Alternative therapies in health and medicine最新文献

Background: Huntington's Chorea is a progressive neurodegenerative disorder characterized by involuntary movements, cognitive decline, and psychiatric disturbances. It is caused by an autosomal dominant mutation in the HTT gene, leading to an abnormal expansion of CAG repeats. The disease typically manifests in mid-adulthood and gradually worsens over time. The progressive nature of the disease leads to motor, cognitive, and psychiatric impairments, significantly affecting the quality of life.

Aim: This study aims to highlight the progressive nature of Huntington's disease, its impact on motor and cognitive functions, and the role of symptomatic management in improving the patient's quality of life through Ayurveda.

Methods: A 40-year-old male presented with involuntary movement in the upper and lower extremities, difficulty in doing daily routine work, anxiety, difficulty in walking, and sleeplessness for a year. A thorough Huntington's disease mutation analysis was conducted to confirm the diagnosis. The patient was treated with Ayurvedic shodana (Bio-purification), Sarvanga Snehan with Prasarini Taila, followed by Shashtik Shali Pinda Swedan, Nasya with Shadbindu Taila, Shiropichu with Brahmi Taila, Sarvang Dhara with dashmoola kwath, Erandmooladi niruh basti, and shamana (palliative) chikitsa (treatment), Zandopa powder, Balasaireyakadi Kashaya, Kalyanak ghrit, and capsule palsineuron orally for 4 months.

Result: Ayurvedic management promoted substantial improvements in behavioral health, neuromotor function, and activities of daily living as assessed by the Universidade Federal de Minas Gerais (UFMG) Sydenham's Chorea Rating Scale (USCRS).

Discussion: The patient's clinical presentation and diagnostic findings were consistent with Huntington's Chorea.

Conclusion: Huntington's Chorea is a debilitating condition with no definitive cure. Early diagnosis and a multidisciplinary management approach can help alleviate symptoms and improve patient well-being. Genetic counseling plays a crucial role in managing the familial impact of the disease.

Keywords: HTT gene, Genetic Counseling, CAG Repeat Expansion, Huntington's Chorea, Motor Dysfunction, Ayurvedic Medicine, Case Report.

Background: Encephalitis is a group of inflammatory brain diseases caused by infectious or autoimmune processes. The predominant symptoms at the onset or during encephalitis are cognitive and behavioral changes, emotional dysregulation, and reduced self-awareness. When any cognitive function is affected, communication skill also gets affected, and this condition is referred to as cognitive communication disorder. There are few studies in the literature describing cognitive communication disorders after encephalitis. However, to our knowledge, there is no study that provides treatment for cognitive communication disorder or evaluates its effect and prognosis.

Case report: This case report details the hospitalization of a 13-year-old boy who had a seizure after complaints of headache and fever, the diagnostic process of encephalitis, the cognitive communication disorder assessment, and the evaluation of therapy process outcomes. Day 1, Week 1, and Month 1 assessments of the case were made to evaluate cognitive communication disorder.

Discussion: After therapy, a gradual improvement was observed in the case's language skills, such as naming, reading, writing, and non-linguistic cognitive skills, such as semantic association, attention, calculation, and memory.

Conclusion: This report emphasizes the importance of early and comprehensive cognitive communication therapy to facilitate recovery from encephalitis. It also suggests that there may be a strong link between non-linguistic cognitive domains and language functioning.

Background: It is crucial to assess the extent of biopsychosocial involvement and consider how treatment affects it as the first step in providing care for individuals with neck pain.

Objective: This study aimed to assess the validity, reliability, and responsiveness of a Cognitive Exercise Therapy Approach (BETY)-Biopsychosocial Questionnaire (BQ) in chronic neck pain.

Method: The Neck Disability Index (NDI), the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), the Short Form-36 (SF-36), and the Hospital Anxiety and Depression Scale (HADS) were used for the validity analysis. For testing reliability, the Intraclass Correlation Coefficient (ICC) and the Cronbach's alpha coefficient were checked. For responsiveness, all scales were reapplied to individuals who were included in a 2-week physiotherapy intervention.

Setting: Physiotherapy and Rehabilitation Department of the General Hospital, Cyprus.

