Journal of Integrative and Complementary Medicine最新文献

Background: Pain during dental injections can negatively impact children's perception of dental visits. Various methods have been explored to reduce this pain.

Aim: This study aimed to assess the effect of sweet aromatherapy on injection pain associated with infiltration anesthesia for primary maxillary molars in 7-9-year-old children.

Design: In this randomized, double blind controlled clinical trial, 48 children (7-9 years old) requiring infiltration anesthesia for maxillary molars were randomly allocated to three groups (n = 16 each) (I) control group receiving anesthetic injection in an unscented room; (II) anesthetic injection in a room saturated with 2% sweet vanilla scent, and (III) anesthetic injection simultaneous with exposure to 2% sweet vanilla scent for 30 sec. Subjective pain was measured using the Wong-Baker Faces Pain Rating Scale, while objective pain was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) behavioral scale. Heart rate (HR) and blood oxygen saturation (SpO₂) were also recorded as physiological indicators. Data were analyzed using SPSS version 25.

Results: The FLACC scores and HR in the intervention groups was significantly lower than that in the control group (P = 0.05). Regarding SpO₂, only the difference between the control and saturated room groups was statistically significant (P < 0.05). There was no statistically significant difference in Wang-Baker score between groups (P > 0.05).

Conclusion: Two percent sweet vanilla scent can be a successful distraction method to reduce injection pain during infiltration anesthesia for maxillary molars in children aged 7-9 years. Further research in different age groups with a larger sample size seems necessary to strengthen the evidence.

Background: A reliable manual examination has not been validated as a diagnostic tool for nociplastic visceral pain.

Aims: To establish the interrater reliability of a manual examination protocol for functional pancreatic visceral dysfunction and the clinical criteria for a manual palpatory diagnosis based on the clinical features of the nociplastic visceral pain.

Methods: This double-blind cross-sectional study involved 60 participants assessed by three raters using a manual protocol for diagnosing functional pancreatic visceral dysfunction. Five palpation-based criteria were evaluated: (1) local pain, (2) referred pain, (3) neurovegetative symptoms, (4) hyperalgesia or allodynia, and (5) tissue resistance/density. Interrater agreement was measured using percentage agreement and Fleiss' kappa. The reliability of the Verbal Numerical Rating Scale (vNRS) was assessed using the intraclass correlation coefficient (ICC). Repeated measures analysis of variance and Cochran's Q test (with Bonferroni correction) were used to analyze vNRS scores and categorical outcomes, respectively. Significance was set at p < 0.05.

Results: Criteria 1, 3, and 4 showed particularly high levels of agreement, with overall agreement percentages of 93.3%, 95.6%, and 95.6%, respectively. The corresponding Fleiss' kappa values were 0.863, 0.880, and 0.908, indicating almost perfect agreement. In contrast, Criteria 2 and 5 demonstrated substantial, but comparatively lower, agreement, with overall percentages of 86.7% and 87.8% and Fleiss' kappa values of 0.679 and 0.755. The vNRS demonstrated excellent reliability across all three pancreas regions, with ICC values well >0.90: head (ICC = 0.943, 95% confidence interval [CI] = 0.913-0.964), body (ICC = 0.950, 95% CI = 0.923-0.968), and tail (ICC = 0.963, 95% CI = 0.944-0.977).

Conclusions: Three blinded raters reached an almost perfect pair-wise interrater agreement on the presence or absence of functional visceral dysfunction in the topographic projection of the pancreas. This study provides preliminary evidence that a manual diagnostic protocol is a reliable and potentially useful diagnostic tool in diagnosing nociplastic pain in the topographic projection of the pancreas. Future research should prioritize evaluating the validity of the nociplastic visceral pain diagnosis.

Background: The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. This systematic review and meta-analysis aimed to determine the efficacy of nanocurcumin on mortality in patients with COVID-19.

Methods: A systematic search was performed in PubMed, Embase, Cochrane Library, and clinicaltrials.gov up to November 2024, without language restrictions.

Inclusion criteria: (1) inclusion of hospitalized patients with COVID-19 who are 18 years or older; (2) polymerase chain reaction positive for severe acute respiratory syndrome coronavirus-2; and (3) use of a randomized controlled design to make a comparison of nanocurcumin with placebo. The Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. Studies were pooled to risk ratios (RRs) and standardized mean differences (SMDs), with 95% confidence intervals (CIs).

Results: Six trials (enrolling 333 participants) met the inclusion criteria. Nanocurcumin therapy showed significant improvements on mortality (RR 0.47, 95% CI 0.25-0.88; p = 0.02), interleukin-6 (IL-6) (SMD -0.30, 95% CI -0.56 to -0.04; p = 0.02), tumor necrosis factor-α (TNF-α) (SMD -0.63, 95% CI -1.16 to -0.10; p = 0.02), and IL-1β (SMD -0.88, 95% CI -1.37 to -0.39; p = 0.0004).

Conclusions: Nanocurcumin significantly reduced mortality, IL-6, TNF-α, and IL-1β in hospitalized patients with COVID-19. Given the lack of safety data and concerns about the risk of bias, the use of nanocurcumin in COVID-19 requires further research.

Purpose: This work explores perceptions across a state with both rural and urban populations in an ecologically informed mapping of health care partners to gain a panoramic view of potential barriers and facilitators to using complementary and integrative healthcare (CIH) for nonpharmacological pain management (NPM).

Materials and methods: Semi-structured interviews (N = 48) were conducted with a regionally representative recruitment in six stakeholder groups: chronic pain patients (n = 15), CIH providers (n = 12), clinicians (primary/specialty care providers, nurse practitioners, n = 8), health care administrators (n = 6), and health insurance representatives (n = 7). A six-phase approach using collaborative and iterative thematic analysis was employed.

