Professional Documents
Culture Documents
Theoretical Framework
This chapter presents the relevant theories, review of related literature, studies,
conceptual framework, hypothesis and definition of various relevant terms used in the
study.
Relevant Theories
College, Oxford, thinks that the issues on the production of herbal products are
conservative (Edwards, 2014). Most of the processes involved in supplying the growing
market for herbal remedies are result of unsustainable and often destructive practices
driven by poverty. He said that people do not replace what they take. For instance, the
market for African cherry (Prunus africana), the bark of which is popular in Europe as a
treatment for prostate enlargement, has collapsed because too many trees have been
destroyed. In the past the trees, which grow in Africa's mountain regions, survived because
traditionally less than half of their bark was harvested. But according to a study by Kristine
Stewart, from consultants Keith and Schnars in Florida, growing commercial pressures
have led to whole forests being stripped or felled. Exports of dried bark halved between
1997 and 2000. Bodeker also says that there is a complete lack of awareness and lack of
education amongst consumers. And those that use herbal medicines might be expected to
medicine: women’s view, knowledge and interaction with doctors, they have concluded
that women in Chesire, UK aged 18 years and above that belong to a higher socio-economic
grouping had little knowledge about herb-drug interactions and rarely disclosed use of
herbal medicines to their doctor. They have found out that motivations for herbal medicine
use were varied but all included at least one of three subcategories: perceived advantages
of herbal medicines, beliefs about the disadvantages of conventional health care and
medicines. They have also cited in their background that people may use complementary
and alternative medicines because prescribed medication is not working or has side effects.
In addition, they’ve cited that previous studies have indicated primary predictors of herbal
medicine use is female gender, white, ethnic origin, high educational status and high
income. Studies have found different age ranges for the highest prevalence of herbal
According to McCaleb, Leigh & Morien (2014) there is a major trend today toward
greater personal responsibility and choice of health care. People are taking the initiative to
learn more about their health and different treatment options for health conditions. People
are becoming more involved in the decision-making process on issues affecting their own
treatment. They are less willing to simply follow doctor’s orders without better
understanding what alternatives may exist such as herbal medicine. Herbal medicines are
also preventive medicine. Amongst the best-researched European phytomedicne are agents
that can reduce the risk of heart disease, cancer, respiratory distress, and liver disease. And
one of the herbal remedies that are best-researched for reducing cholesterol and prevention
against stomach cancer includes garlic. In addition to preventive actions, herbal medicine
can save as safe and effective direct replacements for over-the counter drugs. One of the
strongest benefits of herbs is that they work within the body that brings superior results and
Related Literature
1.1 Age
1.3 Occupation
including chronic cough. Although episodes of incidental, dramatic air pollution are
countries such as total articles, diesel exhaust particles and common cigarette smoke may
be responsible for the development of chronic cough both in children and adults. The
present study analyses the effects of common environmental factors as potential causes of
chronic cough. Different PubMed-based researches were performed that related the term
cough to various environmental factors. There is some evidence that chronic inhalation of
diesel can lead to the development of cough. For long-term exposure to nitrogen dioxide
(NO2), children were found to exhibit increased incidences of chronic cough and decreased
lung function parameters. Although a number of studies did not show that outdoor pollution
directly causes the development of asthma, they have demonstrated that high levels
pollutants and their interaction with sunlight produce ozone (O3) and that repeated
exposure to it can lead to chronic cough. In summary, next to the well-known air pollutants
which also include particulate matter and sulfur dioxide, a number of other indoor and
outdoor pollutants have been demonstrated to cause chronic cough and therefore,
environmental factors have to be taken into account as potential initiators of both adult and
Coughing and mucus secretion are coordinated neuronal reflexes that protect the
However, within chronic exposure to noxious substances such as tobacco smoke, urban
dust, or occupational factors, the originally protective mechanisms may lead to a states of
chronic distress with hypersecretion and chronic coughing. The neurophysiology of the
cough reflex and its relation to bronchoconstriction and different forms of adult and