Participants: One hundred ninety-nine individuals with chronic neck pain were included in the study.

Results: The Pearson's correlations between the BETY-Biopsychosocial Questionnaire and the NDI, DASH, HADS-Anxiety, and HADS-Depression scores were found to be moderate to high (r=0.64, P < .001; r=0.74, P < .001; r=0.64, P < .001; r=0.58, P < .001, respectively). A moderate to high negative correlation was identified between BETY-BQ and SF-36 (r=-0.45 to r=-0.68, P < .001). ICC values were found to be excellent (r=0.993, P < .001). The Cronbach's alpha value showed excellent internal consistency (0.997). There was a good agreement between the pre- and post-test BETY-BQ forms. The calculated effect size for the pre- and post-treatment clinical evaluations was moderate (0.5), and the standardized response mean was found to be large (2.1), indicating that BETY-BQ was responsive to change.

Conclusion: The BETY-Biopsychosocial Questionnaire was found to be reliable, valid, and sensitive to change in individuals with chronic neck pain. This study proposes a practical, easily accessible, low-cost, multi-dimensional, and self-reported biopsychosocial questionnaire for healthcare professionals to holistically evaluate individuals with chronic neck pain using a single form.

Keywords: chronic pain, disability, physiotherapy, exercise, neck pain, BETY-BQ.

Background: As one of the most prevalent musculoskeletal diseases, osteoarthritis, causes pain, deterioration in functioning, and reduction in quality of life. The condition that is thought to contribute most to disability worldwide is knee osteoarthritis. Existing pharmacological treatments for osteoarthritis raise safety concerns. In Unani medicine, several non-pharmacological regimens known as Ilāj bi'l Tadbīr (Regimenal therapies) are advised in the management of painful musculoskeletal disorders. Among all these practices, dry cupping (Hijāmah bilā Shart) is unique and recommended as one of the most effective methods for knee osteoarthritis pain management in the majority of classical Unani literature. This report presents a case of knee osteoarthritis treated using cupping therapy.

Case presentation: A 57-year-old female patient presented with a 3-year-long history of right knee pain, stiffness, and difficulty in daily activities. The patient was examined clinically before intervention and was diagnosed with right knee osteoarthritis which was further supported by radiological investigations. Cupping therapy was administered over the affected knee joint for 4 weeks. A total of 10 sittings were carried out every 2 days. The patient's symptoms gradually ameliorated, ultimately becoming minimal following the 4-week treatment period. Specifically, the Numerical Pain Rating Scale (NPRS) score decreased from 8 to 2, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score for stiffness and functional ability improved with a decrease from 50 to 25, and the quality of life score measured by 36-Item Short Form Health Survey (SF-36) improved from 35 to 75.

Conclusion: Our case study established cupping therapy's effectiveness as a secure, non-invasive treatment option and opened new possibilities for its application in the management of knee osteoarthritis. However, further research is imperative to establish the efficacy and effectiveness of cupping therapy.

Objective: Coumarins are known to have antidiabetic properties. They are also known to have direct effects on the cardiovascular system. However, their insulin and amylin-releasing effects have not been thoroughly studied. This study investigated the effect of 5,7-dimethoxycoumarin (Citropten) fractions in grapefruit peel on insulin and amylin secretions in normal male Wistar rats.

Methods: Methanol extract from grapefruit peels was fractionated using vacuum-assisted liquid chromatography with n-hexane, ethyl acetate, and methanol. Gas Chromatography Mass Spectrometry analysis reported ethyl acetate fraction with the highest concentration (85.66%) of 5,7-dimethoxycoumarin. Intraperitoneal Glucose Tolerance Test was performed on 5 sets of 5 rats receiving intraperitoneally: 1) negative control, 1 ml of sterile water 2) positive control, 0.2 mg/kg glimepiride, 3) ethyl acetate fraction containing 20 mg/kg 5,7-dimethoxycoumarin, 4) methanol fraction containing 20 mg/kg 5,7-dimethoxycoumarin, 5a) 1 ml 0.6% hydrogen peroxide and 20 mg/kg 5,7-dimethoxycoumarin; 5b) 1 ml 6% hydrogen peroxide and 20 mg/kg 5,7-dimethoxycoumarin; and 5c) 1000 mg/kg Vitamin C and 20 mg/kg 5,7-dimethoxycoumarin.

