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Lee JH, Park HS, Park SH, Song YK, Keum DH, Park SH. Pharmacoacupuncture for the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Curr Pain Headache Rep 2024:10.1007/s11916-024-01298-4. [PMID: 39096470 DOI: 10.1007/s11916-024-01298-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Pharmacoacupuncture (PA) is an alternative injection therapy for a broad range of conditions. This meta-analysis evaluates the effectiveness and safety of PA in treating frozen shoulder (FS) and aims to standardise PA characteristics in clinical practice. METHODS Randomized controlled trials (RCTs) assessing PA for FS were systematically reviewed from seven electronic databases up to August 31, 2023. Outcomes measured included the visual analogue scale (VAS) or numerical rating scale (NRS), effective rate, Constant-Murley Score (CMS), Shoulder Pain and Disability Index (SPADI), ROM, quality of life (QoL), and adverse events. Data analysis was conducted using RevMan 5.3, with the risk of bias in each trial evaluated using Cochrane's risk of bias tool. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool assessed the quality of evidence. RESULTS Thirteen RCTs involving 1034 patients met the inclusion criteria, with eleven RCTs and 872 patients included in the meta-analysis. PA showed low-quality evidence of improvement in VAS, effective rate, CMS Total, and CMS Pain. Moderate-quality evidence indicated improvement in CMS ADL and CMS Mobility. PA was effective in four SF-36 subscales: physical function, social role function, mental health, and emotional role function. No significant difference in CMS strength was observed. One trial reported mild anaphylaxis reaction to bee venom as an adverse event. CONCLUSION PA may offer potential benefits as an alternative injection therapy for FS patients. Further well-designed RCTs with rigorous methodology are required to substantiate its therapeutic efficacy and clinical utility. REGISTRATION PROSPERO (CRD42023445708).
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Affiliation(s)
- Ji-Ho Lee
- College of Korean Medicine, Dongguk University Graduate School, Seoul, Republic of Korea
| | - Hyeon-Sun Park
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University Bundang Oriental Hospital Seongnam-si, Gyeonggi-do, 13601, Republic of Korea
| | - Sang-Hyeon Park
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University Bundang Oriental Hospital Seongnam-si, Gyeonggi-do, 13601, Republic of Korea
| | - Yun-Kyung Song
- Department of Korean Rehabilitation Medicine, Gachon University College of Korean Medicine, 21 Keunumul-ro, Jung-gu, Incheon, 22318, Republic of Korea
| | - Dong-Ho Keum
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University Bundang Oriental Hospital Seongnam-si, Gyeonggi-do, 13601, Republic of Korea
| | - Seo-Hyun Park
- College of Korean Medicine, Dongguk University Graduate School, Gyeongju, Republic of Korea.
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Nikvarz N, Sedighi B, Ansari M, Shahdizade S, Shojaei R, Sharififar F. Medicinal plants used in multiple sclerosis patients, prevalence and associated factors: a descriptive cross-sectional study. BMC Complement Med Ther 2024; 24:278. [PMID: 39039480 PMCID: PMC11265095 DOI: 10.1186/s12906-024-04587-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is a chronic and debilitating disease that not only leads to disability and associated condition but also impacts one's ability to maintain a professional life. People's acceptance and utilization of medicinal plants (MPs) play an important role in managing their treatment process. As a result, this study aims to investigate the use of medicinal herbs among patients with MS. METHODS A descriptive cross-sectional study was conducted on 150 MS patients who visited a private clinic and the MS Association in Kerman, Iran in 2021. A questionnaire comprising questions about sociodemographic information, disease variables, and aspects of MPs usage was utilized for data collection. Statistical analysis was performed using SPSS version 20 (SPSS Inc., Chicago, IL). The Chi-square test was employed to identify any association between demographic characteristics and MPs usage. To determine the prevalence of plant use in a specific area and the consensus among informants, the use value (UV) and Informant consensus factor (Fic) were calculated. RESULTS The study revealed a high prevalence of MPs usage among MS patients. Chamomile (66.6%) and golegavzaban (62.0%) were the most commonly used plants with the highest UV indices (0.88 and 0.82 respectively), while St. John's wort and licorice were rarely used (0.67% and 4% respectively). Participants cited pursuing a healthier lifestyle as the primary reason for using MPs (24%). St. John's wort, lavender, and chamomile were the most satisfying plants (100%, 100%, and 53.0% respectively). Chamomile had the highest Fic too. Most patients were motivated to get MPs from their relatives. CONCLUSIONS Given the widespread use of MPs among MS patients, neurologists should enhance their knowledge in this area to guide patients away from seeking advice from non-professionals. Providing standardized formulations can help prevent potential interactions between MPs and mainstream drugs, thereby improving patients safety and outcomes.
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Affiliation(s)
- Naemeh Nikvarz
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Sedighi
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Ansari
- Pharmaceutical Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Shirin Shahdizade
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Reyhane Shojaei
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Fariba Sharififar
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran.
- Pharmaceutical Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
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Hoenders R, Ghelman R, Portella C, Simmons S, Locke A, Cramer H, Gallego-Perez D, Jong M. A review of the WHO strategy on traditional, complementary, and integrative medicine from the perspective of academic consortia for integrative medicine and health. Front Med (Lausanne) 2024; 11:1395698. [PMID: 38933107 PMCID: PMC11201178 DOI: 10.3389/fmed.2024.1395698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients respond well to available treatments in biomedicine alone. Additionally, there are concerns about side effects of many medications and interventions, the unsustainable cost of healthcare and the low resolution of chronic non-communicable diseases and mental disorders whose incidence has risen in the last decades. Besides, the chronic stress and burnout of many healthcare professionals impairs the therapeutic relationship. These circumstances call for a change in the current paradigm and practices of biomedicine healthcare. Most of the world population (80%) uses some form of traditional, complementary, and integrative medicine (T&CM), usually alongside biomedicine. Patients seem equally satisfied with biomedicine and T&CM, but in the field of T&CM there are also many challenges, such as unsupported claims for safety and/or efficacy, contamination of herbal medicines and problems with regulation and quality standards. As biomedicine and T&CM seem to have different strengths and weaknesses, integration of both approaches may be beneficial. Indeed, WHO has repeatedly called upon member states to work on the integration of T&CM into healthcare systems. Integrative medicine (IM) is an approach that offers a paradigm for doing so. It combines the best of both worlds (biomedicine and T&CM), based on evidence for efficacy and safety, adopting a holistic personalized approach, focused on health. In the last decades academic health centers are increasingly supportive of IM, as evidenced by the foundation of national academic consortia for integrative medicine in Brazil (2017), the Netherlands (2018), and Germany (2024) besides the pioneering American consortium (1998). However, the integration process is slow and sometimes met with criticism and even hostility. The WHO T&CM strategies (2002-2005 and 2014-2023) have provided incipient guidance on the integration process, but several challenges are yet to be addressed. This policy review proposes several possible solutions, including the establishment of a global matrix of academic consortia for IM, to update and extend the WHO T&CM strategy, that is currently under review.
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Affiliation(s)
- Rogier Hoenders
- Dutch Consortium for Integrative Care and Health, Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands and Faculty of Religion, Culture and Society, University of Groningen, Groningen, Netherlands
| | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health and Department of Medicine on Primary Care, Faculty of Medicine Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caio Portella
- Brazilian Academic Consortium for Integrative Health and Universidade de São Paulo, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, São Paulo, Brazil
| | - Samantha Simmons
- Academic Consortium for Integrative Medicine and Health, Lake Oswego, OR, United States
| | - Amy Locke
- Academic Consortium for Integrative Medicine and Health and Department of Family and Preventive Medicine University of Utah Health, Salt Lake City, UT, United States
| | - Holger Cramer
- Academic Consortium for Traditional & Integrative Medicine and Health, Germany and Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany and Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Daniel Gallego-Perez
- Physical Medicine and Rehabilitation Department University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Miek Jong
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Fasce A, Karlsson L, Verger P, Mäki O, Taubert F, Garrison A, Schmid P, Holford DL, Lewandowsky S, Rodrigues F, Betsch C, Soveri A. Endorsement of alternative medicine and vaccine hesitancy among physicians: A cross-sectional study in four European countries. Hum Vaccin Immunother 2023; 19:2242748. [PMID: 37581343 PMCID: PMC10431744 DOI: 10.1080/21645515.2023.2242748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/13/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals. In this study, we analyzed the relationship between endorsement of complementary and alternative medicine (CAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries: Germany, Finland, Portugal, and France (total N = 2,787). Our results suggest that, in all the participating countries, CAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average CAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another: 23.72% in Germany, 17.83% in France, 9.77% in Finland, and 5.86% in Portugal. These results constitute a call to consider health care professionals' attitudes toward CAM as a factor that could hinder the implementation of immunization campaigns.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Otto Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Frederike Taubert
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Philipp Schmid
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Liu Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Australia
- Department of Psychology, University of Potsdam, Postdam, Germany
| | | | - Cornelia Betsch
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
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Rzepczyk S, Świderski P, Sommerfeld-Klatta K, Tezyk A, Łukasik-Głębocka M, Zielińska-Psuja B, Żaba Z, Żaba C. Causes of Death during the Intravenous Infusion of Dimethylsulphoxide and Hydrogen Peroxide in the Course of Alternative Medicine Therapy. TOXICS 2023; 11:652. [PMID: 37624158 PMCID: PMC10457729 DOI: 10.3390/toxics11080652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023]
Abstract
Unconventional (alternative, natural) medicine in Poland and worldwide includes hundreds of non-scientifically verified "treatment" modalities. Among the most popular are biological therapies using chemical or natural compounds administered with injection or drip infusion. The latter has found the most excellent use in treating rheumatological and dermatological diseases and certain types of cancer. Vitamin infusions, curcumin, glutathione, perhydrol and dimethylsulphoxide (DMSO) have gained popularity among clients of natural medicine clinics. The present study aims to analyse the case of a 37-year-old woman who was administered infusions containing perhydrol and DMSO (0.5 mL 0.04% hydrogen peroxide/0.5 mL p.d.a DMSO in saline) due to a MTHFR A1298C mutation. After having the next infusion, the woman complained of nausea and then became unconscious. Subsequently, she suffered respiratory and cardiac arrest. Adequate resuscitation was undertaken. After being taken to the hospital, the patient was in critical condition and died due to increasing multiple-organ failure. Initially, there was suspected DMSO poisoning as it was the only compound to have been administered as an intravenous infusion. However, it was not until the analysis of the secured evidence that it became clear that the patient had also been given an intravenous solution of hydrogen peroxide, H2O2, and that there had been a mistake in preparing the intravenous perhydrol solution. The autopsy concluded that the immediate cause of death was an acute cardiopulmonary failure due to the toxic effects of intravenously administered hydrogen peroxide. This conclusion was established after the toxicological testing of the evidence and biological material secured during the patient's treatment and autopsy. Products containing DMSO and perhydrol are not included in the lists of medicinal/therapeutical forms and preparations and thus are not authorised for marketing in Poland. In the case of perhydrol, apart from the topical use of diluted preparations for washing and cleansing wounds, no data on therapeutic use exist in the available scientific literature. Furthermore, "DMSO and perhydrol therapy" cannot even be considered a placebo effect, as both are toxic compounds which could, at most, cause poisoning symptoms rather than improve health.
