Journal of Complementary and Integrative Medicine

Published by De Gruyter

Volume 10 Issue 1 -

Issue of Journal of Complementary and Integrative Medicine

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Publicly Available December 20, 2013

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Phytochemistry & Product Quality

October 15, 2013

Chemical and pharmacological standardization of Ashwagandhadi lehyam: an ayurvedic formulation

Arun Rasheed, K.V. Satyanarayana, P. Swetha Gulabi, M. Sindhura Rao

Page range: 1-9

Abstract

Standardization is an important measurement for ensuring the quality control of herbal drugs. It has become essential to develop reliable, specific and sensitive quality control methods. One of the prime ingredients of Ashwagandhadi lehyam is Withania somnifera L. Dunal (Solanaceae) (ashwagandha). In the present study, Ashwagandhadi lehyam was formulated and the quality assessment of the formulation was based on phytochemical screening and physico-chemical evaluation. Ashwagandhadi lehyam was formulated according to a working formula and subjected to phytochemical screening by FTIR analysis and HPTLC fingerprinting, heavy metal determination by AAS, determination of alcohol content, tested for Escherichia coli , Staphylococcus aureus , aerobic bacteria, yeasts and mould, oral toxicity studies and anti-epileptic activity by MES method. The physico-chemical studies showed total ash content as 6.45%, extractive values and some trace elements such as lead, mercury, cadmium and arsenic with 3.2, 0.05, 0.18 and 0.48 ppm, respectively. FTIR and HPTLC studies revealed the presence of functional groups of withanolides in Ashwagandhadi lehyam, resulting in its chemical standardization. The formulation exhibited less epileptic seizures in various phases when compared with that of standard phenytoin and found to possess better anti-inflammatory activity, thus making it biologically standardized. The physico-chemical and pharmacological analysis to standardize Ashwagandhadi lehyam confirmed its use as a safe anti-inflammatory agent and for various seizure disorders.

June 12, 2013

Phytochemical screening and toxicity studies on the methanol extract of the seeds of moringa oleifera

Temitayo Olabisi Ajibade, Ruben Arowolo, Funsho Olakitike Olayemi

Page range: 11-16

Abstract

: The seeds of Moringa oleifera were collected, air-dried, pulverized, and subjected to cold extraction with methanol. The methanol extract was screened phytochemically for its chemical components and used for acute and sub-acute toxicity studies in rats. The phytochemical screening revealed the presence of saponins, tannins, terpenes, alkaloids, flavonoids, carbohydrates, and cardiac glycosides but the absence of anthraquinones. Although signs of acute toxicity were observed at a dose of 4,000 mg kg − 1 in the acute toxicity test, and mortality was recorded at 5,000 mg kg − 1 , no adverse effect was observed at concentrations lower than 3,000 mg kg − 1 . The median lethal dose of the extract in rat was 3,873 mg kg − 1 . Sub-acute administration of the seed extract caused significant (p<0.05) increase in the levels of alanine and aspartate transferases (ALT and AST), and significant (p<0.05) decrease in weight of experimental rats, at 1,600 mg kg − 1 . The study concludes that the extract of seeds of M. oleifera is safe both for medicinal and nutritional uses.

July 3, 2013

First report of fingerprinting dried herbal products using a subtractive diversity array

Linhai Niu, Nitin Mantri, Hans Wohlmuth, Chunguang Li, Charlie C. Xue, Edwin Pang

Page range: 17-27

Abstract

Introduction Sequence-independent microarrays have never been used to identify and authenticate dried herbal plants. Methods : We report successful fingerprinting of seven species: Leonurus sibiricus, Astragalus membranaceus, Coix lachryma-jobi, Magnolia biondii, Abutilon theophrasti, Physalis alkekengi , and Salvia miltiorrhiza from dried tissues using a sequence-independent microarray, “Subtracted Diversity Array”. Results : Herbal plants could be identified from tissues as they were sold at the clinic. Hierarchical cluster of these species generated using SPSS v.15.0 confirmed to their predicted taxonomical relationships as specified in the Angiosperm Phylogeny Group II classification system. A polymorphism rate of 40.7% was achieved from the 376 spots used for fingerprinting. Functional characterization of polymorphic features by sequencing revealed 27.1% of those were retroelements or genes. Conclusions : This technique provides a new way to produce markers for authenticating dried herbal samples.

Preclinical Studies

July 6, 2013

Antidiabetic and antihypertensive effect of Virgin Argan Oil in model of neonatal streptozotocin-induced diabetic and l-nitroarginine methylester (l-NAME) hypertensive rats

Said Bellahcen, Zineb Hakkou, Abderrahim Ziyyat, Abdelkhaleq Legssyer, Hassane Mekhfi, Mohammed Aziz, Mohamed Bnouham

Page range: 29-36

Abstract

Background : The goal of this study was to examine the effect of Virgin Argan Oil (VAO) obtained from the fruit of Argania spinosa in a model of type 2 diabetes and hypertensive rats. Neonatal diabetes was induced by a single i.p. injection of streptozotocin (90 mg/kg) 2 days after birth. To induce NO-deficient hypertension, the adult diabetic animals were treated with l -nitroarginine methylester ( l -NAME) (30 mg/kg/day) given orally for 21 days. Methods : Following treatment with VAO (21 days), the hyperglycemia decreased to 1.3 ± 0.07 g/l compared with 1.92 ± 0.09 g/l (p < 0.01) in the untreated diabetic-hypertensive rats. The simultaneous administration of VAO with l -NAME prevented the increase in blood pressure during the 3 weeks of treatment. Blood pressure remained constant at 131 ± 1 mm Hg after 21 days – vs 157 ± 0.64 mm Hg in untreated animals (p < 0.001). Results : The treatment with VAO to diabetic-hypertensive rats caused a significant increase of hepatic glycogen levels (13.3 ± 1.8 vs 6.34 ± 0.75 mg/g tissue in untreated diabetic-hypertensive control group; p < 0.01). Conclusions : In conclusion, the overall findings indicate that VAO possesses antidiabetic and antihypertensive activity in n-stz/ l -NAME rats. This effect may be related to its high content of tocopherols, phenolic compounds, and unsaturated fatty acids.

