AIDS (Acquired immune deficiency syndrome) is a disease caused by the virus known as HIV-1 (Human immunodeficiency Virus Type One). The HIV attacks the body’s immune system by destroying certain types of white blood cells (CD4+) called lymphocytes that help the body fight infection. A person with HIV infection may appear and feel healthy for many years. When someone is HIV-positive, that person has HIV antibodies in his or her body. Antibodies are proteins produced by the immune system to fight germs or infections Research suggests that the average incubation period from infection with HIV to the development of AIDS is approximately 10 years.

How do you get HIV?
HIV is transmitted through the bodily fluids of an individual carrying the virus. These bodily fluids are blood, semen, vaginal fluids, and breast milk. HIV can be transmitted in the following ways:

• Through the exchange or intake of blood, semen, or vaginal fluids while having vaginal, anal, or oral sex with someone who is HIV-positive.

• By sharing needles used to draw tattoos, give blood, or pierce ears or by sharing syringes used to inject illegal or prescribed drugs with someone who is HIV positive.

• Through perinatal transmission – when a HIV positive woman transmits the virus to her fetus during pregnancy to her baby while breast-feeding.

How HIV infects the body?
It is only now that scientists have learned how HIV infects the body. They have realized that it works in two phases, the M-tropic phase and the T-tropic phase, and that it looks for receptor sites to bond to. CCR5, a chemokine, is the second receptor site for HIV-1 in the M-tropic phase. Here is given the Process of HIV Replication (animation) in below:

HIV Replecation

HIV epidemiology in Bangladesh:
The first case of HIV/AIDS in Bangladesh was detected in 1989. Since then 1495 cases of HIV/AIDS have been reported (as of December 2008). However UNAIDS estimates that the number of people living with HIV in the country may be as high as 12,000, which is within the range of the low estimate by UNICEF’s State of the World’s Children Report 2009.
The number of AIDS patients has been on the rise in Bangladesh at a fast pace. Data from the country’s Health Ministry revealed that some 445 new HIV positive cases and 251 AIDS patients were detected in 2011. It showed 343 new HIV positives and 231 AIDS cases in 2010 while the number of new HIV positives was 250 and AIDS cases were 143 in 2009 & Some 37 people died of AIDS in 2010.
The overall prevalence of HIV in Bangladesh is less than 1%, however, high levels of HIV infection have been found among injecting drug users (7% in one part of the capital city, Dhaka). Due to the limited access to voluntary counseling and testing services, very few Bangladeshi’s are aware of their HIV status. Although still considered to be a low prevalence country, Bangladesh remains extremely vulnerable to an HIV epidemic, given its dire poverty, overpopulation, gender inequality and high levels of transactional sex. The emergence of a generalized HIV epidemic would be a disaster that poverty-stricken Bangladesh could ill-afford. It is estimated that without any intervention the prevalence in the general adult population could be as high as 2% in 2012 and 8% by 2025.

Medicinal plants as traditional medicine against HIV:
Traditional medicinal knowledge has been a means towards the discovery of many modern medicines. Traditional healers’ indigenous knowledge can help pinpoint medicinal plants used to manage HIV/AIDS. Bangladesh has a rich history of several traditional medicinal systems, among whom the most notable ones are the Ayurvedic, Unani, and the folk medicinal systems. Regarding HIV/AIDS related infections, many people think that using modern medicine is of no use, rather using traditional medicine or spiritual effects can help in this case.
The inclusion of anti-HIV ethnomedicines and other natural products in official HIV/AIDS policy is an extremely sensitive and contentious issue. many HIV-infected persons have access to antiretroviral drugs, but some still use ethnomedicinal plants and other natural products to treat opportunistic infections and offset side-effects from antiretroviral medication. Medicinal plants and other natural products including mushrooms are used as primary treatment for HIV-related problems such as skin disorders, nausea, depression, insomnia, and body weakness. Herbal medicines provide rational means for the treatment of many diseases that are obstinate and incurable in western systems of medicine. Phytomedicines are regaining patient acceptance because they have fewer side effects, are relatively less expensive, are easy to use and have a long history of use. Medicinal effects of plants tend to normalize physiological function and correct the underlying cause of the disorder. Sub-Saharan Africa has rich plant biodiversity and a long tradition of medicinal use of plants with over 3,000 species of plants used as medicines. Several of these plants may contain novel anti-HIV compounds. Indigenous knowledge of medicinal plant use also provides leads towards therapeutic concept thereby accelerating drug discovery; this is now being called reverse pharmacology. Thus, it is important to search for novel antiretroviral agents which can be added to or replace the current arsenal of drugs against HIV.
Some evidences with links:

a) A chemical from the Astragalus root, frequently used in Chinese herbal therapy, can prevent or slow progressive telomere shortening, which could make it a key weapon in the fight against HIV.
Chemical From Medicinal Plants May Be Used To Fight HIV

b) Genetically modified tobacco plants can grow specific proteins that scientists know will act on the HIV virus.
Fighting HIV in developing countries – with tobacco

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Malaria is one of the major tropical parasitic diseases responsible for significant morbidity and mortality especially among children and pregnant women. Malaria is caused by a single celled protozoan parasites called Plasmodium and transmitted to man thought the anopheles mosquito. It is one of the major fatal diseases in the world, especially in the tropics and is endemic in some 102 countries with more than half of the world population at risk. Malaria accounts for 310 – 515 million clinical episodes with 1.5 – 3.0 million deaths per year, 90% of which occur in sub-Saharan Africa. Malaria is the world’s most devastating disease. An estimated 2 billion people are exposed to the global endemic among which 500 million are affected by this disease yearly and 1 – 2 million people die yearly as a result of malaria.

Malaria epidemiology in Bangladesh:
Malaria is a major health burden in the south-eastern part of Bangladesh, especially in the Chittagong Hill Tracts. In Bangladesh, malaria is most likely a seasonal disease and concentrated in border regions. Thirteen districts in the north, north-east and south-east regions are highly malaria endemic. These are Khagrachhari, Rangamati, Bandarban, Cox’s Bazar, Chittagong, Sylhet, Sunamganj, Moulvibazar, Hobiganj, Mymensingh, Netrakona, Sherpur and Kurigram. About 98% of the malaria cases are reported from these districts. The ecological situation of all these districts favours transmission of the disease. Three districts namely Khagrachhari, Rangamati and Bandarban located in hilly remote areas of Chittagong Hill Tracts suffer from geographical disadvantage with difficult communication and intense perennial transmissions of malaria (BHP 2008). Currently the number of malaria endemic upazilas is 70 and the total population at risk is 10.9 million. The average malaria prevalence in Khagrachari district was 15.47% (n = 750). Table 1 lists the individual prevalence of malaria for the thanas in Khagrachari. The highest prevalence was found in Dighinala (22%) and lowest prevalence was found in Panchari (5.72%). The overall malaria prevalence in Chittagong Hill Tracts (CHT) districts was 11.7%. The prevalence rate was 15.25%, 10.97% and 7.42% in Khagrachari, Bandarban and Rangamati districts respectively.

the following link help you to understand the Pathogenesis of Malaria

Malaria – Life Cycle of Plasmodium

Local name of malaria in Bangladesh:
In the Bangali and Chakma communities they used to call it as Kala ajar because some people opined that the malaria patient became short of hearing, few other people opined that the skin of malaria patient turned black. In both the communities, people used to call it Hati jar to refer to malaria because of its mammoth harmfulness. In terms of duration and physical harm and costs, the Bangali community used to call it as Moron jar or Pocha jar because of its long duration and incurability. In Chakma community people regard it as Bhanga jar because of the rapid emaciation of the body. In Tripura community they have a single name for it the Miaung Kulung based on its symptoms.

