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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Aromatherapy with Lavender (Lavandula angustifolia Mill.) on Post-Dural Puncture Headache: A Randomized Placebo-Controlled Trial
Hamid Asayesh, MSc;  Hanieh Bahadori, MSc, BSc;  Meysam Hosseini Amiri, MSc;  Morteza Nasiri, MSc;  Mojtaba Rajaee, BSc;  Zeynab Yousefi Khosroabadi, MSc
Context • Lavender has been proposed as an analgesic agent for different types of headaches in complementary and alternative medicine. However, no documented trial has been performed to investigate the effects of lavender in managing post-dural puncture headache (PDPH). Objective • To evaluate the effects of aromatherapy using lavender essential oil in reducing the severity of PDPH. Design • Randomized, placebo-controlled clinical trial with parallel group design. Setting • Post-operative wards of Kamkar-Arab-Nia and Nekooei Hedayati Hospitals in Qom, Iran. Participants • Patients with PDPH caused by spinal anesthesia (n = 50). Intervention • Patients received 15-minute inhalations of either lavender oil or liquid paraffin as placebo, using the same protocol. Outcome Measures • The severity of headache was scored before (baseline) and five times after the intervention (immediately, 30, 60, 90, and 120 minutes after) using the visual analog scale. Also, dosage and frequency of the received Diclofenac and adverse effects of the intervention were recorded. Results • Both groups showed a reduction in headache scores post intervention. However, the headache scores between the groups was significantly different only immediately after the intervention in favor of lavender oil (difference: 1.60 ± 0.63, P = .015). Furthermore, it was observed that the mean changes of the headache scores compared to baseline were significant at each time interval in favor of the placebo group (P < .05), except immediately after the intervention. No significant difference was observed in diclofenac intake between groups (P = .440). Also, no adverse effects were found from the intervention. Conclusions • Aromatherapy with lavender oil was observed to reduce the severity of PDPH only immediately after the intervention, while only minimal effects were observed at successive time intervals. However, it is noted that the study was likely underpowered and further studies are recommended to better understand the effects of lavender oil on PDPH and compare its effects to other herbal products or pharmacological agents commonly used for managing headaches.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Lycopene-enriched, Organic, Extra Virgin Olive Oil on Benign Prostatic Hyperplasia: A Pilot Study
Ángel Abengozar, MD;  Luis Blanco, Lic Sc;  Cristina Carrasco, PhD;  Ana Beatriz Rodríguez, PhD
Context • Epidemiological evidence has shown that lycopene consumption may be effective in both the prevention and treatment of various diseases, particularly prostate cancer. However, the influence of this dietary carotenoid on some of the most basic aspects of human health remains unknown. Objectives • The aim of the study was to determine the effects of consumption of a lycopene-enriched commercial product of organic, extra virgin olive oil (EVOO) on prostate health, sleep quality, antioxidant status, and anxiety. Design • The research team designed a pilot study with two intervention groups. Setting: The study took place in the city of Badajoz (Extremadura, Spain). Participants • Participants were 20 men aged =50, some of whom were healthy and some of whom had received a diagnosis of benign prostatic hyperplasia. Intervention: Participants were divided into a healthy-men (HM) group (n = 10) and a benign prostatic hyperplasia (BPH) group (n = 10). Both groups consumed 20 ml of lycopene (0.4 mg/ml) daily in a lycopene-enriched commercial product of organic extra virgin olive oil, at breakfast and/or lunch, for 30 days. Outcome Measures • Sleep quality, prostate markers—prostatic specific antigen and protein C reactive—and symptomatology, urine total antioxidant status, and emotional health were assessed at baseline and postintervention. Results • The level of prostatic specific antigen and symptomatology remarkably improved in men with benign prostatic hyperplasia, although the changes wasn’t statistically significant, and the total antioxidant status was significantly increased in healthy men (P < .05). Sleep quality in terms of nocturnal activity was significantly improved in both groups (P < .05). No adverse events were reported. Conclusion • The consumption of a lycopene-enriched, organic, EVOO positively influenced prostate health and other physiological variables. These findings may help to advance the development of new preventive and/or chemotherapeutic strategies based on lycopene.