June 26, 2013

Hypoglycemic activity of the Anisopus mannii N. E. Br. methanolic leaf extract in normal and alloxan-induced diabetic mice

Moses Z. Zaruwa, Aranya Manosroi, Toshihiro Akihisa, Worapaka Manosroi, Samreung Rangdaeng, Jiradej Manosroi

Page range: 37-46

Abstract

The hypoglycemic activities of nine sub-fractions from the methanolic leaf crude extract of Anisopus mannii were investigated in normoglycemic and alloxan-induced diabetic mice. The methanolic sub-fraction M at 400 mg/kg bw showed significantly (p<0.05) high reduction in fasting blood glucose (FBG) at 27.36 and 65.57% in normoglycemic and diabetic mice, respectively. In acute toxicity test, M at 2,000 and 5,000 mg/kg bw showed reduction in blood urea nitrogen and creatinine level, elevations in aspartate transaminase, alanine transaminase and total bilirubin levels, as well as the body weights. The weight-ratios of kidney and liver to the body weight of the mice fed with these doses of M were reduced with no sign of histopathological alteration. The M at 250 mg/kg bw significantly reduced the FBG levels in a postprandial study. The hypoglycemic effect of M was eliminated when co-administered with isosorbide dinitrate or nifedipine indicating the induction of insulin secretion via K + ATP-dependent channels. The UV/HPLC analysis of M indicated saponin at 7.7 mg/g. This study confirmed the traditional use of A. mannii for diabetes mellitus and the potential for the further development as a novel hypoglycemic drug.

June 12, 2013

Aloe vera gel protects liver from oxidative stress-induced damage in experimental rat model

Taslima Nahar, Borhan Uddin, Shahdat Hossain, Abdul Mannan Sikder, Sohel Ahmed

Page range: 47-53

Abstract

: Aloe vera is a semi-tropical plant of Liliaceae family which has a wide range of applications in traditional medicine. In the present study, we sought to investigate the heptaoprotective potential of Aloe vera gel as a diet supplement. To achieve this goal, we have designed in vitro and in vivo experimental models of chemical-induced liver damage using male Sprague–Dawley rat. In the in vitro model, its effect was evaluated on Fenton’s reaction-induced liver lipid peroxidation. Co-incubation with gel significantly reduced the generation of liver lipid peroxide (LPO). Next, to see the similar effect in vivo , gel was orally administered to rats once daily for 21 successive days. Following 1 hour of the last administration of gel, rats were treated with intra-peritoneal injection of CCl 4 . Dietary gel showed significant hepatoprotection against CCl 4 -induced damage as evident by restoration of liver LPO, serum transaminases, alkaline phosphatase, and total bilirubin towards near normal. The beneficial effects were pronounced with the doses used (400 and 800 mg/kg body weight). Besides, we did not observe any significant drop in serum albumin, globulin as well as total protein levels of gel-administered rats. Histopathology of the liver tissue further supported the biochemical findings confirming the hepatoprotective potential of dietary gel.

July 23, 2013

Hepatoprotective activity of Calotropis gigantea flowers against carbon-tetrachloride-induced liver damage in mice

Deepa Krushna Ingawale, Satish Karbhari Mandlik, Ajay Digambar Kshirsagar

Page range: 55-62

Abstract

Ethanol extract of Calotropis gigantea flowers (CGFE) was evaluated for its antioxidant and hepatoprotective activity to validate its use in traditional therapeutic indications. This CGFE exhibited significant antioxidant activity (at 20, 40, 60, 80 and 100 µg/ml in vitro ) as evidenced by its hydroxyl, nitric oxide and hydrogen peroxide anion radical scavenging activities. This in vitro antioxidant activity was reinforced by a significant hepatoprotection (at 250 and 500 mg/kg dose) by decreasing the activity of serum glutamate oxaloacetate transaminase and serum glutamate pyruvate transaminase. The hepatoprotective activity of the CGFE was comparable with standard drug silymarin (100 mg/kg, p.o.).The results obtained from present study indicate the presence of natural antioxidants and hepatoprotective constituents. Hence, the above finding confirms in vitro antioxidant and hepatoprotective potential of CGFE in mice.

