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Saint Louis University School of Nursing 2nd Sem. S. Y.


In Partial Fulfillment Of the requirements in NCM


Submitted To: Mr. Karl Christian Golucan, RN CLINICAL INSTRUCTOR

Submitted By: Marynel Dixie I. Brao BSN IV-M

DECEMBER 19, 2011

Effects of Sour Tea (Hibiscus Sabdariffa) on Lipid profile And Lipoprotein in Patients with Type II Diabetes I. SUMMARY Sour tea also called Roselle here in our country is an herbal plant which mainly has therapeutic effect on our Diabetic clients. We all know that Diabetes is a disease where there a deficiency in insulin secretion or decreased sensitivity of organs to the produced insulin. Contributory factors to this disease include atherosclerosis or the deposition of plaques which would be the main focus of the therapeutic effects of sour tea. This study was conducted in Yazd Diabetes Research Center, Iran. There were 53 participants who were divided into 2 groups namely the sour teat group (ST group) and black tea group (BT group). Patients were instructed to drink one glass of decoction, which was boiled for 20-30 minutes, twice a day in the morning and night. Blood tests were done at the beginning of the study to measure their lipid levels and then compare it with the blood tests after the study. Results showed no significant change in lipid levels in the BT group but in the ST group, a significant decrease in total cholesterol, LDL, triglycerides and increase in HDL levels. With these results it revealed a decrease in atherosclerosis development. Its therapeutic effect was due to the presence of hibiscus acid and hydroxycitric acid which have strong inhibition effects on pancreatic amylase where there would now be inhibition in the breakdown of starch or glycogen to glucose thereby decreasing the excess circulating glucose in the body. With these known results, it can be an alternative option for patients who are financially burdened since these herbal plants can be found within reach aside from the lowering effect in the lipid levels thereby decreasing the risk for developing atherosclerosis.


RELEVANCE TO: A. NURSING PRACTICE Nurses can become enlightened on how to increase more or make their nursing care improve in quality such as by advancing to broader knowledge on delivery of care or on the presence of alternative ways in treating or alleviating possible burdens of diseases. With the information provided by this research, nurses can integrate the concepts in their health teachings to the community with the benefits of having a sour tea plant and utilizing them in their advantage. Through nurses health teachings, they can enhance the awareness of the community of the presence of other herbal plants which they can use as alternative medicine for the illness such as hypertension. Proper health teaching about how to do decoction or other preparations for herbal plants to extract its therapeutic effects can be done so the community can use it and pass it on to other communities increasing their awareness.

B. NURSING EDUCATION The Academe can include the points in this study when giving lectures to its students so that the students would be prepared in their exposures to community duties making them expand more their resourcefulness. Nurses can increase their knowledge by undergoing symposiums or conventions related on other alternative treatments especially herbal plants in order to share it with their community specifically other herbal plants that we dont know have existing therapeutic effects. Need to review the core responsibilities of a PHN can also be done in order not to be mislead by the increasing demands of advancing technology so that they would focus mainly on their core duties or to the needs of their community.

C. LOCAL SETTING (Philippine Setting) Here in our tropical country especially here in the cordillera, there are thousand family species of plants which some have therapeutic effect and some have none. With the presence of readily available herbal plants, community folks can be taught on how to utilize their effects on their advantage especially if they are from far flung areas where they dont have the time or capacity to come in an urban area to seek consult to a physician. Awareness is very important to empower and enhance our fellow community on health consciousness and resourcefulness and remove their intuition of medical treatment as very hard to achieve.

D. CLIENT For our family client, I can share to them the contents of this research by having health teaching on how to make decoction if they have sour tea around their backyard especially if someone in the family has high lipid levels. If other herbal plants are also found in their backyard I can teach them on how to utilize them on their advantage making them more resourceful.

E. NURSING RESEARCH It would be better if side effects of sour tea were also included so other researchers can explore more on these and use this study as a springboard. Other preparation for sour tea can also be explored aside from decoctions.


REVIEW OF RELATED LITERATURE A. Comparison of Sour and Black Tea Consumption on the Serum Lipid Oxidizability in Diabetic Patients. OBJECTIVE: Oxidative stress is a serious complication in diabetic

patients. Black tea and also sour tea contained some flavonoids with antioxidant properties and may be helpful in prevention of lipid oxidation. The aim of this study was to compare the effects of sour tea and black tea on invitro copper induced serum lipids oxidizability in diabetic

patients. MATERIALS AND METHODS: In this sequential double-blind randomized controlled clinical trial, 60 diabetic patients were divided into case and control group randomly. Patients in case group used sour tea, and control subjects used black tea as the same program for 4 weeks. Fasting blood samples were taken at the beginning and end of the study for evaluation of serum lipid oxidizability. Lipid oxidation was followed by the formation of conjugated dienes, in diluted serum, after added Cu2+. RESULTS: There were no significant differences in serum lipid oxidation parameters between the case and control groups. CONCLUSION: Our finding revealed that sour tea or black tea consumption does not affect the quantitative parameters of serum lipid oxidation.

B. The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes. To compare the antihypertensive effectiveness of sour tea (ST; Hibiscus sabdariffa) with black tea (BT) infusion in diabetic patients, this doubleblind randomized controlled trial was carried out. Sixty diabetic patients with mild hypertension, without taking antihypertensive or

antihyperlipidaemic medicines, were recruited in the study. The patients were randomly allocated to the ST and BT groups and instructed to drink ST and BT infusions two times a day for 1 month. Their blood pressure (BP) was measured on days 0, 15 and 30 of the study. The mean of systolic BP (SBP) in the ST group decreased from 134.411.8 mm Hg at the beginning of the study to 112.75.7 mm Hg after 1 month (P-value <0.001), whereas this measure changed from 118.614.9 to 127.38.7 mm Hg (P-value=0.002) in the BT group during the same period. The intervention had no statistically significant effect on the mean of diastolic BP (DBP) in either the ST or BT group. The mean pulse pressure (PP) of the patients in the ST group decreased from 52.212.2 to 34.59.3 mm Hg (P-value <0.001) during the study, whereas in the BT group, it increased from 41.911.7 to 47.39.6 mm Hg (P-value=0.01). In

conclusion, consuming ST infusion had positive effects on BP in type II diabetic patients with mild hypertension.

REFERENCE: Mozaffari-Khosravi, H., Jalali-Khanabadi, B., Afkhami-Ardekani, M., & Fatehi, F. (2009). Effects of Sour Tea ( Hibiscus sabdariffa) on Lipid Profile and Lipoproteins in Patients with Type II Diabetes. Journal Of Alternative & Complementary Medicine, 15(8), 899-903. doi:10.1089/acm.2008.0540

Jalali-Khanabadi, B., Mozaffari-Khosravi, H., & Afkhami-Ardekani, M. (2010). Comparison of Sour and Black Tea Consumption on the Serum Lipid Oxidizability in Diabetic Patients. Iranian Journal Of Diabetes & Obesity (IJDO), 2(1), 1-6.

Mozaffari-Khosravi, H., Jalali-Khanabadi, B., Afkhami-Ardekani, M., Fatehi, F., & Noori-Shadkam, M. (2009). The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes. Journal Of Human

Hypertension, 23(1), 48-54.