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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
Clam Extract Decreases Nasal Symptoms and Improves Sleep Quality after Septoturbinoplasty
Szu-Chi Chen, MD;  Chun-Yen Ke, PhD;  Ru-Ping Lee, RN, PhD;  Lieber Po-Hong Li, MD, PhD
Context • Nasal septal deviation (NSD) causes nasal blockage, which results in lower sleep quality among patients. A high percentage of patients still suffer from nasal symptoms as a result of the inflammatory response that occurs with septoturbinoplasty. Freshwater clams are a common food with an anti-inflammatory effect and have been used for promoting liver function for patients in China. Objectives • The study intended to evaluate the effects of clam extract (CE) in reducing inflammatory response, alleviating nasal blockage, and improving sleep quality for NSD patients after septoturbinoplasty. Design • The study was a randomized, controlled pilot that used a prospective design. Setting • The study took place at the Cheng Hsin General Hospital in Taipei, Taiwan. Participants • Participants were 52 patients with NSD at a clinic at the hospital. Intervention • Patients were randomly assigned to 2 groups: (1) an intervention group that received CE capsules and (2) a control group that received empty capsules that were identical in appearance to the CE capsules. Participants received the treatments 3 times a day for 2 weeks after septoturbinoplasty. Outcome Measures • Participants were assessed for nasal-symptom severity, wound inflammation, serum concentration of tumor necrosis factor alpha (TNF-a), and sleep quality. All outcome measures were undertaken at baseline, on various days during the study depending on the measure, and postintervention on day 14 for wound assessment and sleep quality. Results • After the septoturbinoplasty, the intervention group had lower nasal-symptom severity, wound inflammatory response, TNF-a concentration, and sleep disruption than those in the control group (P < .05). Conclusions • After septoturbinoplasty, CE can reduce nasal-symptom severity and inflammatory response and also improve patients‘ sleep quality. The anti-inflammatory effects of CE indicate that it can be considered to be an adjuvant therapy to improve sleep quality after surgery.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effect of Oral Care with Black Mulberry Syrup on Oral Mucositis in Patients With COPD: A Mixed Study
Songül Karadag, RN, PhD;  Sevda Korkut, RN, PhD;  Salih Levent Çinar, MD
Background • Oral mucositis often affects the quality of life of patients living with Chronic Obstructive Pulmonary Disease (COPD). Its symptoms include loss of oral mucous membranes, ulceration, bleeding and pain as well as bacterial, fungal and viral infections of the oral mucosa. Objectives • This study was carried out to investigate the effect of oral care with black mulberry syrup on oral mucositis healing in patients with COPD. Design • This mixed study was carried out in two stages– quantitative and qualitative. The quantitative stage was conducted as a randomized controlled experimental study while the qualitative stage was conducted by in-depth interview method. Setting • This study was conducted at the chest diseases clinic of a tertiary hospital in Turkey. Participants • The randomized controlled experimental study was completed with a total of 40 patients who had been diagnosed with COPD and oral mucositis between March 2017 and June 2018. They were divided into intervention and control groups consisting of 20 patients each. The qualitative study was conducted on 10 patients in the intervention group. Intervention • Patients in the intervention group gargled with 5 ml of black mulberry syrup for an average of 1 minute and swallowed it upon completion. They did this 3 times a day after meals for a period of 15 days after which they were interviewed. Outcome Measures • The quantitative data was collected using the Patient Information Form, Oral Evaluation Guideline, and WHO Oral Mucositis Scoring Index, while the qualitative data was collected using the in-depth interview form. Patients’ oral mucosa was assessed a total of 3 times during 3 interviews held on the first, seventh and fifteenth days of the study. Results • There was a significant decrease in scores of oral mucositis of the patients in the intervention group at the second and third follow-ups. Oral mucositis of the intervention and the control groups healed at an average of 9.1 ± 2.5 days and 12.1 ± 1.4 days, respectively. In addition, oral care with black mulberry syrup was found to alleviate mucositis-related symptoms. Conclusion • Oral care with black mulberry syrup accelerates mucositis healing and alleviates mucositis-related symptoms.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Qigong Exercise on Physical and Cognitive Performance in Young Sedentary Females: A Quasi-Experimental Design, Placebo-Controlled Study
Martin Burtscher, MD, PhD;  Kultida Klarod, PhD;  Suphannika Ladawan, PhD;  Sanita Singsanan, PhD;  Niramon Thamaviriyasati, PhD