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Affiliation(s)
- Szymon Rzepczyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Paweł Świderski
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Karina Sommerfeld-Klatta
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Artur Tezyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Magdalena Łukasik-Głębocka
- Department of Emergency Medicine, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznan, Poland
| | - Barbara Zielińska-Psuja
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Zbigniew Żaba
- Department of Emergency Medicine, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
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Mittal R, Maltese C, Bolt E, Paul D, Mainali G, Naik S, Paudel S, Lehman E, Kumar A. Use of Complementary and Alternative Medicine in Children with Neuromuscular Disorders Followed at Penn State Health Pediatric Muscular Dystrophy Association Care Center Clinic. J Child Neurol 2023; 38:367-372. [PMID: 37455403 PMCID: PMC10466977 DOI: 10.1177/08830738231186490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/04/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
The exact prevalence of complementary and alternative medicine (CAM) use is not known in pediatric patients with neuromuscular diseases followed by any of the 150 Muscular Dystrophy Association (MDA) Care Center Clinics nationwide. This study describes the prevalence and variety of CAM usage in this population, while also assessing the prevalence of caregiver disclosure of CAM use and caregiver perception of provider support for CAM. Fifty-two caregivers of pediatric patients seen at Penn State Health's Pediatric MDA Care Center Clinic completed our online survey. Overall, 19.2% of caregivers reported CAM use by their child. Less than half of caregivers reported discussing CAM use with their child's neurologist (41.5%); however, a majority of respondents reported interest in using CAM for their child in the future (52.8%). Understanding the prevalence of CAM usage and disclosure in pediatric MDA clinics may facilitate safer use of CAM in this community.
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Affiliation(s)
- Rea Mittal
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
| | - Caroline Maltese
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
| | - Elizabeth Bolt
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
| | - Dustin Paul
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
| | - Gayatra Mainali
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
| | - Sunil Naik
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
| | - Sita Paudel
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
| | - Erik Lehman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Ashutosh Kumar
- Department of Pediatrics and Neurology, Penn State College of Medicine, Hershey, PA, USA
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Are There Ethnic Differences in Hand Eczema? A Review. J Clin Med 2023; 12:jcm12062232. [PMID: 36983235 PMCID: PMC10056516 DOI: 10.3390/jcm12062232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/06/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023] Open
Abstract
Hand eczema is a common disease with economic and social ramifications. This study undertakes a review of certain existing literature to provide insight into contributory factors which may result in the varying prevalence and severity of hand eczema among different ethnic groups, particularly to identify modifiable risk factors, as well as to ascertain knowledge gaps for future research direction. The existing literature suggests that factors including (a) genes, (b) differing skin physiology, (c) cultural practices, (d) dietary habits and associated food preparation, (e) climate, (f) predominant occupations, (g) socioeconomic factors, and (h) dissimilar laws and regulations may account for the disparity in the risk of hand eczema among different ethnicities. Given that endogenous factors cannot be avoided, but certain exogenous aspects can be modified, especially as the environment plays an important role in hand eczema flares, it is helpful from a practical perspective to focus on addressing the modifiable risk factors. These factors pertain to unique cultural practices, customs, and food preparation methods. Healthcare professionals should be well-acquainted with such factors to tailor the treatment approach for patients of different ethnicities accordingly because, with globalization, physicians face increasingly diverse patient populations such that cultural customs no longer remain limited to particular geographic regions.
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Complementary Health Approaches for the Symptoms of Pediatric Oncology Patients. Holist Nurs Pract 2023; 37:98-109. [PMID: 32301898 DOI: 10.1097/hnp.0000000000000376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study was conducted to determine the complementary health approaches (CHAs) used by pediatric oncology patients' parents for symptoms, their positive-negative effects, and the factors that influence their usage. The study was a descriptive design. The data were collected between March and November 2014 from the parents of 156 pediatric oncology patients in 2 different university hospitals in Turkey using the face-to-face interview method. In total, 99.4% of the parents who participated in the study used at least 1 CHA for their children. Complementary health approaches frequently adopted by the parents included praying (96.8%), oblation/sacrifice (50.6%), carob molasses (27.6%), grape molasses (22.4%), and massage (22.4%). Forty-three parents reported that they gave carob molasses to their children to reduce the symptoms of neutropenia, whereas 32 parents reported that they gave them grape molasses and 34 parents reported that they massaged their children to mitigate symptoms of pain. The parents reported that they used CHAs to enhance their child's immune system (61.3%), to do everything in their power to treat their child (42%), and to combat the side effects of medication/radiotherapy (25.8%). None of parents stated that they had observed any side effects from using CHAs. Almost all of the parents use one of the CHAs. The health personnel especially nurses should inform pediatric oncology patients and their parents about CHAs, which have no evidence and are potentially harmful and encourage them to approaches supportive to medical treatment.
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An Overview on Antimicrobial Potential of Edible Terrestrial Plants and Marine Macroalgae Rhodophyta and Chlorophyta Extracts. Mar Drugs 2023; 21:md21030163. [PMID: 36976212 PMCID: PMC10058896 DOI: 10.3390/md21030163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Antibiotics are used to prevent and treat bacterial infections. After a prolonged use of antibiotics, it may happen that bacteria adapt to their presence, developing antibiotic resistance and bringing up health complications. Nowadays, antibiotic resistance is one of the biggest threats to global health and food security; therefore, scientists have been searching for new classes of antibiotic compounds which naturally express antimicrobial activity. In recent decades, research has been focused on the extraction of plant compounds to treat microbial infections. Plants are potential sources of biological compounds that express several biological functions beneficial for our organism, including antimicrobial activity. The high variety of compounds of natural origin makes it possible to have a great bioavailability of antibacterial molecules to prevent different infections. The antimicrobial activity of marine plants, also called seaweeds or macroalgae, for both Gram-positive and Gram-negative, and several other strains infective for humans, has been proven. The present review presents research focused on the extraction of antimicrobial compounds from red and green macroalgae (domain Eukarya, kingdom Plantae). Nevertheless, further research is needed to verify the action of macroalgae compounds against bacteria in vitro and in vivo, to be involved in the production of safe and novel antibiotics.
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Integrating herbal medicine into oncology care delivery: development, implementation, and evaluation of a novel program. Support Care Cancer 2023; 31:128. [PMID: 36680628 PMCID: PMC9860233 DOI: 10.1007/s00520-023-07577-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/05/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the feasibility of a novel program facilitating patient-provider communication about appropriate use of herbal medicine at a large academic cancer center and its impact on patient wellbeing. METHODS In the Herbal Oncology Program (HOP), integrative medicine providers counseled patients about unmet symptom needs and prescribed traditional Chinese medicine (TCM) herbs when indicated, taking into consideration the clinical context, patient preference, and research evidence. To evaluate the feasibility and outcomes, we performed a retrospective analysis using medical record data (symptoms and other concerns that motivated patients to seek herbal products, types and numbers of dispensed TCM herbs, and demographic characteristics). We also conducted a survey to assess patient experience and satisfaction. RESULTS All 851 participants were outpatients, with 712 (84%) in active treatment. HOP dispensed 1266 herbal prescriptions for a range of symptoms, most commonly GI symptoms (467, 37%); pain (353, 28%); and treatment-related fatigue, sleep, and mood disorders (346, 27%). Of 269 patients invited to the survey, 107 (40%) completed it. A majority of respondents 70.9% (73/103) were satisfied with the effectiveness of dispensed herbs in relieving their symptoms, and few 6.7% (7/104) had experienced mild adverse events that resolved after discontinuing herbal use. CONCLUSIONS The study's findings support the feasibility of integrating herbal medicine into an academic oncology setting. Patient satisfaction with HOP was high, with limited adverse events. The patterns of herbal prescriptions in HOP suggest future areas for clinical research to strengthen the evidence base around safe and effective use.
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Iktidar MA, Chowdhury S, Roy S, Liza MM, Akter S, Islam AMK, Pranto SA, Chowdhury S, Rahman MA, Shafiul CSB, Dev D, Tanvir SMS, Nabi MH. Knowledge, attitude, perceived effectiveness and self-practice of complementary and alternative medicine: a cross-sectional comparison between medical and non-medical students of Bangladesh. BMC Complement Med Ther 2022; 22:342. [PMID: 36578028 PMCID: PMC9795584 DOI: 10.1186/s12906-022-03797-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 11/16/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Bangladesh's population commonly utilizes Complementary and alternative medicine (CAM) to treat their health issues. Despite the increasing interest in CAM, it has been excluded from conventional medical training in Bangladesh for many years. Therefore, this study assessed and compared the knowledge level, attitude, perceived effectiveness, and self-practice of CAM among undergraduate students of Bangladesh. METHODS This cross-sectional group comparison study was conducted among undergraduate (both medical and non-medical) students of Bangladesh between November and December 2021. Data was collected using a self-reported pretested semi-structured online questionnaire. The questionnaire contained questions regarding background information, knowledge regarding CAM, source of CAM knowledge, attitude towards CAM, interest in attaining CAM knowledge, perceived effectiveness of CAM, perceived adverse effects of CAM, self-practice of CAM, and whether would they refer CAM to others. A total of 576 students responded and the data gathered allowed for the following: (1) an overview of the study groups, (2) respondents' general perception and knowledge regarding CAM, and (3) a comparison of respondents' CAM knowledge, general perception, and usage by area of study. Data were analyzed using STATA (v.16) and descriptive statistics, Pearson's chi-square test, and Mann-Whitney U test were performed. RESULTS A total of 329 medical students and 247 non-medical students participated in the study. The mean age of the participants was 21.57 ± 1.8 years and 56.2% of them were male. The most known CAM among medical (M) students was homeopathy (44.6%) and among non-medical (NM) students were herbal medicine (45.7%). Non-medical students had significantly better knowledge about nine out of twelve CAM modalities included in the study, and no significant differences were present for the rest of the modalities. Medical (81.1%) and non-medical students (86.2%) perceived traditional Chinese medicine and homeopathy to be the most effective respectively. "Incorporating CAM with conventional medicine would result in increased patient satisfaction" showed the most statistically significant (p = 0.0002) difference among both groups. Yoga was the most often practiced modality among medical students and homeopathy among non-medical students. CONCLUSION Medical students have a lacking of knowledge and a positive attitude towards CAM, despite its very common practice among the people of Bangladesh. Therefore, emphasis should be put on the inclusion of CAM modules in medical training.
