Journal of Complementary and Integrative Medicine

Published by De Gruyter

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Issue of Journal of Complementary and Integrative Medicine

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Journal Overview

January 20, 2023

Crude extract from Euphorbia prostrata extended curative period of glibenclemide in alloxan-induced diabetic rats

Mohammad Parvez, Farrukh Hussain, Murad Khan

Abstract

Euphorbia prostrata is traditionally used alongside antidiabetic agents to manage diabetes. Bioactive ingredients of medicinal herbs may alter the overall pharmacokinetics of antidiabetic agents. We assessed hypoglycemic activities of ethanolic plant extract (EPE) singly and its effects on antidiabetic properties of gliclazide, glibenclemide and metformin in allaxonized rats. Varying concentrations of EPE (250 and 500 mg/kg) with or without metformin (10 mg/kg), glibenclemide (2 mg/kg) and gliclazide (5 mg/kg) were orally administered to evaluate herb-drug interaction. The levels of blood glucose declined significantly after treatment with metformin, glibenclemide and gliclazide singly (p<0.01) or concomitantly with EPE (p<0.001). Concentration dependent mild to moderate reduction (5.2 and 10.0%) was registered in blood glucose for 250 and 500 mg/kg of EPE respectively. The overall reduction in blood glucose due to combined treatment with EPE and standard agents was additive. On the other hand, synergistic herb-drug interaction was registered for insulin levels in rats that received glibenclamide and gliclazide alongside EPE. Extract with metformin had antagonistic insulin outcome. Regarding the duration of hypoglycemic activities, periodical changes were similar in case of glibenclamide and gliclazide separately or in combination with EPE. However, in case of metformin with extract, the blood glucose continued to decline for 14 h and retained at 15.0% below the baseline values even after 24 h of treatment. In conclusion, the extract itself had weak hypoglycemic effects but prolonged the therapeutic duration of metformin to more than 24 h when administered combinedly.

January 9, 2023

Milicia excelsa (Moraceae) reversed the effects of letrozole-induced aromatase inhibition in rats with polycystic ovary syndrome

Jonathan Noubouossie Pouegue, Marie Alfrede Mvondo

Abstract

Objectives Polycystic ovary syndrome (PCOS) is an endocrinopathy affecting 5–20% of women of childbearing age. There is no single drug for the treatment of PCOS and current therapies have significant side effects. This study evaluated the ability of Milica excelsa to improve PCOS symptoms in rats. Methods Induction of PCOS was achieved using letrozole (a reversible aromatase inhibitor; 1 mg/kg; given orally for 21 days). From day 22, PCOS rats received the aqueous extract of M. excelsa roots (14 and 140 mg/kg). Clomiphene citrate (1 mg/kg) was administered to the positive control. The negative and the normal controls received the vehicle (5% DMSO). Treatments were given orally for 7 or 14 days. Vaginal smears were scrutinized daily during the experiment. Body weight was measured hebdomadal. Animals were sacrificed after the two treatment periods for biochemical and histological analyses. Results Aromatase inhibition caused hyperandrogenism (p<0.001), overweight (p<0.001) and fat accumulation (p<0.001). It also blocked the estrous cycle at the diestrus phase and altered ovarian dynamics as evidenced by the accumulation of cystic (p<0.001) and atretic (p<0.001) follicles. In contrast, M. excelsa induced weight loss (p<0.001), reduction in fat weight (p<0001), and lower serum androgen and LH levels (p<0.001). It also restored the estrous cycle and improved ovarian dynamics by increasing the amount of Graafian follicles (p<0.001) and corpora lutea (p<0.001), and decreasing that of cystic and atretic follicles (p<0.001). Conclusions Milica excelsa corrected hyperandrogenism and overweight in PCOS animals, and reduced cyst formation and follicle atresia in their ovaries.

January 4, 2023

Screening and validation of the iris manifestation among patients with hemiplegia – an observational study

Fathima Jebin Mohamed, Venugopal Vijayakumar, Narayanaswamy Manavalan, Kuppusamy Maheshkumar

Abstract

Objectives Understanding and validating the science behind traditional diagnostic methods is a niche area to be explored. Iris diagnosis is one such valuable diagnostic tool used in Naturopathy. In the current study, we have assessed and documented the iris changes observed among patients with hemiplegia with respect to the iridology chart. Methods We recruited 35 patients with hemiplegia which includes both genders. Iris image was captured by Angel Kiss New 5.0MP Iridology Camera with Pro Iris Analysis Software. Lesion characters, such as open lesion, closed lesion, spot, furrow, radii solaris, intestinal crypts etc., in the iris were noted along with its various characteristics in an excel sheet in numerical order for analysis. Results Majority of the included patients were male (n=30) and the mean age of the patients was 46 years. The most common iris lesions noted were radii solaris and intestinal crypt in the cerebrum and cerebellum regions. Other notable lesions include open lesion, closed lesion, brown spot, hole and nerve ring. ROC analysis for selected iris lesions showed that intestinal crypt (AUC=0.82, p=0.01) and radii solaris (AUC=0.62, p=0.04) to be potential markers for hemiplegia. Conclusions Two common lesions observed in patients with hemiplegia are radii solaris and intestinal crypt, corresponding to the cerebrum and cerebellum regions of the iris. Future studies with larger sample size would help warrant our current findings, and also the possible application of iris diagnosis as an early diagnostic marker for hemiplegia.

December 28, 2022

Protective effects of cinnamon on acetylcholinesterase activity and memory dysfunction in diabetic rats

Maryam Farazandeh, Ali Akbar Asghari, Sadegh Shabab, Narges Marefati, Arezoo Rajabian, Maryam Mahmoudabady, Mahmoud Hosseini

Abstract

Objectives Regarding neurocognitive and immunomodulatory properties of cinnamon (Cinn) we aimed to investigate whether cinnamon regulates acetylcholinesterase (AChE) activity, and oxidative abnormalities with concomitant memory dysfunction in streptozotocin (STZ)-induced diabetes. Methods 47 male adult rats were divided into seven groups (n=8 animals): Control group: in these non-diabetic rats only saline 0.9% NaCl was gavaged, Diabetic (Dia) group: diabetic rats in them saline 0.9% NaCl was gavaged for six weeks. Dia-Cinn 100, Dia-Cinn 200, and Dia-Cinn 400, Dia-Met groups: in these diabetic rats the extract (100, 200, 400 mg/kg respectively) or metformin (300 mg/kg) was gavaged for six weeks. Passive avoidance performance, AChE enzyme activity, and oxidative indicators were examined among the groups. Results vs. the Control group, blood glucose level and stay time in the dark were remarkably increased in Dia group whereas the latency time was decreased. Meanwhile, antioxidant levels (superoxide dismutase, catalase, and thiols) noticeably decreased in the Dia group compared to the Control group. On the other hand, Cinn extract espicailly at the highest dose recovered the changes similar to those found in the metformin-treated group. Conclusions These findings proposed that the cinnamon hydro-ethanolic extract promotes memory recovery in diabetic conditions through the atteuation of the AChE activity and oxidative injury.

December 21, 2022

Psychobiotic interventions attenuate chronic alcohol use-mediated exacerbation of posttraumatic stress disorder in rats: the role of gut-liver axis response

Elizabeth T. Akinluyi, Edem E. Edem, Kelvin M. Dakoru, Chinaza J. Nnodim, Michael A. Oladipupo, Olusegun A. Adeoluwa, Abiola O. Obisesan, Benneth Ben-Azu, Olusegun G. Adebayo

Abstract

Objectives The incidence of co-occurring alcohol-use disorder (AUD) and post-traumatic stress disorder (PTSD) is high, and the presence of one disorder aggravates the severity of the other. Emerging evidence shows the neuroprotective and anti-inflammation functions of psychobiotics. Hence, the study explored the effects of probiotics and synbiotic inulin on the gut- and liver-oxidative and inflammatory biomarkers in chronic alcohol exacerbation of PTSD symptoms in rats. Methods Young adult rats were administered 10% ethanol in a two-bottle choice test for six weeks and were subjected to single prolonged stress. Probiotics and synbiotic intervention followed this. Markers of oxido-inflammatory stress, liver functions, intestinal (faecal) metabolites, occludin expression, and histopathology of the ileum and liver were evaluated. Results Chronic alcohol drinking and PTSD increased oxido-inflammatory stress, markers of hepatic damage, and reduced faecal metabolites, which were attenuated by probiotic and synbiotic interventions. Furthermore, reduced immunoexpression of gut and liver occludin, with loss of barrier integrity, viable hepatocytes, congestive portal area, and shortened villi and crypt depth, were observed. Probiotic and synbiotic interventions mitigated these effects. Conclusions The study demonstrates that psychobiotics mitigate the detrimental effects of co-occurring chronic alcohol intake in the context of PTSD.

December 9, 2022

β-elemene regulates epithelial-mesenchymal transformation and inhibits invasion and metastasis of colorectal cancer cells

Heng Deng, Guo Chen, Jun Zhang

Abstract

Objectives To study the inhibitory effect of β-elemene on invasion and metastasis of colorectal cancer cells and its possible mechanism. Methods Human colon cancer HCT116 cells were treated with different concentrations of β-elemene. The proliferation inhibition rate of the cells was detected by MTT assay, cell migration rate was detected by scratched assay, and cell invasion rate was evaluated by Transwell cell invasion assay. The expressions of Vimentin, E-cadherin, N-cadherin, and β-catenin were detected by Western blotting. The mRNA expressions of Vimentin, E-cadherin, N-cadherin, and β-catenin were detected by real-time PCR. Results Compared with the control group, the expressions of migration rate, invasion rate, scratch healing rate, N-cadherin, and Vimentin protein of HCT116 cells were decreased after β-elemene treatment, while the expression of E-cadherin protein was increased, and the inhibition rate of cell proliferation was increased (p<0.05). Conclusions β-elemene may inhibit cell proliferation and invasion and metastasis by inhibiting EMT signaling pathway in human colon cancer cell line HCT116.

December 1, 2022

Evaluation of the toxicity of crude aqueous Pleurotus tuber-regium (Fr.) Singer extract in mice

Sarah Princess Edoh, Dahiru Sani, Christian Emeka Mbah, Hindatu Yusuf, Kelvin Olutimilehin Jolayemi, Mohammad Kamal Ibrahim

Abstract

Objectives The study aimed to determine the phytochemical profile and safety of the aqueous extract of Pleurotus tuber regium using laboratory animal model. Methods The pulverized sample was macerated with water and allowed to stand for 24 h, then filtered. Preliminary qualitative phytochemical screening was carried out on the crude extract and LD 50 determination was done using standard procedures. Haematological and serum biochemical parameters to assess the kidney and liver functions were carried out using standard methods. Results The phytochemical screening revealed the presence of alkaloids, cardiac glycosides, saponins, phenolic compounds, tannins, steroids, carbohydrates, flavonoids and terpenoids. However, anthraquinones were observed to be absent in the extracts. The LD 50 of the extract was found to be greater than 5,000 mg/kg when administered orally with no physical signs of toxicity and death over the 14-day period. There was no significant (p>0.05) increase in the level of serum alanine aminotransferase, aspartate transaminase, alkaline phosphatase, blood urea nitrogen and creatinine (p<0.05) when compared to the control group. There was a significant (p<0.05) increase in the total white blood cells of the mice administered with P. tuber-regium . Conclusions This study showed that P. tuber-regium (Fr.) Singer does not possess toxic principles, hence, the wide safety margin observed in the mice.

Open Access November 25, 2022

Integrative medicine approaches to chronic depression: case studies of the recovery process with a three-step path to recovery and significant cure

Ronko Itamura

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Abstract

Objectives The support provided by conventional treatments centered on the administration of medication for chronic or other types of depression is limited. Integrative medicine, which is based on both modern Western medicine and a range of complementary and alternative medicine practices, is patient-centered and promotes natural healing in patients to achieve significant cure. This report focuses on the indications of recovery from depression using integrative medicine, especially homeopathy. Methods Thirty-one patients (9 males and 22 females) with depression underwent homeopathic treatment using various strategies over 3 months, in addition to antidepressants. All patients were diagnosed with Major Depressive Disorders, except bipolar disorders. Three steps were used to model indications of their recovery from depression: reducing difficulties in everyday life, reducing and stopping antidepressants, and reducing and stopping the homeopathic remedies. Patients were considered to have recovered when antidepressants had been stopped for 6 months or more and 3 or more months had passed since homeopathic medicines were stopped. Results Of the 31 patients with depression, 13 recovered within 2 years of starting homeopathic treatment, and 11 completely recovered from chronic depression. Conclusions This study suggests that integrative medicine can be a useful strategy for depression, including the use of a three-step strategy for reducing all dependence on clinical treatment. As most patients, especially chronic patients, significantly recovered from depression through homeopathy over 2 years, this model can help understand recovery from depression through integrative medicine.

