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December, 2021 - VOL. 27, NO. 12  December, 2021
Attitudes and Knowledge of Community Pharmacists Toward Complementary and Alternative Medicine: A Narrative Review
Kevin Clayton, BPharm;  Yoni Luxford, PhD;  Ieva Stupans, PhD
Context • The use of complementary and alternative medicine (CAM) in Australia is widespread, and self-treatment with CAM often occurs. Community pharmacies are a major supplier of CAM in Australia; consequently pharmacists may be approached by consumers in relation to self-treatment. Objectives • The study intended to appraise peer-reviewed literature regarding the supply of CAM in retail pharmacies and pharmacists’ knowledge and attitudes in relation to it. Design • The research team performed a narrative review of peer-reviewed studies published between January 1997 and December 2017. Four electronic databases—Web of Science, ScienceDirect, CINAHL, and PubMed—were systematically searched using keywords. A search strategy was devised using 4 keywords: knowledge and attitude, complementary and alternative medicine, stress, and pharmacist. English-language, full-text studies were sought, and the team considered only the results of studies conducted in Australia or in countries with similar healthcare systems. Setting • The study is a literature study. Results • Performance rankings were considered, with 10 studies being identified. Pharmacists were generally positive about CAM; however, they displayed a degree of uncertainty, particularly about efficacy and safety, that pointed toward a lack of confidence and a desire for better education. Knowledge, both self-rated and assessed, was lacking. Few studies explored the use of CAMs for specific physical-health conditions and fewer still addressed mental health. Conclusions • Pharmacists are ideally placed to interact with consumers and are often the first point of contact for those people wanting to self-treat. Pharmacists may lack the necessary practice knowledge and skills to appropriately advise consumers about CAM or about those conditions where self-treatment products fall predominantly into the CAM category, such as for stress.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Adjunctive Treatment of Pediatric Adenoidal Hypertrophy: A Review
Murat Çetkin, PhD;  Hatice Esra Çetkin, PhD
Context • Adenoids play an important role in the protection of the upper respiratory tract against pathogens. Nonphysiological enlargement of adenoids is defined as adenoid hypertrophy (AH). In treating AH, physicians prefer medical therapy and often disregard adjunctive methods. Studies on the effects of adjunctive methods on adenoid tissue are quite scarce. Objective • The current review aims to examine the clinical studies that have investigated adjunctive methods—nasal irrigation, herbal therapy, bacteriotherapy, and halotherapy—used to treat AH and its associated symptoms and to evaluate their effectiveness in pediatric patients. Design • The research team performed a narrative review by searching seven electronic databases (Pubmed, Cochrane Library, Google Scholar, Web of Science, EMBASE, Science Citation Index and Elsevier) were used for the literature search. The search used the keywords adenoid hypertrophy, adjunctive treatment, nasal irrigation, herbal medications, bacteriotherapy and halotherapy. Setting • This study was took place in Department of Anatomy, Medicine Faculty, Istanbul Medeniyet University. Results • The nasal irrigation with hypertonic solution decreased to size of enlarged adenoid tissue. The bacteriotherapy used with nasal spray and tablet form decreased to surgery rate and adenoid size.The adenoid and/or tonsillar hypertrophy were decreased by halotherapy used with micronized, iodized-salt aerosol. Conclusions • A review of studies on this matter indicates that the studied adjunctive methods can be used safely in the treatment of AH, either separately or in combination with conventional medical treatment. However further clinical studies are needed on this topic.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Red Pepper, Ginger, and Turmeric on Energy Metabolism: Review of Current Knowledge
Nilüfer Acar Tek, MSc, PhD;  Mehmet Arif Icer, MSc
Context • Energy metabolism is the main determinant of obesity etiology. Consumption of some spices, such as red pepper, ginger, and turmeric, can be considered to be an environmental factor affecting energy metabolism. Objective • This review aimed to examine the effects of red pepper, ginger, and turmeric on weight control, weight loss, and energy metabolism. Design • The research team performed a narrative review by searching the Google scholar, Scopus, PubMed, ResearchGate, Web of Science, and Science Direct databases. The search used the keywords red pepper, ginger, and turmeric in combination with energy metabolism, energy expenditure, energy balance, thermogenesis, anti-obesity, weight management, weight control, weight loss, metabolic rate, and oxygen consumption, without considering any time limitation. Setting • This study has been carried out in Ankara / Turkey. Results • Red pepper, ginger, and turmeric affect energy metabolism through various mechanisms. Dietary red pepper and its pungent principle capsaicin affects satiety and has a promising thermogenic influence. Ginger has positive effects on weight control, obesity prevention, and energy metabolism. In addition, curcumin inhibits the conversion of preadipocytes to mature adipocytes. Conclusions • Red pepper, ginger, and turmeric affect energy metabolism using mechanisms related to thermal effect, BMR, total energy expenditure, oxygen consumption, and lipid oxidation. These spices haven’t been assigned appropriate doses and periods of use, and no definite judgments can be made on their use. Therefore, it’s necessary to conduct further randomized controlled research to reach absolute conclusions and determine by which mechanisms these spices show this effect on energy metabolism.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Acupressure for Cancer-Related Fatigue in Elderly Cancer Patients: A Randomized Controlled Study
Ülkü Özdemir, PhD, RN;  Sultan Tasci, RN, PhD