pediatric asthma is very complex. However, there is little doubt that chronic cough can be
related to the exposure to different environmental air pollutants. Amongst them, pollutants
such as diesel exhaust, ozone, nitrogen and sulfur dioxide have all been suggested to
suggestions do not only base on epidemiological and clinical observations, but also on the
generally accepted, that airway pollutant-caused airway irritation leading to chronic cough
three major types of vagal sensory receptors is suggested to act as "cough receptors". Next
to these RARs, a further effect by bronchopulmonary C-fibers on the cough reflex has been
suggested, and there are data indicating that i.e. ozone, one of the main environmental air
potential vanilloid-1 seems to play a role in the mediation of the cough reflex and airway
nerves and their mediators in general are likely to play an important role in the general
In the light of the clinical, epidemiological and experimental data which point to a
major role of environmental pollutants as co-factors for the development and progression
of chronic cough, the present study analyzed the data available on the association between
environmental pollutants and chronic cough on the basis of a large amount of existing
recent literature reviews and original articles. It illustrates the deposition of some
2.2 Personal Hygiene Mental hygiene, industrial hygiene, oral hygiene, vocal
hygiene, respiratory hygiene. There are many “hygienes,” but what does the word actually
mean? Its definition the science of preventive medicine and the preservation of health is
broad enough to incorporate concepts such as exercise and diet. But the original and still
Public concerns about SARS (severe acute respiratory syndrome) and current efforts to
influenza have returned hygiene concepts to the public sphere. Home hygiene and
Hand hygiene, household cleaning and food safety constitute the main focus for
clean hands often by washing with soap and warm water, or to use alcohol-based gel
sanitizers if running water is not accessible. Hands should be washed before eating, before
preparing food, after using the toilet, changing diapers or other similar exposure, and after
playing with or feeding pets. Hand hygiene after contact with potentially infected fomites
includes turning away and covering the mouth or nose when coughing or sneezing, together
with appropriate disposal of tissues, hand hygiene, and staying home when ill with a cough
and fever.
3. Herbal Plants
Among patients who see mainstream health care providers, 33% to 42% use herbal
remedies (Fetrow & Avila 2014). Many of these patients fail to disclose this fact to their
primary health care providers. Market sales of herbs in the United States were an estimated
$14 billion in 2000, and rate of growth has increased dramatically in recent years. Studies
indicate that many patients who use alternative medicines and also seek conventional
treatment exercise more; are more careful about avoiding fatty foods, tobacco, and alcohol;
are more compliant with their regular medication regimen; and make lifestyle
modifications more readily than patients who seek conventional health care alone. The
National Institute of Health (NIH) estimates that in the United States about one in three
remedies. The use of such therapies is probably greatest in certain subgroups of the
population, such as the terminally or chronically ill. Many drugs commonly used today are
of herbal origin. Indeed, about 25 percent of the prescription drugs dispensed in the United
States contain at least one active ingredient derived from plant material. Some are made
from plant extracts while others are synthesized to mimic a natural plant compound.
According to the World Health Organization (2014) estimate, four billion people
or 80 percent of the world’s population presently use herbal medicine for some aspect of
primary health care. Herbal medicine is a major component in all indigenous peoples’
traditional oriental and Native American Indian medicine. The World Health Organization
(WHO) notes that of 119 plant-derived pharmaceutical medicines, about 74 percent are
used in modern medicine in ways that correlated directly with their traditional uses as plant
extensive research on plant materials gathered from the rain forests and other places for
As part of primary health care and because of the increasing costs of drugs, the
Department of Health of the Philippines had been promoting products of medicinal plants
as alternative medicines (Reyala, 2013). Many local plants and herbs in the Philippine
backyard and field have been found to be effective in the treatment of common ailments as
attested to by the National Science Development Board, other government and private
The Department of Health (DOH) said its campaign to promote alternative health
care and herbal medicines in the country has been successful (Philippine Nurses
Association (2015). The Department of Health’s health education and promotion officer
said Filipinos have been using alternative health care to avoid hospital expenses. Herbal
medicines are also becoming widely popular with the high price of imported medicines.
