Advances in integrative medicine最新文献

Background and objectives

Chronic Venous Insufficiency (CVI) is often associated with prolonged standing at work. CVI could lead to multiple symptoms and vascular inflammation. Yoga as therapy has helped in mitigating several occupational hazards. The current study protocol is designed to assess the effect of Yoga on CVI.

Materials and methods

One hundred industry workers with CVI will be randomly allotted to Yoga and wait-list control groups following an equal allocation ratio. Yoga group will receive a specially designed Yoga module six days a week for three months. The Control group will continue with the routine activities. Serum homocysteine, Venous Clinical Severity Scale (VCSS), Ankle Brachial pressure index and psychological status will be assessed at baseline and the end of three months of intervention.

Statistical analyses

Data will be tested for normality and appropriate tests will be used to assess the differences between the groups.

Expected outcomes

Specifically designed Yoga module will help to reduce the vascular inflammation, symptoms of CVI and enhance psychological functioning.

Persian medicine is a branch of complementary and alternative medicine that tries to offer simple and suitable approaches and methods for treating diseases and health protection. Ma'oljobon is known as a kind of whey protein. It is a remedy with various characteristics, such as removing viscous wastes from the body without causing any dryness and moistening, while also providing nutrition. A 7-year-old boy with severe chronic cough refers to Traditional Persian Medicine Clinic due to allergic rhinitis. Formerly he had multiple failed attempts of treatment. The cough resolved with a 12-week period administration of Ma'oljobon. This is the first report evaluating the remedial effect of Ma'oljobon on allergic rhinitis.

Objective

The present study was aimed at investigating the effect of Salvia rosmarinus (syn: Rosmarinus officinalis L.; rosemary) extract on acetyl cholinesterase (AChE) activity and oxidative stress biomarkers in healthy volunteers.

Method

In a double-blind randomized controlled trial, 50 healthy participants (21–25 years old) were divided into two groups: placebo (N = 25) and rosemary (N = 25). The rosemary and placebo groups respectively received rosemary (500 mg rosemary powder) and placebo capsules (500 mg starch powder) twice a day for one month. AChE activity, total antioxidant capacity (TAC), lipid peroxidation, and protein carbonylation were determined in blood samples before and after the trial.

Discussion

Administration of 1000 mg of rosemary for 30 days significantly decreased AChE activity compared to AChE activity before rosemary treatment (p value<0.001) and also in the placebo group (p value<0.01). Notably, administration of rosemary considerably improved TAC (p value<0.01) and protein carbonylation (p value<0.05) compared to those values before rosemary treatment and in the placebo group. After administration of rosemary, no significant changes were observed in lipid peroxidation (p value>0.05) compared to that value before rosemary treatment and in the placebo group.

Conclusion

The findings indicated the inhibitory effect of rosemary on AChE activity and the improvement of non-enzymatic antioxidant defense system. The results may reinforce the use of rosemary as a potential antioxidant supplement. Further evaluations are recommended to find out the effectiveness of rosemary in patients with Alzheimer’s disease.

Context

Recurrent aphthous stomatitis (RAS) is a highly prevalent oral lesion that is limited in many cases to symptomatic remedies.

Objective

In this work, a buccoadhesive paste was prepared from Fenugreek extract (Trigonella foenum graecum L.) and clinically evaluated on RAS patients.

Design

This study was a double blind randomized clinical trial.

Setting

The study took place at Kerman University of Medical Sciences, Department of Oral Medicine, School of Dentistry.

Participants

SCytotoxicity of fenugreek extract was studied on five cell lines using MTT and Neutral red assay. A buccoadhesive paste was formulated at non-toxic concentration. ixty patients randomly in two groups were treated with fenugreek buccoadhesive paste (FBP) and dexamethasone mouthwash respectively. The patients were followed for the intensity of pain, size of the lesion, erythema and exudate severity on 0, 4, 6, 10 days after the treatment.