Medicinal Plants against Malaria Treatment:
The antimalarial drug, quinine, whose use has been documented almost 400 years ago, was isolated from the bark of the Cinchona tree, which also contains three other antimalarial compounds, namely, quinidine, cinchonine, and cinchonidine. A common antimalarial drug in use today is chloroquine, a synthetic derivative of quinine. The latest antimalarial drug is artemisinin, which is derived from the plant Artemisia annua L. (Asteraceae), and has been used in Chinese traditional medicine for more than 1,000 years for treatment of malaria. Artemisinin derived antimalarial drugs like artesunate and artelinic acid reportedly caused embryo death and malformations in pregnant rats by killing embryonic erythroblasts. Some findings indicate that P. falciparumstrains may be developing resistant varieties to artemisinin in China. Studies have documented over 1,200 plant species from 160 families used in the treatment of malarial or fever. Ethnobotanical survey is an important step in the identification, selection and development of the therapeutic agents from medicinal plants. In ethnobotany and natural products chemistry, the mode of preparation and administration of herbal preparations are often crucial variables in determining efficacy in pharmacological evaluation.

Cancer is an abnormal growth of cells caused by multiple changes in gene expression leading to deregulated balance of cell proliferation and cell death and ultimately evolving into a population of cells that can invade tissues and metastasize to distant sites, causing significant morbidity and, if untreated, death of the host. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected. Cancers are caused by exogenous chemical, physical, or biological carcinogens.
Although cancer can occur at any age, it is usually considered a disease of aging. The average age at the time of diagnosis for cancer of all sites is 67 years, and about 76% of all cancers are diagnosed at age 55 or older. Although cancer is relatively rare in children, it is the second leading cause of death in children ages 1–14. In this age group leukemia is the most common cause of death. Thus even though the overall death rates due to cancer have almost tripled since 1930 for men and gone up over 50% for women, the age-adjusted cancer death rates in men have only increased 54% in men and not at all for women. World Health Organization (WHO) estimates that some 84 million people will die of cancer between 2005 and 2015 around the world. In 2007, there were 7.9 million deaths from cancer, around 13 percent of all deaths.


Cancer Epidemiology in Bangladesh

Like many other countries in the world cancer in Bangladesh is one of the major killer diseases. The National Institute of Cancer Research and Hospital (NICRH), Dhaka, started a cancer registry in 2005 for the first time in Bangladesh with technical assistance from the World Health Organization (WHO).  This report covers three years from 2005 to 2007. Data were collected from 24,847 cancer patients who attended the NICRH for the first time. Essential information (confirmed diagnosis) could be made available for 18,829 cases, and they are included in this analysis. Among them 10,847 (57.6%) were males. Lung cancer was the leading cancer (17.3%), followed by cancers of breast (12.3%), lymph nodes and lymphatics (8.4%) and cervix (8.4%) for sexes combined in all ages. In males lung (25.5%) and in females breast (25.6%) and cervical (21.5%) cancers were predominant. In children aged 14 years or younger (n=657) lymphoma, retinoblastoma, osteosarcoma, leukaemia and kidney cancers were most prevalent. lung cancer in males, and cervical and breast cancer in females constitute 38% of all cancers in Bangladesh (Cancer registry report 2005-2007). According to the latest WHO data published in April 2011 Oral Cancer Deaths in Bangladesh reached 11,562 or 1.21% of total deaths. The age adjusted Death Rate is 12.52 per 100,000 of population ranks Bangladesh #4 in the world.  At present, there are one million (10 lakh) cancer patients in Bangladesh while approximately 200,000 new patients, mostly women, are added every year creating a social burden on the country. The country’s women are now in danger of being affected by cervical cancer, one of the sexually transmitted diseases that claim the life of 18 women every day in the country for lack of awareness.