Background • Qigong exercise represents one type of traditional Chinese exercise that might positively affect physical and psychological functioning, slow down disease development and improve quality of life. However, study findings are somewhat conflicting and mechanisms contributing to expected beneficial effects are rather poorly known. Objective • This study aims to evaluate the effects of qigong exercise training for 8 weeks on selected physical, cognitive, and biochemical outcomes in young sedentary females. Method/Design • Quasi-experimental design, placebo-controlled study. Setting • The study was performed at the Department of Physical Therapy, Faculty of Allied Health Science, Burapha University, Bangsean, Chonburi province, Thailand. Participants • Participants were 41 females with sedentary lifestyles. Interventions • 41 sedentary females were allocated to qigong exercise (QG, n = 20) or to the control group (CG, n = 21). Primary Outcome Measures • VO2 max predicted from step testing, aspects of cognitive functions (e.g., digit span forward, DSF, and digit span backward, DSB, task), hematological and biochemical parameters, and body composition were assessed in both groups before and after the 8-week training period. Results • Physical performance (estimated VO2 max) significantly increased after qigong training compared to the CG (P < .001). Working memory (DSB) increased after intervention only within the QG (P = .009) but changes did not reach significance between the groups. Changes in neutrophils (potential mediators of inflammation) tended to be improved in the QG in comparison to the CG (P = .075). Body composition remained unchanged. Conclusion • These findings indicate that 8 weeks of qigong training increased aerobic capacity and tended to improve working memory in otherwise sedentary young females. Neutrophils tended to decrease within the QG. Thus, it was speculated that enhanced oxygen supply to the brain and the decrease of neutrophils adhering to cortical capillaries might have contributed to improved cognitive function.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effect of Acupressure Applied to Sanyinjiao (SP6) on Primary Dysmenorrhea
Yeliz Dincer, PhD;  Umran Oskay, PhD
Context • With the technological developments and advancement of scientific knowledge in the field of health, healthcare professionals are now expected to identify strategies for the use of complementary therapies and to guide healthy and ill individuals in their correct and effective use. Acupressure—a simple, effective, safe, and economical therapy—may reduce the pain caused by dysmenorrhea. Objective • The aim of the study was to determine the benefits of acupressure applied to the Sanyinjiao (SP6) acupressure point for treatment of primary dysmenorrhea. Design • The research team designed a randomized controlled trial. Setting • The study took place at the Health Services Vocational School at Duzce University in Duzce, Turkey. Participants • Participants were 67 students with dysmenorrhea, who were studying business administration at the university between October 2016 and January 2018. Intervention • Participants were randomly assigned to one of two groups, in compliance with the study’s criteria. The acupressure group pressed the SP6 acupressure point on each leg once a day for 10 minutes, for the first three days of each menstrual period for three months. The students in the acupressure and placebo group have been followed up for a total of four cycles. The participants in the acupressure group have been advised to press to the SP6 acupressure point for ten minutes every day on each leg for the first three days of each menstruation period for three months; the participants in the placebo group have been recommended to scrub the sham-acupressure point for ten minutes every day on each leg for the first three days of each menstruation period for three months. Within the last month(Month 4), evaluation forms have been applied without any further practices. The control group rubbed a false acupressure point on each leg once a day for ten minutes, for the same period. Outcome Measures • A diagnostic form was used to collect the study’s data and to determine participants’ demographic characteristics. A visual analogue scale (VAS) and the Brief Pain Inventory (BPI) were used to evaluate dysmenorrhea pain. A satisfaction form was used to evaluate participants’ satisfaction. Results • On the VAS, the severity of pain was lower in the acupressure group than in the control group. On the BPI, the scores were lower and the pain caused less discomfort in the acupressure group than in the control group. Moreover, both groups were satisfied with the practices. Conclusions • Acupressure can be used as an effective and reliable method for the management of primary dysmenorrhea.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Is Musical Auditory Stimulation Able to Influence the Recovery of Autonomic Modulation After Exercise?