Results: Findings suggest that themes of determinants exist on a continuum from barrier to facilitator, rather than in isolation. Continuums emerged in four categories of themes: Financial, Logistic, Relational, and Experiential. Major barriers were access, insurance, biases, and education, and major facilitators were partnership, education, and awareness. Ecological nesting of stakeholder major themes showed that perceptions by patients emphasized Financial and Experiential categories; providers emphasized Financial, Logistical, and Relational; administrators emphasized Relational and Experiential; and insurance representatives emphasized Relational.

Conclusion: The continuum model enables use of person-centered scaling of barriers to facilitators in four categories to communicate their own personal context. Socioecological mapping reveals potential differences in perceptions of health care partners. Future work includes systematic review of the literature within the categories and development of a tool to identify person-centered barriers, needs, and facilitators to utilization of CIH for NPM.

Introduction: It is well established that there is a significant health gap between Indigenous and non-Indigenous Australians, with access to health care being a contributing factor. Aboriginal Health in Aboriginal Hands (AHAH) is an allied health service based at an Indigenous community center. Its objectives are to provide allied health services that are not commonly accessed by members of the Indigenous community. The aims of this study were to investigate stakeholders' perceptions of the service and alignment with the principles of delivering allied health services to Indigenous communities.

Methods: Participants were recruited from two distinct groups: (1) Those who had developed, administered, and provided the services (n = 4); and (2) recipients of the services (n = 8). Perceptions of AHAH were collected via individual "yarnings," which involved answering broad questions regarding the service. Data were analyzed using thematic inductive analysis.

Results: Both groups perceived that the "cultural appropriateness" of the setting was essential for its success. This included: its location at an Indigenous community center; the central roles of Indigenous people within the service; being affordable; being welcoming; and being accessible. Another positive attribute was that it provided the opportunity for community members to attain related training and qualifications in areas such as "sports therapy." Both groups perceived that the service could be expanded in terms of more weekly sessions and the inclusion of other allied health services. Staff were aware that while allied health students on placement at the center had undergone some "cultural awareness training," more was needed.

Discussion: Overall, the AHAH service was perceived to align with the five dimensions of accessibility, approachability, acceptability, availability, and affordability, and was being delivered in accordance with the principles of engaging with Aboriginal communities (lore, love, look, listen, learn, lead, and land), which were key attributes contributing to its popularity and success.

Objectives: This study aimed to compare the efficacy of Nigella sativa (N. sativa) mouthwash and chlorhexidine (CHX) in the management of gingivitis. Methods: This triple-blind, parallel-group randomized controlled trial (Iranian Registry of Clinical Trials, IRCT20221212056786N2) was conducted at the Department of Periodontology, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Thirty-six patients aged 20-40 years with gingivitis were randomized in a 1:1 ratio using simple randomization to receive either 20% N. sativa mouthwash or 0.2% CHX mouthwash twice daily for 14 days. Participants, outcome assessors, and statisticians were blinded. Clinical parameters, including plaque index (PI, primary outcome), bleeding index (BI), and staining index (SI), were recorded at baseline and after 14 days. Data were analyzed using analysis of covariance, with statistical significance set at p < 0.05. Results: All 36 participants completed the study. Both N. sativa and CHX mouthwashes significantly reduced PI (mean difference: N. sativa, 33.44 ± 0.72; CHX, 32.72 ± 1.37; p < 0.001 for both) and BI (mean difference: N. sativa, 19.44 ± 0.80; CHX, 19.98 ± 0.81; p < 0.001 for both) after 14 days compared with baseline. Between-group differences were not significant for PI (mean difference: -0.72; 95% confidence interval [CI]: -1.94 to 0.50; p = 0.057) or BI (mean difference: -0.54; 95% CI: -1.10 to 0.02; p = 0.053). A statistically significant but clinically trivial increase in SI was observed in the N. sativa group (mean change: 0.78 ± 1.06; p = 0.006), but not in the CHX group (mean change: 0.44 ± 1.29; p = 0.163). No adverse events, such as taste alteration or mucosal irritation, were reported based on participant self-reports. Conclusions: N. sativa mouthwash showed similar efficacy to CHX in reducing plaque and gingival inflammation over 14 days, suggesting it may be a viable alternative for short-term gingivitis management. However, its potential for slight tooth staining warrants caution, and further studies are needed to assess long-term effects.

Aim: This randomized controlled study aimed to examine the effects of mandala coloring on perceived stress and anxiety levels in patients with type 2 diabetes. Method: This study was conducted between December 2023 and December 2024 with 92 inpatients in the endocrinology clinic of a university hospital. Patients were randomly assigned to the intervention group (n = 46) or control group (n = 46). The intervention group colored one mandala daily for 7 consecutive days, while the control group received routine care. Data were collected using the Personal Information Form, Perceived Stress Scale (PSS), and State Anxiety Scale (SAS). Statistical analyses were performed using two-way mixed ANOVA to examine group, time, and interaction effects, with Bonferroni correction applied for two primary outcomes. The study was reported in accordance with the CONSORT 2010 guidelines. Results: Compared with the control group, the intervention group showed significant reductions in the PSS total score (η² = 0.122, p = 0.000), Inadequate Self-Efficacy subscale (η² = 0.156, p < 0.001), Stress Perception subscale (η² = 0.067, p = 0.013), and SAS score (η² = 0.284, p = 0.000) after the intervention. No adverse events related to mandala coloring were reported. Conclusion: Mandala coloring effectively reduced perceived stress and state anxiety in patients with type 2 diabetes. It may be considered a feasible nursing intervention for the psychological management of these patients.