Results

From the fourth day of the treatment, the size of the lesion and severity of pain was significantly improved in patients treated with FBP. On the sixth day of the intervention, the erythema level and the size of the ulcer significantly decreased (p < 0.05).

Conclusion

FBP could improve the most symptoms of RAS in comparison to the control due to the good adhesion of the paste to the surface of the ulcer and release the extract and forms a protective barrier against more mechanical irritations or infections.

Objective

Around 30% of patients with Attention-Deficit/Hyperactivity Disorder (ADHD) do not respond to Ritalin or cannot tolerate its side effects, which necessitates the consideration of alternative options. Previous studies have shown the beneficial effects of Crocus sativus (saffron) in children with ADHD. However, its potential therapeutic effects in adults with ADHD is unknown. This study aimed to evaluate the efficacy and safety of saffron as an adjuvant to Ritalin for improving symptoms in adults with ADHD.

Design

This was a randomized, double-blind, placebo-controlled clinical trial.

Methods

Fifty-six patients diagnosed with ADHD were assigned into two parallel groups to receive Ritalin (30 mg/day) plus placebo or Ritalin plus saffron (15 mg twice daily) for six weeks. The patients were assessed with Conners' Adult ADHD Rating Scales (CAARS) and the Adult ADHD Self-Report Scale (ASRS) at baseline, week 3 and week 6.

Results

Forty-four patients completed the trial. GLM repeated-measure analysis demonstrated significant time × treatment interaction effect for ASRS (df=2, F=3.455, and P-value=0.036) and CAARS (df=1.584, F=3.939, and P-value=0.033) score from baseline to the study endpoint. We found a significantly greater reduction in ASRS scores in the saffron group compared with the placebo group from baseline to the study endpoint (week 6) (P-value=0.024). However, the change score from baseline to week 3 was not significantly different between trial groups (P-value=0.269). There was no significant difference in the improvement of CAARS scores between saffron and placebo from baseline to week 3 or 6 (P-value=0.564 and 0.089, respectively). There was no significant difference between the two groups in baseline parameters and frequency of side effects.

Conclusions

Saffron combination therapy with Ritalin can effectively improve symptoms of patients with ADHD. However, further studies with larger sample sizes and longer follow-up treatment are needed to confirm our findings.

This trial was registered with the Iranian Registry of Clinical Trials (www.irct.ir; No IRCT20090117001556N111).

Background

Amidst the adversities of the COVID-19 pandemic, the health care system has seen a new paradigm shift towards e-health or telehealth services. In the advent of catering to the geometrically increasing health care needs of the patients suffering from various chronic health conditions when in social isolation, the need for such shifts is paramount. Patients with Ankylosing spondylitis using immunosuppressants with variable degrees of disabilities are at higher risk from this isolated status. This study aims to assess the efficacy of e-Yoga as a treatment option for these patients.

Methods

The proposed study is a single-center, parallel-group prospective randomized, open-blinded end-point trial. Patients aged between 30 and 50 years will be recruited from the members of Antardhwani: A society of ankylosing spondylitis based in Ahmedabad, Gujarat. Yoga experts will administer a scientifically developed and validated Yoga module via e-Yoga modalities. A total of 135 patients will be recruited and randomly allocated to Yoga and control groups. Data will be recorded at baseline and three months on disease activity, degree of functional limitations in patients, quality of life, inflammatory biomarkers, depression, and anxiety using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), AS Quality of Life index (ASQOL), C reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Physical health questionnaire-4 (PHQ-4), respectively.

Discussion

The study will report the efficacy of e-Yoga in catering to the physical and mental insufficiencies of inpatients with Ankylosing spondylitis amidst COVID-19 pandemic. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2020/08/027215)

Background

Vitiligo causes patchy hypo-pigmentation of skin and mucous membrane, with cosmetic and psychological effects. Studies suggest Psoralea corylifolia (PC) has pigmentor properties and that individualized homeopathic medicines (IH) are a promising treatment option in vitiligo. This pilot trial was aimed at testing the feasibility of a future definitive trial comparing the effects of three treatment regimens – 1. IH, 2. PC mother tincture (MT) external application, and 3. IH and PC (IHPC) in the treatment of vitiligo.