This was shown by results of a National Demographic and Health Survey (NDHS) done
by the National Statistics Office (NSO). DOH health education and promotion officer said
this is proof that DOH's promotion is successful. The survey showed that in Central Visayas
alone, about 67.6 percent of households are familiar with acupressure or therapeutic
massage and iridology. Other modes relatively known are acupuncture and aromatherapy.
As to herbal medicines, the NSO survey showed that guava is the most commonly used in
Central Visayas, with 59.8 percent of households having at least one member using the
herbal medicine. Other popular herbal medicines are sambong, ampalaya and bawang
(garlic). The NDHS also said most Filipinos are aware of the serious diseases in the country
today, such as the acquired immune deficiency syndrome (AIDS), dengue, malaria,
diabetes, leprosy and cancer. This shows the DOH has been successful in its information
campaign. The NDHS data was made for decision makers to improve health services in the
country.
Extensive research by Filipino scientists is done because the cheap yet effective
herbal medicine helps many Filipino families (Lacanilao, 2014). The Department of
Science and Technology has scientifically validated 102 plants for safety and efficacy. Ten
of these plants are under different stages of development, and that studies have been
completed on sambong, lagundi, and akapulko. From sambong and lagundi alone, a local
maker of herbal drugs is earning millions of pesos. But recent reviews of the scientific
literature on herbal medicinal products have a warning: they are not risk free. One such
Universities of Exeter and Plymouth, United Kingdom. It was published in the journal
Pharmacoepidemiology and Drug Safety in 2014. The study focused on the toxicity,
interactions, and quality of herbal products. Toxicity data indicate that some herbal drugs
have the potential to cause serious adverse events and fatalities. They affect
patients in danger, and that most often implicated are herbal drugs from Asia. The review
concludes that the widespread notion of herbal drugs being inherently safe is naive at best
and dangerous at worst, and that more research and more information are required to ensure
consumer’s safety.
Cough
perceived by the person as a threat to life itself (Quiambao O-udan, 2009 p. 111) . All
human beings experienced cough due to different reasons. Coughing greatly affects the
life or activity of daily living of each and everyone of us. Coughing can either alter level
Cough are often common symptoms caused by many factors. It can result from
cough depends on the amount and color of sputum, the frequency and the duration of the
coughing episodes. Cough syrups are abundantly available in the market today. But the
syrups do have sedative side effects that can affect your daily activities. Although the drug
provides coughing relief, the use of these over-the-counter drugs should be observed
coughing action. Expectorants contribute to the expulsion of phlegm from the airway
passages. Mucolytics are intended to unclog the respiratory passages by “melting” the
mucus and phlegm. Suppressants act on coughs by suppressing the coughing reflex. A
natural way to treat common coughs is to take herbal meds. Although some people frown
on its use, studies and testimonials from other users have found herbal medicine effective
for the treatment and relief of coughing episodes. Still, precaution should be practiced, and
you should get advice from medical experts to check if you bear allergies to these herbs.
(Premna odorata) The alagaw is a herbal plant from the Philippines that is used to
loosen phlegm and relieve coughs. Fresh alagaw leaves with sugar for taste are boiled in
purpurea) This is a highly recommendable herb for colds, cough and flu especially for those
who reside in North America and Europe. This herb alleviates cough in tincture form.
(Eucalyptus globules) The essential oil found in eucalyptus acts to loosen the phlegm
within the air passages. Inhaling eucalyptus vapors can help treat coughs. It is
recommended to use fresh leaves in teas or gargles to soothe irritated throats brought by
coughs. Also, ointments containing this herb can be applied to chest area to relieve
common herbal plant found in the Philippines. The dried or fresh lagundi leaves are
boiled. Drinking this concoction will yield cough and asthma relief.
2013, via the Cochrane Library, MEDLINE (PubMed), Scopus, and Embase databases.
