicine arose. There is no doubt that the earlier Greco-Roman scholarly medical literature was the stem from which much Arab-Islamic medicine grew, just as, several centuries later, ArabIslamic medicine was to be the core of late middle ages and early European medical education. As will be seen in this review, however, Arab-Islamic medicine was not simply a continuation for Greek ideas but it was a venue for innovation and change. Medical innovations introduced by Arab and Muslim physicians included: The discovering of the immune system, the introduction of microbiological science, and the separation of pharmacological science from medicine. The high degree of development achieved in Greco-Arab and Islamic medicine is observable in a statement of Rhazes who said: "when the disease is stronger than the natural resistance of the patient, medicine is of no use. When the patient’s resistance is stronger than the disease, the physician is of no use. When the disease and the patient’s resistance are equally balanced, the physician is needed to help tilt the balance in the patients favour”. This article provides a Review Article European Journal of Medicinal Plants, 4(3): 249-258, 2014 250 comprehensive overview on traditional Greco-Arab-Islamic herbal medicine including the historical background, medical innovations introduced by Arab physicians, methods of therapies, and a state of the art description of traditional Arab herbal medicine.

Diabetes has been recognized by ancient physicians and its main symptoms were known by the increased thirst, frequent urination, and tiredness. Medicinal plants were commonly used for treating these combined symptoms. In addition to several instructions for specific food consumption, a mild exercise was recommended. Currently, traditional medicine continues to be practiced in most Middle East, Asia, as well as developed countries. The current form of herbal medicine has historical roots in medieval Greco-Arab, ancient Egyptians, Chinese, and other ancient medicines. More than 800 plant species are reported as antidiabetic. Over 400 plants as well as 700 recipes and compounds have been scientifically evaluated for type 2 diabetes treatment. For instance, metformin, the most popular antidiabetic drug nowadays, was developed based on a biguanide compound isolated from French lilac. Medicinal herbs contain various bioactive compounds and thus can display multiple actions on insulin production as well as distinct insulin action mechanisms: insulin sensitizing, insulin mimicking, and inhibition of intestinal carbohydrate digestion and absorption. Herbal-derived insulin sensitizers act in a synergetic mechanism to increase glucose disposal and uptake by muscle, hepatic cells, and fat as well as those that control hepatic glycogen metabolism. This chapter provides a comprehensive overview on traditional herbal medicine including the historical background, medical innovations introduced by physicians and researchers, methods of therapies, and a state-of-the-art description of traditional herbal medicine.

Obesity is a global health problem affecting all age groups, leading to many complications such as type 2 diabetes, systemic hypertension, cardiovascular diseases, dyslipidemia, atherosclerosis, and stroke. Physiologically, obesity which arises from metabolic changes at tissue and organ levels results in an imbalance between energy intake and energy expenditure, which in turn results in increased fat accumulation in adipose tissue. Adipose tissue is an important endocrine organ, which secretes several hormones, including leptin and adiponectin and chemokines. These factors can regulate tumor behavior, inflammation, and the tumor microenvironment. Excessive adipose expansion during obesity causes adipose dysfunction and inflammation to increase systemic levels of pro-inflammatory factors. Cells from adipose tissue, such as cancer-associated adipocytes and adipose-derived stem cells, enter the cancer microenvironment to enhance pro-tumor effects. Dysregulated metabolism that stems from obesity including insulin resistance, hyperglycemia, and dyslipidemia can further affect tumor growth and development. Two different obesity treatment drugs are currently on the market: orlistat, which reduces intestinal fat absorption via inhibiting pancreatic lipase, and sibutramine, an anorectic or appetite suppressant. Both drugs have side effects, including increased blood pressure, dry mouth, constipation, headache, and insomnia. For this reason, a wide variety of natural materials has been explored for their obesity treatment potential. The present chapter focuses on the safety and efficacy of commonly used herbal medicines in the management of obesity through covering their beneficial effects and mechanism of action.

Diabetes and obesity have reached epidemic proportions globally, and they are a major contributor to the development of many pathological processes including hypertension, hyperlipidemia, cardiovascular diseases, and certain types of cancer. Increased consumption of more energy-dense, nutrient-poor diets with high levels of carbohydrates and saturated fats, combined with reduced physical activity, has led to currently observed high rates of diabetes and obesity. A strong relationship exists between diabetes and obesity, with fat tissue playing an important role in diabetes, a disease characterized by hyperglycemia, insulin hyposecretion, and insulin resistance. The resistance manifests primarily as impaired ability of the muscle tissue to take up glucose and of the liver to curb glucose output in response to insulin. Eventually, pancreatic beta cell insufficiency leads to overt diabetes.

The utilization of herb-based products to prevent/treat diseases is a therapeutic modality that has stood the test of long history of use and has played important roles in the development of conventional medicine. Indeed, many of the currently utilized pharmacological classes of drugs include a phytochemical prototype. Aspirin, atropine, codeine, ephedrine, digoxin, L-dopa, morphine, quinine, reserpine, taxol, and tubocurarine are a few examples of drugs, which were originally discovered through the study of medicinal plants and traditional knowledge of indigenous people. Black seeds, garlic, ginseng, ginger, ginkgo, olive oil, pomegranate, milk thistle, and St. John’s wort are a few examples of medicinal plants, which are gaining popularity among modern physicians and researcher, and this trend is likely to continue partly due to high cost involved in the development of patentable synthetic drugs. There is growing evidence to show that pharmacological effects of medicinal plants are potentiated through synergistic mechanisms and/or side effect-neutralizing combinations.

