Alternative therapies in health and medicine最新文献

Background: Increasing evidence suggests the effectiveness of virtual reality (VR)-based neuro-rehabilitation. However, the evidence is not well defined, specifically for progressive neurological disorders.

Primary study objective: This study aimed to determine the efficacy and safety of VR therapy over conventional therapy in treating progressive neurological disorders in adults.

Methods/design: The study comprises a systematic review and a meta-analysis, following the PRISMA guidelines, and was registered with PROSPERO (CRD42024582827). Relevant literature was searched in electronic databases including Scopus, Web of Science, PEDro, PubMed, Cochrane Library, and Google Scholar. Seven articles were meticulously selected after eliminating irrelevant ones based on inclusion and exclusion criteria. The PEDro scale was used to assess the methodological rigor of the selected studies. The risk of bias was evaluated using the Cochrane's Risk of Bias 2 tool.

Setting: Within an academic research context, the published studies from the databases were used for this study.

Participants: No participants were directly recruited; this review included participants reported in the included studies.

Intervention: VR therapies (non-immersive or semi-immersive) were compared with conventional therapy as reported in the original studies.

Primary outcome measures: Measuring motor rehabilitation of upper or lower limbs, balance, quality of life (QoL), and adverse effects.

Results: Both groups demonstrated improvement in analyzed parameters (e.g., motor functions, balance, and QoL). No difference was found in motor function measures between groups. The QoL measures insignificantly favored the VR group, while the balance measures significantly favored conventional therapy. Moreover, VR therapy was not significantly linked with adverse effects, except for some minor reactions.

Conclusion: Non-immersive or semi-immersive VR was at least on par with conventional therapy for assessed outcome measures, except for the balance measures, which significantly favored conventional therapy.

Keywords: virtual reality, progressive neurological disorders, neurodegenerative diseases, neurological rehabilitation, systematic review, comparative effectiveness research.

Background: Dysregulated activation of macrophages through the Toll-like receptor 4 (TLR4) pathway plays a central role in the pathophysiology of numerous inflammatory diseases. The immunomodulatory potential of AYUSH-64, a polyherbal formulation, has recently gained renewed interest. However, the individual contributions of its constituent botanicals, Alstonia scholaris (AS), Picrorhiza kurroa (PK), Swertia chirata (SC), and Caesalpinia crista (CC), remain poorly characterized.

Objective: To evaluate and compare the prophylactic immunomodulatory effects of AYUSH-64 and its individual plant extracts on lipopolysaccharide (LPS)-induced inflammation in THP-1-derived macrophage-like cells.

Methods: THP-1 monocytes were differentiated using phorbol 12-myristate 13-acetate (PMA) and subsequently stimulated with LPS (100 ng/mL) to activate TLR4 signaling. Before stimulation, cells were pre-treated with AYUSH-64 or its individual extracts (AS, PK, SC, and CC) at concentrations of 30, 100, and 300 µg/mL. Dexamethasone (30 nM) was used as a positive control. Gene expression of pro-inflammatory and regulatory cytokines (TNF-α, IL-1β, and IL-10) was quantified using qRT-PCR, and cytokine secretion levels via ELISA.

Results: All treatments, including AYUSH-64 and the individual botanical extracts, were non-cytotoxic to PMA-differentiated THP-1 cells. AYUSH-64 elicited a moderate suppressive effect on TNF-α and IL-10 at both the transcriptional and protein levels, with minimal impact on IL-1β expression. In contrast, individual extracts specifically SC, PK, and CC, demonstrated more pronounced and selective inhibition of inflammatory markers. Notably, SC and PK significantly reduced IL-10 secretion, achieving effects superior to those of dexamethasone. AS showed strong downregulation of TNF-α and IL-10 gene expression, while CC induced a dose-dependent reduction in IL-10 expression and secretion.

Conclusion: Individual components of AYUSH-64, especially SC, PK, and CC, demonstrate stronger and more selective anti-inflammatory effects in vitro. They outperformed AYUSH-64 in reducing IL-10 secretion. Thus, constituent-level evaluation in polyherbal formulations is warranted, though further in vivo and clinical studies are needed to confirm their therapeutic potential.

Keywords: AYUSH-64, Alstonia scholaris, Picrorhiza kurroa, Swertia chirata, Caesalpinia crista, toll-like receptor 4, inflammation, macrophage.

Background: The COVID-19 pandemic outbreak caused physical, psychological, and social problems all over the world, especially in individuals with chronic diseases such as diabetes mellitus. People have sought complementary and alternative medicine methods to prevent this disease or treat its symptoms.