November 24, 2022

Short-term effects of a maqui-based nutraceutical on heart rate variability, psycho-physical resilience and on a few metabolic biomarkers: a randomized controlled study

Attilio Cavezzi, Roberto Colucci, Luca Bastiani

Abstract

Objectives To assess the immediate/short-term outcomes of a maqui berry-based nutraceutical (MBN) supplementation on the autonomic nervous system (ANS), resilience level, metabolism and body composition. Patients and Methods A randomized controlled single-blind study was performed on healthy subjects. Throughout 30 days, one group took 1,000 mg/day of an MBN (Maqui 500 ® ), the control group had no supplementation. On day 0 (T0) and 30 (T3) all subjects performed blood tests, bioimpedance spectroscopy and questionnaires for resilience, perceived stress and short-form 12 (SF12). At T0, 75′ after T0 (T1), on day 7 and at T3 the subjects underwent biometric parameter measurement and heart rate variability (HRV) test to investigate psycho-physical resilience. Results Fifteen subjects per group were included; abnormal seasonal high temperatures altered individuals’ lifestyle and nutrition, influencing the trial’s outcomes. Biometric parameters, blood pressure, oxygen saturation and blood tests did not differ between T0 and T3 in both groups. In the MBN group the HRV analysis showed a significant increase of ANS coordination (p=0.05), parasympathetic activity at 75′, very low frequencies and total power at T3, whereas these parameters decreased in the control group. SF12 mental score improved in the maqui group (p=0.02); the questionnaire-based outcomes showed no further variations. In the control subjects bioimpedance showed an increase of resistance and fat mass, with decreased total body water and lean mass (p=n.s.). Conclusions The maqui-based nutraceutical improved HRV, namely ANS activation/coordination, and SF12 mental component. Blood tests and bioimpedance/biometric parameters mildly varied. The elapsed hot weather likely biased many investigated variables.

November 21, 2022

The roles of HDAC with IMPDH and mTOR with JAK as future targets in the treatment of rheumatoid arthritis with combination therapy

Reshma Rajendra Mane, Pravin Popatrao Kale

Abstract

Various studies have shown that cytokines are important regulators in rheumatoid arthritis (RA). In synovial inflammation alteration of the enzyme HDAC, IMPDH enzyme, mTOR pathway, and JAK pathway increase cytokine level. These increased cytokine levels are responsible for the inflammation in RA. Inflammation is a physiological and normal reaction of the immune system against dangerous stimuli such as injury and infection. The cytokine-based approach improves the treatment of RA. To reach this goal, various researchers and scientists are working more aggressively by using a combination approach. The present review of combination therapy provides essential evidence about the possible synergistic effect of combinatorial agents. We have focused on the effects of HDAC inhibitor with IMPDH inhibitor and mTOR inhibitor with JAK inhibitor in combination for the treatment of RA. Combining various targeted strategies can be helpful for the treatment of RA.

November 21, 2022

Gallic acid a flavonoid isolated from Euphorbia hirta antagonizes gamma radiation induced radiotoxicity in lymphocytes in vitro

Ramesh Chakka, Ravichandra Vadaguru Dakshinamurthy, Pinkey Rawal, Sowmya Belladamadagu Appajappa, Soma Pramanik

Abstract

Objectives The current study was executed to isolate and evaluate gallic acid from Euphorbia hirta for in vitro radioprotective potentials against gamma irradiation caused radiotoxicity in human lymphocytes. Methods The defatted E. hirta plant material was treated to methanol extraction using the soxhlet device. Bioflavonoids were isolated from the E. hirta methanol extract using column chromatography. In human cells exhibited to gamma radiation, separated flavonoid gallic acid was examined for in vitro radioprotective potentials using the micronucleus test, DNA fragmentation assay, superoxide free radical scavenging method, and apoptic assay. Results The frequency of micronuclei was considerably declined when cells were preprocessed with Gallic acid (25 g/mL) before being exhibited to 2 Gy gamma radiation, as determined by the cytokinesis blocked micronucleus test. Similarly, pre-gamma radiation treatment of human cells with gallic acid led in markedly less DNA injury, as assessed by comet metrics like Olive tail moment and percent tail DNA. Gallic acid (25 g/mL) given to lymphocytes prior to gamma irradiation considerably decreased the percentage of apoptotic bodies. Gallic acid also considerably lowered the reactive oxygen species concentrations elicited by gamma radiation. Conclusions Our findings showed that gallic acid protects lymphocytes isolated from human blood from gamma radiation-induced DNA destruction and anti-apoptotic activity, which could be because of inhibition of free radicals formed by gamma radiation as well as the decline of gamma radiation-induced oxidative stress.

November 21, 2022

Antimicrobial, anti-adhesion, anti-biofilm properties of goji berry (Lycium barbarum) against periodontal bacteria: potential benefits for periodontal diseases

Amee Dilip Sanghavi, Aditi Chopra, Ashmeet Shah, Richard Lobo, Padmaja A. Shenoy

Abstract

Background Lycium barbarum, commonly known as goji berry, Himalayan berry, or Tibetian berry, is emerging as a popular “superfood” with anti-inflammatory and antioxidant properties. However, its use for the management of oral inflammatory diseases has not been explored. The present study aims to evaluate the antimicrobial, anti-adhesion, anti-biofilm, and cytotoxic properties of an ethanolic extract of L. barbarum (LBE) against common oral and periodontal pathogens. Methods The antimicrobial properties of LBE against five potential periodontal pathogens ( Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Tanerella forsythia ) were tested and compared to chlorhexidine and doxycycline using serial dilution and disc diffusion assay. The MTT Assay was performed for evaluating the cytotoxicity and cell viability of the LBE on the gingival fibroblast and modified keratinocyte cell lines. The anti-adhesion and anti-biofilm properties of LBE against P. gingivalis at its minimal bactericidal value were also assessed. Results LBE inhibited the growth of periodontal pathogens as compared to control, however, the zone of inhibition of LBE was less when compared to doxycycline and chlorhexidine. The de novo extract showed a maximum zone of inhibition against Tf and Aa. The LBE extract was also compatible to gingival fibroblast tissues and oral keratinocytes at 1 mg/mL. Conclusions L. barbarum is a promising alternative to Chlorhexidine for the management of oral and periodontal infections.

November 18, 2022

Effects of crude methanol extract of Adansonia digitata fruit pulp on Naja nigricollis venom-induce toxicity in Wistar rats

John Oluwamayokun Elijah, Mohammed Mamman, Dahiru Sani, Peter Ofemile Yusuf, Hindatu Yusuf, Mary Oluwatomisin Elijah, Samson James Enam, John Addra Abari, Kelvin Olutimilehin Jolayemi, Dennis Otie

Abstract

Objectives This study evaluated the effects of Crude Methanol Extract of Adansonia digitata Fruit Pulp on Naja nigricollis Venom-Induce Toxicity in Wistar rats. Methods A . digitata was extracted using 70% methanol and median lethal dose (LD 50 ) of both the extract and venom were determined using the up-and-down method. Sixty Wistar rats were randomly assigned into 10 groups of 6 rats each and were administered with normal saline, venom only, venom + antivenom, 125 mg/kg, 250 mg/kg and 500 mg/kg crude methanol extract (CME) pre-envenomation, 125 mg/kg, 250 mg/kg and 500 mg/kg CME post-envenomation, and venom + antivenom + 250 mg/kg CME, respectively. Blood samples were collected 8-h post-envenomation in EDTA and plain sample bottles. Erythrocyte osmotic fragility (EOF) test was carried out on the EDTA blood samples while serum was harvested and used for Malondialdehyde (MDA) and Superoxide Dismutase (SOD) assays. Results LD 50 of the CME and venom was >5,000 mg/kg and 0.889 mg/kg, respectively. N . nigricollis -induced oxidative stress was evident in group B through increased % haemolysis, MDA and lowered SOD activities. The groups treated with antivenom only, 250 mg/kg CME post-envenomation and antivenom +250 mg/kg CME significantly (p<0.05) reduced EOF, MDA values and increased SOD. The CME revealed better ameliorative effect than protective via inhibition of EOF, MDA values and increased SOD activity. Conclusions The CME when administered singly showed more ameliorative properties and the combination of CME with antivenom for protection was not as effective as when compared to single administration.

November 16, 2022

Method development and validation for quantification of six bioactive compounds (andrographolide, columbin, piperine, gallic, paracoumaric and oleanolic acids) by HPTLC

Murugammal Shanmugam, Subashini Subramanian, Shakila Ramachandran

Abstract

Objectives During the spread of pandemic diseases, immunity boosting herbal drugs are taken as a preventive medicine. Kapacurak Kuṭinīr Cūraṇam is a Siddha drug used for flu like viral infections, cold and fever. Developing an analytical method to estimate the content of active phytoconstituents in such antiviral immune boosting drug will be useful in the phyto pharmaceutical industry. Methods A precise, reliable and sensitive ordinary phase high performance thin layer chromatography (HPTLC) method has been developed and validated for identification and simultaneous estimation of six bioactive components namely like andrographolide, columbin, gallic acid, ρ-coumaric acid, piperine and oleanolic acid from any Indian traditional medicine, medicinal plant, drugs and food materials etc. The separation was achieved on silica gel 60F 254 TLC plates using toluene: ethyl acetate: formic acid (7:3:0.5, v/v) as mobile phase. The gallic acid, ρ-coumaric acid, piperine markers were estimated using the densitometric scanning in absorption mode at 254 nm. The densitometric scanning was done after derivatization (vanillin–sulphuric acid reagent) at λ=520 nm for andrographolide, columbin and oleanolic acid. Results The linear regression analysis data for the calibration plots showed a correlation coefficient in the concentration range 1–5 μg per band for the bioactive markers with respect to area. The method was validated for accuracy, precision, limit of detection (LOD), and quantitation of limit (LOQ). Conclusions Developed method was accurate, precise and fast to ensure the quality of Kapacurak Kuṭinīr Cūraṇam.

November 10, 2022

Palpatory tests in manual therapies: an international survey on osteopathic clinical practice

Emanuele Novelli, Livio Molinari, Stefano Consolo, Luca Mingrone

Abstract

Context In osteopathic manipulative medicine, palpatory tests are used as a primary element for osteopathic assessment. Objectives The primary aim of the study is to explore the knowledge and use of palpatory tests in detecting somatic dysfunction, the second is to assess the knowledge about the inhibitory tests among osteopathic practitioners in Italy, England, and France. Methods A quantitative survey was conducted, between March and May 2021, through the administration of a semi-structured questionnaire. The participants had to answer 8 questions. Results 2,223 e-mails were sent: 423 manual therapy professionals participated in the survey. Subsequently, only the responses of the 385 osteopaths (280 Italian, 23 French and 82 British) were included in the data processing; the 38 excluded were physiotherapists and chiropractors. The most significative outcomes for the total sample were found to: years of working experience and knowledge of a palpatory test that allows to discriminate two dysfunctional anatomical structures was significant with a χ 2 =12.509 (p-value <0.006); 68.5% answered in the affirmative to this last question. It was found that less work experience is associated with knowledge of a palpatory test to discriminate two dysfunctional structures. The correlation between years of work experience and knowledge of the inhibitory test was explored with the result being statistically significant (p value <0.001). 64.4% know and use the inhibitory test. 39.1% base the inhibitory test on tissue change. Conclusions The clinical practice of Italian and French professionals, makes possible to establish the hierarchy between two somatic dysfunctions with respect to English sample. The osteopaths reported a wider use of the tissue change parameters rather than pain reported by the patient. Furthermore, more than half of the sample-based their discriminatory test on the musculoskeletal and fascial systems. There is a vast knowledge of the inhibition test among osteopaths.

Publicly Available November 1, 2022

2022 INCAM Research Symposium

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October 31, 2022

A cross-sectional survey exploring clinician perceptions of a novel Medicaid back pain policy

Catherine J. Livingston, Mary Gray, Kate LaForge, Esther K. Choo

Abstract

Objectives Oregon Medicaid (Oregon Health Plan, or OHP) implemented an innovative policy in 2016 that increased coverage of evidence-based non-pharmacologic therapies (NPT, including physical therapy, massage, chiropractic, and acupuncture) while restricting opioids, epidural steroid injections, and surgeries. The objective of this study was to compare the perspectives of clinicians who see back pain patients and can prescribe pharmacologic therapies and/or refer to NPTs and clinicians who directly provide NPT therapies affected by the policy. Methods A cross-sectional online survey was administered to Oregon prescribing clinicians and NPT clinicians between December 2019 and February 2020. The survey was completed by 107 prescribing clinicians and 83 NPT clinicians. Results Prescribing clinicians and NPT clinicians had only moderate levels of familiarity with core elements of the policy. Prescribing clinicians had higher levels of frustration caring for OHP patients with back pain than NPT clinicians (83 vs. 34%, p<0.001) and were less confident in their ability to provide effective care (73 vs. 85%, p = .025). Eighty-six percent of prescribing clinicians and 83% of NPT clinicians thought active NPT treatments were effective; 74 and 70% thought passive NPT treatments were effective. Forty percent of prescribing clinicians and 25% of NPT clinicians (p<0.001) thought medically-light therapies were effective, while 29% of prescribing clinicians and 10% of NPT clinicians thought medically-intensive treatments were effective (p=0.001). Prescribing clinicians thought increased access to NPTs improved outcomes, while opinions were less consistent on the impact of restricting opioid prescribing. Conclusions Prescribing clinicians and NPT clinicians had varying perspectives of a Medicaid coverage policy to increase evidence-based back pain care. Understanding these perspectives is important for contextualizing policy effectiveness.