Results: Results showed that ethyl acetate fraction containing 20 mg/kg 5,7-dimethoxycoumarin had comparable plasma glucose control as obtained with glimepiride, with indirect insulin secretion effect unlike direct-acting glimepiride; the methanol fraction was less effective. An oral Glucose Tolerance Test confirmed the antidiabetic efficacy of 5,7-dimethoxycoumarin. Both ethyl acetate and methanol fractions of 5,7-dimethoxycoumarin induced extrapancreatic amylin synthesis and secretion.

Conclusion: 5,7-dimethoxycoumarin will find special applications in the management of obesity and for people with diabetes having chronic complications. Since the overall plasma glucose regulation is achieved through amylin and insulin synergy, attention should be shifted from insulin-based to amylin-based therapy. There is a need to focus on natural compounds that stimulate extrapancreatic amylin release, especially in patients with type 1 diabetes who are insulin dependent.

Objective: This study aims to evaluate the efficacy of integrating nursing early warning systems with doula-assisted childbirth nursing on natural childbirth rates and associated outcomes.

Methods: A total of 150 women who underwent childbirth in the obstetrics and gynecology department of our hospital between September 2021 and March 2023 were enrolled as participants. They were randomly allocated into either the observation group or the control group, each comprising 75 individuals. The control group received standard nursing care, while the observation group received nursing early warning systems combined with doula-assisted childbirth nursing. Comparison between the two groups included modes of childbirth, the intensity of childbirth pain, neonatal Apgar scores, the incidence of postpartum hemorrhage, duration of the first and second stages of labor, and maternal satisfaction with nursing care.

Results: Our findings indicated a higher natural childbirth rate in the observation group compared to the control group (P < .05). Furthermore, the SAS score of the observation group post-nursing was significantly lower than that of the control group. Additionally, neonates in the observation group exhibited higher Apgar scores compared to those in the control group. Moreover, mothers who underwent natural childbirth in the observation group experienced lower childbirth pain scores and reduced postpartum hemorrhage incidence (P < .05). The duration of both the first and second stages of childbirth was shorter in the observation group than in the control group. Furthermore, overall satisfaction with care was significantly higher in the observation group than in the control group, with a statistically significant difference (P < .05).

Conclusions: This study underscores the effectiveness of implementing nursing early warning systems combined with doula-assisted nursing in enhancing maternal satisfaction, reducing postpartum hemorrhage, and improving maternal well-being and neonatal outcomes. The findings advocate for the widespread adoption of this intervention in clinical practice.

The hypersensitivity of the nasal mucosa to pathogens, allergens, or nasal drugs, accompanied by a dysfunctional immune response, is the cause of various types of rhinitis. Regardless of the commercial drugs used in treatment, rhinitis is a chronic disease of the modern population. Hence the dilemma: can commercially-available drugs cure rhinitis or only temporarily suppress the disease symptoms. This article aims to contribute to clarifying the dilemma and highlight some possible solutions to the problem of rhinitis. Screening of the scientific literature, both in the field of pharmacotherapy and traditional herbal medicine, on the mechanisms of rhinitis treatment and the possibility of restoring the atrophied nasal mucosa led us to an acceptable idea. Namely, the evidence-based review indicates that herbal medicines may be considered a new class of immune adjuvants. Traditional Chinese, Japanese, and Indian herbal medicine dominate studies that indicate the importance and efficacy of herbal extracts of various medicinal plants in this indication area. However, most phytotherapy-related studies focus mainly on alcoholic plant extracts. Due to possible incidences of irritation, herbal oily macerates may bea better option for direct application to an already livid or atrophied nasal mucosa. We indicate that oily macerates are enriched in liposoluble phytocomponents that can prevent the inflammatory reaction and exert their immunoregulatory effect as efficiently as those in the alcoholic extract. We hypothesize that the selected herbal oils could not only alleviate existing rhinitis symptoms but also restore atrophied nasal mucosa. The oily macerates are characterized by better stability than ethanolic extracts, higher concentration of medicinal substances, synergistic effect in polyherbal formulation, prolonged release and improved penetration of bioactive compounds, epithelizing properties, antiviral and anti-inflammatory activity, and only a small amount is needed to achieve the desired therapeutic effect in the nasal cavity.