Primary study objective: This study aimed to evaluate the use of complementary and alternative medicine practices among diabetes patients during the pandemic.

Methods/design: The study adopted a cross-sectional descriptive design. The study sample comprised patients diagnosed with diabetes who were treated at a state hospital in southern Turkey from September 2022 to October 2023. Data were collected using a questionnaire (containing three sections) form prepared by the researcher in line with the literature.

Setting/participants: Patients with diabetes mellitus, aged over 18 years, were included in the study. A total of 300 patients completed a demographic information questionnaire and a questionnaire regarding complementary and alternative medicine use. The data obtained from the study were analyzed using descriptive tests and the SPSS 22 package program.

Results: The findings revealed that 75.3% of participants were knowledgeable about complementary and alternative medicine methods, and 94.7% reported using them during the pandemic. The commonly preferred practices included drinking herbal tea (68.0%), consuming a variety of vegetables and fruits (54.3%), using probiotic products (37%), taking vitamin and nutritional supplements (23%), and engaging in prayer (65.7%). Hygiene practices mainly included using hand sanitizer and cleaning household surfaces with bleach.

Conclusion: The study's findings suggest that diabetes patients widely utilized nutritional supplements, medicinal plants, and personal hygiene products during the Coronavirus disease 2019 outbreak. Towards this end, healthcare professionals must educate patients on the correct and effective use of complementary and alternative medicine methods and hygiene products to ensure their safety and well-being.

Keywords: coronavirus disease 2019, diabetes mellitus, complementary and alternative medicine, nursing, prevention.

Background: Electrical devices around us are sources of electromagnetic fields (EMF). The EMR induces the formation of free radicals, leading to oxidative damage in various tissues, with the kidney being highly sensitive to oxidative damage.

Aim: This study aimed to evaluate the physiopathological effects of 2600 MHz EMF on the kidney tissue of rats and DNA damage in blood tissue. Quercetin (Qu) was administered as an antioxidant to reduce these effects.

Methods: Male Wistar-Albino rats were divided into four groups, with each containing 8 rats. Group 1 (control group), Group 2 (sham group), Group 3 (EMF group), and Group 4 (EMF + Qu). From the animals sacrificed on the end of the 30th day, kidney tissues were taken for physiopathological examination. Additionally, blood samples were collected for DNA damage analysis by the Comet assay method.

Results: Histopathological examination of the kidney tissue revealed tubular dilatation damage at a low level in all groups. The immunohistochemical evaluation gave similar results in all groups. There was no significant change in malondialdehyde, catalase, and superoxide dismutase levels. Additionally, in the EMF group, DNA damage was observed in the lymphocytes (P = .007, <.05).

Conclusion: It was rationalized that 2600 MHz EMF exposure did not cause any significant damage to the kidney tissue. However, it caused remarkable DNA damage in blood tissue.

Keywords: 2600 MHz, kidney, mobile phone, quercetin, rat.

Background: Adhesive capsulitis, also known as frozen shoulder, is a painful and gradual loss of active and passive shoulder motion caused by fibrosis and contracture of the joint capsule. The Niel-Asher technique is a hands-on manual therapy used to treat adhesive capsulitis, while the Spencer technique focuses on mobilizing the glenohumeral and scapulothoracic joints.

Objective: The study aims to compare the effect of the Niel-Asher and Spencer techniques on frozen shoulder.

Method: A randomized clinical trial on 36 participants with frozen shoulder compared the Niel Asher technique (Group A) and the Spencer technique (Group B). Both groups underwent 10 sessions over 2 weeks, along with a hot moist pack and conventional therapy. Outcomes, including Shoulder Pain and Disability Index (SPADI), Visual Analog Scale (VAS),and Shoulder Range of Motion (ROM), were assessed at baseline and post-treatment after 2 weeks, to evaluate pain and functional abilities.

Results: The results showed significant improvement within the groups across all measured variables, Shoulder Pain and Disability Index (SPADI), Visual Analogue Scale (VAS), and Range of Motion (ROM) (P < .001). Group A and Group B showed greater improvement in pain intensity, decreased shoulder disability, and increased range of motion. No significant differences were found between groups for the outcome measures. Group B had a slightly better clinical response, as evidenced by larger effect sizes (Cohen's d).