October 10, 2022

Innovative histological and histochemical characterization of tongue biopsies from patients with burning mouth syndrome

Imanol Zubiate Illarramendi, Angel Martinez-Sahuquillo, Fernando Monsalve Iglesias, Jose Dario Sanchez Lopez

Abstract

The present pilot study aims to perform an innovative histological and histochemical characterization of samples from patients with burning mouth syndrome (BMS) to correlate these findings with the clinical scenario. To carry out this objective, the study samples were stained with the hematoxylin-eosin stain and later, an histochemical study was carried out to determine the composition of the extracellular matrix (ECM) using the stains of Alcian Blue, Picrosirius, Reticulin from Gomori and Verhoeff. The results of this study revealed histological patterns compatible with cellular hypertrophy in different layers of the epithelium as well as a greater keratinization in BMS cases. On the other hand, a lower amount of proteoglycans and a greater amount of collagen fibers were observed compared to the control. In addition, older patients had fewer reticular fibers and younger patients had fewer elastic fibers compared to the control. In conclusion, the present study shows the existence of a correlation between the histological patterns, age and symptoms of patients with BMS. Therefore, it is necessary to develop synergistic studies in order to assess and implement new classification systems that could improve the therapeutic approach of patients with BMS.

October 6, 2022

A randomized, double-blind, placebo-controlled, cross-over trial to evaluate the effect of EstroSense^® on 2-hydroxyestrone:16α-hydroxyestrone ratio in premenopausal women

Tim Green, Janet See, Marita Schauch, Julie Reil, Melissa Glover, Jennifer Brix, Adella Gerry, Kathy Li, Mark Newman, Roland J. Gahler, Simon Wood

Abstract

Objectives Some estrogen metabolites are associated with increased breast cancer risk, while others are protective. Research efforts have focused on modifiable factors, including bioactive compounds found in food or supplements, promoting estrogen profiles with anti-cancer properties. EstroSense ® is a nutraceutical product with bioactive compounds, including Indole-3-carbinol and green-tea catechins, which may favourably affect estrogen profiles. This study was conducted to determine if EstroSense use, compared to placebo, promotes a higher urinary 2-hydroxyestrone:16α-hydroxyestrone ratio (2-OHE 1 :16α-OHE 1 ), a biomarker associated with a lowered risk of breast cancer. Methods 148 premenopausal women were recruited from British Columbia, Canada to participate in a randomized, double-blind, cross-over, multicentre, placebo-controlled study in which women were randomized to a treatment sequence that consisted of either EstroSense ® , followed by placebo or vice-versa. The women were instructed to consume three capsules per day of EstroSense ® or the placebo for three menstrual cycles (∼12 weeks). The primary outcome was the measurement of 2-OHE1:16α-OHE1 in casual samples at baseline and after each treatment phase. Results After 12 weeks of intervention, the mean (95% CI) urinary 2-OHE 1 :16α-OHE 1 was 4.55 (2.69, 6.42) (p<0.001) higher following EstroSense than placebo adjusted for baseline values. Conclusions EstroSense use led to markedly higher urinary 2-OHE1:16α-OHE1 than the placebo, a biomarker associated with a lower risk of breast cancer. Registration http://clinicaltrials.gov (NCT02385916).

September 30, 2022

Comparing the influence of foot reflexology and fasting mimicking diet on quality of life and sleep quality in obesity hypoventilation syndrome

Rana Hesham Mohamed Elbanna, Sherif Osama Abdelsalam Elabd, Salma Ibrahim Abdelmohsen Alghitany

Abstract

Objectives Obesity hypoventilation syndrome is one of the most serious outcomes of obesity-related respiratory difficulties, resulting in higher healthcare costs as well as increased cardio-respiratory morbidity and mortality. Subject and methods Sixty-two males who had a high risk of obstructive sleep apnea according to the STOP-BANG Sleep Apnea Questionnaire were enrolled in the study. Their age is 50–60 years old, and they have a BMI of 35–40 kg/m 2 , daytime hypercapnia, and sleep breathing problems. The patients were divided into two equal groups at random reflexology fasting-mimicking diet groups. Weight, height, waist, and neck circumference were assessed at the beginning of the study and after two months of the intervention. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), which is used to evaluate sleep quality. The Maugeri Obstructive Sleep Apnea Syndrome (MOSAS) questionnaire was used to assess a patient’s quality of life. Results There was a significant change in the MOSAS and PSQI questionnaires for both groups post-intervention, as the p-value was less than 0.05. The percentage change in the MOSAS questionnaire score and PSQI questionnaire was higher in the mimic diet group than in the reflexology group. Also, the mimic diet group’s weight and neck circumference were considerably reduced after the intervention, with no change in the reflexology group. Conclusions Reflexology and a fasting-mimicking diet were found to have a substantial impact on enhancing the quality of life and sleep in people with obesity hypoventilation syndrome.

September 12, 2022

Halimeda gracilis (Kadarpassi chooranam) Phytochemical analysis and biological significance – a novel Siddha drug

Sabari Anandh J. V, Manimekalai K, Rajendra Kumar A, Bragadeeswaran S

Abstract

Objectives To evaluate biological activity and the phytochemical analysis of kadarpasi chooranam. Seaweeds are the marine macro algae, species belonging to Protista kingdom that has no true system, internal vascular systems, seeds and flowers. It has a lot of biological activity and has been proven to have a lot of medicinal benefits. Since time immemorial, their usage in traditional medicine has been recognized. Methods Halimeda gracilis has been standardized as per siddha pharmacopoeia standard protocol guidelines and prepared kadarpasi Chooranam curtained for Phytochemical analysis (qualitative and quantitative) and carried out various pharmacological activity. Results The antioxidant, anti-inflammatory, and anti-cancer actions of kadarpasi Chooranam have been associated to alkaloids, phenols, flavonoids, cardiac glycosides, saponins, tannins, and diterpenes. Conclusions The Siddha medicine, kadarpassi chooranam has various phytochemical bioactive compounds, and because of its pharmacological activity can be a potential drug candidate for human use.

Open Access September 12, 2022

Naturopathic knowledge and approaches to managing endometriosis: a cross-sectional survey of naturopaths with experience in endometriosis care

Rebecca Redmond, Amie Steel, Jon Wardle, Jon Adams

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Abstract

Objectives Endometriosis is a chronic gynaecological disease with varying symptomatology and negative health outcomes. To ensure the best care for women with endometriosis, women require a multidisciplinary team approach. While some women consult with naturopaths for endometriosis, there has been little research on naturopathic knowledge and the naturopathic approach to endometriosis care. Methods This cross-sectional survey recruited naturopaths with experience in menstrual disorders from the Practitioner Research and Collaboration Initiative (PRACI) a Practice-Based Research Network (PBRN). Data collection was conducted via an online self-administrated 62-item questionnaire. Results Invitations were sent to 109 naturopaths who self-reported having experience in menstrual disorders, of whom 29 completed the survey (26.6% response rate). Naturopaths perceived endometriosis to be caused by inflammation (n=28, 96.5%) and risk factors associated with familial history (n=26, 89.6%). Many naturopaths aimed at reducing inflammation (n=27, 93.1%) and supporting gastrointestinal function (n=25, 86.2%) in their prescriptions. Naturopaths reported using various healthcare referrals to support women with endometriosis, primarily general practitioners (n=12, 41.3%), acupuncturists/Traditional Chinese Medicine practitioners (n=11, 37.9%), and gynaecologists (n=9, 31%). Naturopaths reported receiving referrals from general practitioners (n=8, 27.5%) and psychologists (n=6, 20.6%). Conclusions Naturopathic knowledge and management of endometriosis targets known problematic areas of endometriosis that can have debilitating effects on women’s quality of life. Naturopathic care has the potential to align with important health outcomes for women with endometriosis however, further attention is needed to assess the effectiveness and continue to establish a multidisciplinary approach involving naturopathic care.

August 26, 2022

Anti-inflammatory effect of polyherbal composition with hepatoprotective and choleretic properties on LPS-stimulated murine macrophages

Malahat Gahramanova, Andriy Ostapchuk, Olga Molozhava, Vitalina Svyatetska, Mariia Rudyk, Yevheniia Hurmach, Oleksandr Gorbach, Larysa Skivka

Abstract

Objectives A polyherbal formulation with hepatoprotective and choleretic properties combining pharmacological potential of eight medicinal plants was developed in Nargiz Medical center (Republic of Azerbaijan) for the use as herbal tea. To explore the effect of polyherbal composition on the metabolism of LPS-stimulated macrophages in vitro . Methods The qualitative and quantitative phytochemical analysis was conducted using specific color reactions and gas chromatography-mass spectrometry (GC–MS). Nitric oxide (NO) assay was determined using the Griess reaction. Reactive oxygen species (ROS) generation was measured using ROS-sensitive fluorescence indicator, H2DCFDA, by flow cytometry. Arginase activity was examined by colorimetric method. Results The studied polyherbal formulation exerted anti-inflammatory activity in LPS-stimulated macrophages which was evidenced by dose-dependent decrease of ROS generation and by shift of arginine metabolism to the increase of arginase activity and decrease of NO release. Conclusions Our findings suggest that the herbal tea reduces macrophage inflammatory activity, that provide an important rationale to utilize it for the attenuation of chronic inflammation typical of hepatobiliary disorders.

August 9, 2022

The effects of Cynodon dactylon (Poaceae family) and Dolichos biflorus (Fabaceae family) extracts on decreasing size and excretion of kidney and urinary tract stones: a randomized, double-blind controlled trial

Mohammad Azad Manjiri, Amir Abbas Asadpour, Mahdi Yousefi, Jamshid Jamali, Behrooz Davachi, Mohammad Reza Ahmadpour, Roshanak Salari

Abstract

Objectives Given high and growing prevalence rate of urolithiasis in most societies as well as the problems caused by this issue, it is necessary to apply more cost-effective and safer therapeutic methods, which are accessible for all the individuals worldwide. Therefore, this study aimed to investigate efficacy of herbal medicines named Cynodon dactylon and Dolichos biflorus on solving and excretion of renal and urinary tract stones in patients with urolithiasis. Methods This study included 96 patients with urolithiasis who were randomly allocated into three groups. The first group received the extract of D. biflorus seeds (1,600 mg), the second group received extract of C. dactylon rhizome (1,600 mg) and the third group received placebo for 21 days. In this study, we used an hydroalcoholic extract of D. biflorus and C. dactylon prepared by Soxhlet method. For each patient, the size of the stones, the amount of calcium in the urine, the number of stones excreted and their chemical substance type were measured. Results In this study, changes were observed at the significance level in the interventions groups of 1 and 2, and the placebo group in the left kidney, so that changes in size of the stone in left kidney as intergroup were significantly different in these three groups (p=0.02). The mean of changes in stone size in left kidney in the group C. dactylon was 3.78 ± 7.1 and in the group D. biflorus , it was 0.27 ± 0.6. Conclusions A significant difference in the results of this study show that C. dactylon rhizome and D. biflorus seed extracts are able to decrease the size of the stone and can be effective on kidney stones excretion.

August 2, 2022

A neurotherapy protocol to remediate cognitive deficits after adjuvant chemotherapy: a pilot study

Stephen Sideroff, David Wellisch, Valerie Yarema

Abstract

Adjuvant chemotherapy for breast cancer is undeniably effective in increasing survival rates but many breast cancer survivors (BCS) exhibit side effects including nausea, fatigue, stress, and neurocognitive deficits, known as “chemobrain.” Objectives This pilot study explored how neurotherapy, or EEG biofeedback, a non-pharmacological approach, improved neurocognitive, behavioral, and neurophysiological deficits associated with BCS who underwent chemotherapy. Methods Subjects underwent 18 sessions of EEG biofeedback training, in which audio and visual feedback occurred with successful shifting of EEG patterns. Results Quantitative EEG and assessment tests demonstrated neurophysiological, cognitive, and behavioral deficits in all nine subjects prior to training. EEG biofeedback resulted in significant improvements in neurophysiological, neurocognitive, and psychological functions in all nine subjects after training. Conclusions We propose that this intervention and related forms of EEG biofeedback have the potential to significantly alleviate common side effects of chemotherapy in BCS and therefore merits additional research attention.

