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The clinical evaluation of herbal anti-round worm medicine: Kemol

February 2011
Journal of Medicinal Plants Research 5(3):467-469

February 2011
5(3):467-469

Authors:

Muhamamd Ibrahim Khan

University of Management and Technology (Pakistan)

Maheer Akram

Glasgow Caledonian University

Akhtar Naveed

The Islamia University of Bahawalpur

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Objective: To evaluate the efficacy and side effects of herbal medicine "Kemol tablet" for the treatment of round worm infestation. Study design: Open randomized descriptive study was employed. Methodology: Kemol was prescribed to 50 patients registered at Shifa Ul Mulk Memorial Hospital and belong to villages around Hamdard University and urban population of Gadap Town area. The ages of patients were 5 to 16 years. The response of the treatment on symptomatology of round worm infestation such as abdominal pain, bloating, blood in stool, itching around the anus, fatigue and palpitation, bed wetting, nausea and vomiting, weight loss were analyzed. Result. Significant improvement in different parameters like abdominal pain, abdominal bloating, blood in stool, bed wetting, nausea and vomiting, weight loss, itching around anus, fatigue, malaise, insomnia and rashes was observed. Conclusion: Kemol tablet is an economical, safe and effective anti-round worm remedy.

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Jan. Med. Plant. Res. Ibrahim et al 467

Journal of Medicinal Plants Research Vol. 5(3), pp. 467–469, 4 February, 2011

Available online at http://www.academicjournals.org/JMPR

Short Communication

The clinical evaluation of herbal anti-round worm medicine:

Kemol

M. Ibrahim Khan

, Khan Usmanghani

, M. Akram

Naveed Akhtar

, Qaiser

Jabeen

, Irshad Ahmed

, Pervaiz Akhtar Shah

, H. M. Asif

, Khalil Ahmed

and S.

M. Ali Shah

Shifa Ul Mulk Memorial Hospital, Hamdard University, Karachi, Pakistan.

Faculty of Pharmacy and Alternative Medicine, Islamia University of Bahawalpur,

Pakistan.

University College of Pharmacy, Punjab University Lahore, Pakistan.

*Corresponding author. E-mail: makram_0451@hotmail.com. Tel: 92-021-6440083.

Fax: 92-021-6440079.

Accepted 17 January, 2011

Abstract

Objective: To evaluate the efficacy and side effects of herbal medicine "Kemol tablet"

for the treatment of round worm infestation. Study design: Open randomized descriptive

study was employed. Methodology: Kemol was prescribed to 50 patients registered at

Shifa Ul Mulk Memorial Hospital and belong to villages around Hamdard University and

urban population of Gadap Town area. The ages of patients were 5 to 16 years. The

response of the treatment on symptomatology of round worm infestation such as

abdominal pain, bloating, blood in stool, itching around the anus, fatigue and palpitation,

bed wetting, nausea and vomiting, weight loss were analyzed. Result. Significant

improvement in different parameters like abdominal pain, abdominal bloating, blood in

stool, bed wetting, nausea and vomiting, weight loss, itching around anus, fatigue,

malaise, insomnia and rashes was observed. Conclusion: Kemol tablet is an economical,

safe and effective anti-round worm remedy.

Key words: Round worm, Kemol, efficacy

Introduction

Roundworm infections are diseases of

the digestive tract and found more

common in warm climate (Graham et al.,

2007). The eggs of roundworm usually

enter the body through contaminated

water. Symptoms of roundworm

infection include fatigue, weight loss,

irritability, poor appetite, abdominal

pain, diarrhea and vomiting (Williams et

al., 2002). The round worm infestation

can be treated with mebendazole or

pyrantel pamoat (Moreels et al., 2006).

Jan. Med. Plant. Res. Ibrahim et al 468

Piperazine toxicity manifest itself as

ataxia, hypotonia, vomiting, severe

diarrhea, drowsiness (Magen et al.,

2005; Massara et al., 2004). There fore,

herbal medicine to treat roundworms

could be an alternate choice. But the

efficacy and safety of herbal medicine is

very much required in order to treat

roundworms(Bradley et al., 2004;

Bethony et al., 2006). Kemol tablet is a

combination of four plants drugs named

as; Embelia ribes Burm, Mallotus

philippinensis Muell, Butea monosperma

Lam and Mentha avernensis Linn.