August 22, 2013

In vivo and in vitro estrogenic activity of extracts from Erythrina poeppigiana (Fabaceae)

Dieudonné Njamen, Sefirin Djiogue, Stephane Zingue, Marie Alfrede Mvondo, Benedicta N. Nkeh-Chungag

Page range: 63-73

Abstract

In developing countries, around 80% of the population still resorts on traditional medicine for their primary health care. Erythrina poeppigiana (Walp.) O.F. Cook, one of these medicinal plants, was found to be particularly rich in isoflavonoids which exhibited, individually, significant estrogenic activity in vitro . The possible combined effects of these bioactive isoflavones, as they are naturally found in the crude extracts of E. poeppigiana , prompted us to assess their in vivo estrogenicity. We first tested the ability of the extracts to transactivate estrogen receptor alpha (ERα) in vitro using U2OS human osteosarcoma cells. We next investigated their effects in vivo in an uterotrophic assay, using ovariectomized rats treated with the extracts at the doses of 50, 100, 200, and 400 mg/kg BW/d orally for 3 days. Finally, we assessed their ability to relieve hot flushes, using data loggers. At the end of treatments, animals were sacrificed, and organs (mammary glands, vagina, and uteri) were collected for histo-morphometric analyses. The methanol extract significantly and dose-dependently transactivated ERα at all tested doses. All extracts induced significant increases of vaginal and uterine epithelial heights. Only the dichloromethane extract could significantly relieve hot flushes as estradiol. These results indicate that E. poeppigiana extracts have estrogen-like effects in vivo , suggesting that its active principles act in synergy when they are taken in combination in the crude extract. These findings, therefore, support the traditional use of E. poeppigiana to alleviate some menopausal problems; our previous phytochemical investigations contribute to the standardization of this phytomedicine.

November 7, 2013

Liposomal-formulated curcumin [Lipocurc™] targeting HDAC (Histone Deacetylase) prevents apoptosis and improves motor deficits in Park 7 (DJ-1)-knockout rat model of Parkinson’s disease: implications for epigenetics-based nanotechnology-driven drug platform

Simon Chiu, Kristen J. Terpstra, Yves Bureau, Jirui Hou, Hana Raheb, Zack Cernvosky, Vladimir Badmeav, John Copen, Mariwan Husni, Michael Woodbury-Farina

Page range: 75-88

Abstract

Background : Converging evidence suggests dysregulation of epigenetics in terms of histone-mediated acetylation/deacetylation imbalance in Parkinson’s disease (PD). Targeting histone deacetylase (HDAC) in neuronal survival and neuroprotection may be beneficial in the treatment and prevention of neurodegenerative disorders. Few pharmacological studies use the transgenic model of PD to characterize the neuroprotection actions of a lead compound known to target HDAC in the brain. Methods : In our study, we investigated neuroprotective effects of liposomal-formulated curcumin: Lipocurc™ targeting HDAC inhibitor in the DJ-1(Park 7)-gene knockout rat model of PD. Group I (DJ-1-KO-Lipocurc™) received Lipocurc™ 20 mg/kg iv 3× weekly for 8 weeks; Group II: DJ-1 KO controls (DJ-1 KO-PBS) received i.v. phosphate-buffered saline (PBS). Group III: DJ-1-Wild Type (DJ-1 WT-PBS) received PBS. We monitored various components of motor behavior, rotarod, dyskinesia, and open-field behaviors, both at baseline and at regular intervals. Toward the end of the 8 weeks, we measured neuronal apoptosis and dopamine (DA) neuron-specific tyrosine hydroxylase levels by immunohistochemistry methods at post-mortem. Results : We found that DJ-KO Group I and Group II, as compared with DJ-1 WT group, exhibited moderate degree of motor impairment on the rotarod test. Lipocurc™ treatment improved the motor behavior motor impairment to a greater extent than the PBS treatment. There was marked apoptosis in the DJ-1 WT group. Lipocurc™ significantly blocked neuronal apoptosis: the apoptotic index of DJ-1-KO-Lipocurc™ group was markedly reduced compared with the DJ-KO-PBS group (3.3 vs 25.0, p<0.001). We found preliminary evidence Lipocurc™ stimulated DA neurons in the substantia nigra. The ratio of immature to mature DA neurons in substantia nigra was statistically higher in the DJ-1-KO-Lipocurc™ group (p<0.025). Conclusions : We demonstrated for the first time Lipocurc™’s anti-apoptotic and neurotrophic effects in theDJ-1-KO rat model of PD. Our promising findings warrant randomized controlled trial of Lipocurc™ in translating the novel nanotechnology-based epigenetics-driven drug discovery platform toward efficacious therapeutics in PD.

June 15, 2013

Antimalarial potential of China 30 and Chelidonium 30 in combination therapy against lethal rodent malaria parasite: Plasmodium berghei

Aswathy Rajan, Upma Bagai

Page range: 89-96

Abstract

: Homeopathy is a therapeutic method based on the application of similia principle, utilizing ultra-low doses of medicinal substances made from natural products. The present study has been designed to evaluate the efficacy of Cinchona officinalis (Chin.) 30C and Chelidonium majus (Chel.) 30C in combination therapy against lethal murine malaria. Five groups having twelve BALB/c mice each were administered orally with 0.2 ml/mouse/day of different drugs, and their antimalarial potential was evaluated by Peter’s 4-day test. The combination of Chin. 30 and Chel. 30 exhibited complete parasite clearance by the 28th day post-inoculation which was similar to the positive control [artesunate (4 mg/kg)+sulphadoxine-primethamine (1.2 mg/kg)] group. Both the groups exhibited enhanced mean survival time (MST) 28±0 days,whereas, the mice of infected control group survived up to 7.6±0.4 days only. The preventive and curative activities of the combination in comparison to the positive controls [pyrimethamine (1.2 mg/Kg) and chloroquine (20 mg/Kg), respectively] were also evaluated. The combination had a significant preventive activity (p<0.0005), with 89.2% chemosuppression which was higher than the standard drug, pyrimethamine (83.8%). It also showed a moderate curative activity with complete clearance of parasite in 50% of surviving mice, and enhancing the MST of mice up to 26.8±2.8 days. These findings point to the significant antiplasmodial efficacy of the combination of these homeopathic drugs against Plasmodium berghei .