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Affiliation(s)
- Mohammad Azmain Iktidar
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | - Sreshtha Chowdhury
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | - Simanta Roy
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | - Mowshomi Mannan Liza
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | - Sharmin Akter
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | - A. M. Khairul Islam
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | | | - Sristi Chowdhury
- grid.449503.f0000 0004 1798 7083Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Md Asikur Rahman
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | | | - Dipa Dev
- grid.414267.20000 0004 5929 0882Chittagong Medical College, Chittagong, Bangladesh
| | - Syed Md Sayeem Tanvir
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
| | - Mohammad Hayatun Nabi
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229 Dhaka, Bangladesh ,Public Health Professional Development Society (PPDS), 1215 Dhaka, Bangladesh
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12
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When a Traditional Medicine Customer Becomes a Plastic Surgery Patient. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4669. [DOI: 10.1097/gox.0000000000004669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 09/27/2022] [Indexed: 11/11/2022]
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13
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Prevalence of Use of Traditional, Complementary and Alternative Medicine by the General Population: A Systematic Review of National Studies Published from 2010 to 2019. Drug Saf 2022; 45:713-735. [PMID: 35788539 PMCID: PMC9296440 DOI: 10.1007/s40264-022-01189-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/13/2022]
Abstract
Introduction Traditional, complementary and alternative medicine (TCAM) refers to a broad range of health practices and products typically not part of the 'conventional medicine' system, and its use is substantial among the general population. TCAM products and therapies may be used in addition to, or instead of, conventional medicine approaches, and some have been associated with adverse reactions or other harms. Objectives The aims of this systematic review were to identify and examine recently published national studies globally on the prevalence of TCAM use in the general population, to review the research methods used in these studies and to propose best practices for future studies exploring prevalence of use of TCAM. Methods MEDLINE, Embase, CINAHL, PsycINFO and AMED were searched to identify relevant studies published since 2010. Articles/reports describing the prevalence of TCAM use in a national study among the general population were included. The quality of included studies was assessed using a risk of bias tool developed by Hoy et al. Relevant data were extracted and summarised. Results Forty studies from 14 countries, comprising 21 national surveys and one cross-national survey, were included. Studies explored the use of TCAM products (e.g. herbal medicines), TCAM practitioners/therapies, or both. Included studies used different TCAM definitions, prevalence time frames and data collection tools, methods and analyses, thereby limiting comparability across studies. The reported prevalence of use of TCAM (products and/or practitioners/therapies) over the previous 12 months was 24–71.3%. Conclusion The reported prevalence of use of TCAM (products and/or practitioners/therapies) is high, but may underestimate use. Published prevalence data varied considerably, at least in part because studies utilise different data collection tools, methods and operational definitions, limiting cross-study comparisons and study reproducibility. For best practice, comprehensive, detailed data on TCAM exposures are needed, and studies should report an operational definition (including the context of TCAM use, products/practices/therapies included and excluded), publish survey questions and describe the data-coding criteria and analysis approach used. Traditional, complementary and alternative medicine (TCAM) includes products (e.g. herbal medicines, dietary supplements) and therapies/practices (e.g. chiropractic, acupuncture), and is a popular healthcare choice for many people. This study systematically reviewed national surveys of TCAM use around the world. We identified studies carried out in 14 different countries and one continent (Europe) on the extent of use of TCAM in the general population. TCAM use was found to be substantial, ranging from 24 to 71.3% in different countries. National surveys use different methods and different survey questionnaires. Some studies did not publish the survey questionnaire that they used and/or did not describe the types of TCAM included in the study. This means that it is not possible to compare the results between countries or to do further data analysis. For example, the survey questions from different countries asked people if they had ‘used’ or ‘seen a practitioner’ for a specific therapy, such as homeopathy. These questions look similar, but could elicit different answers from people. This means that the answers to these questions cannot be pooled together or compared directly. Also, some studies collected information on use of a category of TCAM products, such as herbal medicines, but other studies collected information on use of specific herbal medicines, such as St John’s wort. New surveys of the extent of use of TCAM should provide full information on the types of TCAM products, practices and therapies included in the study and consider collecting comprehensive information on use of specific TCAM products, practices and therapies.
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14
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Descalzo-Casado E, Sierra-Santos L. Quemadura química por Sanguinaria canadensis. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2022. [DOI: 10.55783/rcmf.150209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
La Sanguinaria canadensis, o Bloodroot, es una planta originaria de Norteamérica que contiene sustancias alcaloides y es ampliamente empleada en el tratamiento de lesiones y tumores de la piel en animales. Sin embargo, en los últimos años ha aumentado su uso en humanos como terapia alternativa en el tratamiento de lesiones precancerosas y cáncer de piel. Su uso inadecuado en humanos puede causar lesiones graves y profundas en la piel.
Presentamos el caso de un paciente joven que por voluntad propia se aplicó un preparado de Sanguinaria canadensis (Bloodroot paste) para eliminar dos nevus cutáneos, produciéndole lesiones extensas que requirieron tratamiento y curas hasta su cierre por segunda intención, dejando cicatrices hipertróficas como secuela.
Palabras clave: Sanguinaria, úlcera cutánea, heridas penetrantes.
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Affiliation(s)
- Elena Descalzo-Casado
- Médica Interna Residente de Medicina Familiar y Comunitaria. Unidad Docente Multidisciplinar de Atención Familiar y Comunitaria Zona Centro. Madrid (España)
| | - Lucía Sierra-Santos
- Especialista en Medicina Familiar y Comunitaria. Consultorio Local de El Boalo. Manzanares el Real. Madrid (España)
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15
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Descalzo Casado E, Sierra Santos L. Quemadura química por Sanguinaria canadensis. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2022. [DOI: 10.55783/150209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
La Sanguinaria canadensis, o Bloodroot, es una planta originaria de Norteamérica que contiene sustancias alcaloides y es ampliamente empleada en el tratamiento de lesiones y tumores de la piel en animales. Sin embargo, en los últimos años ha aumentado su uso en humanos como terapia alternativa en el tratamiento de lesiones precancerosas y cáncer de piel. Su uso inadecuado en humanos puede causar lesiones graves y profundas en la piel.
Presentamos el caso de un paciente joven que por voluntad propia se aplicó un preparado de Sanguinaria canadensis (Bloodroot paste) para eliminar dos nevus cutáneos, produciéndole lesiones extensas que requirieron tratamiento y curas hasta su cierre por segunda intención, dejando cicatrices hipertróficas como secuela.
Palabras clave: Sanguinaria, úlcera cutánea, heridas penetrantes.
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Affiliation(s)
- Elena Descalzo Casado
- Médica Interna Residente de Medicina Familiar y Comunitaria. Unidad Docente Multidisciplinar de Atención Familiar y Comunitaria Zona Centro. Madrid (España)
| | - Lucía Sierra Santos
- Especialista en Medicina Familiar y Comunitaria. Consultorio Local de El Boalo. Manzanares el Real. Madrid (España)
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16
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Hanitsch LG. [Prophylactic and therapeutic management of increased susceptibility to infection in patients with immunodeficiency]. Internist (Berl) 2022; 63:484-492. [PMID: 35412057 PMCID: PMC9002026 DOI: 10.1007/s00108-022-01326-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/30/2022]
Abstract
Infections are an important warning sign for a weakened immune system. In the internal medical practice acquired (secondary), particularly drug-induced immunodeficiencies, are much more frequent than congenital (primary) immunodeficiencies. The management starts as early as the planning phase before initiation of immunosuppression. The risk of infection should be individually stratified and protective vaccinations should be completed. Depending on the immunosuppressive treatment, there can be a necessity for preventive treatment, e.g. for latent tuberculosis infection or hepatitis B. The serological results on varicella zoster virus and JC polyomavirus must also be considered. The basic immunological diagnostics include differential blood count and the determination of immunoglobulins (IgG, IgA, IgM) prior to and during immunosuppressive treatment. Relevant conspicuous laboratory results before initiation of treatment should prompt advanced immunological work-up for the identification of primary immunodeficiencies, which are often accompanied by clinical signs of immune dysregulation. Depending on the type of pathogen, localization, frequency and duration as well as the severity of the infection, prophylactic antibiotic treatment may be required. Patients with chronic severe lymphocytopenia, in particular with CD4 positive T (helper) cells < 200/µl, are at increased risk for opportunistic infections so that an antibiotic prophylaxis is recommended. In patients with significantly increased proneness to infections and detection of a relevant quantitative (IgG < 4 g/l) and/or qualitative antibody deficiency (impaired vaccine response), additional immunoglobulin replacement therapy may be necessary and can be administered intravenously (IVIG) or subcutaneously (SCIG) as home treatment. In accordance with the localization of the infection, multidisciplinary clarification and management is warranted.
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Affiliation(s)
- Leif G Hanitsch
- Immundefekt-Ambulanz, Institut für Medizinische Immunologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
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17
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Arji G, Rezaeizadeh H, Moghadasi AN, Sahraian MA, Karimi M, Alizadeh M. Complementary and alternative therapies in multiple sclerosis: a systematic literature classification and analysis. Acta Neurol Belg 2022; 122:281-303. [PMID: 35060096 DOI: 10.1007/s13760-021-01847-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIM Multiple Sclerosis (MS) is a disease determined by inflammatory demyelination and neurodegeneration in the Central Nervous System (CNS). Despite the extensive utilization of Complementary and Alternative Medicine (CAM) in MS, there is a need to have comprehensive evidence regarding their application in the management of MS symptoms. This manuscript is a Systematic Literature Review and classification (SLR) of CAM therapies for the management of MS symptoms based on the International Classification of Functioning Disability and Health (ICF) model. METHOD Studies published between 1990 and 2020 IN PubMed, Science Direct, Scopus, Pro-Quest, and Google Scholar using CAM therapies for the management of MS symptoms were analyzed. RESULTS Thirty-one papers on the subject were analyzed and classified. The findings of this review clearly show that mindfulness, yoga, and reflexology were frequently used for managing MS symptoms. Moreover, most of the papers used mindfulness and yoga as a CAM therapy for the management of MS symptoms, which mostly devoted to mental functions such as fatigue, depression, cognition, neuromuscular functions such as gait, muscle strength, and spasticity, and sensory function such as balance, in addition to, reflexology is vastly used to management of mental functions of MS patients. CONCLUSION Evidence suggested that CAM therapies in patients with MS have the potential to target and enhancement numerous elements outlined in the ICF model. Although the use of CAM therapies in MS symptom management is promising, there is a need for strict clinical trials. Future research direction should concentrate on methodologically powerful studies to find out the potential efficacy of CAM intervention.