Traditional Medicine against Cancer

Various plants have been used against cancer in folk traditional medicine of Bangladesh. . Traditional medicinal knowledge has been a means towards the discovery of many modern medicines (Cotton, C.M., 1996). Bangladesh has a rich history of several traditional medicinal systems, among whom the most notable ones are the Ayurvedic, Unani, and the folk medicinal systems. Folk medicine is practiced by Kavirajes who utilize simple formulations of medicinal plants in most of their preparations. Recently World Health Organization has shown great interest in documenting the use of medicinal plants used by tribes from different parts of the world. Many developing countries have intensified their efforts in documenting the ethnomedical data and scientific research on medicinal plants. Natural products or natural product derivatives comprised 14 of the top 35 drugs in 2000 based on worldwide sales (Butlet, 2004). Two plant derived natural products, paclitaxel and camptothecin were estimated to account for nearly one-third of the global anticancer market or about $3 billion of $9 billion in total annually in 2002 (Oberlines and Kroll, 2004). Several anticancer agents including taxol, vinblastine, vincristine, the camptothecin derivatives, topotecan and irinotecan, and etoposide derived from epipodophyllotoxin (Epipodophyllotoxins are alkaloids naturally occurring in the root of American Mayapple plant (Podophyllum peltatum) and currently used in the treatment of cancer) are in clinical use all over the world. There are more than 270,000 higher plants existing on this planet. But only a small portion has been explored phytochemically. So, it is anticipated that plants can provide potential bioactive compounds for the development of new ‘leads’ to combat cancer diseases.

References:

Butlet MS. The role of natural product chemistry in drug discovery. J Nat Prod. 2004; 67: 2141-53.

Cancer Registry Report 2005-2007, National Institute of Cancer Research and Hospital, Dhaka, December 2009.

Cotton CM., 1996. Ethnobotany: Principle ad Application, John Wiley and Sons, New York, pp: 399.

Oberlines NH, Kroll DJ. Camptothecins and taxol: historic achievement in natural products research. J Nat Prod. 2004; 67: 129-35.

Wingo P. A., C. J. Cardinez, S. H. Landis, R. T. Greenlee, A. G. Ries, R. N. Anderson, and M. J. Thun: Long-term trends in cancer mortality in the United States, 1930–1998. Cancer 97:3133, 2003.

A medicinal plant is any plant which, in one or more of its organs, contains substances that can be used for therapeutic purposes, or which are precursors for chemo-pharmaceutical semi-synthesis. When a plant is designated as ‘medicinal’, it is implied that the said plant is useful as a drug or therapeutic agent or an active ingredient of a medicinal preparation. Medicinal plants may therefore be defined as a group of plants that possess some special properties or virtues that qualify them as articles of drugs and therapeutic agents, and are used for medicinal purposes.

History of Plant Based Traditional Medicine 

Plants have formed the basis of sophisticated traditional medicine (TM) practices that have been used for thousands of years by people in China, India, and many other countries. Some of the earliest records of the usage of plants as drugs are found in the Artharvaveda, which is the basis for Ayurvedic medicine in India (dating back to 2000 BCE), the clay tablets in Mesopotamia (1700 BCE), and the Eber Papyrus in Egypt (1550 BCE). Other famous literature sources on medicinal plant include “De Materia Medica,” written by Dioscorides between CE 60 and 78, and “Pen Ts’ao Ching Classic of Materia Medica” (written around 200 CE).

Nowadays plants are still important sources of medicines, especially in developing countries that still use plant-based TM for their healthcare. In 1985, it was estimated in the Bulletin of the World Health Organization (WHO) that around 80 % of the world’s population relied on medicinal plants as their primary healthcare source. Even though a more recent figure is not available, the WHO has estimated that up to 80 % of the population in Africa and the majority of the populations in Asia and Latin America still use TM for their primary healthcare needs. In industrialized countries, plant-based traditional medicines or phytotherapeuticals are often termed complementary or alternative medicine (CAM), and their use has increased steadily over the last 10 years. In the USA alone, the total estimated “herbal” sales for 2005 was $4.4 billion, a significant increase from $2.5 billion in 1995. However, such “botanical dietary supplements” are regulated as foods rather than drugs by the United States Food and Drug Administration (US FDA).

Role of Plants in Human History

Plants have also been used in the production of stimulant beverages (e.g. tea, coffee, cocoa, and cola) and inebriants or intoxicants (e.g., wine, beer, kava) in many cultures since ancient times, and this trend continues till today. Tea (Camellia sinensis Kuntze) was first consumed in ancient China (the earliest reference is around CE 350), while coffee (Coffea arabica L.) was initially cultivated in Yemen for commercial purposes in the 9th century. The Aztec nobility used to consume bitter beverages containing raw cocoa beans (Theobroma cacao L.), red peppers, and various herbs. Nowadays, tea, coffee, and cocoa are important commodities and their consumption has spread worldwide. The active components of these stimulants are methylated xanthine derivatives, namely caffeine, theophylline, and theobromine, which are the main constituents of coffee, tea, and cocoa, respectively.