Methods

An open, randomized (1:1:1), three parallel arms, pragmatic, pilot trial was conducted on 60 patients at the dermatology and Materia Medica outpatients of National Institute of Homoeopathy (NIH), India. Primary outcome was Vitiligo Area Scoring Index (VASI); and secondary outcomes were Vitiligo Quality of Life (VitiQoL) and Dermatological Life Quality Index (DLQI); assessed at baseline, 3rd month and 6th month. Intention-to-treat analysis was performed; intra-group and inter-group comparisons were made by Friedman and Kruskal-Wallis tests respectively.

Results

Five patients dropped out (IH: 2, PC: 2, IHPC: 1). Intra-group changes over 3 and 6 months were mostly statistically significant in all 3 outcomes (P < 0.001). No significant differences were observed in VASI and DLQI total scores among the three groups over either 3 or 6 months. Differences among groups after 3 and 6 months showed statistical significances in VitiQoL total scores (P = 0.038 and 0.037 respectively) favoring PC and IHPC respectively.

Conclusion

A definitive trial appears feasible. All three regimens appeared equally effective and safe, though a small positive direction of effect towards PC and IHPC was observed. As a pilot trial, no definite conclusions could be drawn. Trial registration: CTRI/2018/04/013446.

Background

The use of technologies continues to grow in healthcare provision, and learning technologies now dominate tertiary education. Meanwhile, complementary medicine (CM) constitutes a substantial component of contemporary healthcare, yet the education of existing and future CM practitioners has received little empirical attention. In direct response, our study examines the perceptions of CM students and faculty related specifically to health and learning technologies in clinical CM work and education.

Methods

A cross-sectional online survey was administered to all current students (n = 4851) and tenured, contracted and adjunct academics (n =530) at two CM education institutions – in the US and in Australia.

Results

Most student respondents (n = 134, 49%) reported that they either felt they were unsure if they would use telehealth in clinical practice or that they would use it (n = 116, 43%). The majority of all academic respondents did not believe it possible to conduct basic clinical processes online such as reading a patient's body language (M3.8, SD 1.0), conducting quality clinical training in CM settings (M3.2, SD 1.3) or learning rapport skills (M3.2, SD 1.2). Of those academics who were also in clinical practice, only a small number reported conducting virtual consultations in their CM work (n = 7,15.9%).

Conclusion

Our findings highlight a potential disparity of perceptions between academics and students in these CM educational settings especially in relation to telehealth. Academics expressed hesitancy to fully rely on technologies to develop practitioners in a field where ‘formation of professional character’ is considered so important.

Objectives

To test the effect of noninvasive self-performed acupressure therapy as an add-on to pharmacological treatment to manage knee main and to evaluate the improvement of pain due to intervention according to age and body mass index.

Methods

In the study, 240 participants were assigned into three groups (1) KAP group (verum acupressure and pharmacological treatment) (2) Comparison Group 1 (sham acupressure and pharmacological treatment), and (3) Comparison Group 2 (pharmacological treatment only). Outcome measures were subscales of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual analog scale and 36-item Short-Form Health Survey. Intention–to–treat analysis was used and missing data was deal with multiple imputation method. The general linear mixed model was carried out to assess the differences between the study groups at different durations (3 months, 6 months, and 1 year).

Results

Compared with CG-1 and CG-2, participants of the KAP group reported considerable improvements in WOMAC pain (mean difference: −2.50 units; 95% CI, 3.74–1.25, and mean difference: −1.69 units; 95%CI, −3.24 to −0.13 respectively) at 1 year. Similarly, VAS pain, stiffness, and physical function were also improved among the participants of KAP group.

Conclusion

Self-administered acupressure has an additive effect to the pharmacological treatment to improve pain, stiffness, and physical function as compared to pharmacological treatment only.