Luana Almeida Gonzaga, MSc;  Vítor Engrácia Valenti, PhD;  Anne K. França Da Silva, PhD;  Rayana Loch Gomes, PhD;  Rafael Luiz de Marco, MSc;  Luiz C. Marques Vanderlei, PhD;  Sany Martins Pérego, BSc;  Felipe Ribeiro, MSc
Context • The effects of musical auditory stimulation on the human body have received considerable interest, especially when related to health and wellbeing, so the objective was to verify the influence of classical music exposure on autonomic modulation in recovery after exercise. Methods • 35 healthy young men aged 21.74 ± 2.59 years were evaluated. Volunteers perform 2-day evaluations, 1 day without musical stimulus and 1 with musical stimulation through classical music during exercise and recovery. Physical exercises were performed on a treadmill with an intensity of 6.0 km/hr + 1% of inclination in the first 5 minutes for physical “warm-up”, followed by 25 minutes with an intensity equivalent to 60% of the maximum velocity (Vmax), with a same slope according to the Conconi’s threshold. Finally, the volunteers remain at rest for 60 minutes for recovery. Heart rate variability (HRV) was analyzed in some moments of recovery by linear (RMSSD, SDNN, LF and HF (milliseconds squared and normalized unit) and LF/HF ratio, RRtri, TINN and the Poincaré plot: SD1, SD2 and SD1/SD2) and nonlinear indexes (DFA Total, DFA Alpha 1 and Symbolic Analysis: Shannon’s Entropy, 0V%, 1V%, 2LV% and 2ULV%). Results • No differences were found in the comparison between the values of the HRV indexes between protocols and interaction moments vs protocols. Differences were observed between the moments for most indexes (P < .05). Conclusions • Classical music did not significantly influence the autonomic control of heart rate in the recovery phase after submaximal exercise.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Fibromyalgia: A Report of 2 Cases Treated With Homeopathy
Vipul Gandhi, MD
Fibromyalgia is a chronic condition that is characterized by widespread pain and a multitude of other symptoms, including fatigue, sleep disturbances, cognitive dysfunction, stiffness, and depressive episodes. Fibromyalgia is most common in women, though it can occur in men as well. It most often starts in middle adulthood but can occur in the teen years and in old age. Fibromyalgia has also been termed central pain amplification disorder, meaning the volume of pain sensation in the brain is turned up too high. This study has been conducted to evaluate the role of homeopathic treatment in fibromyalgia, a chronic pain disorder which a physician may come across fairly commonly in their practice. Homeopathy has demonstrated great efficacy in mitigating the symptoms of widespread pain, sleep disturbance, and fatigue, which are the most commonly reported symptoms of fibromyalgia.
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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, MS;  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
The Effect of Hypnotherapy for Obesity
E. Erdal Ersan, MD
Objectives • The aim of this study was to evaluate the effects of hypnotherapy on the treatment of obesity, which seriously affects people’s quality of life. We evaluated the changes in Body Mass Indexes with hypnotherapy used to treat obesity. Methods • A total of 230 subjects with a Body Mass Index of 25 and over, who completed a minimum of 10-week sessions, were included in the study. The participants were first identified with the information form and the Body Mass Index. Then, once a week hypnotherapy session was performed for at least 10 weeks. This study is a non-randomized prospective study examining the effect of hypnotherapy on body mass index. Results • There was no statistically significant difference between the, dinner heavy meals and regular exercise or movement, and there was no statistically significant difference in terms of the baseline and endpoint of hypnotherapy (P = .777 and P = .770). There was a statistically significant difference in terms of sex and night feeding status at the beginning and end of hypnotherapy (P = .042 and P < .001). According to the Body Mass Indexes at the beginning and end of hypnotherapy; The initial Body Mass Index was 34.83 ± 5.81 and the end Body Mass Index was 32.61 ± 5.66. The difference was statistically significant (P < .001). Conclusions • It has been found that hypnotherapy is an effective method in the obesity treatment. It is easy to apply, cheap, effective, no side effect potential, the advantages of being added either alone or in other treatments.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects on Anxiety and Vital Signs of the Emotional Freedom Technique and Music Before Surgery for Lumbar Disc Hernia
Remziye Cici, PhD;  Meral Özkan, PhD
Context • Patients hospitalized for surgical treatment for lumbar disc herniation (LDH) are adversely affected psychologically, with fury, anger, helplessness, anxiety, and depression being observed in patients. Anxiety in particular is a common problem, with an incidence of around 90%. Objective • This study intended to determine the effects on patients’ anxiety and vital signs of the emotional freedom technique (EFT) and music before LDH surgery. Design • The research team designed a quasi-experimental study. Setting • The research was carried out in the neurosurgery clinic of a university hospital in Turkey. Participants • Participants were 162 adult patients at the clinic who had LDH surgery between February 2018 and September 2019. Intervention • Using the nonprobability sampling method, participants were allocated to one of three groups: (1) 54 to the music group, an intervention group; (2) 54 patients to the EFT group, an intervention group; and (3) 54 to the control group. Outcome Measures • The Patient Information Form, the Life Findings Form, the Subjective Units of the Distress Scale (SUDS), and the State-Trait Anxiety Inventory-State Anxiety (STAI-S), were used to collect data. In the data analysis, the numbers, percentages, means, standard deviations, and chi-square values were found, and the t test and an analysis of variance (ANOVA) were used in the dependent and independent groups, respectively. The Tukey test was used for further analysis. Results • EFT and music were determined to significantly reduce participants’ state anxiety and subjective discomfort (P < .001). EFT significantly reduced the pulse and respiratory rates and the systolic blood pressure, and music significantly lowered the diastolic and systolic blood pressures (P < .05). Further analyses showed that EFT was more effective on state anxiety and reducing the respiratory rate than music. Conclusions • Both music and EFT before LDH surgery reduced anxiety and regulated vital signs, and EFT was found to be more effective than music in regulating anxiety and respiratory rate.