Patients were administered kemol two

tablets twice daily for one week at Shifa

ul Mulk Memorial Hospital.

Study design

This examination based study was

conducted at Shifa-ul-Mulk Memorial

Hospital for Eastern Medicine on the

patient living in the rural areas of 70

villages surrounding Madinat-ul-Hikmah

Hamdard University, Karachi and urban

population of Gadap Town.

The study has been conducted according

to the principles of good clinical practice

i.e., a written informed consent was

obtained from the patients before

enrollment and proper history and

clinical examination were recorded at

base line and on each follow up. The

study was carried out from 2007 to 2009.

Patients 50 in number were treated with

Kemol for one week based on inclusion

and exclusion criteria.

Patients and dosage form design

The study was carried out on the patients

of ages between 5 –16 years. The trial

was conducted on 50 patients

irrespective of socio economic status at

outpatient department in Shifaul-Mulk-

Memorial Hospital. The patients

received Kemol Tab that is a herbal

coded formulation of compound drugs

with drugs design calculated according

to herbal pharmacopoeia Monographs of

Unani medicine, Hamdard

Pharmacopoeia and Tibbi

Pharmacopoeia (Chopra et al.,1956; Said

1969). Each 500mg Kemol tablet

contains Embelia ribes Burm. 125mg,

Mallotus philippinensis Muell. 125mg,

Butea monosperma Lam.125mg, Mentha

arvensis Linn., 125mg. The patients

suffering from diabetes, hypertension,

renal impairment and other

musculoskeletal disorders were excluded

from this study. As such it was

monitored that patients were not

suffering from any other serious disease

or ailment.

Setting

The clinical evaluation of Kemol was

conducted after the diagnoses of round

worms on clinical and biochemical

evaluation at Shifa-ul-Mulk Memorial

Hospital, for Eastern Medicine,

Hamdard University. The patients were

registered from the general O.P.D. and

hospitalized to the clinical Research

ward of the Hospital. All the patients

selected for the study, were thoroughly

examined and clinical history was

recorded.

Sample selection

The sample was selected from the out

patient enrolled in Shifa ul Mulk

Memorial Hospital and on the basis of

preliminary clinical examination the

patients who were suffering from round

worms were referred to the project

physician and upon the basis of inclusion

and exclusion criteria the patient marked

as candidates were selected. The study

period include 2 years time from 2007 to

2009. Among this population all the

patient suffering from round worms

were interviewed immediately and upon

their consent to participate they were

grouped as case group.

Jan. Med. Plant. Res. Ibrahim et al 469

Result and Discussion

Kemol exhibit the anti-round worm

effects. Anti-round worm treatment

shows that Unani therapy is safer and

proficient in its activity. After analysis

Coded formulation Kemol was

remarkably effective for the associated

round worm symptoms. In the statistical

analysis of all the variables it was

conclusively proved that Kemol has

furnished overall good efficacy, more

suitable and superior for the prevention

and treatment of round worm. The

different sign and symptoms as given in

table 1 show over all efficacy of

improvement of the treatment. The

clinical data generated, clearly proved

that Kemol is the herbal drug of choice

for round worm.

Table 1: Improvement by use of Kemol

Level of

Improvement

Complete

Improvement

Slight

Improvement

Abdominal pain 83.33% 16.67% 0%

Abdominal bloating 85.71% 14.29% 0%

Blood in stool 88.89% 11.11% 0%

Bed wetting 83.33% 16.67% 0%

Nausea and vomiting

91.67% 8.33% 0%

Weight loss 84.62% 15.38% 0%

Itching around anus 90% 10% 0%

Fatigue and

palpitation 75% 25% 0%

Malaise 92% 8% 0%

Insomnia 90% 10% 0%

Rashes 80% 20% 0%

Conclusion

Kemol is effective for the treatment of

roundworm infection. It did not display

or show any untoward manifestation and

found acceptability by all treated

patients.