June 12, 2013

Structure elucidation and inhibitory effects on human platelet aggregation of chlorogenic acid from Wrightia tinctoria

Ripal P. Amin#, Naveen Kunaparaju#, Sunil Kumar, Tony Taldone, Michael A. Barletta, S. William Zito

Page range: 97-104

Abstract

Background : Interest in natural compounds as sources of potentially new treatment options is growing rapidly. Preliminary screening of many different plant extracts showed that Wrightia tinctoria acts as a potent human platelet aggregation inhibitor. The aim of the present study was to isolate and characterize the active compound responsible for potent inhibition of human platelet aggregation in vitro . Methods : A 70% ethanolic extract derived from W. tinctoria seeds was fractionated with chloroform followed by ethyl acetate. The ethyl acetate fraction was further fractionated and purified through a series of three successive column chromatographic separations using silica gel, Sephadex LH‐20, and C‐18 columns. Liquid chromatography coupled to negative electrospray ionization tandem mass spectrometry (LC‐MS/MS) and nuclear magnetic resonance (NMR) studies were performed in the structure determination of the active phenolic compound present in the ethyl acetate fraction of W. tinctoria seeds. Results : A phenolic compound has been isolated and identified as chlorogenic acid by LC‐MS/MS and NMR studies. Chlorogenic acid showed concentration-dependent inhibitory effect on collagen-induced platelet aggregation in vitro with an IC 50 of 0.2363 μg/μl. Conclusion : The present data suggest that chlorogenic acid can be developed as potential antiplatelet agent in the treatment of cardiovascular diseases in diabetes mellitus.

July 16, 2013

Cytotoxic effects of crocin on MOLT-4 human leukemia cells

Ramin Rezaee, Mahmoud Mahmoudi, Khalil Abnous, Shahrzad Zamani Taghizadeh Rabe, Nafiseh Tabasi, Mahmoud Hashemzaei, Gholamreza Karimi

Page range: 105-112

Abstract

Background : Among various naturally occurring compounds which have been extracted from Crocus sativus , crocin has shown different pharmacological effects i.e. neuroprotection and anti-tumor activity. Methods : Here, crocin effects on human T-cell leukemia cell line, MOLT-4, were evaluated. In this study, we examined the effects of 24 and 48 h of crocin treatment (50, 250 and 500 µM) on the viability of MOLT-4 cell line. Moreover, probable apoptotic/necrotic outcomes, reactive oxygen species (ROS) production variations along with crocin treatment consequences on DNA, were investigated. Results : Results from MTT assay demonstrated that 48-h crocin treatment at 500 µM, significantly reduced cell viability (p<0.01). DNA fragmentation was recorded to be significantly increased at higher doses of crocin following 24 and 48 h (p<0.01). According to our results, while apoptosis was detected at all concentrations, necrosis detected at the highest dose, only. In comparison with control, ROS production was reduced at 50 and 250 µM. Conclusions : In accordance with previous reports, crocin exhibited mild cytotoxic effects on a leukemia cell line which might be mediated through the increase of DNA fragmentation.

June 26, 2013

Synergistic cytotoxicity of red beetroot (Beta vulgaris L.) extract with doxorubicin in human pancreatic, breast and prostate cancer cell lines

Govind J. Kapadia, G. Subba Rao, Cheppail Ramachandran, Akira Iida, Nobutaka Suzuki, Harukuni Tokuda

Page range: 113-122

Abstract

Although a wide variety of cytotoxic plant extracts and phytochemicals are known to act synergistically with anticancer drug doxorubicin (D), their clinical application is hindered by safety concerns of such combination therapy. Our earlier studies showed that red beetroot ( Beta vulgaris L.) extract (B), approved by Food and Drug Administration and European Union as red food color E162, reduced multi-organ tumor formations in various animal models when administered in drinking water. This led us to postulate that a long-term daily exposure to low doses of B through diet might be safe and sufficient to produce cancer chemopreventive effect in humans. Further, our recent comparative cytotoxic investigation with B and D in several human cancer cell lines indicated their potential for synergistic activity. Since B is considered safe for human use with no known toxicity, we conducted the present study to evaluate its synergistic antiproliferative activity with D against pancreatic (PaCa), breast (MCF-7) and prostate (PC-3) tumor cells of human origin. Different concentrations of B and D (0.29–290 μg/ml) and in various combinations (B:D ratio = 1:0, 1:1, 5:1, 1:5 and 0:1) were tested for cytotoxic effects against the three cancer cells. The viability of cells was assessed after 72 h incubation with various combinations of B and D using the trypan-blue staining method. The cytotoxic data were analyzed by the combination index method of Chou and Talalay to establish synergy between B and D. The results indicated that an overall positive reduction in drug concentration was achieved by D when combined with B in its cytotoxicity profile in the three human cancer cells tested. The synergistic cytotoxicity was best when the B:D ratio of 1:5 was used in PaCa cells at IC 50 , IC 75 and IC 90 dose levels and in MCF-7 cells at IC 90 dose level. These results warrant further studies on the potential of red beetroot extract–doxorubicin combination in treating human cancers.