Context • Fatigue is the most common symptom experienced by elderly cancer patients. It negatively affects their daily functioning and quality of life. Integrative approaches such as acupressure can be used to treat cancer-related fatigue in elderly patients. Objectives • The aim of this study was to investigate the effect of acupressure on the severity and level of cancer-related fatigue in elderly patients with cancer. Design • This study was carried out in two stages comprising a quantitative study (pretest, posttest, randomized controlled) and a qualitative study (in-depth interview). Setting • The study was conducted at the hematology and medical oncology clinic in a university hospital in Turkey. Participants • The study included 31 cancer patients aged 65 and over, who were experiencing cancer-related fatigue. Intervention • Participants were randomly assigned to the acupressure group (intervention group) or the control group. The intervention group was administered acupressure on three acupuncture points on the hands and legs (LI4, SP6, ST36) by caregivers or the patients themselves for three minutes twice daily, for a period of four weeks. The acupressure group was examined before and after the four-week intervention. The control group was similarly examined though no intervention was applied. Outcome Measures • Data were collected using Patient Information Form, Visual Analog Scale (VAS), Piper Fatigue Scale (PFS), and Acupressure Experience Patient Opinion Form. Results • In the follow-up examination of individuals in the acupressure group, there was a significant reduction in the severity and level of fatigue compared to the first examination. However, there was no significant difference between the first and second examination of individuals in the control group. The qualitative findings obtained during the in-depth interview support the quantitative findings of the study. Conclusion • Acupressure can be recommended as an integrative treatment for cancer-related fatigue because it is effective, easy to use, tolerable and does not cause serious side effects.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Association of Sudarshan Kriya Yoga with Happiness: A Case-Control Observational Study from Singapore
Divya Kanchibhotla, MTech;  Robert A. Sloan, MA, PhD
Happiness is a complex subjective experience that is essential to societal progress. This study investigated the association between Sudarshan Kriya Yoga (SKY) and subjective happiness in Singapore. Subjective happiness data were collected from a convenience sample (N = 733) comprised of 2 groups: SKY (n = 385) and non-SKY (n = 348) practitioners. SKY was categorized into non-, monthly, weekly, and daily practitioners and happiness was categorized into lower, middle and higher tertile groups. Confounding variables included age, gender, ethnicity, marital status, education level, body mass index (BMI), smoking status, alcohol consumption and self-reported health. Daily SKY participation was positively associated with a 2-fold higher likelihood of being happier in a multivariate regression analysis. The trend analysis showed that as SKY frequency increases, the odds of being happier increases. These findings help generate the hypothesis that yogic breathing may promote happiness. Further experimental and prospective investigations are warranted.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Psoriasis Management Using Herbal Supplementation: A Retrospective Clinical Case Study
Samir Alhilo, MD;  Iman Alhilo, MD;  Buthaina Alkhatib, PhD
Background • Currently, there is no effective long-term treatment for psoriasis by conventional medicine. Thus, several alternative treatments are currently used to attenuate the severity, including herbal and dietary supplements. Primary Study Objective • The aim of this study was to investigate the effect of a mixture of traditional Jordanian herbal supplements on psoriasis treatment. Methods/Design • A retrospective case study was conducted at The Herbal Dynasty Medical Center, Jordan. Three psoriasis patients were selected to participate (2 males; 1 female); patients obtained their diagnosis by a physician. Participants were prescribed a specific dose of 2 capsules daily of the herbal supplement, which consisted of dandelion, olive leaf, nettle leaf, and turmeric, along with 2 capsules of milk thistle half an hour before breakfast. Participants were instructed to follow therapy protocol for 5 consecutive months. The psoriasis area and severity index score was calculated pretreatment and posttreatment. Results • The 3 psoriasis cases were diagnosed as mild, moderate, and severe at the study onset. The severity index scores were 3.2, 14, and 16.2, respectively, and improved posttreatment to 0, 0.8, and 2, respectively. Conclusion • Traditional herbal supplementation was shown to be beneficial for the treatment of psoriasis.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Tai Chi and Qigong in Medical Research: A Comprehensive Bibliometric Analysis
Gabriella Morandi;  Daniele Pepe, PhD
Objective • Tai Chi and Qigong are mind-body practices deriving from Traditional Chinese Medicine (TCM) which are used clinically as therapeutic interventions. The objective of this study was to identify patterns and research trends in reviews about Tai Chi and/or Qigong through bibliometric analysis. Methods • Based on a search of Scopus, authors, collaborations and source journal impact were analyzed, along with citation counts and alternative metrics. Results • In all, 205 documents were retrieved, 72% of which concerned the practice of Tai Chi. According to the type of practices, the average citation per year was 2.2 for Qigong studies, 3.2 for Tai Chi and 5.6 for Tai Chi and Qigong reviewed together. The most productive authors were Lee, Ernst and Pittle who shared a high number of papers. The strongest institutional connection was between universities in Korea and Exeter, UK. The source journals had good ranking positions both among journals belonging to the alternative medicine category and specialized clinical journals. Conclusion • The level of collaboration among universities, the increasing number of meta-analysis studies, and the prestige of the journals in which articles were published attest that Tai Chi and Qigong practices are creating new opportunities in the traditional medicine.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Herbal Formulation Comprised of Methanol Extracts of Tribulus terristris L. and Zingiber officinale Roscoe Has Antihypertensive Effects
Muhammad Naeem Aamir, PhD;  Khizar Abbas, PhD;  Muhammad Imran Qadir, PhD;  Muhammad Naeem Qaisar, PhD;  Ghazala H Rizwani, PhD;  Talal Shaheer, MPhil;  Faheem Ahmad Siddique, PhD;  Asif Wazir, MPhil;  Muhammad Younis, MPhil