Conclusion: Both the Niel-Asher and Spencer techniques are equally effective in improving pain, shoulder range, and functional disabilities, with no statistical difference between them (P ≥ .05).However, the Spencer technique is clinically more effective than the Niel-Asher technique in subjects with frozen shoulder.

Keywords: frozen shoulder, Spencer technique, Niel-Asher Technique, adhesive capsulitis, glenohumeral joint.

Introduction: Abdominal surgery is the most common cause of gastrointestinal disorders due to the formation of adhesions in the visceral structures. Few studies have been done in rat models, which revealed that visceral mobilization can effectively prevent adhesion; however, no study has been done on human subjects. The current study was done to provide evidence for future research in this aspect of manual therapy. The objective of the case study was to identify the effectiveness of visceral mobilizations in preventing adhesive bowel disorder.

Case presentation: A 23-year-old male with a height of 164 cm and a weight of 50 kg was admitted to the hospital due to an Enterocutaneous fistula, and surgical correction of ileal perforation was done. The patient underwent abdominal surgery with mesh placement and visceral mobilization post-surgery to reduce the adhesion-related complications.

Clinical discussion: The subsequent development of adherent bowel loops at the umbilical level, accompanied by subcutaneous stranding, indicates significant post-surgical adhesion formation leading to exaggerated gastrointestinal dysfunction. The patient underwent visceral mobilization treatment of the abdomen, followed by breathing exercises from day 1 to day 6 postoperatively. The patient reported notable improvement in gastrointestinal symptoms and constipation, and mild improvement in the quality of life, post-treatment. Follow-up showed significant improvement in Gastrointestinal Symptom Rating Scale (GSRS), Constipation Assessment Scale (CAS), Visual Analogue Scale (VAS), and Gastrointestinal Quality of Life Index (GIQLI) scores.

Conclusion: Visceral mobilization notably improved the gastrointestinal and constipation-related symptoms in early operative days as well as in long-term follow-up, along with improvement of health-related quality of life.

Keywords: abdominal surgery, visceral mobilization, quality of life, case report, enterocutaneous fistula, abdominal adhesions, post-operative rehabilitation, gastrointestinal dysfunction.

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the metabolic conditions that contribute to chronic liver illnesses, and about 25% of the world's general population is estimated to be affected with this condition. If it is not effectively delayed or reversed, 20% of the patients may develop cirrhosis or carcinoma of the liver or both. Despite the high prevalence and severity associated with NAFLD, there is a lack of efficient diagnosis and treatment.

Objective: This study aimed to perform a thorough and systematic assessment of NAFLD and its status quo, ongoing and published research studies on different traditional medicinal systems in India, viz. Unani, Ayurveda, and Siddha for NAFLD management, and to explore the potentials and possible avenues for managing NAFLD.

Method: This review systematically searched databases, viz. PubMed, Scopus, Web of Science, Google Scholar, AYUSH portals, Clinical trial registry-India, and a few classical Unani texts to identify evidence on NAFLD and its herbal management in Unani, Ayurveda, and Siddha. After screening, 58 key studies and 12 clinical trials were synthesized, comparing traditional concepts with modern diagnostics and highlighting therapeutic insights.

Results: There are several herbal drugs and Indian traditional formulations that can be used to prevent and reverse NAFLD. Herbal extracts and natural products are currently the subject of an increasing number of research studies, many of which have been found effective with appreciable benefits against NAFLD.

Conclusion: Herbal remedies comprise a promising class of prospective medications for the treatment of NAFLD.

Keywords: non-alcoholic fatty liver disease, quantitative ultrasonography, herbal medicine, Unani medicine, narrative review.

Background: Cognitive inhibition refers to the active suppression of irrelevant cognitive information or processes in working memory, enhancing task performance by maintaining focus on the relevant task at hand. It is a fundamental cognitive function that is crucial for efficient cognitive processing and memory retention. Combination yoga practices are known to shorten cognitive inhibition and improve memory. Pranchakra meditation (PCM) is a new protocol, and this study aims to explore its immediate effect on cognitive inhibition under the Stop Signal Test (SST) paradigm.

Objective: The pilot study examines the immediate effect of PCM on inhibitory control using the widely accepted Stop Signal Test (SST) paradigm for furthering research.

Method: In a self-as-control study design, eight healthy Bachelor of Naturopathy & Yoga (BNYS) students aged between 19 and 30 years (22.38 ± 3.4 years) were recruited from a medical university in Uttarakhand, India. They received training in PCM. Pre- and post-data in the SST paradigm were collected using the INQUISIT software. Stop‑signal reaction time (SSRT), mean Go trial reaction time (GoRT), and the probability of responding to stop-signal trials [p (r/s)] were analyzed at a significance level of .05.