July 7, 2022

Evaluation of the effectiveness of Lactuca Sativa syrup in controlling pain after periodontal flap surgery: a split-mouth, randomized, double-blind placebo-controlled trial

Hadi Jafari, Seyed Amirhossein Latifi, Mojtaba Bayani

Abstract

Objectives Effective pain control after oral surgeries including periodontal flap surgery is one of the biggest problems in the periodontology field. The use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) to reduce pain after periodontal flap surgery is common, but these have some adverse side effects such as impaired platelet function and causing digestive problems. Today, the tendency to use omedicinal plants is more than synthetic drugs due to their safety. Therefore, we designed a split-mouth randomized controlled clinical trial to evaluate the effects of Lactuca Sativa ( L.Sativa ) syrup as an adjunct therapy in reducing pain after periodontal flap surgery. Methods This split-mouth, randomized, double-blind, placebo-controlled trial was performed on 26 subjects. Patients were assigned for two surgery. Primary surgery was performed on the right maxilla and after 30 days, secondary surgery was performed on the left maxilla. In primary surgery, patients consumed L.Sativa syrup (3 times a day for 72 h) and in secondary surgery, patients consumed placebo syrup (3 times a day for 72 h). Pain intensity was measured at 6, 12, 24, 48, and 72 h after a periodontal flap surgery in both surgeries using the Visual Analogue Scale (VAS). All patients received their routine drugs, including analgesics. The number of analgesics used after surgery was recorded. Statistical analysis of t-test was used to compare the results of the two surgery. Results The results showed that the mean pain based on VAS score at 6, 12, 24, 48 and 72 h after primary periodontal flap surgery was significantly reduced compared to the secondary periodontal flap surgery (p<0.001). The results also showed that the use of analgesics after 72 h of surgery was significantly reduced in the primary periodontal flap surgery compared to the secondary periodontal flap surgery (p<0.001). Conclusions According to the results of this study, L.Sativa syrup can be effective as adjuvant therapy in reducing pain after periodontal flap surgery.

May 26, 2022

Effects of complementary spiritual therapy on stress, anxiety, burnout syndrome and hematological parameters of professionals in a public hospital: a randomized controlled trial

Élida Mara Carneiro, Livia Figueira Avezum Oliveira, Djalma Alexandre Alves da Silva, Jonatas da Silva Catarino, Rodolfo Pessato Timóteo, Chamberttan Souza Desidério, Virmondes Rodrigues Junior, Maria de Fátima Borges

Abstract

Objectives This randomized controlled trial evaluated the stress, anxiety, and burnout of professionals exposed to complementary spiritist therapy (CST), which consists in therapeutic resources as prayer, Spiritist passe , fluidic water and spiritual education or control. Methods Seventy-six professionals were randomized to CST or control: to maintain the routine for 5 weeks. The ISSL scale, anxiety and depression Beck’s indices, Maslach instrument, subjective well-being and WHOQOL-BREF were used at baseline and five-week. Blood count and cytokine dosage were collected at baseline, one-week and five-week. Analysis using the intention to treat approach. Results The means of variation of stress (exhaustion phase) between baseline and five-week were −1.50 ± 3.31 in the CST and 0.72 ± 3.50 in the control (p=0.036), effect size for CST group was d=0.65, which is considered medium effect. CST showed decrease in emotional exhaustion and negative affects, and increase in lymphocytes, erythrocyte parameters and platelets between the baseline and five-week (p<0.05). Reduction in IL-1β and increase in total lymphocyte count were observed with 2–3 sessions per week, but that does not maintain when the number of sessions is decreased. Participants receiving ≥7 sessions reduced emotional exhaustion, depersonalization and stress, and improved hematological parameters throughout the study (p<0.05). Conclusions CST may be effective in reducing stress (exhaustion phase) compared to control. Higher frequency of interventions promotes better psychic state, evidenced by large effect size for emotional exhaustion in burnout, and improves hematological parameters of professionals. Trial registration ClinicalTrials.gov Identifier NCT03356691.

February 14, 2022

Plants with potential anti-ulcerogenic activity and possible mechanism of actions based on their phyto-constitutional profile

Ekta S. Keny, Pravin Popatrao Kale

Abstract

Gastric ulcer, the most common disorder of the digestive tract is formed due to an imbalance between acid and mucus content of the stomach. However, the currently used western therapeutic regimens have many drawbacks like adverse effects, recurrence of gastric ulcers, are expensive, and also, may have interactions with other drugs. Hence, there is a need for effective alternative therapy. Medicinal herbs have been used since ancient times to treat several diseases and are also evidenced to be effective against gastric ulcers. It is also evident that medicinal herbs have been proved to be equally effective or superior as compared to the existing synthetic medicines. In this review, five herbs have been taken into consideration and assumed to be effective against gastric ulcers. Abrus mollis , Korean Thistle ( Cirsium japonicum var. maackii ), Astralagus complanatus Bunge, Bauhinia monandra , and Embelia ribes Burm f. are the herbs whose data is been collected and reviewed for their potential gastro-protective action. Although, their side effects and toxicity profile need to be further evaluated. Hence, the purpose of this review is to gather evidence of these five medicinal herbs and their probable mechanism of action against gastric ulcers based on their phyto-constitutional profile.

January 31, 2022

Variation determinants within massage therapists’ professional identity

Amanda Baskwill, Meredith Vanstone, Del Harnish, Kelly Dore

Abstract

Objectives Individuals have multiple, competing identities that vary in importance to the self. Professional identity is a way in which individuals attribute meaning to their contribution to society and is influenced by complex factors. Globally, the roles and responsibilities of massage therapists (MTs) vary, making it challenging to articulate a cohesive professional identity. This article describes the investigation into the variables which influenced response regarding MTs’ professional identity in Ontario, Canada. Methods An online questionnaire was distributed to active MTs with available email addresses in the public register of the College of Massage Therapists of Ontario. Chi-square tests of independence were used to compare dependent variables with independent variables. Significance was adjusted post hoc, using Bonferroni’s correction, to reduce the chance of a type I error occurring. The threshold for significance was adjusted from p≤0.05 to p≤0.01 as multiple analyses were conducted with a high response rate. Results The results provided insight into the variables associated with differences in responses. Variation was seen based on gender, primary practice setting, length in practice, additional education, additional roles within the profession, additional designation as a healthcare provider, and membership in the RMTAO. Conclusions While previous studies sought to describe the common and unifying features of MTs’ identity, these findings provide insight into variables that determine differences in responses. These findings are valuable for the development of future studies. They provide a priori assumptions regarding the inclusion of these demographic items that can inform decisions regarding enrollment of the sample and data analysis.

January 25, 2022

The effect of Salvia officinalis on blood glycemic indexes and blood lipid profile in diabetic patients: a systematic review and meta-analysis

Ali Abdollahi, Faeze Adelibahram, Nafiseh Ghassab-Abdollahi, Mostafa Araj-khodaei, Zahra Parsian, Mojgan Mirghafourvand

Abstract

Diabetes is one of the most common endocrine disorders that increases the economic burden on the public health system. In this regard, understanding the effect of available herbs on diabetes can be useful. This systematic review was performed to determine the effect of Salvia officinalis on blood glycemic indexes and blood lipid profile (primary outcomes) and 2 h postprandial blood glucose (2HPPG), alanine transaminase (ALT) (U/L) and aspartate transaminase (AST) (U/L) and its side effects (secondary outcomes) in diabetic patients. A systematic search was conducted in the English (Cochrane Library, Medline (PubMed), Scopus, CINAHL, ProQuest and Persian databases since inception to March 2021, without publication time restriction. Two authors separately evaluated the quality of the articles using Cochrane Collaboration’s tool for assessing the risk of bias in randomized trials and extracted the data. Heterogeneity of data was evaluated by squared I ( I 2 ). Three studies included in the review and all of them included in meta-analysis. The results of meta-analysis showed that S. officinalis reduced fasting blood sugar (FBS) (mg/dL) (MD: −31.15; 95% CI: −37.56 to −24.73; p<0.00001). It also reduced HbA1c (%) (MD: −0.94; 95% CI: −1.25 to −0.63; p<0.00001) and total cholesterol (mg/dL) (MD: −43.64; 95% CI: −83.26 to −4.02; p=0.03) and reduction of low-density protein (LDL) (mg/dL) (MD: −19.23; 95% CI: −35.81 to −2.65; p=0.02) but it did not have a significant effect on triglyceride (mg/dL) (p=0.09), and high-density lipoprotein (HDL) (mg/dL) (p=0.18). Regarding the secondary outcomes, S. officinalis also had significant effect on 2HPPG, but it did not have a significant effect on ALT (U/L) and AST (U/L). No specific side effects for this plant were reported in these three studies. The results showed that S. officinalis has a positive effect on blood glycemic status and blood lipid profile in diabetes except for triglyceride and HDL. However, due to the small number of included articles, it is recommended that stronger clinical trials be conducted in this field.

January 24, 2022

The effect of lavender on mothers sleep quality in the postpartum period: a systematic review and meta-analysis

Leila Seiiedi-Biarag, Mojgan Mirghafourvand

Abstract

Poor sleep quality in the postpartum period can have various negative effects on the health of mothers and infants such as anxiety, depression, low breastfeeding self-efficacy and disrupted child-mother attachment. Accordingly, intervention seems necessary to improve sleep quality. Given the probable effect of lavender on sleep problems, the present research intended to determine its effects on mothers’ sleep quality during postpartum period. The PubMed, Embase, Cochrane Library, Scopus databases and the Persian language databases (Magiran and SID) were searched for all the articles they included at the end of February 2021. The risk of bias of the included studies was assessed using the Cochrane tool. The results of the meta-analysis were reported as the standardized mean difference (SMD). Heterogeneity of the studies was investigated using the I-squared test (I 2 ). Three out of the 292 obtained studies entered the meta-analysis. The results indicated that sleep quality in the group receiving lavender improved compared to the control group, (SMD = −0.61; 95% CI: −1.07 to −015 p = 0.01) whereas the heterogeneity was higher. (I 2 = 75%; Tau2 = 012; Chi2 = 7.905, p = 0.02). According to the results of this systematic review, use of lavender can improve postpartum maternal sleep quality. However, further randomized controlled trials using identical methodology, larger sample sizes and longer follow-up periods are needed.

January 10, 2022

Neuroprotective potential of Celastrus paniculatus seeds against common neurological ailments: a narrative review

Divya Sankaramourthy, Lakshmi Sankaranarayanan, Kavimani Subramanian, Sudha Rani Sadras

Abstract

The most common human neurodegenerative diseases like Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease (HD) etc. have been recognized to result from a complex interplay between genetic predisposition and defective cellular dynamics such as inappropriate accumulation of unfolded proteins, oxygen free radicals and mitochondrial dysfunction. The treatment strategies available today for these neurodegenerative ailments are only palliative and are incapable of restraining the progression of the disease. Hence, there is an immense requirement for identification of drug candidates with the ability to alleviate neuronal damage along with controlling progression of the disease. From time immemorial mankind has been relying on plants for treating varied types of dreadful diseases. Among the various medicinal plants used for treating various neurological ailments, Celastrus paniculatus (CP) popularly known as Jyotishmati or Malkangni is well known in the Ayurveda system of Indian Traditional Medicine whose seeds and seed oil have been used for centuries in treating epilepsy, dementia, facial paralysis, amnesia, anxiety, sciatica, cognitive dysfunctions etc. This review apart from specifying the phytochemical characteristics and traditional uses of C. paniculatus seeds and seed oil also exemplify the comprehensive data derived from various research reports on their therapeutic potential against some common neurological disorders.

December 17, 2021

Effects of Yogic practices on cardiovascular system and salivary alpha amylase on Indian healthy jail inmates

Khushbu Jain, Rameswar Pal, Sachendra Badoni, Jitender Kaushik, Pooja Kumari Gond, Ishwar V. Basavaraddi

Abstract

Objectives Imprisoned people usually have a poor health status and an increase risk to suffer chronic debilitating conditions, co-infection due to their limitations in physical activity and mental disturbances. This study was carried to find out the health impacts of Yogic practice of Indian healthy jail inmates. Methods It was interventional single group pre-post design study. A total no of 30, Jail inmates including 08 female were participated in this study and practiced Yoga for six months. Body Mass Index, Heart Rate, Blood Pressure, Salivary alpha amylase activity (SAA) a stress marker were assessed before, after three months and after completion of six months of Yogic practice. Results Improvement was noted in all parameters, but significant improvement was noted in systolic blood pressure, diastolic blood pressure, mean blood pressure, double product a index of load in the heart and SAA following Yogic practice in total participants. Significant improvement was also noted in systolic blood pressure, diastolic blood pressure, mean blood pressure, double product a index of load in the heart and SAA following Yogic practice in male group. No significant effect was noted in female group. Conclusions The present study revealed that regular Yogic practice resulted in reduction blood pressure, load in the heart and stress in mail jail inmates, when it is practiced regularly and carefully.

December 16, 2021

Intuitive and mindful eating to improve physiological health parameters: a short narrative review of intervention studies

Lauren C. Hayashi, Giada Benasi, Marie-Pierre St-Onge, Brooke Aggarwal

Abstract

Objectives This brief narrative review aims to give an up-to-date overview of intuitive and mindful eating (I/ME) interventions with specific focus on cardiometabolic risk factors, including glucose, lipid profile, blood pressure and inflammatory markers. Content I/ME intervention studies in adults which measured at least one physiological parameter other than weight were identified from PubMed. The clinical trial/randomized controlled trial filters and publication dates 2001 through April 2021 with variations of the following keywords were applied: intuitive eating, mindful eating, weight neutral. Ten articles were identified. Summary/Outlook Of the 10 studies, seven showed I/ME interventions were more effective than control in at least one cardiometabolic outcome, two showed significant I/ME within-group improvements but no between-group differences, and one showed neither within-group nor between-group differences. Specifically, I/ME improved glucose levels among pregnant women with or without gestational diabetes, lipid profile among adults with overweight or obesity, blood pressure among participants with overweight and inflammatory markers among post-menopausal women with obesity. However, the positive impact of I/ME on each of these cardiometabolic parameters was not consistent across studies: of the six studies that examined glucose regulation, two demonstrated positive outcomes for I/ME group, whereas four found no effect compared to control. Three out of five studies had positive lipid effects, one out of five demonstrated systolic blood pressure (SBP) improvements and one of two showed improvements in inflammatory markers. Given these mixed results, more research is needed to understand the possible effectiveness of I/ME to improve cardiometabolic health.