People prefer to use medicinal plants rather than chemical compounds because they are low cost and have fewer adverse events. Zingiber officinale Roscoe is a natural dietary rhizome with anti-oxidative, anti-inflammatory and anti-carcinogenic properties. Tribulus terrestris L. has been used for the treatment of impotence, to enhance sexual drive and performance and for its diuretic and uricosuric effects. The aim of this study was to evaluate the combined effect of 2 extracts, Tribulus terristris and Zingiber officinale (TZ) for antioxidant, enzyme modulation, liver function, kidney function, blood profile and anti-hypertensive effects, which may pave the way for possible therapeutic applications. Antioxidant potential was measured with the 2,2-diphenyl-1-picryl-hydrazyl-hydrate free radical method antioxidant assay (DPPH) and kojic acid was used as the standard drug for tyrosine inhibition assay. The effect of TZ on biochemical parameters of the liver (alanine transferase [ALT], alkaline phosphatase [ALP], aspartate aminotransferase [AST], total serum protein, total serum albumin, serum bilirubin), kidney (blood urea and creatinine) and hematology (hemoglobin, red blood cells [RBC], platelets, thin-layer chromatography, neutrophils, eosinophils, lymphocytes, monocytes, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration) of Wister rats were studied by administering 100, 250 and 500 mg/kg-1 body weight TZ dose orally for 28 days. Antihypertensive effects were measured by the invasive method. The results showed that the scavenging percentage of TZ was 78.5 to 80.4, with an IC50 value of 1166.7 µg/ ml and tyrosinase inhibition was 72% compared with 93% for kojic acid. Different doses (100, 250 and 500 mg/kg) did not show an increase in serum biomarkers of liver and renal parameters. A significant increase in hemoglobin, erythrocytes, hematocrit, white blood cells (WBC) and lymphocytes with no significant increase/decrease in platelet count was observed but blood pressure was significantly decreased. Therefore, we concluded that TZ is safe and can be used in the treatment of hypertension.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Maqams in Music on Anxiety: A Preliminary, Randomized Controlled Trial
Ozan Eroy, PhD;  Hakan Gulmez, MD
Introduction • Music is widely used to reduce anxiety, and the beneficial effects of music on anxiety are well established. Maqams represent a system of melodic modes used in traditional Turkish music. Different maqams may have different effects on anxiety. Objective • The current study intended to investigate the effects of Hicaz and Huseyni maqams on anxiety and to evaluate whether a difference in effects exists. Design • The research team performed a preliminary, randomized controlled trial. Setting • The study took place in the Department of Family Medicine, Faculty of Medicine and the Department of Music, Faculty of Fine Arts, at Izmir Democracy University in Izmir, Turkey. Participants • The participants were 87 volunteers between the ages of 18 and 27, who were students studying at the university. Intervention • The participants were randomly divided into three groups, with 29 participants in each group. One intervention group listened to the music in the Hicaz maqam—the Hicaz group—and the second listed to the music in the Huseyni maqam—the Huseyni group—for 30 minutes a day for a week. The control group received no intervention. Outcome Measures • The Beck Anxiety Inventory (BAI) was used to measure participants’ level of anxiety. Results • No significant differences existed between the three groups in the BAI scores at baseline (P = .97). For the Hicaz and Huseyni groups, a significant decrease was found in the mean BAI scores between baseline and postintervention (P < .001), but no statistically significant difference was found for the control group (P = .29). No statistically significant difference in the BAI scores existed postintervention between the Hicaz and the Huseyni groups (P = .66) or between the Hicaz group and the control group (P = .06), but a statistically significant difference did exist between the Huseyni and the control groups (P = .01). Conclusions • Listening to music is an effective auxiliary method for reducing anxiety. The type of music to which an individual listens can affect this benefit, with some types having a greater positive effect than others.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Therapeutic Use of Trace Elements in Dermatology
Anita Gade, DO;  Karl Hoegler, MD;  Jacqueline R Hwang, BS;  Amor Khachemoune, MD;  Samiya Khan, BS
Trace elements (microminerals) play a role in many physiological functions, including hormone production and cellular growth. However, their importance in diagnosing and treating dermatologic disease has not been well examined. In this review, we discuss the functions, sources, and recommended requirements of each micromineral. In addition, we analyze the systemic and dermatological manifestations associated with micromineral imbalances. The pathogenesis of genodermatoses, such as Wilson disease, Menkes disease, acrodermatitis enteropathica, and allergic dermatitis, are also discussed. Included are studies examining the potential therapeutic role of zinc, selenium, and copper in inflammatory diseases, skin cancer, and photoaging.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effect of Acupressure on Pre-Exam Anxiety in Nursing Students
Eunkyung Lee, PhD, GNP, RN;  Jin-Hwa Park, PhD, APRN-BC, RN
Background • Academic stress and anxiety are experienced by students as a consequence of examinations. Objective • The purpose of this study was to explore whether or not auricular acupressure therapy can reduce exam anxiety, state anxiety and trait anxiety in nursing students. Methods/Design • A single blinded randomized control trial was designed. Setting • The study was conducted at one univeristy in Daegu City, South Korea. Participants • A total of Fifty-eight sophomore nursing students were initially recruited for the study and were randomly assigned to either the experimental or control group (n = 29 each). In the experimental group, 2 participants dropped out and 1 dropped out in the control group before completing the study, resulting in a final count of n = 27 for the experimental group and n = 28 for the control group. Intervention • Participants in the experimental group received auricular acupressure at the Shen Men point and endocrine point bilaterally, and participants in the control group received the intervention at a sham point bilaterally. Primary Outcome Measures • Test anxiety levels were rated with the Korean version of the Revised Test anxiety Scale and state-trait anxiety levels were determined with the Korean version of the State-Trait Anxiety Inventory Form Y before the intervention and immediately after the examination. Data analysis was performed using the IBM SPSS WIN 25.0 software program. Results • After controlling for baseline outcome values, auricular acupressure therapy was effective in decreasing the test anxiety level; however, no differences were found in state anxiety or trait anxiety. Conclusion • Auricular acupressure therapy is effective in reducing test anxiety in students prior to taking an examination.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Ocimum Sanctum: An All-Round Treatment for Cancer?