Result: A significant difference was observed between pre- and post-SSRT results.

Conclusion: In this pilot study, PCM effectively reduced the SSRT time. Therefore, further studies with a larger sample size are recommended for generalization.

Keywords: Pranchakra meditation, cognitive inhibition, SSRT, yoga, BNYS.

Background: Chronic non-healing ulcers (CNUs), particularly those complicated by neuropathy and multi-morbidity, represent a profound therapeutic challenge with limited effective interventions. This case study investigates the novel application of topical anhydrous aluminum potassium sulfate (AAPS), a traditional astringent agent, for a refractory postsurgical ulcer with concomitant saphenous neuropathy.

Case presentation: A 65-year-old male with poorly-controlled type 2 diabetes mellitus, schizophrenia, and severe alcohol use disorder, presented with a three-year-old, post-surgical CNU inferior to the right medial malleolus. The ulcer had failed multiple courses of targeted intravenous and oral antibiotics and was not amenable to a planned skin graft due to psychosocial constraints. Clinical and neurophysiological examination confirmed severe sensory mononeuropathy of the right saphenous nerve with Utah Early Neuropathy Scale (UENS) score of 9/12.

Therapeutic intervention and outcome: After exhaustive conventional therapy failed, a protocol of once-daily topical AAPS dusting powder was initiated alongside phased mechanical debridement. The intervention resulted in complete ulcer closure within 60 days, with a 57% reduction in surface area observed by day 30. Critically, the patient reported the return of protective sensation (pain) at day 30, and the UENS score improved significantly to 3/12 post-treatment, indicating neurological recovery. No recurrence was noted during a six-month surveillance period.

Conclusion: This first-reported case demonstrates AAPS dusting as a highly effective intervention for complex CNUs, achieving both tissue repair and neurological recovery. The clinical outcomes align with recent evidence of AAPS-mediated ERK pathway inhibition, suggesting a potential molecular mechanism for its therapeutic action in chronic wounds. These dramatic results warrant controlled trials to validate efficacy and the mechanistic pathways.

Keywords: anhydrous aluminum potassium sulfate, chronic non-healing ulcer, ERK pathway, nerve regeneration, wound healing.

Introduction: Dermatophytosis, particularly tinea corporis and tinea cruris, is a frequent superficial fungal infection, especially in tropical and humid regions. Conventional antifungal treatments, including topical or oral antifungals, may cause side effects, especially with long-term use. Increasing cases of recurrent dermatophytosis and antifungal resistance have prompted the exploration of alternative, safer treatment options.

Objectives: The study aims to evaluate the effectiveness of individualized homeopathic medicines (IHMs) for the treatment of tinea corporis and cruris.

Materials and methods: The study was conducted at four Homeopathy Outpatient Departments from August 2021 to March 2024. Patients with clinically diagnosed tinea corporis or cruris, confirmed by positive potassium hydroxide (KOH) mount test, were included. IHMs were prescribed based on symptom totality and repertorization. The primary outcome was assessed using a Clinical Cure Scale, which evaluates lesion's resolution, itching, and infection clearance. Mycological assessment was conducted to detect the presence or absence of fungus. The Skindex-16 questionnaire measured the impact of skin disease on quality of life (QoL). Assessments were performed at baseline and monthly, until resolution or for up to six months.

Results: A total of 147 patients (mean age of 38.92±12.09 years) were analyzed. Tinea corporis was most prevalent (47%), followed by mixed tinea corporis and cruris (30%) and tinea cruris (23%). After six months, statistically significant improvements were observed in Clinical Cure Scale scores (7.01±1.73 to 2.90±2.66, P < .001) and Skindex-16 scores (from 56.04±25.34 to 27.03±28.99, P < .001). 93 patients (63.3%) tested KOH-negative at the end of treatment. Commonly prescribed medicines included Sulphur (35%), Natrum muriaticum (24%), Sepia (13%), Arsenicum album (11%), Lycopodium clavatum (4%), and Graphites (3%).

Conclusion: The findings support the effectiveness of IHMs in managing dermatophytosis. Rigorous clinical and QoL assessments confirm therapeutic benefits. Future randomized controlled trials and long-term follow-up are recommended to validate these results and assess recurrence.

Keywords: tinea corporis, tinea cruris, KOH mount, Skindex-16, homeopathy.