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Affiliation(s)
- Goli Arji
- School of Nursing and Midwifery, Health Information Technology Department, Saveh University of Medical Sciences, Saveh, Iran
| | - Hossein Rezaeizadeh
- Department of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Abdolrreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- Department of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mojtaba Alizadeh
- Department of Computer Engineering, Lorestan University, Khorramabad, Iran.
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18
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Keathley JR, Arbour A, Vohl MC. Towards a Standardized Definition of Medical Nutrition Therapy and Regulatory Reform in Canada. CAN J DIET PRACT RES 2022; 83:75-80. [PMID: 35014549 DOI: 10.3148/cjdpr-2021-033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Various definitions have been proposed to describe Medical Nutrition Therapy (MNT). Broadly, MNT encompasses the provision of nutrition information and advice aimed to prevent, treat, and/or manage health conditions. In Canada, the provision of such information and advice is unregulated, thus allowing anyone to provide MNT services regardless of their education and training. This inevitably poses risks of harm such as the provision of unsafe and/or ineffective nutrition advice as well as delayed evidence-based treatment. Canadian research has further demonstrated that the general public is unable to properly differentiate between regulated, evidence-based nutrition providers (registered dietitians) and those who are unregulated. Therefore, the public is at risk. To reduce nutrition misinformation and ultimately improve the health and well-being of the public, the objective of this paper is, first, to propose a standardized definition of MNT for use across Canada and, second, to propose province- and territory-specific legislative amendments for the regulation of MNT throughout the country. We also present an opposing perspective to the proposed viewpoint. Ultimately, health care regulation across the country requires an overhaul before we expect that nutrition information and advice communicated to the public may be consistently evidence based.
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Affiliation(s)
- Justine R Keathley
- Centre Nutrition, Santé et Société (NUTRISS)-Institut sur la nutrition et les aliments fonctionnels (INAF) and School of Nutrition, Université Laval, Quebec City, QC.,Centre Nutrition, Santé et Société (NUTRISS)-Institut sur la nutrition et les aliments fonctionnels (INAF) and School of Nutrition, Université Laval, Quebec City, QC
| | - Amélie Arbour
- Centre Nutrition, Santé et Société (NUTRISS)-Institut sur la nutrition et les aliments fonctionnels (INAF) and School of Nutrition, Université Laval, Quebec City, QC.,Centre Nutrition, Santé et Société (NUTRISS)-Institut sur la nutrition et les aliments fonctionnels (INAF) and School of Nutrition, Université Laval, Quebec City, QC
| | - Marie-Claude Vohl
- Centre Nutrition, Santé et Société (NUTRISS)-Institut sur la nutrition et les aliments fonctionnels (INAF) and School of Nutrition, Université Laval, Quebec City, QC.,Centre Nutrition, Santé et Société (NUTRISS)-Institut sur la nutrition et les aliments fonctionnels (INAF) and School of Nutrition, Université Laval, Quebec City, QC
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19
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Mousavi T, Nikfar S, Abdollahi M. Comprehensive study on the administrative, economic, regional, and regulatory prospects of complementary and alternative medicine (CAM) in inflammatory bowel disease (IBD). Expert Rev Clin Pharmacol 2021; 14:865-888. [PMID: 33993811 DOI: 10.1080/17512433.2021.1925108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Introduction: Due to the high cost, low effectiveness, and adverse effects plus the life-long nature of inflammatory bowel disease (IBD), and misconception on safety, efficacy, and cost-effectiveness of complementary and alternative medicine (CAM), the market demand for CAM has risen over the past decades. A critical review of patients' and physicians' attitudes, market drivers, economic aspects, regulatory roles, and regional distribution is lacking.Areas covered: Through relevant databases, the existing English language literature concerning the association of CAM use with IBD was collected over the past two decades. Data was then analyzed, comprehensively summarized in tables/figures, and justified concerning administrative, organizational, regional, economic, and regulatory perspectives.Expert opinion: Although CAM utilization is more prevalent among younger, female, and high-educated IBD patients, issues concerning weak study designs, limited-time period/regional distribution of recent surveys, and lack of economic evaluations on CAM make it entirely unfeasible to draw a firm conclusion. Regulators are lagging in meeting the dire need of IBD patients, especially the elderly. Lack of legislation regarding registration, sales monitoring, licensing, insurance coverage, efficacy/safety assessments, post-marketing surveillance, quality assurance, and reference pricing alongside the limited support for CAM research are the main matters that should be urgently addressed.
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Affiliation(s)
- Taraneh Mousavi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Nikfar
- Personalized Medicine Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Evidence-Based Evaluation of Cost-Effectiveness and Clinical Outcomes Group, Pharmaceutical Sciences Research Center (PSRC), and the Pharmaceutical Management and Economics Research Center (PMERC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Personalized Medicine Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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20
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Ridzuan MH, Ali MF, Tan CE, Abdul Aziz AF. Traditional and Complementary Medicine Use During Postpartum Period: A Cross-Sectional Analysis at a Rural, Public Maternal and Child Health Clinic in West Malaysia. Cureus 2021; 13:e15410. [PMID: 34249557 PMCID: PMC8254049 DOI: 10.7759/cureus.15410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background and objective Despite the widespread use of traditional and complementary medicine (TCM) during pregnancy, very few studies have focused on the use of these practices during the postpartum period among women in Malaysia. This study aimed to evaluate users’ profiles and factors associated with the use of TCM during the postpartum period among women attending a community clinic in rural Malaysia. Materials and methods A cross-sectional study was conducted among 210 women at a maternal and child health clinic in Bagan Serai, Perak, Malaysia from January to April 2019. A self-administered questionnaire was used to determine the prevalence, the different types, and reasons for the use of TCM and perceptions toward TCM. Factors associated with TCM use during the postpartum period were derived from multiple logistic regression analyses. Results The prevalence of TCM use during the postpartum period was 66.2% among the subjects. The most common type of TCM used was massage (88.3%), and the most common reason reported was to improve general well-being (72.1%). “Family belief” had the highest mean for influence toward TCM use (mean: 3.63). Malays (adj. OR: 4.52, 95% CI: 1.93-10.59, p=0.001) and those having a low monthly household income (adj. OR: 3.68, 95% CI: 1.24-10.91, p=0.019) were the groups that were more likely to use TCM. Conclusion TCM use during the postpartum period is highly prevalent among Malay women with low household monthly incomes. Further studies should be conducted to address the benefits and risks of using TCM during the postpartum period.
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Affiliation(s)
| | - Mohd Fairuz Ali
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Chai-Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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21
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Miladinia M, Voss JG, Molavynejad S, Malehi AS, Zarea K, Nouri EM, Ahmadzadeh A. Slow-Stroke Back Massage Compared With Music Therapy for Leukemia-Related Pain and Fatigue: A Randomized Controlled Trial. JCO Oncol Pract 2021; 17:e1614-e1621. [PMID: 34077243 DOI: 10.1200/op.21.00156] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Comparison of two safe complementary medicine methods to treat cancer-related pain and fatigue in adult patients with acute leukemia during active treatment with chemotherapy. METHODS A randomized trial with three groups (light massage, music therapy, and standard care) in Ahvaz, Iran, between 2018 and 2019. A total of 104 participants of the massage and music therapy groups received 15-minute intervention sessions, thrice weekly for 4 weeks, and participants of the control group received standard care. Cancer-related pain and fatigue intensity were measured by numeric self-report rating scales. During the 4 weeks of the interventions, pain and fatigue intensity were measured weekly. All the groups were followed up for 2 weeks after the end of the intervention. RESULTS Pain and fatigue intensity decreased significantly over time between the intervention groups compared with the standard care group. In the massage and music therapy groups, a progressive reduction of pain and fatigue intensity over time (from the baseline to the fourth week) was observed. Fatigue intensity did not differ between the two intervention groups. Pain intensity decreased more in the massage group compared with the music therapy group. The durable effects of the massage therapy were greater compared with the music therapy 2 weeks after the intervention was completed. CONCLUSION Light massage was more effective and persisted longer than the music therapy for controlling leukemia-related pain and fatigue in adult patients with acute leukemia.
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Affiliation(s)
- Mojtaba Miladinia
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Nursing Care Research Center in Chronic Diseases, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Joachim G Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki Malehi
- Nursing Care Research Center in Chronic Diseases, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Mousavi Nouri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Ahmadzadeh
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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22
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Suparmi S, Wahidin D, Rietjens IMCM. Risk characterisation of constituents present in jamu to promote its safe use. Crit Rev Toxicol 2021; 51:183-191. [PMID: 34032188 DOI: 10.1080/10408444.2021.1912708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Safety in use of jamu consumption, as part of traditional medicine from Indonesia, is dependent on the complete and adequate assessment of potential hazards and risks of the botanicals and botanical constituents included. This includes especially hazards and risks related to the presence in jamu of active pharmaceutical ingredients (APIs) as well as of constituents that are genotoxic and carcinogenic. The present review presents an overview of the current state-of-the art on these hazards and risks based on case reports on adulteration, and the actual detection of genotoxic and carcinogenic ingredients of concern in jamu. Based on the overview thus obtained, it appears that drug-adulteration presents important hazards responsible for potential adverse effects, due to overdosing. The potential hazards of exposure to APIs mainly relate to the presence of constituents that may cause liver damage, renal impairment, kidney failure, steroid dependence or genotoxicity and carcinogenicity. For these APIs, a risk characterisation was performed based on comparison of health-based guidance values (HBGVs) and exposure, while for the genotoxic carcinogens the margin of exposure (MOE) approach was used. Results of this risk characterisation should be used by risk managers to impose specification for constituents of health concern to protect consumers. It is concluded that to manage the risks identified and further improve the safety in use of jamu, a collaboration between farmers, manufacturer/producers, academia, government, health professionals, and consumers is indicated.