June 12, 2013

Tea toxicity and cholinesterase inhibition of Huilliche herbal medicine

Anne Adsersen, Alfonso Guzman, Per Mølgaard, Henrik Toft Simonsen

Page range: 123-127

Abstract

Eleven species of Huilliche medicinal plants used traditionally against infections and for wound healing were tested for their cholinesterase inhibition activity. Two different teas (a 5–7 min infusion and a 1 h decoction, both in water) were tested for their toxicity against Artemia salina . The results from the present study clearly show that teas boiled for 1 h is much more toxic than teas infused for 5–7 min. These results support the different traditional use of the two teas, where the 1h tea is for external use only. Additionally, significant inhibition of cholinesterase has been observed for MeOH extracts of Acaena argentea, Amomyrtas meli and Pseudopanax laetevirens , with that of A. argentea being the most potent. All findings call for further investigations.

August 20, 2013

Iatrogenic venous thrombosis secondary to supplemental medicine toxicity

Christopher Ryan Newey, Aarti Sarwal, Deborah Tepper

Page range: 129-134

Abstract

Objective : We described a case of cerebral venous sinus thrombosis in a patient taking multiple supplements as part of a naturopathic anti-aging regimen. Methods : Case report. Results : The patient presented with a thalamic infarct associated with a thrombus in the vein of Galen. He reported no previous history of endocrinopathy and no known hypercoagulability risk factors. He was treated with therapeutic anticoagulation resulting in improvement. Diagnostic workup revealed hyperthyroidism and gonadotrophic deficiency attributed to significant supplement medicine usage. Conclusion : This case highlights a potential risk of dietary supplements. Use of these supplements may be a risk factor for idiopathic cerebral venous thrombosis.

Clinical Studies

June 12, 2013

Decreasing cardiovascular risk factors in obese individuals using a combination of PGX^® meal replacements and PGX^® granules in a 12-week clinical weight modification program

Ronald G. Reichert, Michael R. Lyon, Veronica Kacinik, Roland J. Gahler, Priya Manjoo, Monica Purnama, Simon Wood

Page range: 135-142

Abstract

: In this open, clinically based, weight modification program, we determined in six sedentary obese adults (five women; one male; age range 30–62 years) that the combination of a modified calorie diet plus PGX ® meal replacement and PGX ® supplementation resulted in a significant reduction in several cardiovascular risk factors over a 12-week time period. This included a significant improvement in lipids (−0.98 mmol/l LDL-C), reduction in average weight (−9.2 kg), mean reduction in fat (−4.1%) and an increase in fat-free mass (2.8%).

July 1, 2013

The use of an anti-inflammatory supplement in patients with chronic kidney disease

Jennifer J. Moreillon, Rodney G. Bowden, Erika Deike, Jackson Griggs, Ron Wilson, Brian Shelmadine, Matt Cooke, Alexander Beaujean

Page range: 143-152

Abstract

Chronic kidney disease (CKD) is characterized by a continuous reduction in kidney function, increased inflammation, and reduced antioxidant capacity. The objective of this study was to assess the effects of a herbal supplement on systemic inflammation and antioxidant status in non-dialysis CKD patients. Sixteen patients with CKD (56.0±16.0 yrs, 171.4±11.9 cm, 99.3±20.2 kg) were randomly chosen to receive a herbal supplement composed of Curcuma longa and Boswellia serrata , or placebo. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), glutathione peroxidase (GPx), and serum C-reactive protein (CRP) were measured at baseline and 8 weeks. Baseline data demonstrated elevated inflammation and low antioxidant levels. A significant time effect (p=0.03) and time x compliance interaction effect (p=0.04) were observed for IL-6. No significant differences were observed for any other variables. This study demonstrates that mild and moderate CKD is associated with chronic inflammation and low antioxidant activity. Systemic inflammation and impaired antioxidant status may be greater in CKD populations with multiple comorbidities. Curcumin and Boswellia serrata are safe and tolerable and helped to improve the levels of an inflammatory cytokine.

July 16, 2013

Impact of relaxation training according to the Yoga In Daily Life^® system on anxiety after breast cancer surgery

Tine Kovačič, Miha Zagoričnik, Miha Kovačič

Page range: 153-164

Abstract

The purpose of this pilot study was to gather information on the immediate and short-term effects of relaxation training according to the Yoga In Daily Life ® (YIDL ® ) system on anxiety of breast cancer patients. The YIDL ® system is a holistic system being practised and taught worldwide and has been proven to be highly effective in the prevention and treatment of various diseases. The system aims to establish physical, mental, spiritual, and social health. Thirty-two patients at the Institute for Oncology Ljubljana were randomized to the experimental (n=16) and to the control groups (n=16). Both groups received the same standard physiotherapy for 1 week, while the experimental group additionally received 1-hour group relaxation training session according to the YIDL ® system per day. At discharge, the experimental group was issued with audiocassette recordings containing similar instructions for relaxation training to be practiced for 3 weeks individually at home. Anxiety measures were obtained by blinded assessors using standardized questionnaires. The results indicate that relaxation training according to the YIDL ® system could be a useful clinical physiotherapy intervention for breast cancer patients experiencing anxiety.