Pulkit Kumar;  Dhaniket Patel, BSc
Background • This review is a great route for future researchers on the topic of alternative medicine. The review goes in depth with respect to Ocimum sanctum and its proposed mechanism of action for different types of cancers. Primary Study Objective • The primary objective of the study was to bring traditional therapy back, which can prove to be economically beneficial and may be helpful to many patients with cancer with few to no adverse events. Intervention • Ocimum sanctum (OS), commonly known as Holy Basil or tulsi, is a very important medicinal herb in parts of India and Southeast Asia. OS has been found to lower blood pressure and cholesterol, reduce the risk for heart attacks and may also be effective for treating depression and anxiety. It also protects the body from prolonged physical exertion, ischemia, exposure to cold and excessive noise, but its anti-tumorigenic effect remains largely unexplored. A few studies have observed that extracts of OS have inflammatory, analgesic, antipyretic, antidiabetic, hepatoprotective, hypolipidemic, anti-stress, and immunomodulatory activities. A few cell culture and animal studies have also shown that some of its phytochemicals like eugenol, rosmarinic acid, apigenin, myretenal, luteolin, ß-sitosterol and carnosic acid prevent chemical-induced skin, liver, oral and lung cancers and mediate these effects by increasing antioxidant activity, altering gene expression, inducing apoptosis and inhibiting angiogenesis and metastasis. They are also shown to prevent radiation-induced DNA damage. This review details the different chemoprotective and radioprotective properties of OS and also gives an idea for future research.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Intuitive Eating on the Quality of Life and Wellbeing of Yoga Practitioners, Physical Activity Practitioners and Sedentary Individuals
Maria Carolina Alves De Martini, MS;  Everton Artuso, PhD;  Dalila Moter Benvegnú, PhD;  Yana Cristina de Barba, BS;  André Lazarin Gallin, PhD;  Angela Khetly Lazarotto, MS;  Eduardo Henrique Szpak Gaievski, MS
This study is a comparative analysis of the effects of intuitive eating and correlations with quality of life and wellbeing in Yoga practitioners, physical activity practitioners and sedentary individuals. The study involved 204 participants, comprising 66 Yoga practitioners, 74 physical activity practitioners and 64 sedentary individuals, between the ages of 20 and 59, who were resident in Brazil at the time of the study. Quantitative research was conducted through Facebook and the application questionnaires via Google Forms to measure intuitive eating, food consumption, quality of life, stress level, satisfaction with body image and level of mindfulness. The study found that while intuitive eating did not differ between Yoga practitioners and physical activity practitioners, both showed greater adoption of intuitive eating as compared to inactive individuals. Still, Yoga practitioners had better confidence in their physiological signs of hunger and satiety, as well as better eating behavior, quality of life, satisfaction with body image, healthy body weight, and stress-related emotional regulation, as compared to the other groups. In addition, there was a positive correlation between intuitive eating and quality of life, body esteem, mindfulness and eating behaviors that discouraged eating in response to external or psychological influences, and a negative correlation to stress and weight gain. This study finds that physical exercise, in particular the practice of Yoga, is linked to the promotion of better intuitive eating behavior as well as better quality of life and wellbeing.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Osteopathic Manual Treatment Compared to Kaltenborn-Evjenth Orthopedic Manual Therapy for Chronic Low Back Pain: A Randomized Study
Jaroslaw Jaszczur-Nowicki;  Wojciech Kobza, PhD, BMed;  Pawel Lizis, PhD;  Damian Wisniewski, PhD, BMed
Context • Low back pain (LBP) is a painful pathology causing pain and disability despite treatment with the best evidence-based therapies. Osteopathic manual therapy (OMT) and Kaltenborn-Evjenth orthopedic manual therapy (KEOMT) are alternative treatments for LBP. Objective • The study intended to evaluate the efficacy of OMT compared to that of KEOMT for patients with chronic LBP. Design • The research team designed a randomized study. Setting • The study was held at the Medita Health Center in Warsaw, Poland. Participants • The study included 68 participants of both genders, aged 30 to 60, with chronic LBP. Intervention • Participants were randomly assigned to one of two parallel groups, each with 34 members. The OMT group received, as a direct technique, a high-velocity/low-amplitude (HVLA) impulse, and as indirect techniques, strain counterstrain (SCS), myofascial release (MFR), and visceral mobilization therapy (VMT). The KEOMT group received lumbar segmental traction and lumbar segmental mobilization—flexion and gliding therapy grade 3. The participants in both groups received 10 treatments, two per week for five weeks. Outcome Measures • The primary outcome was pain severity, using a numeric pain rating scale (NPRS). The secondary outcome was measurement of functional disability, using the Oswestry Disability Index (ODI). Results • The OMT and KEOMT both decreased pain and disability; however, the changes on the NPRS and ODI postintervention were statistically greater for the OMT group compared to the KEOMT group (P < .05) . Conclusions • OMT was better at reducing pain and improving quality of life. It reduced functional disability more than KEOMT in patients with chronic LBP.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Long-Term Effects of Hatha Yoga on Heart Rate Variability In Healthy Practitioners: Potential Benefits For Cardiovascular Risk Reduction
Bindu Balakrishnan, MSc, PhD;  Jacob Day, BS;  Mohan Ganesan, PT, PhD;  Kashinath G Metri, MD, PhD