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Affiliation(s)
- Suparmi Suparmi
- Division of Toxicology, Wageningen University and Research, Wageningen, The Netherlands.,Department of Biology, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia
| | - Dasep Wahidin
- Badan Pengawas Obat dan Makanan RI, Jakarta, Indonesia
| | - Ivonne M C M Rietjens
- Division of Toxicology, Wageningen University and Research, Wageningen, The Netherlands
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23
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Fu Q, Zhang X, Yan H, Xu J, Liu H, Yang L, Zhao S, Rong P, Ma R. Acupuncture for treating tic disorders in children: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24860. [PMID: 33761644 PMCID: PMC9282123 DOI: 10.1097/md.0000000000024860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Tic disorders (TDs) are a group of neurodevelopmental disorders in children, while pharmacotherapy is often associated with various side effects and has limited clinical effects for some patients, thus significantly affecting patients' quality of life. Studies have found acupuncture shows certain advantages in the treatment of TDs. However, there is no high level of evidence evaluating the effectiveness and safety of acupuncture for children with TDs. METHODS Each data of acupuncture for treating TDs will be searched. We will search for related English and Chinese databases. The time is limited from inception until November 2020. The primary outcome is the reduction rate (amount) of tic severity using related scales or methods, and the secondary outcomes include recurrence rate and adverse events. The risk of bias will be assessed, and the RevMan5.3 and Stata14.0 will be performed for meta-analysis. Finally, we will assess the level of the resulting evidence. RESULTS The results of the study will synthesize the current evidence and be published in peer-reviewed journals. CONCLUSIONS This research aims to provide convincing evidence of the effectiveness and safety of acupuncture for treating TDs in children. INPLASY REGISTRATION NUMBER INPLASY2020110050.
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Affiliation(s)
- Qianfang Fu
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Xiqing
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Xiqing
| | - Xilian Zhang
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Xiqing
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Xiqing
| | - Haihong Yan
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Xiqing
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Xiqing
| | - Jiabao Xu
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Xiqing
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Xiqing
| | - Hui Liu
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Xiqing
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Xiqing
| | - Libin Yang
- School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Shuyi Zhao
- School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Ping Rong
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Xiqing
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Xiqing
| | - Rong Ma
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Xiqing
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Xiqing
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Jin LL, Zheng J, Honarvar NM, Chen X. Traditional Chinese Medicine in the United States: Current state, regulations, challenges, and the way forward. TRADITIONAL MEDICINE AND MODERN MEDICINE 2021. [DOI: 10.1142/s2575900020100023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In the United States, there has been a steady presence and growth of Traditional Medicine (interchangeable in this paper with Complementary or Alternative Medicine) over the past few decades. The costs for such practices are relatively low along with minimal-to-no obvious side effects. Amongst a variety of traditional medical systems, Traditional Chinese Medicine is one of the most popular alternatives to help manage chronic health conditions or to improve the overall quality of life. While not exhaustive, this paper provides a snapshot of Traditional Chinese Medicine in the United States with insights into its current state, regulations, challenges, and the way forward.
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Affiliation(s)
- Louis Lei Jin
- International Institute of Systems Medicine, Inc., WI, USA
| | | | - Niyaz M. Honarvar
- Department of Nutrition, Harvard School of Public Health Harvard University, Boston, MA, USA
| | - Xiqun Chen
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA, USA
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Singh A, Dixit S. A study on the motivation of Indian patients to consult complementary and alternative medicine practitioners to treat coronary artery disease. Int J Health Plann Manage 2020; 36:423-441. [PMID: 33197088 DOI: 10.1002/hpm.3091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/15/2020] [Accepted: 11/01/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In India, the use of traditional medicine for health problems is a part of the cultural discourse on treatment, but the introduction of Western medicines has adversely affected their popularity. However, with the rapid spread of chronic diseases like coronary artery disease (CAD), many Indians are reverting to complementary and alternative medicine (CAM) treatments. Although previous literature has identified several motivational factors underlying CAM usage, we know little from the perspective of its practitioners. AIM The aim of the present study was to investigate the motivations behind the use of CAM treatments among Indian patients with CAD. METHOD Using semi-structured interviews, we collected data from 15 CAM practitioners and 14 CAD patients utilising CAM treatments alongside conventional biomedical (BM) treatment. We used the Clarke and Braun (2006) method of thematic analysis. RESULT AND CONCLUSION Our findings suggest that the use of CAM treatments depends on various factors working at multiple levels viz., personal factors, disease' characteristics, perceived treatment characteristics (positive attributes of CAM and negative attributes of BM) and external facilitators. Furthermore, our analysis also identifies the role of two underlining forces-push and pull-in motivating CAD patients to choose CAM treatments. The push force comprises factors that participants found to have a repelling nature, whereas pull forces were regarded as advantageous for CAM usage. Although some reasons behind the usage of CAM treatments according to patients and practitioners were overlapping, both groups also provided many distinct insights into the studied health behaviour.
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Affiliation(s)
- Arti Singh
- Department of Humanities and Social Science, Indian Institute of Technology, Kanpur, India
| | - Shikha Dixit
- Department of Humanities and Social Science, Indian Institute of Technology, Kanpur, India
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Nho JH, Lee HJ, Lee SY, Jang JH, Yang BD, Jeong JH, Lee GY, Cho HW, Kim JC, Jung HK. A 13-week repeated oral dose toxicity evaluation and a 4-week recovery evaluation of the Sam So Eum (SSE) in male and female rats. JOURNAL OF ETHNOPHARMACOLOGY 2020; 260:112988. [PMID: 32446926 DOI: 10.1016/j.jep.2020.112988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 01/17/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHAMACOLOGICAL RELEVANCE Sam So Eum (SSE), used in traditional Korean medicine, has been prescribed for the treatment of various ailments including emesis, and fever for centuries. SSE is known by several different names (Shen Su Yin in traditional Chinese medicine; Jin So In traditional Japanese Kampo medicine). It is a mixture of medicinal plants including Panax ginseng C. A. Mey., Perilla frutescens (L.) Britton, and Peucedanum praeruptorum Dunn. Studies have revealed that SSE has many pharmacological effects including anti-inflammatory, anti-cancer, and anti-allergic properties, but its toxic effects have not been evaluated in vivo. Recently, the use of traditional medicinal herbs to treat various diseases has increased, owing to increased number of studies supporting their efficacy. However, safety evaluations for toxicity and other adverse effects have not been extensive. It is commonly considered that natural products extracted from traditional medicinal herbs are safer than synthetic drugs, but this lacks a scientific basis. Thus, in this study, we evaluated the toxicity of SSE in male and female rats. AIM OF THE STUDY To evaluated the safety of SSE in male and female rats. MATERIALS AND METHODS SSE was administered orally for 13 weeks at 1000, 2000, and 4000 mg kg-1·day-1, and then the rats were maintained for 4 weeks without SSE administration (recovery evaluation). RESULTS We observed the animals for changes in clinical signs, including hematological parameters, and food consumption; serum chemistry profiling and urinalysis were also carried out. Creatinine levels in the serum were significantly increased following oral administration of SSE at 2000 and 4000 mg kg-1·day-1 in male and female rats, but returned to the normal levels during the recovery period. In addition, SSE administration does not cause kidney and liver toxicity. Thus, we determined that the no-observed-adverse-effect level of SSE is 4000 mg kg-1·day-1. The no-observed-effect level of SSE was determined to be 1000 mg kg-1·day-1, because serum creatinine was increased by oral administration of SSE at 2000 and 4000 mg kg-1·day-1 in male and female rats. CONCLUSIONS SSE administration does not cause toxicity at 4000 mg kg-1·day-1 in male and female rats.
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Affiliation(s)
- Jong-Hyun Nho
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Hyun-Joo Lee
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Seon-Yu Lee
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Ji-Hun Jang
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Beo-Deul Yang
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Ji-Hyun Jeong
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Guk-Yeo Lee
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Hyun-Woo Cho
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea.
| | - Jong-Choon Kim
- College of Veterinary Medicine, Chonnam National University, Gwangju, 61186, South Korea.
| | - Ho-Kyung Jung
- Department of Traditional Korean Medicine Resource Development, National Development Institute of Korean Medicine, Jangheung-gun, 59338, South Korea; College of Veterinary Medicine, Chonnam National University, Gwangju, 61186, South Korea.
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Senthilkumar CS, Malla TMUD, Akhter S, Sah NK, Ganesh N. Susceptibility of the Bhopal-methyl isocyanate (MIC)-gas-tragedy survivors and their offspring to COVID-19: What we know, what we don't and what we should? CIENCIA & SAUDE COLETIVA 2020; 25:4225-4230. [PMID: 33027359 DOI: 10.1590/1413-812320202510.2.28682020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 11/21/2022] Open
Abstract
There is credible evidence that the 1984-Bhopal-methyl isocyanate (MIC)-gas-exposed long-term survivors and their offspring born post-exposure are susceptible to infectious/communicable and non-communicable diseases. Bhopal's COVID-19 fatality rate suggests that the MIC-gas tragedy survivors are at higher risk, owing to a weakened immune system and co-morbidities. This situation emboldened us to ponder over what we know, what we don't, and what we should know about their susceptibility to COVID-19. This article aims at answering these three questions that emerge in the minds of public health officials concerning prevention strategies against COVID-19 and health promotion in the Bhopal MIC-affected population (BMAP). Our views and opinions presented in this article will draw attention to prevent and reduce the consequences of COVID-19 in BMAP. From the perspective of COVID-19 prophylaxis, the high-risk individuals from BMAP with co-morbidities need to be identified through a door-to-door visit to the severely gas-affected regions and advised to maintain good respiratory hygiene, regular intake of immune-boosting diet, and follow healthy lifestyle practices.