Diabetes is one of the prominent metabolic disorders nowadays. It is associated with many complications, including polyuria, weight loss, polydipsia, polyphagia, blurred vision, retinopathy, neuropathy, and nephropathy. Ongoing research has advanced on the mechanisms accompanying the prevention and treatment of diabetes, and the vast majority of research papers in the field of drug design and pharmacokinetics concentrate on the mechanisms through which the homeostasis of serum glucose is achieved. Several organs are fundamental in the process of regulating blood glucose levels, namely, the pancreas, liver, muscles, and adipose tissues. On the one hand, pancreatic β-islets are responsible for insulin production. As such, some drugs are focused to augment the islet size, cell size and number, or insulin secretion levels. On the other hand, the liver is the most crucial organ to sense fluctuations in blood glucose concentration and respond via buffering mechanisms accordingly. Furthermore, muscle and adipose tissues play concomitant roles to withdraw extra glucose from the bloodstream. Several key enzymes (e.g., phosphofructokinase, phosphorylase, glucose-6-phosphatase, etc.), transporters (GLUT2, GLUT4, etc.), as well as cell surface receptors (IRS, TM7, and others) in the hepatic, muscular, and adipose tissues are major targets for antidiabetic drugs. Global control of blood glucose levels can be via insulin-dependent protein kinase B (PKB) or insulin-independent AMP-activated protein kinase (AMPK) signaling cascades. Additionally, several drugs target to soothe the cell damage associated with hyperglycemia. In this respect, antioxidants have invaluable effects that should not be ignored. Moreover, the simple routes for glycemic control are via the inhibition of glucose digestion and absorption. In this chapter, strategies to treat diabetes are discussed, with an emphasis on the phytochemical drugs used in the Middle East and their mechanisms of action.

Recent researches demonstrated the potential of phytochemicals to prevent and to counteract obesity. Multiple combinations of phytochemicals can result in a synergistic activity that increases their bioavailability and action on multiple molecular targets, offering advantages over chemical treatments. Herbal-derived compounds have potential for controlling appetite, inhibiting pancreatic lipase activity, stimulating thermogenesis and lipid metabolism, promoting lipolysis and adipogenesis, and inducing apoptosis in adipocytes. Appetite reduction and inhibiting pancreatic lipase activity represent the first line in the regulation of body weight. Stimulating lipolysis and thermogenesis represents an essential target for the development of anti-obesity drugs. Furthermore, targeting adipocyte life cycle using various dietary bioactives that affects different stages of adipocyte life cycle represents also an important target for the development of new anti-obesity drugs. In this regard, different stages of adipocyte development that are targeted by anti-obesity drugs can include preadipocytes, maturing preadipocytes, and mature adipocytes. Various herbal-derived active compounds, such as genistein, daidzein, cyanidin, proanthocyanidin, xanthohumol, apigenin and luteolin, kaempferol, myricetin, quercetin, epigallocatechin gallate, conjugated linoleic acid, docosahexaenoic acid, quercetin, resveratrol, and ajoene, affect adipocytes during specific stages of development, resulting in either the induction of apoptosis or inhibition of adipogenesis. Although numerous molecular targets that can be used for both treatment and prevention of obesity have been identified, targeted single cellular receptor or pathway has resulted in limited success. Therefore, targeting several cellular pathways simultaneously with multiple phytochemicals to achieve synergistic effects might be an appropriate approach in the management of obesity.

Because of their natural origin and reduced side effects, we are watching worldwide an extensive growth and increased popularity in the field of herbal mixtures. In contrast to synthetic pharmaceuticals based upon single compounds, many medicinal plants exert their beneficial pharmacological effects through synergistic or additive mechanisms of multiple active compounds acting at single or multiple cellular/tissue target sites associated with a physiological/pathological process. These additive or synergistic pharmacological effects are known to reduce or to eliminate side effects associated with the use of synthetic drugs. Synergistic effect of phytochemicals likely has its origin in their functional role in promoting plant survival. For instance, a mixture of active principles having additive or synergistic effects at multiple target sites would not only ensure effectiveness against a wide range of herbivores or phytopathogens but also decrease the chances of these organisms developing resistance or adaptive responses.

The incidence of cancer is increasing in the developed countries and even more so in developing countries parallel to the increase in life expectancy. In recent years, clinicians and researchers advocate the need to include supportive and palliative care since the establishment of the diagnosis and throughout the duration of treatment, with the goal of improving patients' quality of life. This patient-centered approach in supportive care is also shared by various traditional and complementary medicine approaches. Traditional Arab-Islamic medicine offers a variety of therapeutic modalities that include herbal, nutritional, and spiritual approaches. Physicians and scholars, such as Avicenna (980–1037), Rhazes (965–915), Al Zahrawi (936–1013), and Ibn al Nafis (1218–1288) referred to cancer etiology in various medicinal texts and suggested both preventive and therapeutic remedies to alleviate suffering. This review presents research data related to the anticancer activities of herbs used in Arab-Islamic medicine and allude to their potential role in improving the quality of life of cancer patients.

Islamic medicine, Arabic medicine, Arab-Islamic medicine, or Greco-Arab and Islamic medicine refers to medicine developed in the Golden Age of the Arab-Islamic civilization, which extended from Spain in the west to Central Asia and India in the east. In temporal terms it covered a period of roughly nine centuries, from the middle of the seventh to the end of the fifteenth century. Medicine was a central part of this medieval civilization. Famous Arab and Muslim physicians, e.g., Rhazes, Avicenna, Al Zahrawi, Ibn al Nafis studied and developed treatments regimes for cancer as well as most known diseases at that time. They described most types of cancers which were known at that time and suggested several therapies. This review is an eye-bird view on the ancient Arab-Greco and Islamic cancer diagnosis, herbal treatment and nowadays herbal treatment research.