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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
Medicinal Plants and Nonsteroidal Anti-inflammatory Drugs (NSAIDs) in Treatment of Arthritis: A Literature Review
Azharul Islam, BSc, MSc, MPhil;  Muhammad Maaz Ali;  Saeed Ur Rashid Nazir, BPharm, MPhil, MBA, PhD;  Taha Nazir, BPharm, MPhil, PhD;  Ruqaiya Rasheed Kayani, Pharm D, MPhil;  Humayun Riaz, BPharm, MPhil, PhD;  Rahat Shamim, BPharm, MPhil, MBA, PhD;  Misbah Sultana, BPharm, MPhil, PhD;  Safia Sultana Munir, MBBS, DGO, FCPS
Context • Arthritis is an inflammatory disease of diarthrodial joints and is associated with swollen inflamed joints, disruption of joints, and loss of integrity of articular cartilage and synovial joints. Objective • The current review intended to examine the data on the epidemiology, causes, clinical diagnosis, and prevention and control of different types of arthritis and on the use of medicinal plants in gouty arthritis. Design • The research team performed a literature review, searching relevant literature databases, including bioRxiv, medRxiv, Google Scholar, Embase, PsychINFO, and PubMed. The search terms were arthritis, diarthodial joints, use of medicinal plants in gouty arthritis, and synovial joints. Setting • The study took place in the main library of the University of Sargodha in Sargodha, Pakistan. Results • The research team identified 135 studies, and eventually 92 unique academic publications were included in the analysis. Arthritis can develop and progress in any musculoskeletal joint, and most commonly occurs in knees, hips, shoulders, and hands. Major risk factors for arthritis include age, obesity, trauma, other diseases, and smoking. Arthritis is classified into various types, including rheumatoid arthritis (RA), osteoarthritis (OA), gouty arthritis, septic arthritis, and psoriatic arthritis (PsA). RA and OA are the most common types worldwide. RA is an autoimmune disease in which the body’s immune cells attack the joints. OA develops due to damage of cartilage, tissues, and joints due to age, obesity, or stress on joints. Gouty arthritis develops due to hyperuricemia; deposits of monosodium urate crystals can lead to gouty arthritis. Septic arthritis occurs due to a microbial infection in synovial joints because in synovial joints the basement membrane is absent. PsA develops due to the psoriasis—skin disease. Conclusions • The current review showed that different types of arthritis has different causes and pathogeneses. Pain in joints is a major and common symptom in all types of arthritis. Arthritis is managed pharmacologically and nonpharmacologically. Treatment is different for each class of arthritis according to its cause and symptoms.
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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
Efficacy of Cyclical Prescription in Homoeopathic Management of Polycystic Ovary Disease: A Case Report
Asmita Alekar, MD;  Jayant Mahajan, MS;  Vineet V Sinnarkar, MD (Hom)
Polycystic ovarian disease is a very common condition affecting women of reproductive age. Homoeopathy believes in a holistic approach and, when prescribed, can correct hormonal imbalances, regulate ovulation, and deal with associated complaints, as well as help to cure the condition from its root cause. A case of a 17-year-old female came into the Homoeopathic outpatient department with complaints of irregular menses and hyperpigmented patches on her back. Hormonal assay and thyroid function tests were done to rule out other disorders, and ultrasound of the abdomen and pelvis was done to confirm the diagnosis of polycystic ovarian disease. In this case Sulphur, Calcarea Carb, and Lycopodium were prescribed in a cyclical manner and proved to be beneficial.