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Butea monosperma Lam.: A review

Article

Sep 2011
J MED PLANTS RES

Butea monosperma Lam. is a medicinal plant that has been used since ancient times for various ailments. In Unani system of medicine, this plant is used as antibacterial, antioxidant and hepatoprotective agent. In this review article, introduction, active constituents, research study of B. monosperma has been elaborated.

Article

Full-text available

Jan 2011
J MED PLANTS RES

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Article

Full-text available

May 2002

Nematode parasites show a characteristic aggregated distribution among hosts. This observation has important implications for pathogenesis, immunology, and control of these infections, but the relative roles of environment and genetics in determining these patterns have remained uncertain. This paper presents the results of the first genome scan for susceptibility to infection with roundworm (Ascaris lumbricoides). Data on 375 genetic markers were generated for each of 444 members of a genetically isolated Nepalese population, the Jirels. Ascaris worm burden as assessed by egg counts was measured in these same individuals by using the Kato Katz thick smear method. The extensive genealogical data available for the population allowed assignment of all 444 individuals to a single pedigree that contained 6,209 pairs of relatives that were informative for genetic analysis. A variance components linkage analysis resulted in the unequivocal localization of two genes (one on chromosome 1 and another on chromosome 13) with clear, significant effects on susceptibility to Ascaris infection. This is the first evidence that individual quantitative trait loci influence variation in Ascaris burden in humans.

Glossary of Indian Medicinal Plants

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Jan 1986

Treatment options in the management of Ascaris lumbricoides

Article

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Infection with Ascaris lumbricoides constitutes one of the most common helmintic diseases in the world, especially in tropical and subtropical regions. Transmission of this disease involves environmental contamination with eggs, and therefore, is classified as a soil-transmitted disease. The public health importance of ascariasis is made evident by the high number of infected individuals suffering its consequences, which can become severe, depending on the worm burden. Since the introduction of benzimidazoles, chemotherapy has improved significantly, offering fast and direct effects at relatively low cost, as a result of the simple and safe application of these drugs. Unfortunately, the effects are not long-lasting or permanent. The intervention with chemotherapy alone constitutes a fast and efficient way to reduce the worm burden in a population of high prevalence, but does not avoid reinfection. Therefore, the option of integrated control programmes based on chemotherapy in combination with sanitation and health education, together with strong community involvement, must be considered in order to ensure the positive long-term effects of such programmes.

Immunity, immunoregulation and the ecology of trichuriasis and ascariasis

Article

Nov 2004

Immune responses to human roundworm (Ascaris lumbricoides) and whipworm (Trichuris trichiura) and their role in controlling worm populations are reviewed. Recent immunoepidemiological data implicate T(H)2-mediated responses in limiting A. lumbricoides and T. trichiura populations. Reinfection studies further suggest that IL-5 cytokine responses are negatively associated with adult recruitment in T. trichiura but not A. lumbricoides and may therefore be involved in negative intraspecific and interspecific interactions mediated through the host immune system. The importance of inducible immunoregulatory networks in the ecology of the host-parasite relationship is considered, with particular regard to possible manipulative strategies by the parasites. This aspect of the worms' interaction with the host immune system is both poorly known and potentially central to an understanding of parasite population dynamics and the evolutionary pressures that have shaped present-day host-parasite associations. Some possible implications of worm-mediated immunomodulation for the occurrence of bystander infectious diseases in human populations and the management of de-worming programmes are also discussed.

Can worms defend our hearts? Chronic helminthic infections may attenuate the development of cardiovascular diseases