Hatha yoga is commonly practiced in Western countries and is claimed to reduce risk of cardiovascular disease. The purpose of this study was to evaluate and compare time-domain and frequency-domain metrics of heart rate variability (HRV) in Hatha yoga practitioners and healthy controls. This cross-sectional study, which was conducted at a regional university and community wellness center, included convenience sampling of 19 Hatha yoga practitioners and 8 healthy controls. Using a lead II ECG system, 10 minutes of electrocardiogram (ECG) recording was collected for each participant. Artifact-free, 5-minute signals were used to derive time-domain and frequency-domain measures of HRV. The mean duration of Hatha yoga practice among practitioners was 11.47 ± 8 years. Demographic and anthropometric characteristics did not differ significantly between groups. Compared with the control group, the yoga group had significantly greater mean high frequency (HF) power (859.2 ± 1342.1 vs 175.5 ± 121.1; P = .04) and mean HF normalized units (nu) (57.0 ± 16.6 vs 36.7 ± 13.4; P = .02) and a significantly lower low frequency (LF)/HF ratio (1.1 ± 0.5 vs 2.2 ± 1.1; P = .01). No significant intergroup differences were observed for LF power, LF nu, or any time-domain measures of HRV. These results lack generalizability due to small sample size and lack of blinded assessment of outcome measures. Hatha yoga practitioners showed parasympathetic predominance compared with healthy controls. Analyzing frequency-domain HRV metrics enables detecting changes in cardiac autonomic function earlier than by analysis of time-domain metrics. Parasympathetic predominance demonstrated in the yoga group suggests Hatha yoga practitioners may be at lower risk for stress-related comorbidities.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Schizophrenia and Homoeopathy: A Review
Gaurav Gupta, PhD
Context • Schizophrenia is a mental condition that is affecting approx. 1.0 percent of the worldwide population, with devastating consequences for affected individuals and their families. Homoeopathy could be an effective alternative mode of treatment and can minimize the consequences of it. Objective • This study is done to have a brief review of the condition of Schizophrenia and to evaluate the role of Homoeopathy as an alternative mode of treatment in patients suffering from this condition. Design • The research team performed a narrative review by searching Pubmed, IJRH, ISOR-JDMS, WHO, and Medscape databases. Reference books related to medicine and homoeopathy were also reviewed. The search used the keywords like Schizophrenia, Homoeopathy, psychiatry, hallucinations, paranoia, ICD-10, DSM-5, etc. Setting • This study is conducted at Faculty of Homoeopathic Sciences in Jayoti Vidyapeeth Women’s University. Results • Schizophrenia alters the thinking, feeling and behavior of affected person and is presented in form of delusion, hallucination with social withdrawal. Homoeopathy can be an alternative mode of treatment to not only help in improving this condition but also treat the same. There are not much studies that has been conducted to evaluate the role of Homoeopathy in schizophrenia. Out of few, one study has suggested improvement in the symptoms of paranoid schizophrenia using Brief Psychiatric Rating Scale (BPRS) score system. Conclusions • Schizophrenia is a psychiatric condition not only affecting routine of daily of life but also the Quality of life. Homoeopathy is a non-toxic, gentle, permanent treatment which is based on totality of symptoms (TOS) and individualization. In the process of construction of TOS and individualization, more importance is given to mental symptoms. As again pschizophrenia is a psychiatric condition which affects the mental process of patient, Homoeopathy can be used as an effective method of treatment but to establish the efficacy of it, more studies including randomized controlled trials are suggested.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Preliminary Study of Virtual-reality-guided Meditation for Veterans with Stress and Chronic Pain
Joyce S Chung, PhD;  Odette A Harris, MD, MPH;  Colin S Kalahar, LCSW;  Kevin Liu, BA;  Esmeralda Madrigal, LCSW;  Donald Nguyen, BS;  Mira Parekh, BS;  Molly Timmerman, DO
Context • Studies have found evidence for meditation’s positive effects on health and well-being, but the difficulty of learning and engaging in meditation practice has been identified as a major barrier. Virtual reality (VR) technology may facilitate meditation practice by immersing users in a distraction-free and calming virtual environment, although this theory has yet to be rigorously tested. Objective • This study intended to examine the efficacy of VR-guided meditation in a population of US veterans as a tool to facilitate meditation and relaxation practice for reduction of stress and chronic pain as well as to elicit participants’ feedback regarding their perceptions of VR-guided meditation. Design • The research team designed a preliminary study to identify the scope of future investigations. Setting • The study was conducted at an outpatient polytrauma clinic in a Veterans Affairs (VA) Palo Alto Health Care System, located in Palo Alto, California. Participants • Participants were a convenience sample of 31 veterans, with an average age of 55.2 years, who were patients at the polytrauma clinic and who had conditions with varying levels of stress and chronic pain. Intervention • All participants completed a 10-minute, VR-guided-meditation session based on the Zen form of meditation. Outcome Measures • At baseline immediately before and postintervention immediately after the VR meditation session, self-report ratings of pain and stress, physiological measures testing heart rate (HR) and blood pressure (BP), and participants’ survey responses that assessed their experiences with, attitudes toward, and concerns about VR for clinical therapy were obtained. Results • Participants showed statistically significant reductions in self-reported pain and stress, HR, and systolic and diastolic BP. Participants reported high satisfaction with VR-guided meditation, and few reported negative side-effects. Conclusions • The study provided evidence for the usefulness of VR technology as a facilitator of meditation practice for reduction of stress and chronic pain. Future studies are needed to examine the long-term effects of repeated VR-guided-meditation sessions for patients with stress and chronic pain.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Gentle, Massage-like, Head Stroking Provokes Salivary Oxytocin Release
Yoshitaka Koshino, MD;  Naohisa Tomosugi, MD