December 3, 2021

Trends in the St. John’s wort (Hypericum perforatum) research literature: a bibliometric analysis

Jeremy Y. Ng

Abstract

Objectives St. John’s wort ( Hypericum perforatum ) has been used in traditional medicine for centuries for different conditions, including kidney and lung ailments, insomnia, depression, and to aid wound healing. The objective of the present bibliometric analysis is to capture the characteristics of research publications on the topic of St. John’s wort. Methods Searches were run on April 09, 2021, and results were exported on the same day to prevent discrepancies between daily database updates. Trends associated with this subset of publications were identified and presented. Bibliometric networks were constructed and visualized using the software tool VOSviewer. Results A total of 1,970 publications were published by 5,849 authors across 961 journals from 1859 to 2021. Beginning in the late 1990s, a steep increase was found in the volume of publication on this topic. The journal that published the largest number of publications was Phytotherapy Research. The most productive countries included Germany and the United States. Conclusions The present study provides the characteristics of the St. John’s wort literature that allows understanding of the past, present, and future of research in this area. It is a useful evidence-based framework on which to base future research actions and academic directions.

December 3, 2021

Degradation product of curcumin restrain Salmonella typhimurium virulent protein L-asparaginase

Archana Vimal, Mohammad Haris Siddiqui, Ashish Verma, Awanish Kumar

Abstract

Objectives Salmonella typhimurium is a pathogen responsible for causing a wide range of infectious diseases. The emergence of multi-drug resistance (MDR) in this microbe is a big challenge. L -asparaginase (less explored drug target) is selected as a drug target because it is actively involved in the virulence mechanism. To block this virulent enzyme, curcumin that is traditionally renowned for its medicinal properties was examined. However, its pharmacological behavior and targeting property is less understood because of its poor bioavailability. Therefore, the present work explores the antimicrobial effect of both curcumin and its degradation product against the MDR pathogen. Methods Molecular docking studies were carried out to evaluate the inhibitory effect of curcumin and its degradation product against the L -asparaginase enzyme using Schrodinger Maestro interface tools. The Absorption, Distribution, Metabolism, Excretion and Toxicity (ADMET) profile of all the test ligands was also performed. Results The docking score of curcumin was −5.465 kcal/mol while its degradation product curcumin glucuronide has the lowest i.e., −6.240 kcal/mol. All the test ligands showed better or comparable docking scores with respect to control (Ciprofloxacin). Arg 142 and Asn 84 amino acid residues of L -asparaginase were found to be interacting with test ligands inside the binding pocket of the target protein. ADME/toxicology study also indicated the potency of curcumin/curcumin degradation products as a potent inhibitor. Conclusions It was found that both curcumin and its degradation products have the potential to inhibit Salmonella . This information could be valuable for futuristic drug candidate development against this pathogen and could be a potential lead for mitigation of MDR.

November 25, 2021

Effect of cell phone use on salivary components; a review of literature

Fateme Arbabi Kalati, Tahereh Nosratzehi

Abstract

Mobile phones have been increasingly used in the past decade and have become a cultural instrument. There is a great concern over the harmful effects of electromagnetic and radiofrequency waves as well as microwaves generated by mobile phones and their telecommunication stations on health. The saliva plays an important role in preserving oral homeostasis as the first defensive line against the microbial invasion which protects oral mucosa mechanically and immunologically. A search was run in Pub med, Goggle Scholar, Medline, and Web of Science databases using the following keywords: cell phone, mobile phone, antioxidant profile, saliva, oxidative stress, interleukin, and inflammation. Sixty-five published articles were identified. Studies on the use of cell phones as educational aids, the use of immune histochemistry on salivary glands, or the evaluation of saliva in individuals with specific conditions, such as the use of orthodontic brackets, were excluded. In addition, duplicate articles are eliminated, and finally, 14 articles were included in the present study. Nowadays mobile phone is very popular, causing concern about the effect it has on people’s health. Parotid salivary glands are in close contact with a cell phone while talking with the phone and the possibility of being affected by them; so this study was designed to investigate the effect of cell phone use on salivary components.

November 19, 2021

Anti-osteoporotic effect of Terminalia arjuna (Roxb.) Wight & Arn. In bilateral ovariectomized induced post-menopausal osteoporosis in experimental rats

Nimisha Kakadia, Niranjan Kanaki

Abstract

Objectives In ancient times Terminalia arjuna (Roxb.) Wight & Arn. (TA) was used for fast healing of fracture and to strengthen the bone. However, no scientific study has been done to validate its usefulness in the alleviation of osteoporosis. To investigate the efficacy of stem bark TA against post-menopausal osteoporosis using bilateral ovariectomized rat model. Methods Aqueous (TAA) and methanolic (TAM) extracts of TA was evaluated for its anti-osteoporotic activity. Sham control rats were allotted as Group I (Normal control); Group II animals acted as OVX control (Disease control); Group III OVX rats were treated with estrogen (Standard group – 2 mg/kg) Group IV and V OVX rats give treatment to TAA (250 and 500 mg/kg, p.o.), respectively. This treatment is continue for the four weeks and at the end, serum biochemical parameters such as serum calcium and alkaline phosphate were evaluated. Femoral bone parameters (Compression of vertebrae, femoral neck load testing, Three point bending of tibia, Femur length and weight), histology, body weight, and fifth lumbar vertebra breaking strength were also assessed after the sacrificing the animal. Results In OVX rats, atrophy of uterus and descent of BMD were suppressed by treatment with TAA and TAM. In addition, TAM 500 completely corrected the decreased serum concentration of Calcium, Phosphorus, ALP and TRAP observed in OVX rats. TAA and TAM both increased biomechanical strength significantly in comparison to the sham group. Histological results also revealed its protective action through elevation of bone formation. TAM significantly increase the uterine and femoral bone weight The TAM showed maximum anti-osteoporotic activity in in vivo study as compare to TAA. Conclusions The results, evaluated on the basis of biochemical, bone mineral density, biomechanical, and histopathological parameters, presented that TAA and TAM has a definite antiosteoporotic effect, like to estrogen, especially effective for inhibition bone fracture induced by estrogen deficiency.

November 12, 2021

Fast improvements in functional status after osteopathic manipulative treatment based on myofascial release in patients with moderate or severe fibromyalgia: a retrospective study

Fulvio Dal Farra, Angelo Chiesa, Roberta Giulia Risio, Luca Vismara, Andrea Bergna

Abstract

Objectives Fibromyalgia (FM) is a chronic pain syndrome characterized by a large variety of symptoms. Evidence suggests that an alteration of central nervous system processing of pain could be involved. The purpose of this study is to analyze clinical records of patients affected by FM who underwent osteopathic manipulative treatment (OMT), predominantly based on a myofascial release approach (MFR). Methods This retrospective study considered records of 21 FM patients with moderate or severe functional impact, who consented to OMT in addition to their usual care. The assessment considered the following measures: FIQ (functional status), SF36 (quality of life), VAS (pain), TSK (kinesiophobia) and PSQI (quality of sleeping). Patients were preliminarily assessed over a 1 month run-in phase, then after 1, 2 and 4 months; a 1 month follow-up was also considered. Results After one month, 71% of patients reported a decrease in functional impact and scores remained stable until follow-up (from 69.8 to 52.37, p≤0.001). Overall, after four months, patients improved their quality of life, with a score ranging from 33.47 to 42.6 (p≤0.05). We also observed a reduction of pain (p≤0.05). Conclusions A series of OMT sessions based on MFR could play a therapeutic role in improving functional status, pain and quality of life over a period of 4 months.

November 11, 2021

Osteopathic structure/function models renovation for a person-centered approach: a narrative review and integrative hypothesis

Francesca Baroni, Marco Tramontano, Nicola Barsotti, Marco Chiera, Diego Lanaro, Christian Lunghi

Abstract

Objectives The construct of the osteopathic structure-function models is reported as a cornerstone of clinical reasoning and treatment processes. Nevertheless, there are no shared procedures described for their use in clinical practice. The present narrative review aims to analyze a more comprehensive perspective on the phenomenon. Methods A structured narrative review was conducted . A database search was conducted using Pubmed, ScienceDirect, and Google Scholar. Peer-reviewed papers without specifying limits on dates and design were included. Results Twenty-five findings were reported and grouped into two main themes: 1) Debate on models and theoretical frameworks for osteopathic care; 2) Clinical reasoning and decision-making process in the osteopathic field. Conclusions An integrated osteopathic care approach based on the structure/function models represents a starting point to establish a shared osteopathic diagnostic and clinical reasoning and an evidence-informed practice promoting health in an interdisciplinary person-centered care process. The present review highlights the limited amount of literature on using osteopathic conceptual models in decision-making and treatment strategies. A research plan is required to develop a common framework for an evidence-based osteopathic practice that promotes well-being in an interdisciplinary person-centered care process.

November 11, 2021

Anti-hyperplastic effects of the Dacryodes edulis (Burseraceae) leaves aqueous extract on tamoxifen-induced endometrium hyperplasia on Wistar rat

Marie Alfrede Mvondo, Marius Trésor Wego Kamgaing, Sylvie Léa Wansi Ngnokam

Abstract

Objectives Combining tamoxifen, the most common breast cancer hormonal therapy, with natural antitumor substances may prevent its hyperplastic effects on the uterine endometrium. Dacryodes edulis ( DE ) is traditionally recommended for the treatment of cancerous diseases. To investigate its antiproliferative properties, the present study was designed to assess the ability of the combined administration of tamoxifen with the aqueous extract of DE leaves to inhibit the trophic effect of this hormone therapy on rat uterine endometrium without compromising its non-proliferative effect on breast tissue. Methods Ovariectomized (OVX) female Wistar rats were simultaneously treated with tamoxifen (10 mg/kg) intraperitoneally and DE leaves (at doses of 25, 50 and 100 mg/kgBW) by gavage. Control groups received either distilled water or tamoxifen alone. Treatments lasted 37 days. The 38th day, animals were sacrificed under anesthesia (diazepam: 10 mg/kgBW and ketamine: 50 mg/kgBW). The relative uterine weight was determined and the histological analysis of the uterus and mammary gland was performed. The oxidative status of the uterus was assessed and the levels of cholesterol and estradiol were evaluated in serum and uterus. Results Tamoxifen increased uterine weight and induced endometrial hyperplasia. This effect was associated with increased uterine levels of cholesterol (164.22%; p < 0.001), estradiol (927.5%; p < 0.001) and malondiadehyde (86%; p < 0.05), but unchanged antioxidant enzymes activities. The administration of DE leaves unchanged tamoxifen-increased uterine weight but reduced uterine epithelium hypertrophy (56.4%; p < 0.01). DE also increased uterine levels of malondiadehyde and antioxidant enzymes. The levels of estradiol and cholesterol in the uterus decreased while no changes were observed in the mammary gland of animals treated with tamoxifen alone or in co-administration with DE . Conclusions D. edulis has antiproliferative properties and could complement endocrine therapy of estrogen-dependent breast cancer.

November 9, 2021

Role of Bifidobacterium spp. intake in improving depressive mood and well-being and its link to kynurenine blood level: an interventional study

Yusr I. Kazem, Maha H. Mahmoud, Hend A. Essa, Osama Azmy, Wafaa A. Kandeel, Marwa Al-Moghazy, Ibrahim El-Attar, Adel Hasheesh, Nayra S. Mehanna

Abstract

Objectives Evidence for the contribution of the brain-gut-microbiota axis to the depression pathophysiology is increasing nowadays. Disturbed gut microbiota equilibrium along with bad dietary habits both lead to kynurenine pathway abnormalities contributing to the depression pathophysiology. In this respect, many studies are found but the interventional clinical trials are limited. The present interventional study aims to evaluate the impact of Bifidobacterium spp. supplementation together with improving dietary intake on depressive mood and well-being and their correlation with kynurenine blood level in adult Egyptian healthy volunteers. Methods A number of 98 healthy female volunteers with a mean age of 46.96 ± 1.82 years were selected and enrolled in this study. They were given yogurt enriched with Bifidobacterium spp. daily for eight weeks. Clinical examination as well as questionnaires for the evaluation of psychological well-being and depression were done at base line and after eight weeks of intervention. Fasting blood samples and stool samples were collected from all subjects at baseline and eight weeks after the intervention for the investigation of serum kynurenine concentration, blood hemoglobin, serum transaminases (ALT & AST) serum urea and creatinine as well as fecal Bifidobacterium count. Results Data revealed that both depression and well-being showed highly significant improvement combined with significant drop in kynurenine blood level after intervention. Also, a significant rise in fecal Bifidobacterium count and a significant improvement in hemoglobin level and activity of liver enzymes were recorded. After intervention, a significant negative correlation was recorded between depression and fecal Bifidobacterium count as well as between serum kynurenine level, and well-being. Conclusion Bifidobacterium spp. supplementation combined with improvement in dietary intake resulted in improvement of depressive mood and well-being and reduced kynurenine blood level.