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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
Chinese Herbal Fumigation Steam Therapy and Acupuncture in the Treatment of Knee Osteoarthritis: A Three-armed, Randomized, Controlled Trial
Shang-Chih Chang, CS, MD;  Jung-Peng Chiu, JP, MD;  Chung-Hua Hsu, CH, MD, PhD;  Shu-Yi Lin, SY, MStat;  Anthony J Venuti, DiplOM;  Kai-Chiang Yu, KC, MD
Context • Knee osteoarthritis is a common form of joint disease found in humans and one of the leading causes of disability globally. Knee osteoarthritis (KOA) is responsible for a higher number of disabilities than any other medical condition affecting activities of daily living (ADL). To date no definitive, conventional medical protocol is available to deal with KOA. Objectives • The study intended to clinically investigate whether the benefits of acupuncture in the treatment of KOA) could be augmented by the addition of Chinese herbal fumigation steam therapy (CHFST) to the treatment protocol and to what degree it had benefits. Design • The research team designed a three-armed, randomized, controlled trial. The sample size was determined by analysis of power; for a sample size of 42, the power was 83.5%; the effect size was 0.5; and the a was 0.05. Setting • The setting was the traumatology department in the Chinese Medicine Branch of Taipei City Joint Hospital in Kun Ming, Taiwan. Participants • Participants were 45 males and females between the ages of 35 and 75, who were patients in the traumatology department and who were suffering from bilateral knee osteoarthritis. Three participants were lost to follow-up. Interventions • Participants were randomly assigned to one of three groups, each with 15 participants; (1) the control group, who received acupuncture only; (2) the normal CHFST group, an intervention group who received acupuncture plus a normal dose of CHFST; and (3) the one-sixteenth CHFST group, an intervention group who received acupuncture plus one-sixteenth of a normal dose of CHFST. Participants underwent biweekly treatments for four consecutive weeks. Outcomes Measures • The primary outcome measures included a visual analog scale (VAS) to assess variations in pain intensity and a goniometer measure for range of motion (ROM). Results • The addition of CHFST to acupuncture in the treatment of KOA significantly reduced pain (P = .0017) for the normal CHFST group compared to the control group and the one-sixteenth CHFST group. Chinese medical interventions overall for all groups showed a decrease in pain and increases in ROM, and health related quality of life (HrQoL). Conclusions • CHFST, in conjunction with acupuncture, showed promise in the treatment of KOA in reducing pain, increasing ROM, and improving quality of life (QoL).
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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
Dynamics of Decision-Making in Medical Pluralism: A Systematic Review of Conceptual Models
Praheli Dhar Chowdhuri, MPhil;  Kaushik Kundu, PhD;  Suman Meyur, MBBS, MD, MRSPH (UK)
Purpose • Plurality of treatment choice is often observed, as in many instances people choose to use both conventional and complementary and alternative medicine (CAM). The existing models of healthcare utilization or healthcare behavior do not specifically address this medical pluralism. Hence, to understand an individual’s pluralistic choice of treatment, major studies describing this have been systematically reviewed in this study in order to extract the principal factors driving such choice. Also, applicability of current healthcare models is qualitatively analyzed in order to identify whether they properly explain the factors driving such pluralistic choices. Methodology • A systemic literature review was performed of 20 studies including 6 National Surveys. The major variables included were prevalence of integrative medicine in the last 12 months, nature of pluralism, major factors driving plurality of choice and the underlying model describing such choices. Results • Mean usage of plurality was 44.48% (95% CI, 44.12-44.84%). The major drivers of plurality were enabling (access) and cognitive factors, followed by post-decision dissonance, philosophical congruence and social factors. The studies followed several established conceptual models with almost equal distribution. These major factors and the underlying treatment models were significantly dependent upon each other (Fisher’s exact test; P = .025), but the cognitive and personality factors were found to be significantly exclusive (t = 2.39; P = .017). Conclusion • Medical pluralism incorporates a multitude of decision factors, which are separately related to different healthcare-decision models. Among them, personality trait was observed to be an important but neglected component of existing models. From the existing studies, no single pluralism-driven integral model could be established, satisfying all the important conditions of pluralistic choice.