Article

Feb 2005
MED HYPOTHESES

The established risk factors for atherosclerosis fail to fully explain the extent and severity of coronary artery diseases in 50% of the patients. Thus, the causative agents and processes, which may be involved in the pathogenesis of atherosclerosis, are being sought. Notoriously, atherosclerosis and cardiovascular event rates are much lower in developing countries. Clinically, severe infections by intracellular pathogens are widespread mostly in developing countries with poor sanitation, nutrition and massive worm infections. A link between atherosclerosis and helminth infections has never been examined. Based on the present knowledge of immune and infectious mechanisms related to atherosclerosis, it is proposed that chronic helminthic infections can have a significant bearing on the epidemiology of cardiovascular diseases. How can helminthic infections affect the cardiovascular risk? (1) Helminths evade or suppress host immune responses, by producing anti-inflammatory and other immunomodulatory molecules. (2) Helminths induce chronic Th2 activation, which can modify cytokine profiles and immunological responses to heat shock proteins, Chlamydia pneumoniae and cytomegalovirus. (3) The chronic Th2 profile may modulate monocyte activation and chemotaxis to inflammatory sites (atherosclerotic plaques). (4) Chronic Th2 activation may lead to a cytokine profile that could be beneficial for attenuation of atherosclerosis development (upregulation of IL-4, IL-10 and IL-13 and downregulation of proinflammatory cytokines). (5) Helminthic infections may reduce plasma LDL level not only by affecting the host nutrition, but also via modulation of naturally occurring antibodies to cholesterol. Studies are needed to clarify these suggestions. If the hypothesis that helminthic infections impact atherosclerosis is correct, it should be taken into consideration in atherosclerosis immunomodulation therapy and especially in the design of vaccines and vaccine trials.

Soil-transmitted Helminth Infections: Ascariasis, Trichuriasis, and Hookworm

Article

Jun 2006
LANCET

The three main soil-transmitted helminth infections, ascariasis, trichuriasis, and hookworm, are common clinical disorders in man. The gastrointestinal tract of a child living in poverty in a less developed country is likely to be parasitised with at least one, and in many cases all three soil-transmitted helminths, with resultant impairments in physical, intellectual, and cognitive development. The benzimidazole anthelmintics, mebendazole and albendazole, are commonly used to remove these infections. The use of these drugs is not limited to treatment of symptomatic soil-transmitted helminth infections, but also for large-scale prevention of morbidity in children living in endemic areas. As a result of data showing improvements in child health and education after deworming, and the burden of disease attributed to soil-transmitted helminths, the worldwide community is awakening to the importance of these infections. Concerns about the sustainability of periodic deworming with benzimidazole anthelmintics and the emergence of resistance have prompted efforts to develop and test new control tools.

Treatment options in the management of Ascaris lumbricoides

Article

Apr 2004

The hygiene hypothesis and inflammatory bowel diseases: Role of helminths

Article

Oct 2006
ACTA GASTRO-ENT BELG

The incidence of atopic and immune diseases has dramatically increased during the second half of the twentieth century. This has been attributed to improved sanitation and hygiene with reduced exposure to infections. The concept of this hygiene hypothesis is not new, and is currently used to explain the increasing incidence of a wide area of diseases. Parasitic helminths are powerful modulators of their host's immune system. It is suggested that the reduced exposure to helminths, due to better hygiene conditions, may predispose to the development of inflammatory bowel diseases. This article reviews the current epidemiological, experimental and clinical data supporting the role of helminths in the hygiene hypothesis in inflammatory bowel diseases.

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Article

Jul 2007
AM J MED SCI

Intestinal parasites are difficult to eradicate in tropical climates where poor sanitation exists. In addition, pharmaceutical stability is poor making traditional three day dosing for the treatment of A. lumricoides challenging. Single 100 mg doses of mebendazole were administered to persons living along Amazon tributaries in Northeastern Peru. Directly-observed treatment was repeated at 3-month intervals over a 2-year period in a single treatment village. Treatment was repeated at 12-month intervals in the remaining (control) villages. Treatment was accompanied by a regimen of multivitamins with iron to be taken daily for 14 days after each treatment. Subjects were screened for ova and parasites prior to treatment and at 1-year intervals. In addition to A. lumbricoides, other parasites found on screening were recorded. Treatment resulted in a 92.5% cure rate for A. lumbricoides at the 2-year assessment. Growth and development assessments demonstrated fewer individuals below the 3 percentile for age-adjusted measurements when treated quarterly. Based on these limited data, single low-dose mebendazole administered quarterly appears to have a positive effect on the health of isolated village populations in the Amazon River basin.

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Jan 1969
400-404

H Said

Said H.M (1969). Hamdard Pharmacopoeia of Eastern Medicine. Hamdard Foundation Karachi, 2; 400-404.

The clinical evaluation of herbal anti-round worm medicine: Kemol

Abstract

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