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Affiliation(s)
- Chinnu Sugavanam Senthilkumar
- Central Research Laboratory, Rajas Dental College & Hospital. Kavalkinaru Junction, Tirunelveli Dt. Tamil Nadu India.
| | - Tahir Mohi-Ud-Din Malla
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences. Srinagar Jammu & Kashmir India
| | - Sameena Akhter
- Clinical Cytogenetics Laboratory, Department of Research, Jawaharlal Nehru Cancer Hospital & Research Centre. Bhopal Madhya Pradesh India
| | | | - Narayanan Ganesh
- Clinical Cytogenetics Laboratory, Department of Research, Jawaharlal Nehru Cancer Hospital & Research Centre. Bhopal Madhya Pradesh India
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Girish P, Jayanthi M, Gitanjali B, Manikandan S, Rajan S. Screening of Weight-Loss Herbal Products for Synthetic Anti-Obesity Adulterants: A Target-Oriented Analysis by Liquid Chromatography-Tandem Mass Spectrometry. J Diet Suppl 2020; 18:92-104. [PMID: 32081055 DOI: 10.1080/19390211.2020.1723774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The medical and social impact of being overweight, as well as the difficulty in making long-term changes in diet, physical activity, and pitfalls associated with allopathic management, lure obese individuals to over-the-counter weight-loss herbal products (WHPs). However, the safety of herbals is questionable, as reports from all over the world suggest adulteration with synthetic weight loss agents. Objective: The present study was carried out to develop a rapid and sensitive method to screen potential weight loss adulterants in WHPs. Methodology: We procured 33 licensed brands of WHPs that are available in Puducherry (India) and through web stores. Drug-free spiked herbal matrices were used for internal proficiency testing. Spiked herbal matrices and samples were extracted and centrifuged. The supernatant was collected and subjected to liquid chromatography-tandem mass spectrometry analyses. Isocratic elution was carried out by the mobile phase of methanol: 0.1% v/v formic acid (70%:30% v/v) through a C18 column. Analytes were monitored in electrospray ionization positive and negative modes, and an multiple reaction monitoring (MRM) scan was used. Results: Run time was 12 min. Intra- and inter-day precision was < 15% and recoveries were in the range of 99% to 115%. Limit of quantification (LOQ) of the analytes were in the range of 0.1 to 0.3 ng/ml. Conclusion: We developed a sensitive and rapid validated method for the detection of potential adulterants in WHPs. None of the WHPs analyzed were found to contain adulterants. The proposed method will be useful for routine monitoring. WHPs analyzed in this study were not adulterated indicating that WHPs from licensed sources are reliable.
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Affiliation(s)
- P Girish
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - M Jayanthi
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - B Gitanjali
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.,All India Institute of Medical Sciences, Bhubaneswar, India
| | - S Manikandan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - S Rajan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
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Gamret AC, Price A, Nichols AJ. Using Complementary and Alternative Medicine for the Treatment of Psoriasis: A Step in the Right Direction-Reply. JAMA Dermatol 2020; 155:636-637. [PMID: 30865253 DOI: 10.1001/jamadermatol.2018.5346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- A Caresse Gamret
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alexandra Price
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Anna J Nichols
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
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El-Dahiyat F, Rashrash M, Abuhamdah S, Abu Farha R, Babar ZUD. Herbal medicines: a cross-sectional study to evaluate the prevalence and predictors of use among Jordanian adults. J Pharm Policy Pract 2020; 13:2. [PMID: 31988754 PMCID: PMC6971905 DOI: 10.1186/s40545-019-0200-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/29/2019] [Indexed: 12/25/2022] Open
Abstract
Introduction Understanding why adults resort to herbal medicine can help in planning interventions aimed at increasing awareness regarding herbal use. This study sought to investigate the prevalence and to determine factors for predicting the use of herbal medicine among Jordanian adults. Methods A cross-sectional study was conducted involving 378 older adults who were randomly selected from two different areas of Jordan. A questionnaire was used to gather data and validation criteria for validity and reliability of the content were tested by content and face validity in a panel of experts. Results From a total of 500 invited participants, 378 completed the questionnaire. The prevalence of the use of of herbal products in this study was high at 80.2%. Herbal medicines use was not associated with any demographic factors other than age (p < 0.05). Moreover, the only associated health-related characteristic was the patient’s disease state including, notably, hypertension (p < 0.05). Reasons for not using herbal medicines as reported by nonusers included mainly a lack of belief in their efficacy (52.2%). Another two important reasons were that the individuals believed themselves to healthy and have no need for their use (31.3%) and the unavailability of enough information about the herbal medicines (29.7%). Finally, the most common side effects as reported by patients in this study were nausea and vomiting (9.3%), and, to a lesser extent, skin rash (2.1%). Conclusion There is a high rate of use of herbal medicines in Jordan, especially among hypertensive patients. Therefore, there is a need to establish effective herbal medicine policies and health education programs to discuss the benefits and risks of herbal medicine use, with the aim of maximizing patient-desired therapeutic outcomes.
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Affiliation(s)
- Faris El-Dahiyat
- College of Pharmacy, Al-Ain University, Alain campus, Al-Ain, P. O Box 64141, United Arab Emirates
| | - Mohamed Rashrash
- 2Department of Pharmaceutical and Administrative Sciences, School of Pharmacy, University of Charleston, Charleston, WV USA
| | - Sawsan Abuhamdah
- College of Pharmacy, Al-Ain University, Abu Dhabi campus, Al-Ain, United Arab Emirates.,4Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Rana Abu Farha
- 5Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Shaikh Abdul Rahman S, Aziz Z. Complementary and alternative medicine: Pharmacovigilance in Malaysia and predictors of serious adverse reactions. J Clin Pharm Ther 2020; 45:946-958. [DOI: 10.1111/jcpt.13106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 12/13/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Sameerah Shaikh Abdul Rahman
- Department of Pharmacy Faculty of Medicine University Malaya Kuala Lumpur Malaysia
- School of Pharmacy Monash University Selangor Malaysia
| | - Zoriah Aziz
- Department of Pharmacy Faculty of Medicine University Malaya Kuala Lumpur Malaysia
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Tao J, Rupar CA, Miller MR, Ratko S, Prasad C. Use of complementary and alternative medicine in patients with inborn errors of metabolism: A single-center study. JIMD Rep 2019; 51:105-112. [PMID: 32071845 PMCID: PMC7012736 DOI: 10.1002/jmd2.12089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 12/19/2022] Open
Abstract
Background and Objectives There is a paucity of information on the use of complementary and alternative medicine (CAM) in patients with inborn errors of metabolism (IEM). This study's objective was to evaluate the self-reported use and perceived effectiveness of CAM in adults and children with IEM. Methods Patients aged 0-70 years and caregivers seen at the London Health Sciences Centre Metabolic Clinic (London, Ontario, Canada) between July 2017 and August 2017 were recruited to complete a questionnaire regarding CAM use to help their IEM diagnosis and perceived effectiveness of these therapies. Survey responses were analyzed using descriptive statistics; age, sex, and education level associations among CAM users were tested using the Pearson χ 2 test. Results Of 50 potential participants, 44 (88%) completed the questionnaire, including 21 adults (6 by caregivers) and 23 children (22 by caregivers). The most common IEM category was Aminoacidopathies and Small Molecule Disorders (50%). Twenty-seven (61%) participants reported CAM use to help their IEM diagnosis. The most common CAM therapies used were chiropractic manipulation, omega-3 fatty acids, probiotics, and aromatherapy/essential oils. Most CAM users and caregivers (74%) perceived their CAM therapies as effective overall. Among CAM users, 40% had not discussed CAM use with a health care professional (HCP). CAM use was similar when comparing age, sex and education level. Conclusions CAM is commonly used among patients with IEM. The safety and efficacy of CAM therapies for IEM should be further investigated. HCPs and patients should openly discuss CAM use in order to evaluate safety.
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Affiliation(s)
- Jessica Tao
- Faculty of Science Western University London Ontario Canada
| | - C Anthony Rupar
- Department of Pathology & Laboratory Medicine and Biochemistry Western University London Ontario Canada.,Department of Paediatrics Western University London Ontario Canada.,Children's Health Research Institute, Western University London Ontario Canada
| | - Michael R Miller
- Department of Paediatrics Western University London Ontario Canada.,Children's Health Research Institute, Western University London Ontario Canada
| | - Suzanne Ratko
- Children's Hospital, London Health Sciences Centre London Ontario Canada
| | - Chitra Prasad
- Department of Paediatrics Western University London Ontario Canada.,Children's Health Research Institute, Western University London Ontario Canada
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Askarinia M, Ganji A, Jadidi-Niaragh F, Hasanzadeh S, Mohammadi B, Ghalamfarsa F, Ghalamfarsa G, Mahmoudi H. A review on medicinal plant extracts and their active ingredients against methicillin-resistant and methicillin-sensitive Staphylococcus aureus. JOURNAL OF HERBMED PHARMACOLOGY 2019. [DOI: 10.15171/jhp.2019.27] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Staphylococcus aureus is among the pathogens capable of developing a broad spectrum of infections in human beings. In addition to the hospital, the bacterium is present in the community and has a high resistance to antibiotics, which is also increasing on an ongoing basis. Resistance to β-lactam antibiotic family is one of the concerns about the bacterium that has encountered the treatment of such infections with difficulty. Due to the increased resistance and importance of this bacterium, new strategies are needed to control this pathogen. One of these approaches is the use of medicinal plants, which has attracted many researchers in the last decade. Several studies have been carried out or are being designed using various herbs to find active ingredients to deal with this bacterium. The aim of this study was to present the antibacterial activity of different medicinal plants and the effects of their active ingredients on methicillin-resistant and methicillin-sensitive S. aureus and to clarify the pathway to further studies in this regard.
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Affiliation(s)
- Marzieh Askarinia
- Student Research Committee, Yasuj University of medical sciences, Yasuj, Iran
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Ali Ganji
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
- Department of Microbiology and Immunology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Farhad Jadidi-Niaragh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sajad Hasanzadeh
- Department of Internal Medicine, Yasouj University of Medical Sciences, Yasouj, Iran
| | - Bahram Mohammadi
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Farideh Ghalamfarsa
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Ghasem Ghalamfarsa
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Hassan Mahmoudi
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Hajimonfarednejad M, Ostovar M, Raee MJ, Hashempur MH, Mayer JG, Heydari M. Cinnamon: A systematic review of adverse events. Clin Nutr 2019; 38:594-602. [DOI: 10.1016/j.clnu.2018.03.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 03/20/2018] [Accepted: 03/26/2018] [Indexed: 11/25/2022]
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Complementary medicine use during cancer treatment and potential herb-drug interactions from a cross-sectional study in an academic centre. Sci Rep 2019; 9:5078. [PMID: 30911084 PMCID: PMC6434040 DOI: 10.1038/s41598-019-41532-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/12/2019] [Indexed: 12/21/2022] Open
Abstract
Complementary medicine (CM) is used by one third to one half of cancer patients throughout the world. The objective of this study was to describe the prevalence of CM use and the potential for interactions with cancer treatments in an academic oncology centre. A cross-sectional study was conducted among patients undergoing current cancer treatment. Among 132 included patients, 56% had used CM since their cancer diagnosis and 45% were using CM during cancer treatment at the time of the survey. The main CM used were green tea (35%), herbal tea (35%), homeopathy (27%), dietary supplements (27%), and herbal medicines (27%). A small majority of patients (58%) spontaneously mentioned the use of CM to their oncologist. Of 42 identified combinations of concomitant use of biologically based CM and anticancer agents among the study patients, the potential for pharmacokinetic interactions of clinical relevance was not expected in 17 combinations (40%), hypothetical and deemed unlikely in 23 (55%), and of probable low clinical relevance in 2 (5%). Considering the high prevalence of CM use, active enquiries should be made by healthcare professionals to detect symptoms that may relate to CM tolerance and effects or that suggest interactions between CM and cancer treatments.