November 3, 2021

Antidiarrheal activity of Bridelia ferruginea bark methanolic extract involves modulation ATPases in mice and inhibition of muscarinic acetylcholine receptor (M3) and prostaglandin E2 receptor 3 (EP₃) in silico

Blessing Olugbamila Omolaso, Julius Kolawole Adesanwo, Ahmed Adebayo Ishola, Adeoti Gbemisola Adegoke, Francis O. Akingbule, Yetunde Ayoka Ipadeola, Kayode Ezekiel Adewole

Article number: 000010151520210240

Abstract

Objectives Diarrhea, an abnormal state in which the individual has about three or more daily bowel movements, is now considered one of the most challenging global public health problems. Using plant products, such as Bridelia ferruginea is an alternative treatment option. The objective of this study was to investigate the antidiarrheal activity of B. ferruginea bark methanolic extract (BfME) and the mechanisms involved. Methods BfME antidiarrheal activity was evaluated in mice model of castor oil-induced diarrhea and enteropooling. To evaluate motility, gastrointestinal transit time was carried out using phenol red meal, while intestinal activities of selected ATPases were also evaluated. Furthermore, the active components in BfME were detected by GC-MS analysis, while molecular docking of the most abundant compounds with muscarinic acetylcholine receptor (M3) and prostaglandin E2 receptor 3 (EP 3 ) were conducted. Results BfME at 400 and 800 mg/kg showed antidiarrheal activity by delaying onset of diarrhea, reduced gastrointestinal transit and increased intestinal activities of Na + K + -ATPase, Ca 2+ Mg 2+ -ATPase and Mg 2+ -ATPase. Molecular docking revealed that γ-sitosterol, α-amyrin, and stigmasterol have outstanding binding affinity for M3 and EP 3 . Conclusions In view of these results, the observed antidiarrheal activity possibly occurs via the activation of ATPases activities and inhibition of M3 and EP 3 .

October 27, 2021

Immediate effect of a meditation technique on blood glucose, state anxiety and relaxation in patients with type 2 diabetes: a pilot randomized crossover study

Xu Wen, Apar Avinash Saoji, Kashinath Metri, Sriloy Mohanty, Venugopal Vijayakumar

Article number: 000010151520200359

Abstract

Objectives Type 2 Diabetes Mellitus (T2DM) is a major burden on global health and economy. Various Yogic techniques are found to be beneficial in the management of T2DM. Mind Sound Resonance Technique (MSRT) is one of the yoga-based meditation techniques observed to be effective in clinical settings. Methods Thirty-two patients with T2DM were randomized to either MSRT or supine rest (SR) sessions on two separate days separated by a washout period of one day. Fasting blood glucose levels were measured before and immediately after the sessions. State anxiety and subjective feeling of relaxation were assessed using Spielberg’s state anxiety inventory (STAI) and Visual Analogue Scale (VAS) respectively. Results There were significant differences between MSRT and SR groups in fasting blood glucose (p=0.019), STAI scores (p<0.001) and subjective relaxation (p<0.001). Within group analyses revealed significant reductions (p<0.001) in fasting blood glucose and STAI scores, along with an increase in subjective relaxation following the practice of MSRT, whereas, non-significant changes were found following the SR session. Conclusions A single session of MSRT was found to reduce blood glucose levels and state anxiety along with enhanced relaxation when compared to SR.

October 22, 2021

Arq Ajīb – a wonder Unani formulation for inhibiting SARS-CoV-2 spike glycoprotein and main protease – an in silico approach

N. Zaheer Ahmed, G. Dicky John Davis, Asim Ali Khan, Lavanya Prabhakar, Meena Ram Paratap, Zeba Afnaan, Meera Devi Sri, Noman Anwar

Article number: 000010151520210241

Abstract

Objectives The current pandemic caused by Severe Acute Respiratory Syndrome Corona-Virus 2 (SARS-CoV-2) has become a global health menace with significant morbidity and mortality besides huge socioeconomic implications. Despite the approval of few vaccines for the prevention of the disease, the discovery of safe and effective countermeasures especially from natural sources is of paramount importance, as the number of cases continues escalating. Arq Ajīb has long been used for various diseases and its ingredients have been reported for antiviral, antimicrobial, antipyretic, anti-inflammatory, antioxidant activities. The present study investigates the inhibitory effect of phytocompound of Arq Ajīb on potential drug targets of SARS-CoV-2. Methods The structures of phytocompounds present in Arq Ajīb were retrieved from PubChem database and some were illustrated using Marvin Sketch. SARS-CoV-2 S glycoprotein (PDB ID: 6LZG) and 3CL pro (PDB ID: 7BQY) were selected as the target protein. Dock Prep module in UCSF Chimera software was used for receptor structure processing. AutoDock Vina was used to calculate the binding affinities between the protein and ligands and to predict most promising compounds with best scores. Results Molecular docking results predicted that the phytocompounds of Arq Ajīb had good binding affinity and interaction with S glycoprotein and 3CL pro . Quercetin and Isorhoifolin from Mentha arvensis were identified as promising candidates with the potential to interact with 3CL pro and spike glycoprotein and inhibit the viral replication and its entry into the host. Conclusions Arq Ajīb may prove valuable for developing novel therapeutic candidate for COVID-19; however, it has to be substantiated further with in-vitro and in-vivo studies.

October 21, 2021

Leaf paste of Telfairia occidentalis favourably modulates deleterious effects associated with exposure to diethylnitrosamine in male Wistar rats

Solomon E. Owumi, Jeremiah O. Olugbami, Andrew O. Akinnifesi, Oyeronke A. Odunola

Article number: 000010151520210151

Abstract

Objectives Diethylnitrosamine (DEN) is found in workplaces, processed meats, tobacco smoke, whiskey, etc. It is capable of forming DNA-adducts. Fluted pumpkin ( Telfairia occidentalis [ To ]) is a medicinal plant, and its herbal preparations have been employed variously in ethnomedicine. Furthermore, it has been reported to possess anti-oxidant, anti-cancer, anti-inflammatory properties. We investigated the possible mitigating effect of the leaf paste of To on DEN-induced deleterious effects in male Wistar rats. Methods Forty-five rats weighing between 100 and 150 g were equally divided into nine groups and treated thus: Group 1 (negative control), Group 2 (0.05 mg/kg carboxymethyl cellulose [CMC] daily), Group 3 (positive control, 25 mg/kg bw DEN administered intraperitoneally thrice per week), Group 4 (25 mg/kg bw quercetin [QUE] daily alone), Groups 5 and 6 (100 and 200 mg/kg bw To daily, respectively), Group 7 (25 mg/kg bw DEN and QUE), Groups 8 and 9 (25 mg/kg bw DEN with 100 and 200 mg/kg bw To , respectively). Blood glucose levels, liver damage biomarkers (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and gamma-glutamyltransferase [γ-GT]), frequency of micronucleated polychromatic erythrocyte (mPCEs), and liver histology were assessed. Results DEN significantly (p<0.05) increased blood glucose levels, activities of ALT, AST and γ-GT, and frequency of mPCEs. Histologically, DEN caused a severe architectural anarchy. However, the intervention groups demonstrated the remarkable protective properties of To by ameliorating the adverse effects caused by DEN. Conclusions Taken together, the leaf paste of To is capable of mitigating DEN-induced hepatotoxicity and clastogenicity in male Wistar rats.

October 15, 2021

Exploring the scope of homoeopathy in combating the unfortunate consequences of post-COVID-19 survivors based on non-COVID conditions: a narrative review

Ashish Kumar Dixit, Nibha Giri, Shishir Singh

Article number: 000010151520210200

Abstract

Objectives The long-term consequences of COVID-19 survivors care and post-coronavirus infection are not yet well understood. The review aims to see whether homoeopathy can help COVID-19 survivors recover from its consequences and improve their quality of life. Content A systematic search of published articles for post-COVID sequelae and the impact of Homoeopathy were conducted. For the literature search, the major electronic bio-medical database PubMed/MEDLINE was used. In addition, supplementary searches were conducted through the references of those published articles. Summary A total of 113 records were identified of which 61 studies included for this review. Homoeopathy is effective in the treatment of mental disorders including anxiety and depressive disorder (ADD), some research studies have found, although systematic reviews disagree. Likewise, some medical societies denounce homoeopathy for pain management; other literature shows that it can be used to treat pain effectively. Homoeopathy can aid in the treatment of cardiovascular diseases, as Crataegus, a homoeopathic medication, was found to be just as effective as a standard angiotensin-converting enzyme (ACE) inhibitor and diuretic treatment for minor cardiac insufficiency. The outcomes for Chronic Fatigue Syndrome (CFS), Influenza, and Acute Respiratory Tract Infections (ARTIs) are also promising. Outlook Based on the results of homoeopathy in non-COVID conditions, it can be thought of in the management of post-COVID-19 outcomes. Consequently, we propose that while investigating post-COVID-19 patient rehabilitation, homoeopathic management may be included as part of the follow-up route and as much data as possible in the context of homoeopathy should be collected, so that in future, the role of homoeopathy in dealing with it can be better demonstrated. Highlights – The long-term consequences of post coronavirus infections are poorly understood. –The aim of this review is to understand how Homoeopathy may aid COVID 19 survivors in regaining function and improving their quality of life. – Based on non-COVID conditions, Homoeopathy has the potential to play an important role in the treatment of post-COVID 19 survivor complaints such as psychiatric illness, pain management, fatigue syndrome, and cardiovascular complications.

October 14, 2021

Use and perception of complementary and alternative medicine among Iranian psychologists

Hadi Tehrani, Mahbobeh Nejatian, Alireza Jafari

Article number: 000010151520210285

Abstract

Objectives The seeking and use of Complementary and Alternative Medicine (CAM) modalities by people to treat mental disorders has increased and it is necessary for psychologists to have the necessary information in this field. This study aims to evaluate the use and perception of CAM by Iranian psychologists. Methods This cross-sectional study was conducted on 100 psychologists selected by the census in 2019. Data collection tools consisted of four sections of the demographic section, the CAM questionnaire for psychologists, awareness of CAM, and use of CAM. The validity and reliability of this questionnaire were confirmed. Results The mean (standard deviation) scores of attitude and educational needs were 40.45 (11.36) and 33.93 (5.96), respectively. Only 19.25% of psychologists had sufficient knowledge of CAM, and most of them (56.34%) reported that there is an educational need for CAM. In this study, 64% of psychologists used CAM for themselves. There was a significant relationship between the attitude toward CAM modalities and the suggestion of CAM to the clients (p=0.025). There was also a significant relationship between the use of CAM by psychologists and the suggestion of these modalities to their clients (p<0.001). Conclusions Psychologists had not sufficient awareness about CAM and had a moderate attitude. Most of the psychologists reported that there is educational need for CAM. Therefore, it is necessary to design and implement appropriate training courses for psychologists toward CAM modalities.

Open Access October 11, 2021

Efficacy and safety of Ayurveda interventions for sinusitis: a systematic review and meta-analysis

Azeem Ahmad, Manohar S. Gundeti, Parth P. Dave, Sophia Jameela, Shruti Khanduri, Bhogavalli Chandrashekhar Rao, Narayanam Srikanth

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Abstract

Objectives To provide a broad evaluation of the efficacy and safety of Ayurveda interventions for the management of sinusitis. Methods Five electronic databases for published research articles, three databases for the dissertation/doctoral thesis works, clinical trial registries, and hand searches were done till May 2021. All comparative clinical trials recruiting sinusitis patients of any age group, receiving Ayurveda intervention, regardless of forms, dosages, and ingredients, for not less than one week were included. The data extraction and the risk of bias (RoB) assessment were done by two reviewers independently. Results A total of 2,824 records were identified, of which 09 randomized parallel arms trials met inclusion criteria. No studies were found comparing Ayurveda vs. placebo or non-Ayurveda interventions. Combined Ayurveda therapy (CT) was statistically more beneficial compared with either procedural or non-procedural Ayurveda therapy alone in reducing symptoms nasal discharge (standardized MD −0.71, 95% CI −1.16 to −0.26, I 2 58%, 210 participants) and headache (standardized MD −0.44, 95% CI −0.86 to −0.02, I 2 56%, 218 participants), however, no significant difference was found in reducing symptoms nasal obstruction and loss of smell. No data related to the safety of Ayurveda intervention was found. All the trials (09) were having ‘high’ to ‘some concern’ overall bias. Conclusions Although individual studies appeared to produce positive results, very low certainty of total effect hindered to arrive at any conclusion regarding efficacy or safety of Ayurveda interventions for sinusitis. There is a need for well-designed-executed-reported clinical studies on clinically relevant outcomes. PROSPERO registration number CRD42018103995

October 1, 2021

Does acupuncture improve sexual dysfunction? A systematic review

Fatemeh Abdi, Zainab Alimoradi, Nasibeh Roozbeh, Marjan Akhavan Amjadi, Mehri Robatjazi

Article number: 000010151520210194

Abstract

Objectives Sexual dysfunction can adversely affect the quality of life and interpersonal relationships. nowadays, a lot of attention is paid to traditional Chinese medicine with better curative effects and less adverse events. Recent studies have implied the promising effect of acupuncture on sexual function. This systematic review evaluate the effectiveness and safety of acupuncture in treating female and male sexual dysfunction. Content PubMed, Cochrane Central of Controlled Trials (CENTRAL), EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Scopus, and Google Scholar were searched up to 2021. No limitation to language and date. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Summary Among 160 initially assessed papers, 13 articles were included. The findings showed that acupuncture improve sexual dysfunction in domains of desire, libido, erectile dysfunction and impotency. Most studies did not report any serious side effects from acupuncture, and only three studies reported minor adverse events. Outlook The available evidence indicate that acupuncture has positive on improvement of sexual dysfunction with no serious side effects. Although acupuncture has gained increasing popularity for the management of sexual dysfunction, high methodological quality evidence regarding its efficacy is lacking. Highlights – No systematic review research has yet been carried out the effect of acupressure on sexual dysfunction men and women together. Hence, this systematic review aimed to evaluate the effect of acupressure on female and male sexual dysfunction – No limitation to language and date this systematic review – The all of acupressure types included in this systematic review – The side effects of acupressure evaluated. – Due to the negative effects of sexual disorders on people’s lives leading to discontent, people are increasingly approaching clinics therefor the acupressure pointes and treatment design report in this systematic review can help with health provider to improve sexual function among men and women.