Context • The evidence is growing that oxytocin (OXT), a hypothalamic hormone, can induce parturition and lactation, modulate affiliative behavior, and regulate stress and energy metabolism. Although the physiological effects of massage aren’t fully understood, massage may affect OXT release and facilitate adaptive responses to stressors. Objectives • This study intended to examine the effects of gentle, massage-like head, stroking to determine whether it could have a direct influence on the release of OXT. Design • The research team performed a preliminary study. Setting • The study was conducted at Kanazawa Medical University in Kahoku and Mizuho Hospital, Tsubata, Ishikawa, Japan. Participants • Participants were 14 volunteers from Mizuho Hospital. Intervention • The 14 recruited participants were assigned to the massage group and received gentle, massage-like, head stroking, which lasted 60 minutes. Seven of those participants were randomly recruited to become a control group that rested only, without massage, on a different day than the massage occurred. Outcome Measures • Participants’ saliva for both groups was drawn at baseline and postintervention on the different days. Salivary OXT was assayed using a highly sensitive chemiluminescence immunoassay. Analyses were performed at baseline before the intervention and postintervention. Results • The OXT secretion increased significantly in the massage group unlike in the rest group, which had no change. Conclusions • Gentle, massage-like, head stroking is an effective method of releasing endogenous OXT. These findings open up the possibility of using endogenous OXT as an adjunct therapy in both clinical and research settings.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Complementary and Alternative Medicine: Consumers’ Experience With Food Therapy in Traditional Chinese Medicine in Hong Kong
Gigi Kai Yin Au Yeung, PhD;  Crystal Yan Pui Lee, PhD;  Alice Hoi Ying Yau, PhD;  Matthew Wai Lung Yeung, PhD
Context • The trend of people using complementary and alternative medicine (CAM) has been increasing globally. To enact policies and regulations that promote the safe use of CAM, a detailed investigation is needed into people’s knowledge, practices, and beliefs related to CAM. Food therapy has long been regarded as an important part of traditional Chinese medicine (TCM), a type of CAM. Objective • This study intended to empirically examine the public’s knowledge about TCM food therapy, including the sources of that knowledge, actual practices, and the public’s beliefs about the therapy. Design • The research team designed a questionnaire to test the public’s understanding of food properties as designated in TCM food therapy and to identify the public’s sources of knowledge and experience in using food therapy. Setting • The study took place at the College of Professional and Continuing Education, the Hong Kong Polytechnic University, and the University of Hong Kong in Hong Kong, China. Participants • Participants were 447 Chinese students participating in postsecondary or tertiary education at the two higher education institutions mentioned above. Outcome Measures • The survey’s quantitative questions examined respondents’ prior TCM knowledge, sources of knowledge, and food therapy experience compared to their ability to correctly categorize 24 foods. The survey’s qualitative questions examined the general practice of food therapy and the cultural beliefs underlying the food therapy strategies that participants used. Results • The study showed that: (1) having prior and partial knowledge of food properties (P = .000); (2) seeking information from the internet (P = .000), television (P = .0473) and friends (P = .0181); and (3) having used food therapy for chronic conditions (P = .0034) significantly improved participants ability to correctly categorize foods as to their food therapy characteristics. Conclusions • Participants relied less on traditional medical sources such as parents and health professionals but more on the internet, which may have empowered them through wider access to information. The study has further contributed to the study of Complementary and Alternative Medicine (CAM) by highlighting the role of cultural practices and beliefs in TCM food therapy.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effectiveness of Mindful Self-Compassion Training Supported by Online Peer Groups in China: A Pilot Study
Xiaoxia Guo, MD, PhD;  Bettina Hoeppner, PhD;  Xiaoyu Huang, MA;  Felipe A Jain, MD;  Xiaoqin Mai, MD, PhD;  David Mischoulon, MD, PhD;  Emily K Tan, BA;  Qionghui Xie, PhD;  Albert Yeung, MD, ScD
Context • Self-compassion training involves the cultivation of feelings of warmth and safety, presence, and interconnectedness. Mindful Self-Compassion (MSC) training in a group setting has been found to increase self-compassion, mindfulness, and emotional well-being. Objective • The current study intended to examine the outcomes of live, online, videoconference-based MSC training with online peer-support for nonclinical populations in different cities in China. Design • The research team designed a pre-post pilot study. Setting • The study took place at Renmin University in Beijing, China. Participants • Participants were 253 Chinese individuals who were recruited from different regions in China through online advertisements. Intervention • Participants took part in online MSC training in a two-hour, group class each week for eight weeks and received support from online peer groups and through a half-day in-person retreat. Outcome Measures • Self-report outcomes were obtained at baseline and postintervention, using the Self Compassion Scale (SCS) and the Compassion for Others Scale (CS) for primary outcomes, and the Depression, Anxiety, and Stress Scale (DASS-21), the Fear of Compassion Scale (FOCS), the Satisfaction with Life Scale (SWLS), the Subjective Happiness Scale (SHS), and the Cognitive and Affective Mindfulness Scale (CAMS-R), for secondary outcomes. A fixed effects model was used to test for within-group changes in the scales. Results • The online MSC program yielded a high retention rate. Of the 206 first-time participants, 179 (86.9%) attended six or more of the eight MSC sessions, and 183 (88.8%) completed the assessments at both baseline and postintervention. Of the 183 retained participants, 97.8% were female, with an average age of 37.8 ± 7.9; 94% had college or higher education. For all scales, the within-person changes occurred in the expected direction; positive attributes and experiences increased, while negative attributes and experiences decreased. Conclusions • The study showed that first-time participants in China in an online MSC training that was supported by online peer groups had high attendance rates, high assessment completion, and favorable results. These preliminary outcomes suggest that future studies with more rigorous designs are warranted to further investigate online training with peer support as an effective and efficient approach to disseminate MSC training in China.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Demographics of and Costs to Users of Chiropractic Services in the United States with Neck or Back Pain not Meeting Guideline-Based Minimum Treatment Frequency Thresholds