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Wu Y, Sun L, Zeng F, Wu S. A conjugated-polymer-based ratiometric nanoprobe for evaluating in-vivo hepatotoxicity induced by herbal medicine via MSOT imaging. PHOTOACOUSTICS 2019; 13:6-17. [PMID: 30519528 PMCID: PMC6260278 DOI: 10.1016/j.pacs.2018.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/12/2018] [Accepted: 11/13/2018] [Indexed: 05/06/2023]
Abstract
Herbal medicines are widely used around the world, while some of them are associated with adverse effects like herb-induced liver injury due to oxidative/nitrosative stress resulted from hepatically-generated ROS/RNS. It is of significance to accurately evaluate herbal-medicine-induced hepatotoxicity, since it would help provide effective monitoring method of the safety of herbal remedies. Herein we designed a ratiometric nanoprobe for in vivo imaging hepatic injury induced by herbal medicine (polygonum multiflorum, PM) via specifically responding to NO generated in liver by PM, and with MSOT imaging the precise location of liver injury can be identified. The liposomal nanoprobe consists of a responsive dye (IX-2NH2) which could specifically respond to NO and the diketopyrrolopyrrole-based conjugated polymer (DPP-TT) as the internal reference. Thus we can realize ratiometric optoacoustic detection of herbal-medicine-induced liver injury with 3D information in mouse model in a noninvasive way.
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Jones SL, Campbell B, Hart T. Laboratory tests commonly used in complementary and alternative medicine: a review of the evidence. Ann Clin Biochem 2019; 56:310-325. [PMID: 30813740 DOI: 10.1177/0004563218824622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
It is increasingly easy for the general public to access a wide range of laboratory tests. Tests can be ordered online with little or no input from a health professional. The complementary and alternative medicine (CAM) community promote and sell a wide range of tests, many of which are of dubious clinical significance. Many have little or no clinical utility and have been widely discredited, whilst others are established tests that are used for unvalidated purposes. They range from the highly complex, employing state of the art technology, e.g. heavy metal analysis using inductively coupled plasma-mass spectrometry, to the rudimentary, e.g. live blood cell analysis. Results of 'CAM tests' are often accompanied by extensive clinical interpretations which may recommend, or be used to justify, unnecessary or harmful treatments. There are now a small number of laboratories across the globe that specialize in CAM testing. Some CAM laboratories operate completely outside of any accreditation programme whilst others are fully accredited to the standard of established clinical laboratories. In this review, we explore CAM testing in the United States, the United Kingdom and Australia with a focus on the common tests on offer, how they are reported, the evidence base for their clinical application and the regulations governing their use. We will also review proposed changed to in-vitro diagnostic device regulations and how these might impact on CAM testing.
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Affiliation(s)
- Stuart L Jones
- 1 Department of Clinical Biochemistry, King George's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK
| | | | - Tanya Hart
- 3 Department of Clinical Biochemistry, Poole Hospital NHS Foundation Trust, UK
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Bonizzoni G, Caminati M, Ridolo E, Landi M, Ventura MT, Lombardi C, Senna G, Crivellaro M, Gani F. Use of complementary medicine among patients with allergic rhinitis: an Italian nationwide survey. Clin Mol Allergy 2019; 17:2. [PMID: 30804711 PMCID: PMC6373013 DOI: 10.1186/s12948-019-0107-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 02/05/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A growing use of complementary alternative medicine (CAM) has been found in Europe as well in Italy for chronic diseases, including the allergic rhinitis. The study aims at investigating the prevalence and the pattern of use of CAM amongst patient with allergic rhinitis. METHODS A 12-item questionnaire was developed by a panel of experts and administered to patients with moderate/severe allergic rhinitis consecutively referring during the study time-frame to seven allergy clinics placed all around Italy. The items covered several topics including reason for choosing CAM, its clinical efficacy, schedule of treatment, costs, type of therapy. RESULTS Overall 359 questionnaires were analysed. 20% of patients declared CAM use. A significant correlation between the use of CAM and female sex (p < 0.01) and with a higher level of education (p < 0.01) was observed. CAM users were adults (36% in the range between 20 and 40 years and 32% between 41 and 60 years). Youngsters (< 20 years) (7%) and elderly (> 60) (25%) less frequently used CAM.The most used type of CAM was homoeopathy (77% of patients). 60% of users would recommend CAM despite a poor clinical efficacy according to 67% of them. CONCLUSIONS Although no evidence supports CAM efficacy and safety, the number of patients who relies on it is not negligible. As allergic rhinitis is not a trivial disease, the use of CAM as the only treatment for it should be discouraged at any level, but by general practitioner and specialist in particular.
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Affiliation(s)
- G. Bonizzoni
- Allergy Service AOU San Luigi Hospital Orbassano, Turin, Italy
| | - M. Caminati
- Asthma Center and Allergy Unit and Department of Medicine, Verona University Hospital, Piazzale Scuro, 37134 Verona, Italy
| | - E. Ridolo
- Experimental and Clinical Medicine, University of Parma, Parma, Italy
| | - M. Landi
- National Health Care System, Turin, Italy
| | - M. T. Ventura
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - C. Lombardi
- Department Unit of Allergology and Respiratory Diseases, Fondazione Poliambulanza Hospital Institute, Brescia, Italy
| | - G. Senna
- Asthma Center and Allergy Unit and Department of Medicine, Verona University Hospital, Piazzale Scuro, 37134 Verona, Italy
| | - M. Crivellaro
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - F. Gani
- Allergy Service AOU San Luigi Hospital Orbassano, Turin, Italy
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Roh D, Jung JH, Yoon KH, Lee CH, Kang LY, Lee S, Shin K, Kim DH. Valerian extract alters functional brain connectivity: A randomized double‐blind placebo‐controlled trial. Phytother Res 2019; 33:939-948. [DOI: 10.1002/ptr.6286] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/09/2018] [Accepted: 12/14/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Daeyoung Roh
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
- Mind‐neuromodulation LaboratoryHallym University College of Medicine Chuncheon Korea
| | - Jae Hoon Jung
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
- Mind‐neuromodulation LaboratoryHallym University College of Medicine Chuncheon Korea
| | - Kyung Hee Yoon
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
| | - Chang Hyun Lee
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
- Mind‐neuromodulation LaboratoryHallym University College of Medicine Chuncheon Korea
| | - Lee Young Kang
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
- Mind‐neuromodulation LaboratoryHallym University College of Medicine Chuncheon Korea
| | - Sang‐Kyu Lee
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
- Mind‐neuromodulation LaboratoryHallym University College of Medicine Chuncheon Korea
| | - Kitack Shin
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
| | - Do Hoon Kim
- Department of PsychiatryHallym University College of Medicine Chuncheon Korea
- Mind‐neuromodulation LaboratoryHallym University College of Medicine Chuncheon Korea
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Chen L, Li Y, Chen W, Liu X, Yu Z, Zhang S. Utilizing soft constraints to enhance medical relation extraction from the history of present illness in electronic medical records. J Biomed Inform 2018; 87:108-117. [PMID: 30292854 DOI: 10.1016/j.jbi.2018.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 09/05/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022]
Abstract
Relation extraction between medical concepts from electronic medical records has pervasive applications as well as significance. However, previous researches utilizing machine learning algorithms judge the semantic types of medical concept pair mentions independently. In fact, different concept pair mentions in the same context are of dependencies which can provide beneficial evidences for identifying their relation types. To the best of our knowledge, only one study has considered such dependencies in discharge summaries. However, its hard constraints are not applied effectively to the History of Present Illness (HPI) in electronic Medical Records. According to the writing characteristics of HPI records, we generalize two regularities of dependencies among concept pairs mentioned in an HPI record to enhance the performance of relation extraction. We incorporate the two soft constraints corresponding to the regularities and the posterior probabilities returned by a local classifier into a joint inference process which applies Integer Quadratic Programming method to carry out collective classification for all concept pair mentions in an HPI record. We implement four local classification models including support vector machine, logistics regression, random forest and piecewise convolutional neural networks to examine the performance of our approach. A series of experimental results demonstrate that our collective classification method has made a principal improvement and outperforms the other state-of-the-art methods.
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Affiliation(s)
- Li Chen
- Department of Computer Science, Sichuan University, Chengdu, China.
| | - Yuanju Li
- Department of Computer Science, Sichuan University, Chengdu, China
| | - Weipeng Chen
- Department of Computer Science, Sichuan University, Chengdu, China
| | - Xinglong Liu
- School of Basic Medicine, Chengdu University of TCM, Chengdu, China
| | - Zhonghua Yu
- Department of Computer Science, Sichuan University, Chengdu, China.
| | - Siyuan Zhang
- Department of Computer Science, Sichuan University, Chengdu, China
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Li B, Forbes TL, Byrne J. Integrative medicine or infiltrative pseudoscience? Surgeon 2018; 16:271-277. [DOI: 10.1016/j.surge.2017.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/05/2017] [Indexed: 11/25/2022]
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Khan MF, Muzaffar A, Shamim F. History conflict and non-formulary medicine: a threat for anaesthesiologist in low and middle-income countries. BMJ Case Rep 2018; 2018:bcr-2017-224141. [PMID: 30158256 PMCID: PMC6119358 DOI: 10.1136/bcr-2017-224141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2018] [Indexed: 11/03/2022] Open
Abstract
The practice of complementary and non-formulary medicine has gained tremendous popularity due to their claimed beneficial effects in cardiac, respiratory and chronic diseases, as also other disorders. The most threatening aspect related to these practices pertains to the non-disclosure of its use by patients at the time of their preoperative assessment in elective or emergency setting. We report a case of profound, long-lasting unexplained hypotension during and after anaesthesia in a patient presented for emergency vocal cord surgery (cordectomy). He was taking complementary medicine for last 2 years. Serum cortisol level was sent postoperatively in intensive care unit that was found extremely low.