Initially, ‘cough' was searched as a generic symptom, not related to specific medical
(CAM) approaches. The treatments were chosen according to the definitions provided by
the National Institutes of Health's National Center for Complementary and Alternative
‘respiratory dysfunction', ‘flu', and ‘influenza'. These terms were then combined with
medicines to the health of many people throughout the world, as stated in a number of
resolutions adopted by the World Health Assembly and the Regional Committee for the
Western Pacific. Thus herbal medicines have been recognized as a valuable and readily
available resource for primary health care, and WHO has endorsed their safe and effective
utilization and conservation of herbal medicines has been developed. Meanwhile, it has
been realized that medicinal plants are a valuable resource for new pharmaceutical products
and thus a potential source of new drugs as well as for economic development.
WHO supports the appropriate use of herbal medicines and encourages the use of
remedies that have been proven to be safe and effective. A few herbal medicines have
withstood scientific testing, but others are used simply for traditional reasons to protect,
restore or improve health. Most herbal medicines still need to be studied scientifically,
although the experience obtained from their traditional use over the years should not be
ignored. Member States have been seeking the cooperation of WHO in identifying safe and
effective herbal medicines for use in their national health care systems. As there is not
and efficacy about most of the herbal medicines now in use, the rational use and further
Organization 2018)
corresponding herbal drug is safe, however, is a debachart matter. A new draft regulation
published by the Brazilian National Health Surveillance Agency (Anvisa) brought this
controversial topic to the center stage. The proposed regulation, which has recently
undergone a public consultation for reviews and comments, defines two categories of
phytotherapeutic products” (TPTP) (Anvisa, 2013). A product fits into the latter category
if a long-standing (traditional) use is identified that has not been proven unsafe and is
botanical studies. Once the traditional use is recognized, safety and efficacy data from pre-
clinical and/or clinical studies are no longer essential requirements to obtain approval
for commercialization.
The proposed new rules for herbal medicine registration in Brazil are, to some
extent, similar to the regulation released by the European Parliament in 2014. According
to EC Directive 2004/24, herbal medicines with traditional use that are acceptably safe,
albeit not having a recognized level of efficacy, can be classified as “traditional herbal
corresponding herbal drug is safe, however, is a debachart matter. A new draft regulation
published by the Brazilian National Health Surveillance Agency (Anvisa) brought this
controversial topic to the center stage. The proposed regulation, which has recently
undergone a public consultation for reviews and comments, defines two categories of
phytotherapeutic products” (TPTP) (Anvisa, 2013). A product fits into the latter category
if a long-standing (traditional) use is identified that has not been proven unsafe and is
botanical studies. Once the traditional use is recognized, safety and efficacy data from pre-
clinical and/or clinical studies are no longer essential requirements to obtain approval
for commercialization.
The proposed new rules for herbal medicine registration in Brazil are, to some
extent, similar to the regulation released by the European Parliament in 2014. According
to EC Directive 2004/24, herbal medicines with traditional use that are acceptably safe,
albeit not having a recognized level of efficacy, can be classified as “traditional herbal
(2013) and Silano et al. (2014). In order for a medicinal product,or its corresponding
products (i.e., products having the same active ingredients, the same or similar intended
purpose, equivalent strength and posology and the same or similar route of administration),
to be classified as THMP, it must have been in medicinal use for a period of at least 30
years, of which more than 15 years must relate to the European Union. Herbal drugs in the
THMP category undergo a simplified registration procedure. Aspiring herbal products are
required to demonstrate the traditional use of the herb, but this requirement is lifted if the
product complies with the European positive list established by the Committee on Herbal
Medicinal Products (HPMC) (Knöss and Chinou, 2013). Herbal monographs prepared by
HPMC are not binding, and member state agencies may not agree with every single aspect
of the monograph. For instance, applicants that refer to a HPMC monograph may be
Related Literature
The use of herbal medicine has been practiced to cure diseases, ease pain and heal
bodily discomforts and ills. For example, ancient Chinese and Egyptian papyrus writings
describe medicinal plant uses. No one knows exactly when people first began using plants
for medicine, but evidence of at least six medicinal plants was found in a Neanderthal burial
site estimated to be 60,000 years old. In addition, indigenous cultures like African and
Native American used herbs in their healing rituals, while others developed traditional
medical systems like Ayurveda and Traditional Chinese Medicine. Scientists have found
that people in different parts of the globe tend to use the same or similar parts for the same
Herbal medicines today are now being improved due to the found effectiveness on
the more complex-developing diseases. This is not surprising because many of the current
synthetic drugs have been derived from plants at some point. Herbal medicine are approved
and sold around the world with medicinal claims throughout Europe and most of Asia
(McCaleb, Leigh & Morien 2013). The use of herbal medicine has been gaining popularity
these past few years here in the Philippines as clinical proof emerges that validates many
of the age-old alternative medicines used by Filipino. And the use of herbal medicine in
the Philippines has been passed on from generation to generation (Philippine Herbal
Medicine Site, 2013). It is also readily available and abundant here in the country. Garlic,
for an instance is known to lower cholesterol levels and used to prevent heart diseases.