Jennifer Contreras, MPH;  Benjamin Lewing, MS;  Sujit S. Sansgiry, PhD
Context • Acceptance of chiropractic services as an effective therapy for neck or back pain has been well established with randomized controlled trials (RCTs); however, there have been limited observations made on the treatment frequency patterns seen in the real world. Objective • The purpose of this study is to identify chiropractic users with neck or back pain who did not meet recommended treatment frequency guidelines and examine their demographics and chiropractic costs. Design • In this cross-sectional retrospective study, the nationally representative 2017 Medical Expenditure Panel Survey database was used. Setting • This study used nationally representative US survey data. Participants • Inclusion criteria were adults aged 18 years and older with a diagnosis of neck or back pain with one or more chiropractic visits in 2017. Outcomes Measures • Chiropractic utilization was categorized as concordant or discordant with treatment frequency guidelines; concordant was defined as 5 or more visits to a chiropractor within any 2-month time frame or at least 12 total visits during the year. Discordant was defined as circumstances not meeting concordant criteria. The groups were compared by demographics including age, sex, race, region, years of education, health insurance coverage, employment status, family income, presence of headache diagnosis, Charlson Comorbidity Index score and the presence of any limitation of physical function. Comparisons were made between the two groups using Chi-squared tests. Logistic regression was used to adjust for covariates. Results • There were 159 and 310 adults classified as concordant and discordant, respectively (weighted total: 1 849 108 [31.44%] and 4 032 541 [68.56%], with significantly different mean chiropractic costs of $2555 and $434, respectively. Significant independent predictors of discordant chiropractic utilization were race, years of education, family income and the presence of any limitation of physical function. Conclusions • Most chiropractic users with diagnosed neck or back pain were considered discordant with treatment frequency guidelines, which may indicate inefficiencies in treatment and inefficient use of healthcare resources.
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December, 2021 - VOL. 27, NO. 12  December, 2021
A Case Report of Alopecia Areata Treated with Individualized Homoeopathy
Amit Bhasme, MD (Hom);  Preeti Lamba, MD (Hom) Part I;  Uzma Sajjan, BHMS
Introduction • Alopecia areata is a dermatological disorder characterized by hair loss. The exact cause is still unknown but is linked with an autoimmune disease. No efficient treatment is known though many studies have been conducted, yet the optimal treatment is not known. Methods • The case was treated in the Dermatological Department at Dr. D. Y. Patil Homoeopathic Medical College and Research Centre. A 42-year-old female patient with alopecia areata was treated with individualized homoeopathic medicine (iHOM) between 2nd May 2019 and 16th January 2020. During the follow-up visits, the outcome was assessed. To evaluate whether the changes were due to homoeopathic medicine, an assessment using the Modified Naranjo criteria was performed. Results • Over an observational period of eight-months, positive results from iHOM medicine were seen. This treatment can be used by the physicians in the treatment of alopecia areata as a complementary health practice. Conclusion • Considering the multi-factorial aetiology of alopecia areata, iHOM along with local treatment may be effective in treating alopecia areata.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Reconceptualizing Principles and Models in Osteopathic Care: A Clinical Application of the Integral Theory
Torsten Liem, MSc, OST Hons;  Christian Lunghi, BSc, Ost Hons
The cornerstone of osteopathic care lies in the osteopathic tenets—first of all, the idea of a self-regulating, dynamic unit made of body-mind-spirit. The clinical application of the osteopathic principles mainly relies on the structure-function models, but the practitioners’ community is still trying to reach a consensus on the fundamental theoretical framework. Mostly, the debate swings between the biomechanical-structural pole and the biopsychosocial pole. However, there is a compelling need for a robust conceptual framework in osteopathic care. It is necessary to draw up a more consistent interprofessional framework, emphasizing the distinctive focus of the osteopathic intervention in health care. In the present hypothesis paper, the different osteopathic care models are integrated into the 4-quadrant model of the Integral Theory. In light of the Integral Theory, osteopathic care can be construed to improve the individual mind-body function and spiritual behavior integrated with the environment.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Comparison of the Effects of 12 Weeks of 3 Types of Resistance Training (Traditional, Circular and Interval) on Pro-Inflammatory Markers in Nonathletic Men with Obesity
Anthony C Hackney, PhD, DSc;  Mohammad Jahangiri, MSc;  Shahnaz Shahrbanian, PhD
Objective • The primary aim of this study was to compare the effects of 12 weeks of 3 resistance training methods (traditional, circular and interval) compared with no exercise on the plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a) in nonathletic men with obesity. Materials and Methods • The study sample included 44 nonathletic men with obesity who were randomly assigned to one of four groups: traditional, circular, and interval resistance training or a control group. IL-6 and TNF-a cytokines were analyzed using commercial ELISA kits. Results • The results of mixed-design ANOVA with repeated measures showed that there was significant correspondence between the type of training used and time on TNF-a (F(1,40) = 2212.35; P = .001; estimates (ES) = 0.98) and IL-6 (F(1,40) = 2423.69; P = .001; ES = 0.98) levels. Results indicated that there was a significant difference between the resistance training groups and the control group in both TNF-a (F(3, 40) = 11.39; P = .001; ES = 0.46) and IL-6 (F(3, 40) = 4.65; P = .007; ES = 0.25) levels. Conclusion • All types of resistance training decreased biomarker outcomes compared with the control group. However, interval resistance training showed a significant difference from circular resistance training in IL-6 level, while there was no significant difference between the effects of the 3 types of resistance training on TNF-a levels.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Echeveria Pallida: Inhibiting Adhesion of Fibroblasts From Pterygium and Neutrophil Extracellular Traps Production