September 29, 2021

A randomized controlled clinical trial to evaluate safety and efficacy of a Unani formulation in the management of Kalaf (Melasma)

Ifra Abdul Qaiyyum, Mohammad Nawab, Munawwar Husain Kazmi

Article number: 000010151520210353

Abstract

Objectives Kalaf (Melasma) is an acquired facial hypermelanism. It has direct impact on patient’s quality of life and leads to development of various personality disorders. Lack of effective treatment and recurrences have drawn the attention of researcher to find alternative treatment. This study aimed to evaluate safety and efficacy of a topical Unani formulation in the management of melasma. Methods We conducted a prospective randomized controlled clinical study on the participants diagnosed with melasma. The participants (n=72) randomized into test (n=36) and control (n=36) groups. Sixty participants (n=30 in each group) completed the duration of therapy. The participants of the test group were treated with a classical Unani formulation and control group with hydroquinone 4%. The primary end point was change in mean MASI score and secondary end point was improvement in quality of life after eight weeks of treatment. Results The Unani formulation reduced 40.5% mean MASI score (17.31 ± 9.58 to 10.28 ± 5.92) in comparison to 32% reduction in mean MASI score (20.58 ± 9.49 to 13.92 ± 7.38) in the control group after eight weeks of treatment. When comparing with baseline the difference in MASI score was found statistically significant in both groups (p<0.05). On intergroup comparison, the change in MASI score between both groups was not statistically significant (p>0.05). In addition, MQOL and DQLI also improved significantly in both groups. Conclusions This study concluded that the Unani formulation and the control drug were equally effective and safer in the management of melasma.

September 27, 2021

Effect of moderate intensity resistance training with blood flow restriction on muscle strength and girth in young adults –a randomized control trial

Tanya Gujral, Jeyanthi Subburaj, Kiran Sharma

Article number: 000010151520210271

Abstract

Objectives To examine the effects of moderate intensity resistance training with blood flow restriction on muscle strength and forearm girth. Methods Total of 39 students enrolled in this study were divided into three groups that is group A (control group), group B and group C. Group A performed exercise training without restrictive pressure, group B & C performed exercise training with 50 and 75 mmHg respectively. Both the outcome measures were evaluated on day 1 and day 12th with the help of digital dynamometer and measuring tape. Results Repeated measure ANOVA with Post hoc analysis was done using SPSS software version 20. The result of the study showed significant (p≤0.05) within subject improvement in muscle strength and muscle girth in all the three groups. However, significant improvement in muscle strength was found in between group analysis (p≤0.05). Conclusions The results of the study can be concluded as the partial blood flow restriction (50 mmHg) with moderate intensity resistance training resulted in greater handgrip strength than the other two groups. No difference was found in forearm girth among the three groups, however within the group difference was found. Highlights - The High Resistance training improves muscle strength and endurance but it also produces high load on joints. In an attempt to find an alternative to conventional high resistance training, blood flow restriction is combined with resistance training. - But there is lack of literature regarding the optimal vascular occlusion pressure for muscle strength and hypertrophy. - This study explores the effect of moderate intensity training with Blood Flow restriction at different pressures (0, 50, 75 mmHg) and to find the ideal pain free cuff pressure for attaining good muscle strength and hypertrophy.

September 22, 2021

Non-alcoholic fatty liver disease – discussed under the light of Unani medicine

Mohd Riyazuddin, Arisha Shahid

Article number: 000010151520210296

Abstract

Non-alcoholic Fatty Liver Disease (NAFLD) is one of the diseases that have evolved lately into a major challenge for gastroenterologists. Although, the term NAFLD has not been familiar to the medical world since long, other conditions resembling the presentation of NAFLD have been there since primitive times. It is a reversible condition of the liver, wherein large vacuoles of triglyceride fat accumulates in liver cells via the process of steatosis, despite any evidence of excessive alcohol consumption. In the developed countries NAFLD is reported to be the most common liver disorder, with a worldwide prevalence of 6–35%, in India its prevalence has been increasing gradually. Unani physicians have described liver as one of the principal organs of the body. It is the primary source of natural faculties, where the functions of digestion, concoction, absorption and excretion are performed, normally temperament of liver is hot and moist which can get converted to cold due to mutable dietary habits, consumption of fatty and cold food in abundance etc. In Unani System of Medicine, NAFLD has not been described as such, but it can be studied under Su’-i-Mizāj Kabid Bārid due to correlation of most of the symptoms. Its management mainly consists of elimination of morbid matter which is accumulated in the liver and correction of Su’-i-Mizāj Kabid Bārid by using drugs having opposite temperament ( Ilaj bil zid ).

September 15, 2021

Phytochemistry and pharmacology of Celastrus paniculatus Wild.: a nootropic drug

Mohd Aleem

Article number: 20210251

Abstract

Objectives Celastrus paniculatus Wild is an evergreen climbing shrub. The plant is of great significance in the traditional Indian System of Medicine, such as Ayurveda, Unani, and Siddha. The seeds and their oil are extensively used to treat neurological disorders such as cognitive dysfunction, paralysis, epilepsy, insomnia, and other ailments like rheumatism, arthritis, sciatica, and leprosy. This paper aims to highlight the nootropic activity of C. paniculatus and explore its phytochemistry, traditional uses, and other pharmacological activities. Methods All available information concerning C. paniculatus has been searched in the internationally accepted scientific databases, including PubMed, ScienceDirect, Scopus, and Google Scholar. Additional knowledge was gathered from the classical Textbooks and Unani Pharmacopoeia. Results C. paniculatus is a rich source of several secondary metabolites, such as β-Dihydroagarofuranoids sesquiterpenes, alkaloids (Celastrine, Celapanin, Celapagin, and paniculatin), flavonoids, terpenoid (β-amyrin, Lupeol, Pristimerin), sterols (β-sitosterol, campesterol, stigmasterol, α-tocopherol, γ-Tocopherol), fatty acid (palmitic, stearic, oleic, linoleic, linolenic acids) and non-fatty acids (Benzoic acid, Cinnamic acid). The various study shows that the extracts and active constituent of this plant possess potent nootropic activity. Besides nootropic activity, it has also been reported for anti-Alzheimer, anticonvulsant, antidepressant, antioxidant, analgesic, anti-inflammatory, antiarthritic, gastroprotective, anti-psoriatic, wound healing, antibacterial, antimalarial, and several other properties. Conclusions Several in vitro and in vivo trials confirm the conventional use of C. paniculatus in cognitive dysfunction. However, the relations between the possible mechanisms of other activities and traditional uses of the C. paniculatus remain indistinct. Still, pharmacological studies also explored the effects of C. paniculatus , which were not recognized in ancient times, such as cytotoxic, ACE inhibitor, and antidiabetic activities. These discoveries are may be beneficial in the development of the new drug to treat various diseases. It is also confirmed that the β -dihydroagarofuranoids exhibit significant AChE inhibitory, cytotoxic, antibacterial, and insecticidal effects. This versatile medicine is truly a life elixir. Considering the therapeutic importance of the C. paniculatus and the absence of any reported clinical studies, extensive clinical trials are needed to explore its memory enhancing and other activities.

September 10, 2021

Impact of yoga and physical exercise on psychological wellbeing among substance abusers: a randomized controlled trial

Ananda Gaihre, Rajesh Kumar Sasidharan, Suman Bista, Lisasha Poudel, Rakshya Khadka, Bibek Rajbhandari

Article number: 000010151520200506

Abstract

Objectives Substance use disorder is a pattern of recurrent use of illicit substances that leads to severe psychosocial imbalance and recurrent relapse. The study was to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing psychological wellbeing, compared with physical exercise among substance abusers. Methods In this randomized controlled study, 96 male participants with substance use disorder from a residential rehabilitation treatment center, Kathmandu, Nepal, were randomly allocated into two groups namely the yoga group (n=48, mean age ± SD=25.18 ± 6.43) and the physical exercise group (n=48, mean age ± SD=25.02 ± 5.02). The participants in the yoga group attended the 90 min yoga sessions for 12 weeks (six days per week) whereas the physical exercise group attended exercise sessions for the same duration. Above mentioned interventions were in addition to standard rehabilitation treatment. The study measured the Self-Control, Anxiety, Depression, Sleep parameters, and Mindfulness at the baseline and after 12 weeks of intervention. Results A significant enhancement in self-control was observed in both the yoga (p<0.033, d =0.33) and the exercise group (p<0.038, d =0.32). Yoga group showed significant improvement in mindfulness score (p<0.017, d =0.37), whereas exercise group did not show any significant changes in mindfulness (p<0.169, d =0.21). The depression and anxiety scores reduced significantly in both yoga (p<0.044, d =0.31; p<0.025, d =0.35 resp.) and exercise (p<0.032, d =0.34. p<0.039, d =0.32. resp.) group. Furthermore, significant reduction was seen in sleep disturbance after yoga (p<0.001, d =0.52) and exercise (p<0.001, d =0.78) intervention. The sleep – somnolence score reduced significantly only in yoga group ( p <0.020 , d = 0.36). The magnitude of improvement was higher in the yoga group than physical exercise group on self-control, mindfulness, depression, anxiety and some sleep parameters, however the between group differences could not reach to the level of significance. Conclusions The 12 week yoga intervention did not appear to be significantly more effective than the 12 week physical exercise program on psychological wellbeing in male participants with substance use disorder. However, greater improvement in psychological wellbeing was observed within the yoga group. In future, a multi-centric study with robust design, larger sample size and longer follow-up is required to conform the present results and to find out the difference between the impacts of yoga and physical exercise on psychological wellbeing in substance abusers.

August 30, 2021

Low back pain patients’ perceived effectiveness of utilizing complementary and alternative medicine: a systematic review of qualitative studies

Jeremy Y. Ng, Mrinal Anagal, Trisha Bhowmik

Article number: 20210071

Abstract

Objectives The purpose of this systematic review of qualitative studies is to explore patients’ perceived effectiveness of utilizing complementary and alternative medicine (CAM) for the treatment and/or management of low back pain (LBP). Methods MEDLINE, EMBASE, AMED, and CINAHL were systematically searched from database inception until May 2020. Eligible articles included qualitative data about LBP patients’ perceptions of using CAM. Results Of 1,567 items, 1,542 items were excluded; the remaining 25 articles were included in this review. Three themes emerged as follows: physical benefits; mental health benefits; and negative or no perceived effectiveness of CAM on patients with LBP. Conclusions This study explores perceptions of CAM effectiveness among patients with LBP. These findings provide valuable information to CAM and non-CAM practitioners regarding the importance of individualized patient care based on their preferences, values, needs, and perspectives. Further exploration could include practitioners’ perceptions of CAM and their impact on the patient-practitioner relationship.

August 23, 2021

Efficacy and tolerability of Lavandula angustifolia in treating patients with the diagnosis of depression: a systematic review of randomized controlled trials

Ahmad Shamabadi, Shahin Akhondzadeh

Article number: 000010151520200498

Abstract

Pharmacotherapy is the conventional treatment for depression, with only half of the patients responding to the first trial of monotherapy with first-line medicines. One way to overcome this resistance is to use complementary and alternative medicine. The antidepressant effects of Lavandula angustifolia , which is commonly called lavender, have been investigated in previous studies. This study aims to provide the first systematic review of lavender in treating patients with depression diagnosis. ISI Web of Science, Scopus, PubMed, Embase, PsycINFO, Google Scholar, and three trial registries were searched until May 2020 to find randomized controlled trials on lavender for depressed patients. The primary outcome was difference between the intervention and control groups in changing depression scores from baseline to endpoint. The included studies were assessed for effect size and methodological quality. Seven clinical trials were identified, in which 852 patients were studied. In six trials, the effectiveness of lavender in treating depression was reported, as being more pronounced adjunct to a typical antidepressant in one study. Significant reported side effects include headaches and eructation. Lavender is beneficial, tolerable, and safe in treating depression. Despite obtaining promising results, they are not enough to recommend prescribing lavender to depressed patients. Further high-quality, large-scale studies for rectifying the shortcomings of existing studies are recommended.