The most popular inebriants in society today are wine, beer, and liquor made from the fermentation of fruits and cereals. Wine was first fermented about 6000–8000 years ago in the Middle East, while the first beer was brewed around 5000–6000 BCE by the Babylonians. The intoxicating ingredient of these drinks is ethanol, a by-product of bacterial fermentation, rather than secondary plant metabolites. Recent studies have shown that a low to moderate consumption of red wine is associated with reduction of mortality due to cardiovascular disease and cancer.

Examples of Some Modern Medicine Discovered from Plants
Plants can provide biologically active molecules and lead structures for the development of modified derivatives with enhanced activity and reduced toxicity. The small fraction of flowering plants that have so far been investigated have yielded about 120 therapeutic agents of known structure from about 90 species of plants. Some of the useful plant drugs include vinblastine, vincristine, taxol, podophyllotoxin, camptothecin, digitoxigenin, gitoxigenin, digoxigenin, tubocurarine, morphine, codeine, aspirin, atropine, pilocarpine, capscicine, allicin, curcumin, artemesinin and ephedrine among others. In some cases, the crude extract of medicinal plants may be used as medicaments. About 121 (45 tropical and 76 subtropical) major plant drugs have been identified for which no synthetic one is currently available.

It has been estimated that more than 400 traditional plants  or plant-derived products have been used for the management of type 2 diabetes across geographically. Galegine, a substance produced by the herb Galega officinalis, provides an excellent example of such a discovery. Experimental and clinical evaluations of galegine, provided the pharmacological and chemical basis for the discovery of metformin which is the foundation therapy for type 2 diabetes.
Plant derived agents are also being used for the treatment of cancer. Several anticancer agents including taxol, vinblastine, vincristine, the camptothecin derivatives, topotecan and irinotecan, and etoposide derived from epipodophyllotoxin are in clinical use all over the world.

In conclusion, plants have provided humans with many of their essential needs, including life-saving pharmaceutical agents. Recently the World Health Organization estimated that 80% people worldwide rely on herbal medicines for some aspect. Many developing countries have intensified their efforts in documenting the ethnomedical data and scientific research on medicinal plants. Natural products or natural product derivatives comprised 14 of the top 35 drugs in 2000 based on worldwide sales. There are more than 270,000 higher plants existing on this planet. But only a small portion has been explored phytochemically. So, it is anticipated that plants can provide potential bioactive compounds for the development of new ‘leads’ to combat various diseases. As a vast proportion of the available higher plant species have not yet been screened for biologically active compounds, drug discovery from plants should remain an essential component in the search for new medicines & the scientific study of traditional medicines, concerned medicinal plants are thus of great importance.

References:

Bailey, C.J. and Day, C. (1989) Traditional plant medicines as treatments for diabetes. Diabetes Care, 12 American diabetes association,553–564.

Butlet MS. The role of natural product chemistry in drug discovery. J Nat Prod. 2004; 67: 2141-53.

K.G. Ramawat and J.M. Mérillon, Bioactive Molecules and Medicinal Plants, Springer-Verlag Berlin Heidelberg 2008, ISBN 978-3-540-74600-3.

Kumar, N., M. Abdul Khader, J. B. M., Rangaswami, P. and Irulappan, I. 1997. Introduction to Spices, Plantation Crops, Medicinal and Aromatic Plants. Oxford and IBH Publishing Co. Pvt. Ltd., New Delhi.

Kumar, S., Shukla, Y. N., Lavania, U. C., Sharma, A. and Singh, A. K. 1997. Medicinal and Aromatic Plants: Prospects for India. J. Med. Arom. Pl. Sc. 19 (2):361-365.

P. P. Joy, J. Thomas, S. Mathew, B. P. Skaria, 1998. Medicinal plants, Kerala Agricultural University, Aromatic and Medicinal Plants Research Station.