William de Jesús Rios-Rios, MSc;  Gladys Isabel Manzanero-Medina, MSc;  Araceli Pérez-Vásquez, PhD;  Sorely Adelina Sosa-Luis, MSc;  Honorio Torres-Aguilar, PhD
Context • Pterygium, meaty eyes, is a disease that produces a triangular, conjunctival-epithelial, neovascularized overgrowth covering the cornea, which can cause vision loss. Histological characterization of Pterygium reveals the presence of proliferating fibroblasts (FBs) that remodel the extracellular matrix, with infiltration of immune cells, causing chronic inflammation. The fresh juice of Echeveria pallida E. Walther (Crassulaceae), mechanically extracted from the leaves, can be used to lubricate the eyes and remove Pterygium, even in advanced, degenerative ocular disease. Objective • This study aimed to explore the healing mechanisms of an ethanolic extract of E. pallida on pterygium-derived FBs, lymphocytes, and neutrophils. Design • The research team designed an in-vitro study. Primary cultures of FBs were obtained from fresh, surgical pterygium tissues, and neutrophils and mononuclear cells were purified from the peripheral blood of healthy donors. Intervention • An ethanolic extract of E. pallida was evaluated at 30, 50, 80, 100, 200, and 300 µg/mL—the intervention groups—for viability and proliferation of FBs and lymphocytes. The study included a negative control with no extract, and a positive control, Mitomycin C (MMC), used as a FB proliferation inhibitor and anti-inflammatory. Because some reports have suggested that DMSO at low concentrations can stimulate or inhibit lymphocyte proliferation depending on the cell type, the study also included a DMSO control. Outcome Measures • The measures included an analysis of E. pallida’s effects on the proliferation and viability of FBs, the proliferation of human lymphocytes, and human neutrophil extracellular traps (NETs) production. NETs were induced using biochemical and microbiological stimuli—phorbol myristate acetate (PMA), hypochlorous acid (HOCl), Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans—through fluorescence microscopy. Results • The ethanolic extract didn’t affect the viability or proliferation of pterygium-derived FBs and human blood lymphocytes, but it showed significant inhibitory activity, from 100 µg/mL, on FB adhesion and the production of NETs. Conclusion • The study found scientific evidence that supports the effects of an extract of the medicinal plant E. pallida in inhibiting the adhesion of FBs derived from human pterygium and NET production.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Efficacy of Constitutional Prescription in Homoeopathic Management of Psoriasis: Case Report
Asmita Alekar, MD;  Ananya Chitale, MD HOM;  Vineet V Sinnarkar, MD (Hom)
Psoriasis is a chronic inflammatory disease which has multisystem involvement, predominantly skin and joints. It affects quality of life and leads to psychological distress in patients leading to poor self-esteem and depression, ultimately affecting interpersonal relationships. Homoeopathy believes in a holistic approach and, when prescribed on a constitutional basis, helps to cure the condition from its root cause. A diagnosed case of psoriasis in a 23-year-old male came into the Homoeopathic OPD with complaints of psoriatic patches on the face and scalp. Routine investigations were done to rule out other disorders. In this case, Sulphur was prescribed on a constitutional basis and proved to be beneficial. Considering the extent of psoriasis in this patient, the Homoeopathic approach relieved the case in a short period of time with prolonged treatment response, suggesting that this may represent the ideal cure in Homoeopathy.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Oncology Patients’ Health Literacy on Use of Complementary and Alternative Therapy
Irem Çayli Karaoglan, BSc;  Afitap Ozdelikara, PhD
Context • Health literacy is defined as the capacity of an individual to acquire, interpret, and understand basic health information and services to improve their health. Cancer patients often turn to complementary and alternative medicine (CAM) to cope with diagnosis and treatment processes. Objectives • The study aimed to determine the effects of health-literacy levels on oncology patients’ use of CAM. Design • The research team conducted a descriptive cross-sectional study. Using a 95% confidence interval and a 0.95 power ratio, with the analysis performed in the G Power statistical analysis program, version 3.1, the study sample was calculated to be a minimum 120 people. Setting • The study took place in Turkey in the outpatient chemotherapy and oncology unit at Ondokuz Mayis University’s Health Application and Research Center between February 2019 and January 2020. Participants • Participants were 200 oncology patients treated in the unit. Outcome Measures • The data were collected using an introductory information form, the Health Literacy Scale (HLS), and the Holistic Complementary and Alternative Health Questionnaire (HCAMQ). Results were analyzed using percentages, means, and the Spearman correlation analysis, Mann Whitney U, and Kruskal Walls tests. Results • Of the 200 participants, 54% were women; 38.0% were between the ages of 57 and 69; 53.5% were primary school graduates; and 36% were Stage-4 cancer patients. The most common side effect of chemotherapy was fatigue and weakness, with 80.5% experiencing those symptoms. Concerning CAM use, 42.5% used at least one CAM method, and 44.7% of those individuals stated that they resorted to those methods to reduce the treatment’s negative effects. Conclusion • The participants’ health literacy levels were high, and they had moderately positive attitudes toward CAM. No significant relationship existed between health-literacy levels and attitudes toward CAM (P = .219). However, strengthening health literacy can be a preventive practice for the correct and reliable use of CAM.
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