June 12, 2013

Positive impact of Tai Chi Chuan participation on biopsychosocial quality of life compared to exercise and sedentary controls: a cross-sectional survey

Alex Baxter, Andrew J. P. Francis

Page range: 165-174

Abstract

Tai Chi Chuan (TCC) is a traditional Chinese medicine practice and martial art with biopsychosocial aspects. This study aimed to examine the impact of participation in TCC on multiple domains of Quality of Life (QoL) and to assess the involvement of the psychological factors of self-efficacy, Locus of Control (LoC) and Hope in these effects. A total of 68 participants from the general community (13 males and 55 females) aged between 18 and 68 (M=43.55 years) and not currently suffering from a mental or physical illness took part in the study. It was found that TCC participants, as a group, scored significantly better than those in sedentary (book club) and active (gym exercise) control conditions on Psychological and Physical QoL, and that the Physical QoL benefits of TCC continue to accrue with years of practice. The three psychological factors were shown to variously mediate (self-efficacy) and moderate (internal LoC and Hope) this latter relationship. Whilst the results bear limitations (in particular small sample sizes), it is hoped that these findings will encourage further research into TCC, and consideration of TCC as part of the range of treatment options available in community-based mental and physical health management.

June 26, 2013

Using a standardized Viniyoga protocol for lung cancer survivors: a pilot study examining effects on breathing ease

Judith M. Fouladbakhsh, Jean E. Davis, Hossein N. Yarandi

Page range: 175-187

Abstract

Although lung cancer is perceived as a dire diagnosis, increases in the 5-year survival rate of individuals with non-small cell lung cancer (NSCLC) have been reported. Survivors, however, continue to be excessively burdened with symptoms such as respiratory distress which interfere with functioning and quality of life. While exercise and physical activity are strongly recommended, NSCLC survivors may be reluctant to participate due to actual or anticipated shortness of breath exacerbated with movement. This quasi-experimental, intervention-only pilot study aimed to determine the effects of an 8-week standardized yoga protocol for Stage I–IIIa NSCLC survivors (n=9). The protocol was developed within the Viniyoga (Hatha) tradition with respiratory experts. Breathing ease, dyspnea, oxygen saturation, and respiratory function were explored in relationship to yoga practice (45-minute sessions once per week and home practice) using repeated-measures analysis. Number of participants reporting dyspnea ranged from 25 to 50% prior to practice with no significant increase during sessions, and moderate decreases noted at times. Oxygen saturation remained high and vital signs stable; forced expiratory volume in 1 second (FEV 1 ) values increased significantly over the 14-week study period (p<0.0001). Yoga, with an emphasis on postures coordinated with breathing and meditation practices, offers a potentially feasible and beneficial option that requires further study in this population.

July 3, 2013

Research utilization and evidence-based practice among Saskatchewan massage therapists

Donelda M. Gowan-Moody, Anne M. Leis, Sylvia Abonyi, Michael Epstein, Kalyani Premkumar

Page range: 189-198

Abstract

While massage therapy (MT) is an increasingly used health care service with a growing evidence base, there is insufficient information about the extent to which MT practice is evidence-based. The purpose of this study was to provide a comprehensive view of Saskatchewan MT’s research utilization to inform the development of evidence-based massage therapy practice. The main objectives of the study were to describe MT’s perceptions of research, their appraised self-efficacy in research literacy and to identify the characteristic of practitioners who use research. Using a survey design all 815 registered members of the Massage Therapist Association of Saskatchewan were invited to complete a mail-out questionnaire. A total of 333 questionnaires were completed and returned for a 41% response rate. Univariate and logistic regression analysis was conducted using SPSS 17.0. While overall perceptions of research were positive, self-efficacy in research literacy was low and research utilization was limited. Characteristics associated with research use included referring to online research databases and peer-reviewed journals, belief that practice should be based on research, and 20 or greater hours per week of practice. Provincial regulatory status may be the first step to quality service delivery and research literacy training and support is needed for practitioners.

July 9, 2013

Laser acupuncture in treatment of childhood bronchial asthma

Magda Y. Elseify, Nagwa Hassan Mohammed, Asmaa A. Alsharkawy, Mai E. Elseoudy

Page range: 199-203

Abstract

Laser acupuncture is widely used as an alternative treatment for chronic illnesses. Objective : to evaluate the effect of biostimulation by low-level power laser on the traditional Chinese acupuncture points for Egyptian asthmatic children. Method : Thirty asthmatic boys and 20 asthmatic girls 7–18 years (10.6±2.8) were randomly selected from the outpatient chest clinic of Ain Shams University, Children hospitals, and National Research Center outpatient Clinic of Acupuncture, from April 2009 to March 2010. Patients’ symptoms, medications, asthma control questionnaire (ACQ), and spirometric values were recorded before and 1 month after completion of 10 laser acupuncture sessions. Each patient received 10 laser sessions (3 sessions/week) on traditional Chinese acupoints. Results : Started with 36 patients suffering daytime and nocturnal symptoms, ended with two patients suffering nocturnal symptoms (p < 0.001). Also, 48 patients reported better exercise tolerance (p < 0.001). Forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow % increased from 81.8±25.2, 85.4±21.5, and 71.8±22.9 to 98.5±28.1, 104.3±26.2, and 84.3±24.1, respectively (p < 0.001). ACQ improved from 13.9±3.8 to 23.3±3.6 (p < 0.001), 92% of patients became well controlled. Inhaled steroids dose decreased from 200–450 to 0–200 μg/day and all patients stopped short acting B2 agonist (SABA) rescue (p < 0.01, 0.001). Conclusion : low-intensity laser acupuncture can be safe and effective treatment in asthmatic children.