Background: Fall is a public health problem that cannot be ignored by elderly stroke patients, and rehabilitation care plays an important role in the rehabilitation process of elderly stroke patients.

Objective: To investigate the prevention effect of fall risk in elderly stroke patients under the intelligent model of rehabilitation care.

Methods: The general data of elderly patients who were diagnosed as stroke and admitted to our hospital between June 2021 and June 2022 were retrospectively analyzed, with exclusion like unclear clinical data or combined with other severe organ insufficiency. A total of 150 of them were selected for the study, and the patients were divided into a fall group and a non-fall group according to whether they had a fall or not. The factors associated with falls in stroke patients were analyzed univariately, and the rehabilitation care intelligence model of the predictive model of falls in stroke patients was established using multiple covariance ridge regression analysis to observe the predictive value of patients' risk of falling in the rehabilitation care intelligence model.

Results: Results of multiple covariance ridge regression analysis to build the model showed age (P < .001), low MNA-SF score (P < .001), hypertension (P = .035), anaemia(P = .048), gout (P < .001), assistive devices (P = .002), visual impairment (P = .033), elevated ALB (P < .001), and elevated HGB (P < .001) as risk factors for falls in stroke patients. The diagnostic threshold for screening elderly stroke patients for falls based on risk factors was 0.272, with a sensitivity of 90.7%, specificity of 98.1% and an area under the ROC curve of 0.976 (P < .05), which was superior to other single indicators in terms of diagnostic value. The calibration of the prediction model, based on the Hosmer and Lemeshow test of goodness of fit, showed P = 1.14, indicating a high calibration of the prediction model.

Conclusion: There are many risk factors for falls in stroke elderly patients, such as low MNA-SF score, gout, elevated ALB, and elevated HGB. Building a rehabilitation nursing intelligent model based on the above inducement factors can reduce the risk of patients falling to a certain extent, and the prediction model has a high degree of calibration. Therefore, a simple and standardized intelligent rehabilitation nursing model for stroke patients in the early stage can effectively prevent the occurrence of falls.

Background: In China, traditional Chinese medicine (TCM) is an important part of the comprehensive treatment of hepatocellular carcinoma (HCC), and Chinese herb formulas with the effect of "yiqi jianpi jiedu huayu" (replenishing qi, strengthening spleen, and removing toxicity and blood stasis) are the common and efficient treatments for HCC. However, the mechanism of these formulas in treating HCC remain unclear.

Objective: In this paper, our goal is to explore the potential mechanism of Phyllanthus urinaria L anti-neoplastic decoction (PAD), the representative formula of "yiqi jianpi jiedu huayu", in treating HCC.

Design: The research team performed the network pharmacology and in vitro experiment (preparation of PAD aqueous extract, cell cultures and MTT assay, cell apoptosis assay, wound healing assay, transwell assays, western blot).

Setting: The study took place in the Department of Hepatology, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), China.

Outcome measures: The active components and targets of PAD and HCC targets were screened by five Chinese herbs and two disease databases respectively. The network pharmacology was utilized to construct the relationship network between PAD and HCC, and the mechanism was predicted by pathway enrichment analysis. The experiment was performed to verify the intervention effect of PAD on HCC and phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway.

Results: The relationship network between PAD and HCC suggested that PAD mainly regulated the potential therapeutic targets of HCC by key active components such as quercetin, luteolin, calycosin, wogonin, and pinocembrin. Pathway analysis demonstrated PAD could play an anti-HCC effect via multiple pathways (e.g., PI3K/Akt). Results of the experiment showed that PAD could effectively inhibit the proliferation and migration of HCC cells, and promote HCC cells apoptosis in a concentration-dependent behavior. Additionally, PAD could decrease the protein expression of phosphorylated PI3K/Akt.

Conclusion: PAD mainly exerts an anti-HCC effect through multiple active components represented by quercetin and multiple pathways represented by the PI3K/Akt pathway. This study provided an experimental basis for the clinical application of PAD.