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Affiliation(s)
| | - Areeba Muzaffar
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
| | - Faisal Shamim
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
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Risk of anaphylaxis in complementary and alternative medicine. Curr Opin Allergy Clin Immunol 2018; 17:332-337. [PMID: 28731887 DOI: 10.1097/aci.0000000000000384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Complementary and alternative medicine (CAM) use is widespread across the world. Patients with asthma and allergy regularly use CAM therapies. Allergic and anaphylactic reactions to CAM have been reported. RECENT FINDINGS Recent attempts to regulate and monitor adverse reaction to these therapies have given us further insight into potential causes of severe allergic reactions. Several culprits identified including Andrographis paniculata, Echinacea species, bee products, Ginkgo biloba and Ginseng are discussed here. SUMMARY Knowing the factors that increase the risk of anaphylaxis allows reactions to be recognized, reported and further investigated. Research to identify key causative allergens is necessary in the future. Collaboration between the allergy community and CAM practitioners can allow better understanding of allergy to these therapies.
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Menon-Miyake MA, de Oliveira RC, Lorenzi-Filho G, Saldiva PHN, Butugan O. Luffa Operculata Affects Mucociliary Function of the Isolated Frog Palate. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240501900406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Luffa operculata is a medicinal plant used in homeopathic and alternative medicine. In the United States, it is sold in a purified spray form, whereas a homemade L. operculata dry fruit infusion (DFI) is commonly used in Latin America. The L. operculata DFI is applied intranasally, inducing profuse mucous secretion and relieving nasal symptoms. Nevertheless, this medication may cause irritation of the nasal mucosa, as well as epistaxis or anosmia. Given the growing popularity of alternative medicine, a decision was made to evaluate the effects of this substance on mucous membranes. Methods The effects of L. operculata DFI on mucociliary transport velocity, ciliary beat frequency, and transepithelial potential difference (PD) were evaluated in an isolated frog palate preparation. We tested 46 palates immediately before immersion and again at 5 and 20 minutes after immersion. Four groups (n = 10) were tested in frog Ringer: control; L. operculata DFI, 60 mg/L; 600 mg/L; and 1200 mg/L. An additional group was tested using L. operculata DFI prepared with water (600 mg/L of H2O, n = 6). Epithelial samples were harvested for ultrastructural study. Results In treated palates, mucociliary transport velocity and ciliary beat frequency decreased significantly (p < 0.001 and p < 0.008, respectively). There was a dose-dependent decrease in PD modulus (p < .007). Our PD findings indicated ion-fluid transport abnormalities, which were confirmed by transmission electron microscopy that showed enlargement of interepithelial spaces. Conclusion In this ex vivo model, the L. operculata DFI infusion promoted significant changes in the mucociliary function of the epithelium, suggesting that it is potentially noxious to human nasal mucosa.
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Affiliation(s)
| | - Regiani Carvalho de Oliveira
- Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo, São Paulo, SP, Brazil
| | - Geraldo Lorenzi-Filho
- Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo, São Paulo, SP, Brazil
- Department of Cardiology and Pneumology, University of São Paulo, São Paulo, SP, Brazil
| | | | - Ossamu Butugan
- Department of Otorhinolaryngology, University of São Paulo, São Paulo, SP, Brazil
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Kumar A, Duda L, Mainali G, Asghar S, Byler D. A Comprehensive Review of Tourette Syndrome and Complementary Alternative Medicine. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2018; 5:95-100. [PMID: 29755921 PMCID: PMC5932093 DOI: 10.1007/s40474-018-0137-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW Tourette syndrome (TS) is a neuropsychiatric condition defined by both motor and phonic tics over a period of at least 1 year with the onset before 18 years of age. The purpose of this article is to review the use of complementary alternative medicine (CAM) in children and adults with Tourette syndrome with emphasis on recent research. RECENT FINDINGS Most patients do not tell their physician about the use of CAM unless if specifically asked. Of the studies reviewed, description of the treatment and the frequency of use were most often reported. Few studies examine the role or effectiveness of CAM in the treatment of TS specifically. SUMMARY Practitioners should be aware of current research regarding various CAM modalities used for TS patients, including efficacy, potential adverse effects, and interactions with medications. Robust data about the use of CAM, efficacy, and potential side effects is lacking and requires further research to clarify optimal use.
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Affiliation(s)
- Ashutosh Kumar
- Division of Pediatric Neurology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033 USA
| | - L. Duda
- Division of Pediatric Neurology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033 USA
| | - G. Mainali
- Division of Pediatric Neurology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033 USA
| | - S. Asghar
- Division of Pediatric Neurology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033 USA
| | - D. Byler
- Division of Pediatric Neurology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033 USA
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Powell K, Le Roux E, Banks J, Ridd MJ. GP and parent dissonance about the assessment and treatment of childhood eczema in primary care: a qualitative study. BMJ Open 2018; 8:e019633. [PMID: 29449296 PMCID: PMC5829900 DOI: 10.1136/bmjopen-2017-019633] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To compare parents' and clinicians' perspectives on the assessment and treatment of children with eczema in primary care. DESIGN Qualitative interview study with purposive and snowball sampling and thematic analysis. SETTING 14 general practices in the UK. PARTICIPANTS 11 parents of children with eczema and 15 general practitioners (GPs) took part in semistructured individual interviews. RESULTS We identified several areas of dissonance between parents and GPs. First, parents sought a 'cause' of eczema, such as an underlying allergy, whereas GPs looked to manage the symptoms of an incurable condition. Second, parents often judged eczema severity in terms of psychosocial impact, while GPs tended to focus on the appearance of the child's skin. Third, parents sought 'more natural' over-the-counter treatments or complementary medicine, which GPs felt unable to endorse because of their unknown effectiveness and potential harm. Fourth, GPs linked poor outcomes to unrealistic expectations of treatment and low adherence to topical therapy, whereas parents reported persisting with treatment and despondency with its ineffectiveness. Consultations were commonly described by parents as being dominated by the GP, with a lack of involvement in treatment decisions. GPs' management of divergent views varied, but avoidance strategies were often employed. CONCLUSIONS Divergent views between parents and clinicians regarding the cause and treatment of childhood eczema can probably only be bridged by clinicians actively seeking out opinions and sharing rationale for their approach to treatment. Together with assessing the psychosocial as well as the physical impact of eczema, asking about current or intended use of complementary therapy and involving parents in treatment decisions, the management of eczema and patient outcomes could be improved.
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Affiliation(s)
- Kingsley Powell
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma Le Roux
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan Banks
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Matthew J Ridd
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
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Ibrahim IR, Hassali MA, Saleem F, Al Tukmagi HF, Dawood OT. Use of complementary and alternative medicines: a cross-sectional study among hypertensive patients in Iraq. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2017. [DOI: 10.1111/jphs.12209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Inas Rifaat Ibrahim
- Social and Administrative Pharmacy; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - Mohamed Azmi Hassali
- Social and Administrative Pharmacy; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - Fahad Saleem
- Faculty of Pharmacy and Health Sciences; University of Baluchistan; Quetta Pakistan
| | - Haydar F. Al Tukmagi
- Department of Clinical Pharmacy; College of Pharmacy; University of Baghdad; Baghdad Iraq
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Colalto C. What phytotherapy needs: Evidence-based guidelines for better clinical practice. Phytother Res 2017; 32:413-425. [DOI: 10.1002/ptr.5977] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/12/2017] [Accepted: 10/14/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Cristiano Colalto
- Farmacia San Paolo Dr. Colalto; P.zza De L'Osto 37 37035 San Giovanni Ilarione Verona Italy
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Okumu MO, Ochola FO, Onyango AO, Mbaria JM, Gakuya DW, Kanja LW, Kiama SG, Onyango MA. The legislative and regulatory framework governing herbal medicine use and practice in Kenya: a review. Pan Afr Med J 2017; 28:232. [PMID: 29629018 PMCID: PMC5882212 DOI: 10.11604/pamj.2017.28.232.12585] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/06/2017] [Indexed: 11/11/2022] Open
Abstract
Complementary and alternative medicine is an integral component of primary healthcare in Kenya. This is because the infrastructural health setup in the country is inadequate in catering for all the medical needs of the population. This particularly holds true in the rural areas where many rural folk rely on products of herbal origin to offset their healthcare needs. More often than not these products are an elaborate cacophony of several different substances of biological origin and thus need personnel adept in their preparation. Sadly, due to loopholes in legislation and regulation, quacks have a field day in the practice. Moreover, the process of planting, harvesting, preparation and storage of herbs and related products dictates that a significant number of people will ultimately be involved in the whole process. This is likely to set the stage for manipulation and compromise of the safety, quality and efficacy of these products. This state of affairs appears unabated especially in the context of the current legal and regulatory framework governing herbal medicine use and practice in Kenya. Not only are these laws inadequate, they are shrouded in ambiguity, open to interpretation and the authorities mandated to implement them often end up performing duplicate roles. The aim of this review is to critique the legal and regulatory provisions governing herbal medicine use and practice in Kenya. In conclusion, laws and regulations meant to control herbal medicine use and practice in Kenya are wanting. Clear and definitive legislation on herbal medicine use and practice coupled with effective implementation by mandated institutions will go a long way in inspiring confidence to all stakeholders of herbal medicine.
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Affiliation(s)
- Mitchel Otieno Okumu
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, P.O BOX 29053-00625 Nairobi, Kenya
| | - Francis Okumu Ochola
- Department of Pharmacology and Toxicology, Faculty of Medicine, Moi University, P.O BOX 3900-30100 Eldoret, Kenya
| | - Allan Odhiambo Onyango
- Onyango Allan and Company Advocates, 3Floor, Pioneer House, P.O BOX 50485-00100 Nairobi, Kenya
| | - James Mucunu Mbaria
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, P.O BOX 29053-00625 Nairobi, Kenya
| | - Daniel Waweru Gakuya
- Department of Clinical Studies, Faculty of Veterinary Medicine, University of Nairobi, P.O BOX 29053-00625 Nairobi, Kenya
| | - Laetitia Wakonyu Kanja
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, P.O BOX 29053-00625 Nairobi, Kenya
| | - Stephen Gitahi Kiama
- Department of Veterinary Anatomy and Physiology, Faculty of Veterinary Medicine, University of Nairobi, P.O BOX 29053-00625 Nairobi, Kenya
| | - Mary Atieno Onyango
- Department of Pharmacology, School of Medicine, Maseno University, P.O BOX Private bag, Maseno, Kenya
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Herman A, Herman AP. Topically used herbal products for the treatment of hair loss: preclinical and clinical studies. Arch Dermatol Res 2017; 309:595-610. [DOI: 10.1007/s00403-017-1759-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/26/2017] [Indexed: 11/24/2022]
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