Case Reports

June 12, 2013

Developing an in-patient acupuncture treatment in a pediatric hospital

Lynn M. Rusy, Steven J. Weisman, Keri R. Hainsworth

Page range: 205-210

Abstract

: Little is known about the broad application of acupuncture as adjuvant treatment for in-patient pediatric populations. We review a series of cases involving acupuncture for conditions ranging from insomnia to cyclic vomiting. The details of the protocol for each are included. This case series illustrates the benefits of an in-patient acupuncture treatment service, as well as the subtleties of an acupuncture protocol when treating children and adolescents.

Reviews & Perspectives

June 12, 2013

Is yoga an effective treatment in the management of patients with chronic low back pain compared with other care modalities – a systematic review

Christopher Hill

Page range: 211-219

Abstract

Objective : The aim of the study was to assess randomized-control trials (RCTs) to ascertain whether yoga is an effective treatment in the management of patients with chronic low back pain (cLBP) compared with other care modalities. Methods : A search strategy was formulated with key concepts identified using the PICO process. Four databases were searched in June 2012. Appropriate eligibility criteria were set and implemented. Results : Four randomized control trials met the inclusion criteria. All four papers found that yoga lead to a significant improvement in back function, and three demonstrated a significant improvement in back pain when compared with certain care modalities. All papers had significant limitations identified, however. Conclusions : Given the limitations identified within the studies, the conclusions drawn must be considered conservatively. Although early results appear promising, but further well-designed RCTs are warranted, with multiple, specified comparator care modalities before firm conclusions can be gained.

May 24, 2013

Omega-3 fatty acid for the treatment and remission of Crohn’s disease

Katharine Swan, Pat J. Allen

Page range: 221-228

Abstract

: This integrative literature review focused on the use of omega-3 fatty acid supplementation for the treatment of Crohn’s disease (CD). A systematic review of studies investigating the use of omega-3 in individuals with CD was performed. OVID MEDLINE, the Cochrane Database, and CINAHL were searched for pertinent research. Experiments were limited to double-blind placebo controlled trials. Five studies observing CD relapse rates and three studies examining biochemical changes were evaluated. The studies reviewed show contradicting information regarding the efficacy of omega-3 for CD. While some studies have shown supplementation with omega-3 results in sustained remission from disease, other studies concluded no correlation between omega-3 supplementation and improved remission rates. Studies investigating biochemical variables suggest favorable changes in immunological milieu, including modifications of lipid profiles and cytokine production. The studies reviewed are adversely limited by low number of participants, short duration of study and other significant deficits. Limited data remain available and current literature indicated mixed conclusions regarding the efficacy of omega-3 for treatment of CD. Further large-scale studies of longer duration are necessary.

August 6, 2013

Any role for probiotics in the therapy or prevention of autoimmune diseases? Up-to-date review

Öner Özdemir

Page range: 229-250

Abstract

Probiotic use as capable preventive and therapeutic strategy in different diseases varying from allergic to autoimmune disease (AD) has been recently reported. Three interacting factors including an aberrant intestinal microbiota, a “leaky” intestinal mucosal barrier, and altered intestinal immune responsiveness have been suggested to be able to create a “perfect environment” for AD development. Regulation of intestinal microflora composition by probiotics offers the possibility to influence the development of mucosal/systemic immunity besides ADs. Moreover, with various strains of probiotics, development and/or stimulation of T helper type 2 (Th2)-mediated immune responses causing exacerbation of atopic disease have been described. Similarly, certain probiotics are known to stimulate Th1 immunity, which has been suggested as one of the mechanisms by which they can suppress Th2-mediated allergic diseases. Consequently, this presumed that excessive immunostimulation might aggravate or induce Th1-mediated immune responses and diseases such as type 1 diabetes, multiple sclerosis, and it might cause an additional safety issue. Although there is a large amount of conflicting data on the preventive/therapeutic effects of probiotics in ADs, there is fairly promising evidence to recommend as well. Thus, probiotic use cannot be generally recommended for primary prevention and therapy of ADs for now.

June 12, 2013

Hericium erinaceus: an edible mushroom with medicinal values

Md. Asaduzzaman Khan, Mousumi Tania, Rui Liu, Mohammad Mijanur Rahman

Page range: 253-258

Abstract

Mushrooms are considered as nutritionally functional foods and source of physiologically beneficial medicines. Hericium erinaceus , also known as Lion’s Mane Mushroom or Hedgehog Mushroom, is an edible fungus, which has a long history of usage in traditional Chinese medicine. This mushroom is rich in some physiologically important components, especially β-glucan polysaccharides, which are responsible for anti-cancer, immuno-modulating, hypolipidemic, antioxidant and neuro-protective activities of this mushroom. H. erinaceus has also been reported to have anti-microbial, anti-hypertensive, anti-diabetic, wound healing properties among other therapeutic potentials. This review article has overviewed the recent advances in the research and study on H. erinaceus and discussed the potential health beneficial activities of this mushroom, with the recognition of bioactive compounds responsible for these medicinal properties.

