Cite this article as: Saravanan V. Sathasivampillai, Pholtan R.S. Rajamanoharan, Michael Munday and Michael Heinrich, Plants used to treat diabetes in Sri Lankan Siddha Medicine -an ethnopharmacological review of historical and modern sources, Journal of Ethnopharmacology, http://dx.doi.org/10. 1016/j.jep.2016.07.053 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abstract Introduction and background:In recent decades diabetes mellitus has become a considerable health problem in countries like Sri Lanka and results in an increasing economic burden hampering the social and economic development of these countries. About 60 to 70 % of the rural population in Sri Lanka rely on indigenous medicinal systems as their main source for primary health care. Siddha (Tamil) Medicine is one of the four Sri Lankan traditional medicinal systems and it is practised mostly in the eastern and northern provinces of Sri Lanka where the majority of Tamils reside. Aim:The foundation of this study is a documentation of plant species recorded in historical and modern Sri Lankan Siddha Medical documents used to treat diabetes. Based on the systematic documentation and analysis of Siddha concepts about diabetes and its signs and preparations used to treat diabetes in Sri Lankan Siddha Medicine, the plant species included in these preparations (excluding globally or very widely used, very well studied species) were evaluated in terms of the current stateof-the-art about these species' pharmacology and effectiveness in order to lay a foundation for their further development. Method:Historic and modern Sri Lankan university texts books in Tamil were used as sources for information on diabetes Siddha concepts and antidiabetic Sri Lankan Siddha Medicine preparations. Information on the known antidiabetic effects of extracts and compounds obtained from these species were used in order to assess the current state of the art of these species. Results and discussion: Information of ingredients, preparation methods, amount of ingredients used, and dosages of 60 antidiabetic Sri Lankan Siddha Medicine preparations were obtained. Animal parts including marine organisms, inorganic substances, and plants are the three types of ingredients used. Overall 171 plant species in 73 families were documented. Senna auriculata (L.) Roxb. (Fabaceae) was identified as the most frequently cited species. Globally distributed and very well studied plants were excluded in the pharmacological and clinical literature review which includes 123 plant species. The majority (48 %) of the plant species reviewed were studied up to in vivo level as...

Diabetes is affecting the social and economic developments in developing countries like Sri Lanka. Siddha Medicine (Tamil Medicine) is mostly practiced in the Eastern and Northern Provinces of Sri Lanka. Our recent review of Sri Lankan Siddha historical documents identified 171 plant species used to prepare anti-diabetic preparations. On the other hand, there is no study of plants currently used to treat diabetes in Sri Lankan Siddha Medicine. Hence, the aim of this study is to identify and document the plant species currently used in anti-diabetic preparations in Eastern Province, also enabling a comparative analysis with historical uses. Further, assessing the level of scientific evidence (in vitro, in vivo, and clinical studies) available for recorded species. A systematically prepared questionnaire was used to conduct an ethnobotanical survey with 27 Siddha healers residing in Eastern Province to identify the currently used anti-diabetic plants. Furthermore, Web of Science electronic database was used to assess the level of scientific evidence available excluding widespread and very well studied species. On average 325 diabetic patients were seen by 27 healers per week. Interestingly, inorganic substances, and animal parts used as ingredients in historical anti-diabetic preparations are currently not used in Eastern Province. A total of 88 plant species from 46 families were reported in this study. Syzygium cumini (L.) Skeels was the most frequently recorded species and the largest number of taxa are from Fabaceae. Remarkably, one third of reported species were not stated in Sri Lankan Siddha historical documents. The highest number of plant species (59%) have been studied up to an in vivo level followed by no scientific evidence for anti-diabetic activity found (27%), clinical evidence (10%), and in vitro (2%). This is the first ethnobotanical study of plants used to treat diabetes by Siddha healers in the Eastern Province in Sri Lanka. Moreover, awareness should be created to the diabetics about the side effects of herb-drug interactions and complications caused by taking both herbal preparations and biomedical drugs.

Coleus hadiensis (Forssk.) A.J.Paton is a horticultural herb that goes to the Lamiaceae family. This plant species has been using to treat diarrhea, skin and digestive disorders, diabetes, and carcinoma in ethnomedicines. This minireview work purposes to analyze, summarize, and document the reported bioactivities of C. hadiensis. Suitable published works were obtained employing the Web of Science, Scopus, PubMed, Semantic Scholar, and ScienceDirect databases from 1900 to December 2020. Hitherto, in vitro level of scientific evidence is the highest level of scientific evidence available for the bioactivities of this plant species. Various parts of C. hadiensis exhibited antioxidant, antibacterial, anti-inflammatory, anticancer, and antimalarial activities in a range of assays. To date, eight bioactive (antimalarial and antioxidant) compounds have been isolated from C. hadiensis. This minireview analyzed, summarized, and documented the reported bioactivities of C. hadiensis. In addition, this minireview provides a basis for further bioactivities researches using C. hadiensis in future.

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Limonia acidissima Groff is a tree that fits into the Rutaceae family and it is distributed in Asia. This is a food plant and it is also used for medicinal purposes. Its various parts have been using to treat several ailments in ethnomedicines including liver, heart, kidney, eye, and gastric ailments. So far, there is no systematic review available for bioactivities of L. acidissima parts. Hence, this work aims to analyze, summarize, and document the bioactivities and bioactive compounds identified from this plant species. Electronic databases including the Web of Science, Scopus, and ScienceDirect were used to detect published articles linked to bioactivities of L. acidissima from 1900 to October 2020. To date, only in vitro and in vivo level of scientific evidence are available for bioactivities. More investigations have been carried out for anticancer, antifungal, and antioxidant activities. Four bioactive compounds have been identified only for antifungal and cardioprotective activities. Only traditional medicinal treatments for tumors, diabetes, diarrhea, heart disorders, urinary tract illnesses, wound healing, and liver diseases have scientific evidence at present. This work analyzed, summarized, and documented the bioactivities of the extracts and compounds isolated from L. acidissima.

J n e k o l o j k L a p a r o s k o p k Op e r a s y o n l a r d a İ n t r a a b d o m n a l K a r b o n d o k s t İ n s ü fl a s y o n u n a B a ğ l ı E n d -T d a l K a r b o n d o k s t D e