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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
Initial and Continuous Effects of Essential Oil Therapy in Relieving Knee Pain Among Older Adults With Osteoarthritis
Shu-nu Change-Lee, PhD;  Hun-En Liao, PhD;  Cheng-yuan Lin, MS;  Yea-yin Yen, PhD
Background • For older adults, osteoarthritis (OA) is a common chronic disease that may cause pain, stiffness, and even disability of the affected knee joints. Aromatherapy might presumed to be an alternative and supplemental therapy. Primary Study Objective • To investigate the effects of aromatherapy on relieving knee pain and improving physical functions among older adults with OA. Methods/Design • A true experimental design with randomized assignment of both treatment (aromatherapy) and control (placebo) groups was used for this study. Participants • Volunteers from 3 local communities aged =50 y with self-reported OA-related knee pain were recruited. Interventions • A synergistic blend of essential oils diluted to a concentration of 3% was administered to participants in treatment (essential oil) group, whereas mineral oil without essential oil was applied to participants in control (placebo) group. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), including subscales of pain, stiffness, and physical function, was employed to record scores before intervention, 4 wk postintervention, and 8 wk postintervention. Pain scores were also measured and collected by using the visual analog scale at the above counterparts. The Stata v.13 software was used to perform referent statistics with a significance level (a) of 0.05 adopted. Results • The progressive linear model showed that continuous use of essential oils for 8 wk not only relieves pain immediately, but also further reduces the pain scores of participants, thus proving the long-term effect of aromatherapy on alleviating knee arthritis. Repeated measures analysis of variance further showed that time (intervention duration) is an important factor affecting all outcome scores. Except for stiffness subscales measured by WOMAC, all interactions between groups were significant. Conclusions • Aromatherapy is validated to be an effective alternative therapy in improving clinical outcomes for patients with OA-induced knee conditions. In addition, longer intervention duration (8 wk instead of 4 wk) yielded better treatment results for participants.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Polycystic Ovarian Syndrome Treated with Individualized Homeopathy: A Case Report
Preeti Lamba, MD (Hom) Part I;  Dharmendra B Sharma, MD (Hom), PhD Homoeopathy;  Vineet V Sinnarkar, MD (Hom)
Introduction • Polycystic ovarian syndrome (PCOS) is a polygenic, multifactorial, syndromic disorder with reproductive, endocrine, and metabolic dysfunction seen in reproductive aged women (12-45 years). The exact cause is not known may involve increased luteinizing hormone, increased insulin levels, and a defect in androgen synthesis. The symptoms include anovulation, irregular menses, and hyperandrogenism. It is clinically manifested by hirsutism, acne, and androgenic alopecia. Health care practitioners continue to seek a cure for PCOS as it is increasing in frequency and is one of the major causes of anovulatory infertility. Methods • The case was recorded in the gynaecological department at the Homoeopathic Medical College and Research Centre. An 18- year-old female patient with PCOS was treated with individualised homeopathy (iHOM) medicine between 26th September 2019 and 26th November 2020. During the follow-up visits, treatment outcomes were assessed. To assess whether the changes were due to homoeopathic medicine, an assessment using the modified Naranjo criteria was performed. Results • Over an observational period of 1 year, beneficial result from iHOM medicine was seen. This treatment method can be used by the physicians in the treatment of PCOS as a complementary health practice. Conclusion • Considering the multi-factorial aetiology of PCOS, iHOM medicine with lifestyle modification is helpful in treating PCOS.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Medical Evaluation of the Antimicrobial Activity of Rose Oil on Some Standard Bacteria Strains and Clinical Isolates
Sadettin Demirel, MSc, PhD
Introduction • Considerable interest has developed concerning the alternative utilization of aromatic plants rich in essential oils as antibacterial agents in the medical arena. In this study, we investigated the antimicrobial activity for solutions of different concentrations of rose oil on test microorganisms known to potentially have an adverse affect on human health and the environment. Methods • Research was carried out by the microdilution method. The test microorganisms were standard strains and clinical isolates (CIs) of Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Acinetobacter baumannii ATCC 17978, Bacillus subtilis ATCC 6633, Staphylococcus aureus ATCC 25923 and Streptococcus pneumonia ATCC 49619. Results • E coli was inhibited by a minimal concentration of 125 µl/ml rose oil dilution of both the standard strain and CI, B subtilis by a minimal concentration of 15.62 µl/ml and 31.25 µl/ml rose oil dilutions of the standard strain and CI, respectively, and S aureus by a minimal concentration of 31.25 µl/ml and 125 µl/ml of rose oil dilutions standard strain and CI, respectively. Thus, it was determined that rose oil could exhibit antimicrobial activity in both Gram-positive and Gram-negative bacteria. Discussion/Conclusions • Different percentages of diluted solutions of rose oil might be used as a preventive and therapeutic treatment for infections caused by E coli, B subtilis, and S aureus, provided that this is supported by evidence from clinical trials. Consequently, natural antimicrobial rose oil may have beneficial effects on human and environmental health.