July 3, 2013

Are conduits superconductor-like and supported by tetrahedra structure of hyaluronic matrix in living systems? New perspectives

Rainer Fromknecht, Mario Goncalves, Henry Johannes Greten, Jorge Machado

Page range: 259-263

Abstract

All biological–medical treatments need a ground regulation in the intermeshed control loop system in animate matter. The focus of our contribution is to suggest a possible mechanism in this interconnected system that will work in order to supply/assist a higher ordered servo loop. Bonghan ducts indicate similarities to so-called meridians or conduits that are the central part in Chinese Medicine for the energy Qi. It is assumed that the nervous system demands a highly redundant and rapid communication system (RCS) probably established via the extracellular matrix (ECM) and triggered by a threshold value for the entire body. Metabolic processes could work in the picosecond’s range while the nervous system is on the time scale at least one order of magnitude lower; probably most of them in the millisecond range. Long-range coherent electromagnetic phenomena and recent experiments indicate a structured superconducting-like system with the Josephson-effect behavior in biological systems. In the ECM are the components proteoglycans and glycosaminoglycans (PG/GAGs) and among them the ubiquitarian hyaluronic acid plays probably an important role and can behave as liquid crystals while the charge transport is performed via proton “jumping” in the proton-chains. Therefore, the water molecules have to be confident on a nanometer scale, lowering their energy states, and set up a phase transition with a rapid jumping of the protons through the water–carbon-chains. These partial chains could probably be modeled by tiny pyramids of the atoms. We propose that in order to set up those long-range coherent effects, a vortex is created. By doing Qi Gong, an energetic vortex through the body is established and the entire body can be modeled by two-base plane-faced pyramids acting as a tunable cavity resonator obeying electrodynamics laws. Therefore, the phenomenon’s of pyramids should be considered in animate and inanimate matter in order to achieve long-range coherent effects, which by now controversially discussed and to go new ways to come over the clutter.

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

Volume 10 Issue 1 -

Issue of Journal of Complementary and Integrative Medicine

Masthead

Chemical and pharmacological standardization of Ashwagandhadi lehyam: an ayurvedic formulation

Abstract

Phytochemical screening and toxicity studies on the methanol extract of the seeds of moringa oleifera

Abstract

First report of fingerprinting dried herbal products using a subtractive diversity array

Abstract

Antidiabetic and antihypertensive effect of Virgin Argan Oil in model of neonatal streptozotocin-induced diabetic and l-nitroarginine methylester (l-NAME) hypertensive rats

Abstract

Hypoglycemic activity of the Anisopus mannii N. E. Br. methanolic leaf extract in normal and alloxan-induced diabetic mice

Abstract

Aloe vera gel protects liver from oxidative stress-induced damage in experimental rat model

Abstract

Hepatoprotective activity of Calotropis gigantea flowers against carbon-tetrachloride-induced liver damage in mice

Abstract

In vivo and in vitro estrogenic activity of extracts from Erythrina poeppigiana (Fabaceae)

Abstract

Liposomal-formulated curcumin [Lipocurc™] targeting HDAC (Histone Deacetylase) prevents apoptosis and improves motor deficits in Park 7 (DJ-1)-knockout rat model of Parkinson’s disease: implications for epigenetics-based nanotechnology-driven drug platform

Abstract

Antimalarial potential of China 30 and Chelidonium 30 in combination therapy against lethal rodent malaria parasite: Plasmodium berghei

Abstract

Structure elucidation and inhibitory effects on human platelet aggregation of chlorogenic acid from Wrightia tinctoria

Abstract

Cytotoxic effects of crocin on MOLT-4 human leukemia cells

Abstract

Synergistic cytotoxicity of red beetroot (Beta vulgaris L.) extract with doxorubicin in human pancreatic, breast and prostate cancer cell lines

Abstract

Tea toxicity and cholinesterase inhibition of Huilliche herbal medicine

Abstract

Iatrogenic venous thrombosis secondary to supplemental medicine toxicity

Abstract

Decreasing cardiovascular risk factors in obese individuals using a combination of PGX® meal replacements and PGX® granules in a 12-week clinical weight modification program

Abstract

The use of an anti-inflammatory supplement in patients with chronic kidney disease

Abstract

Impact of relaxation training according to the Yoga In Daily Life® system on anxiety after breast cancer surgery

Abstract

Positive impact of Tai Chi Chuan participation on biopsychosocial quality of life compared to exercise and sedentary controls: a cross-sectional survey

Abstract

Using a standardized Viniyoga protocol for lung cancer survivors: a pilot study examining effects on breathing ease

Abstract

Research utilization and evidence-based practice among Saskatchewan massage therapists

Abstract

Laser acupuncture in treatment of childhood bronchial asthma

Abstract

Developing an in-patient acupuncture treatment in a pediatric hospital

Abstract

Is yoga an effective treatment in the management of patients with chronic low back pain compared with other care modalities – a systematic review

Abstract

Omega-3 fatty acid for the treatment and remission of Crohn’s disease

Abstract

Any role for probiotics in the therapy or prevention of autoimmune diseases? Up-to-date review

Abstract

Hericium erinaceus: an edible mushroom with medicinal values

Abstract

Are conduits superconductor-like and supported by tetrahedra structure of hyaluronic matrix in living systems? New perspectives

Abstract

Decreasing cardiovascular risk factors in obese individuals using a combination of PGX^® meal replacements and PGX^® granules in a 12-week clinical weight modification program

Impact of relaxation training according to the Yoga In Daily Life^® system on anxiety after breast cancer surgery