Bitter gourd is another vegetable grown here in the Philippines which is known for
improving the health status of those who have diabetes, liver problems and human
beliefs not based on scientific evidence that are applied to treat, diagnose and prevent
illness within a society. It is defined by a culture's knowledge and values and thus is
(2013) he stated that when modern societies adopt such long-standing health practices
The extent to which the traditional use of an herb ensures that a corresponding
herbal drug is safe, however, is a debachart matter. A new draft regulation published by
the Brazilian National Health Surveillance Agency (Anvisa) brought this controversial
topic to the center stage. The proposed regulation, which has recently undergone a public
consultation for reviews and comments, defines two categories of herbal drugs for
(TPTP) (Anvisa, 2013). A product fits into the latter category if a long-standing
(traditional) use is identified that has not been proven unsafe and is recognized in the
the traditional use is recognized, safety and efficacy data from pre-clinical and/or clinical
The proposed new rules for herbal medicine registration in Brazil are, to some
extent, similar to the regulation released by the European Parliament in 2004. According
to EC Directive 2004/24, herbal medicines with traditional use that are acceptably safe,
albeit not having a recognized level of efficacy, can be classified as "traditional herbal
(2012) and Silano et al. (2014). In order for a medicinal product,or its corresponding
products (i.e., products having the same active ingredients, the same or similar intended
purpose, equivalent strength and posology and the same or similar route of
administration), to be classified as THMP, it must have been in medicinal use for a period
of at least 30 years, of which more than 15 years must relate to the European Union.
Herbal drugs in the THMP category undergo a simplified registration procedure. Aspiring
herbal products are required to demonstrate the traditional use of the herb, but this
requirement is lifted if the product complies with the European positive list established
prepared by HPMC are not binding, and member state agencies may not agree with every
single aspect of the monograph. For instance, applicants that refer to a HPMC monograph
In summary, both the European Medicines Agency (EMA) and the Brazilian National
safety and efficacy, thereby opening a wider door for the registration of manufactured
Edwards, R. (2015). Herbal medicine boom threatens plants. Retrieved September 5, 2007
from http://media.newscientist.com/article.ns?id=dn4538
Fetrow, C. W. & Avila, R. (2014). Herbal Medicine Handbook. USA: Lippincott Williams
& Wilkins.
Herbal Use… (2015). Retrieved January 16, 2019 from http://www.gov.ph/news.
Herbal Medicine. (2017). Retrieved January 18, 2019 from http.//www.wikipedia.com.
Lacanilao, F. (2016). Medicinal Plants. Retrieved August 29,2017 from
http.//www.google.com.
Reyala, J.P. et al. (2013). Community of Health Nursing Service in the Philippines.
Philippines: Community Health Nursing Section.
Vickers, K.A., Jolly K. B. & Greenfield, S. M. (2014). Herbal medicine: women's views,
knowledge and interaction with doctors: a qualitative study. Retrieved January 15, 2019
from http://www.biomedcentral.com/
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