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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
Use of Adapted Dance to Intensify Subacute Rehabilitation Post-Stroke: A Qualitative Study on the Participation Experience and Active Participation Time
Lucie Beaudry, PhD;  Sylvie Fortin, PhD;  Annie Rochette, PhD
Background • Strategies are still needed to intensify stroke rehabilitation. As an alternative therapy, dance warrants examination since its multimodal nature appears to offer an enjoyable means of engaging in a rehabilitation activity. Objectives • (1) To describe the participation experience in an adapted-dance group intervention, and (2) to study the patients’ active participation time. Methods • In this embedded single-case study, the experience of participating patients, relatives and rehabilitation assistants was examined through semi-structured interviews. The verbatim transcripts underwent thematic analysis (qualitative method), while the patients’ active participation time was examined through audiovisual recordings analyzed by type and length of engagement time (quasi-qualitative method). Setting • The study was conducted in the neurology department of a rehabilitation hospital. Participants • The study included patients doing intensive functional rehabilitation post-stroke (=25 days) (n = 6), relatives (n=4) and rehabilitation assistants (n = 4). Patients were recruited irrespective of their neurologic impairments. Their mean age was 71.0 years ± 9.9 years (range 59 to 86 years). Intervention • An adapted-dance group intervention ranging from moderate to somewhat hard/hard intensity was added to their rehabilitation program in the form of biweekly sessions of 55 minutes each, for up to 10 weeks. Carried out mainly on chairs, the intervention borrowed from dance approaches, rehabilitation practices, and movement-based educational approaches. Results • Observed adherence reached 82%. The participation experience involved 3 types of participation incentives (what motivated, fostered and facilitated their participation) and 4 types of perceived effort (unconscious, self-regulated, feasible and appropriate) conducive to participation. Mean motor engagement time of 50 minutes 4 seconds/session ± 2.53 minutes was observed in patients. Conclusion • The use of an adapted-dance group intervention can contribute to the intensification of stroke rehabilitation and have a positive impact on motivation and perceived effort.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effect of Dry Cupping on Gastrocnemius Muscle Stiffness, Range of Motion and Pain Perception After Delayed Onset Muscle Soreness
Dave Hammons, EdD, ATC;  Molly McCullough, MK, ATC
Background • Cupping therapy originated in Eastern Medicine, became renowned in complementary medicine and is utilized as a therapeutic treatment in contemporary medicine for musculoskeletal issues. As with any modality, there is a question of efficacy. Objective • This study investigated the effect of cupping therapy on muscle stiffness (MS), active dorsiflexion (DF) and perceived pain of the medial gastrocnemius muscle following a cupping therapy treatment. Methods • Single cohort design included 20 physically active, healthy participants (10 women, 10 men; age: 22.9 years ± 3.35 years) completed an exercise protocol to induce delayed onset muscle soreness in both lower legs. Intervention • A 5-minute dry cupping treatment was performed on the dominant leg medial gastrocnemius and 5 minutes of rest for the non-dominant control leg. Primary Outcome Measures • Muscle stiffness, active dorsiflexion and perceived pain were measured at baseline, pre-treatment, post-treatment and 5 minutes post-treatment in the medial gastrocnemius muscle. A repeated measures ANOVA was used to analyze the main effect and interaction for condition and time. Results • Active DF was significantly different from baseline to pre-treatment, post-treatment and 5 minutes post-treatment (P < .001, P < .001, P = .01, respectively). Pre-treatment to 5 minutes post-treatment, active DF was also significantly different (P = .05). Active DF was significantly improved post-treatment and 5 minutes post-treatment. Baseline pain was significantly different from pre-treatment, post-treatment and 5 minutes post-treatment measurements (P < .001, P < .001, P < .001, respectively). Pre-treatment pain was significantly different from post-treatment and 5 minutes post-treatment pain (P = .009, P < .001, respectively). Post-treatment pain was also significantly different from 5 minutes post-treatment pain (P = .007). MS was not significant at any of the time points (P = .398) or between conditions (P = .140). Conclusion • A single cupping treatment significantly improved active DF and decreased pain was observed in the treatment group. No significant difference in MS was observed following the treatment.
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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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