July 14, 2021

Evening primrose oil for cervical ripening in term pregnancies: a systematic review and meta-analysis

Shahla Hemmatzadeh, Sakineh Mohammad Alizadeh Charandabi, Afsaneh Veisy, Mojgan Mirghafourvand

Article number: 000010151520200314

Abstract

Induction of labor by using available, inexpensive and non-invasive methods with the least side effects is particularly important. A systematic review was conducted to assess the effect of evening primrose oil on cervical ripening in term pregnancies. In this systematic review and meta-analysis of clinical trials, a search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, Clinical Trials.gov, Google Scholar and Persian databases (Magiran, SID, and IRCT.ir) for published related articles without any time limit. The Cochrane handbook was used to determine the risk of bias of the included articles. The obtained data were analyzed in RevMan and reported in forest plots. The Odds Ratio (OR) was used to find the effect of the dichotomous data and the Mean Difference (MD) for the continuous data. The heterogeneity of the studies was assessed using I 2 , T 2 and Chi 2 . The random effect was used instead of fixed effect if I 2 >40%. A total of 28 titles and abstracts were extracted, 9 articles entered into the meta-analysis. The meta-analysis results showed significant differences between EPO and control groups in terms of bishop score (MD=1.32; 95% CI: 0.98 to 1.66), reducing caesarean section rate (OR= 0.61; 95% CI: 0.43 to 0.86), duration of first stage of labor (MD= -98.67; 95% CI: -140.98 to -56.38) and duration of second stage of labor (MD= -10.98; 95% CI: -21.86 to -0.09). There were no significant differences in terms of birth weight (MD= 100.97; 95% CI: -11.91 to 213.84) and the frequency of induction with oxytocin (OR= 0.53; 95% CI: 0.27 to 1.01). It seems evening primrose oil be effective for cervical ripening, reducing cesarean section rate and shortening the duration of labor. Due to the high heterogeneity of the studies, the researchers recommend further researches on the subject using a standard tool based on the CONSORT statement.

June 23, 2021

A non-inferiority randomized controlled clinical trial comparing Unani formulations & PUVAsol in non-segmental vitiligo

Nazim Husain, Qamar Uddin, Munawwar Husain Kazmi, Mohd Khalid

Article number: 000010151520210057

Abstract

Objectives Greco-Arab medicine is an ancient system of medicine with greater treasure on therapeutics of vitiligo. The trial Unani formulations have not been scientifically explored for their safety and efficacy, but have been repeatedly prescribed by the great Unani physicians in the management of Baraṣ (vitiligo). Hence, these interventions were selected for the trial. Methods In this randomized, controlled, open-label clinical trial, 82 participants with non-segmental vitiligo aged 18–40 years were block randomized to either receive Unani interventions or control for 16 weeks. Out of 82 participants, 42 were randomized to the Unani group and 40 were randomized to the control group. The primary outcome measure was change in vitiligo area scoring index (VASI), which was assessed on weeks 4, 8, 12 and 16. The secondary outcome measures included the patient’s global assessment on VAS and investigator’s global assessment based on photographic evaluation at baseline and after the treatment. Safety parameters included hemogram, LFTs, RFTs, CXR, ECG, urine, and stool examinations, which were evaluated at baseline and after the treatment. Results The per-protocol analysis was done on 30 participants in each group and the response in Unani group was not inferior to those receiving control group. The mean ± SD of vitiligo area scoring index (VASI) decreased from 4.09 ± 2.87 and 5.50 ± 5.73 at baseline to 3.13 ± 2.20 and 4.29 ± 4.95 at the end of the trial in both the Unani and control groups respectively. Conclusions The study inferred that both the interventions are equally effective and well-tolerated in patients with non-segmental vitiligo.

June 3, 2021

Efficacy of individualized homeopathic medicines in primary dysmenorrhea: a double-blind, randomized, placebo-controlled, clinical trial

Shubhamoy Ghosh, Rai Khushboo Ravindra, Amila Modak, Shukdeb Maiti, Arunava Nath, Munmun Koley, Subhranil Saha

Article number: 000010151520200512

Abstract

Objectives Homeopathic treatment is claimed to be beneficial for primary dysmenorrhoea (PD); still, systematic research evidences remain compromised. This study was undertaken to examine the efficacy of individualized homeopathic medicines (IH) against placebo in the treatment of PD. Methods A double-blind, randomized, placebo-controlled trial was conducted at the gynecology outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, West Bengal, India. Patients were randomized to receive either IH (n=64) or identical-looking placebo (n=64). Primary and secondary outcome measures were 0–10 numeric rating scales (NRS) measuring intensity of pain of dysmenorrhea and verbal multidimensional scoring system (VMSS) respectively; all measured at baseline, and every month, up to 3 months. Group differences and effect sizes (Cohen’s d ) were calculated on intention-to-treat (ITT) sample. Results Groups were comparable at baseline (all p>0.05). Attrition rate was 10.9% (IH: 7, placebo: 7). Differences between groups in both pain NRS and VMSS favoured IH over placebo at all time points (all p<0.001, unpaired t -tests and two-ways repeated measures analysis of variance) with medium to large effect sizes. Natrum muriaticum and Pulsatilla nigricans (n=20 each; 15.6%) were the most frequently prescribed medicines. No harms, serious adverse events and intercurrent illnesses were recorded in either of the groups. Conclusions Homeopathic medicines acted significantly better than placebo in the treatment of PD. Independent replication is warranted. Trial registration: CTRI/2018/10/016013.

May 13, 2021

A comparative study of chemical constituents and safety of Thai herbal medicated oil formula and traditional medicated oil

Poorada Booncharoen, Waranya Boonchai, Pravit Akarasereenont, Pinpat Tripatara

Article number: 000010151520200454

Abstract

Objectives Medicated oil has been traditionally used as an analgesic medicine to relieve pain by applying to the skin over painful muscles, and has been established in The National List of Essential Medicines (2556 B.E.). Traditional Medicated oil (TMO) consists of cassumunar ginger, Wan En Lueang, and Wan Ron Thong. It is prepared by frying herbs in coconut oil which is a traditional method. Thai Herbal Medicated oil formula (MOF) comprises cassumunar ginger, sweet flag, lesser galangal, wild turmeric, Wan En Lueang, and Wan Ron Thong. Its preparation by maceration with methyl salicylate is modified method to avoid the heat in the traditional preparation. Since both recipes have different methods of extraction and compositions, it is necessary to determine the chemical constituents and acute skin irritation potential of MOF and TMO. Methods This study applied Gas Chromatography-Mass Spectrometry (GC-MS) for quality assessment of MOF extract and TMO extract. The mass spectra of the compounds matched with authentic standards from the NIST library. The compounds were identified by comparing their retention time and peak area, and the percentage of matched factor was more than 80%. The safety assessment on acute skin irritation used the 4 h human patch test (4 h HPT) in 36 healthy subjects. Results The 37 compounds were found in MOF extract. The most common chemical constituents were terpene derivatives; monoterpenes and sesquiterpenes, and others, namely benzene derivatives, ester, phenylpropanoid, and other compounds. The 33 compounds were found in TMO extract and the chemical groups were similar to MOF extract. The 4 h HPT demonstrated that the MOF extract, TMO extract, methyl salicylate solvent, and coconut oil solvent, did not induce skin irritation. However, the vehicle of the formulae and the whole formulae as MOF and TMO clinically induced skin irritation and accorded with rubefacient. The characteristic as mild erythema or dryness, but not erythema with edema, could appear after the use of rubbing skin products. Conclusions The chemical constituents found in MOF and TMO extracts were partially different and their acute skin irritation reactions were not significantly different. A study on the efficacy of both remedies should be performed in the future, as well as a study on active chemical constituents. This study provides scientific evidences of quality and safety, including GC-MS condition for poly-herbal medicated oil standardization.

May 11, 2021

Efficacy of Ayurvedic treatment protocol in gouty arthritis – a clinical study

Aswathi Rajan Vaprath Kuniyil, Devipriya Soman, Mahesh C. Kundagol, James Chacko

Article number: 000010151520200301

Abstract

Objectives Gout is an inflammatory response to the Monosodium urate crystals formed secondary to hyperuricaemia. The prevalence of gout has increased in recent years. The current conventional medical management aims at symptomatic management. In Ayurveda, gouty arthritis has similarity to Vata-Pittadhika Vatarakta , owing to its comparable aetiology and clinical features and treatment was planned accordingly. The present study is designed to evaluate the combined effect of Ayurvedic formulations and therapy in reducing the signs and symptoms and uric acid level in Gouty Arthritis. Methods The study was a single group pre–post test design. The patients diagnosed on the basis of ACR EULAR Gout classification 2015 criteria. They were given Guduchi Siddha Ksheeravasthi (Therapeutic enema), Guduchi ( Tinospora cordifolia ) Kashaya (diluted decoction) and Punarnava Guggulu . Assessment of pain was done by Visual Analogue Scale and serum uric acid level was assessed on day 1 and on 31st day. Also, the change in symptoms were analyzed before and after the treatment. This study has been registered in the clinical trial registry-India. Results The obtained data were evaluated using paired t-test and Wilcoxon signed rank test. A significant improvement (p=0.0001) was observed in VAS scale (98.77%), serum uric acid levels (57.81%), subjective parameters. Moreover, erythrocyte sedimentation rate was observed to be normal level as compared to baseline of the therapy also with an enhancement of hemoglobin (Hb) levels. Conclusions Thus, the present study revealed that Ayurvedic therapeutic interventions can play a major role in the management of gouty arthritis.

May 6, 2021

Knowledge, attitude and perception of complementary and alternative system of medicine in Tamilnadu and Pudhucherry, South India

Poonguzhali Shanmugam, Venugopal Vijayakumar, Sadhana Socrates, Sankaralingam Thirupathy Venkateswaran, Maheshkumar Kuppusamy

Article number: 20200194

Abstract

Objectives Complementary and Alternate medicine (CAM) remains as the major source of healthcare for majority of the Indian population. This widespread resource needs to be strengthened, adequately trained and effectively utilized in the national health care delivery system for delivering an integrated and effective health care system. Methods A cross sectional study was conducted involving 200 adults in two different settings-a community setting (n=100), and a hospital setting (n=100). A semi-structured questionnaire was used. Results Both in the community and in the hospital, siddha (80%) was the most well-known system of medicine, followed by Yoga (72%) and Naturopathy in the study population. However, the knowledge about the various available CAM therapies still seemed to be limited. Conclusions Opinion on the integrated approach along with conventional medicine was welcoming. Still more awareness about these systems is required to facilitate integrative medicine in healthcare settings.

May 6, 2021

Time to say good-bye? Homeopathy, skeptics and thoughts on how to proceed

Jürgen Pannek, Susanne Pannek-Rademacher

Article number: 000010151520200491

Abstract

Background Although homeopathy is frequently used by many health professionals, there are ongoing debates concerning its effectiveness. Currently no unifying explanation how homeopathy works exists. Homeopaths are frequently challenged by skeptics, and in public opinion, the swan song for homeopathy is frequently sung. Content Regarding the efficacy of homeopathy, several well-designed RCTs, observational studies, case studies, and case reports, have been published, demonstrating its clinical efficacy. Regarding its mode of action, the discovery of the working principle of homeopathy would be a major advance towards a thorough scientific recognition of homeopathy. Basic research has already discovered some milestones, e.g., significant and reproducible effects of homeopathic preparations in plants. Summary To overcome the distrust of skeptics and public opinion, the support of basic research is indispensable. Second, homeopaths should continue to design prospective randomized clinical studies in order to create robust clinical evidence for the efficacy of homeopathy. Third, they should continue to publish their treatment outcomes, as these publications document clinical effectiveness beyond doubts about its mode of action. Outlook These measures will not only support homeopaths in continuing their clinical work, but may lead to a better recognition of this treatment in both the scientific world and the public.

Publicly Available November 2, 2020

Abstracts from 2020 INCAM Research Symposium: Integrative Health at the Crossroads: Learning from the Past, Co-Creating the Future

Article number: 20202120

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About this journal

Objective
Journal of Complementary and Integrative Medicine (JCIM) focuses on evidence concerning the efficacy and safety of complementary medical (CM) whole systems, practices, interventions and natural health products, including herbal and traditional medicines. The journal is edited by Ed Lui of the University of Western Ontario.

Topics

Quality, efficacy, and safety of natural health products, dietary supplements, traditional medicines and their synthetic duplicates
Efficacy and safety of complementary therapies
Evidence-based medicine and practice, including evidence of traditional use
Curriculum development, educational system and competency of complementary health programs
Methodologies on research and evaluation of traditional medicines and herbal products
Integrative medicine: basic and clinical research and practice
Innovation in CAM Curriculum
Educational Material Design

Article formats
Research Articles, Review Articles, Mini Reviews, Discussion/Opinion Papers, Short Communications, Editorials

Ahead of Print / Just Accepted

Issue of Journal of Complementary and Integrative Medicine

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