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Schiele JK, Jeitler M, Michalsen A, Stapelfeldt E, Ortiz M, Sigl M, Brinkhaus B, Wischnewsky M, Kessler CS. Wellness or medicine? Use and perception of Ayurveda in Germany: data from an online-representative cross-sectional study. Front Med (Lausanne) 2024; 11:1408609. [PMID: 38841569 PMCID: PMC11150709 DOI: 10.3389/fmed.2024.1408609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/26/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Ayurveda, South Asia's largest and most relevant system of Traditional Medicine, holds a legal status akin to conventional Western medicine in India and elsewhere. There is an almost complete lack of data on the use of Ayurveda in Germany. The aim of this study was to investigate Ayurveda's utilization patterns, entry points, and factors influencing its use and the perception of Ayurveda among the German population. Methods Basis of this manuscript was an online-representative survey which involved 4,065 participants aged 18-75 about the use and acceptance of Traditional, Complementary and Integrative Medicine (TCIM) in Germany. The survey was conducted online using Computer Assisted Web Interview (CAWI) in 2022. The dataset was analyzed descriptively and inferentially. Results Altogether 9.3% (n = 377) of all survey participants (n = 4,065) had already used Ayurveda somehow, either more often (1.7%) or at least once in a lifetime (7.6%). Responders associated Ayurveda primarily with Indian Medicine (27.7%) and wellness (18%). Commonly used Ayurvedic services included non-medical treatments at wellness resorts/spas (48.3%), in outpatient practices (27.1%), and hotels (23.6%). 30.2% of the participants believe in Ayurveda's therapeutic potential. 76.7% of Ayurveda users find healthy nutrition important or very important. Nine predictors were found to classify Ayurveda users vs. non-users with spirituality and belief in Ayurveda's therapeutic efficacy as the most relevant ones. Ayurveda seems to be primarily used by well-educated and female individuals, often from higher-income groups and with a rather modern social milieu-orientation. Conclusion Study results suggest that about every tenth German citizen has used Ayurveda in the past and about one third believes in its therapeutic potential. Because Ayurvedic therapies are often not evidence-based, there is an urgent need to perform high quality randomized controlled trials to investigate potential effects and safety of Ayurveda and how evidence-based Ayurveda treatments can be integrated into the German healthcare system.
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Affiliation(s)
- Julia K. Schiele
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Nature-Based Therapies, Immanuel Hospital Berlin, Berlin, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Nature-Based Therapies, Immanuel Hospital Berlin, Berlin, Germany
| | - Elmar Stapelfeldt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Nature-Based Therapies, Immanuel Hospital Berlin, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mike Sigl
- Institute for Cultural Studies, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Manfred Wischnewsky
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Mathematics and Computer Science, University Bremen, Bremen, Germany
| | - Christian S. Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Nature-Based Therapies, Immanuel Hospital Berlin, Berlin, Germany
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Egwumba P, Nellums L, Bains M, Chattopadhyay K. Ayurveda for managing noncommunicable diseases in organisation for economic co-operation and development: A qualitative systematic review protocol on experiences, perceptions, and perspectives of ayurvedic practitioners and patients. Health Sci Rep 2023; 6:e1530. [PMID: 37720168 PMCID: PMC10501264 DOI: 10.1002/hsr2.1530] [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: 04/26/2023] [Revised: 07/10/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Background and Aims Ayurveda is a traditional medicine that originated in the Indian subcontinent, and its use remains widespread in the Indian subcontinent, especially for managing noncommunicable diseases (NCDs). It is also becoming increasingly popular in the Organization for Economic Co-operation and Development (OECD) countries as complementary and alternative medicine. Qualitative research studies have been conducted in various OECD countries to explore the experiences, perceptions, and perspectives of Ayurvedic practitioners and patients with NCDs regarding the usage of Ayurveda for managing these conditions. However, to date, no systematic review on this topic has been published. Therefore, this systematic review aims to synthesize the experiences, perceptions, and perspectives of Ayurvedic practitioners and patients with NCDs on the usage of Ayurveda for managing these conditions in OECD countries. Methods The systematic review will be conducted in accordance with the joanna briggs institute systematic review guideline on qualitative evidence. We will include qualitative research studies conducted among Ayurvedic practitioners or adult patients with NCDs in any OECD member country to explore experiences, perceptions, or perspectives regarding the usage of Ayurveda for managing NCDs. MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), PsycINFO (Ovid), AMED, and Web of Science will be searched to identify published studies. EthOS and ProQuest Dissertations and Theses will be searched to identify unpublished studies. No date or language restrictions will be applied. Initially, a narrative synthesis will be conducted. Where possible, study findings will be pooled using the meta-aggregation approach.
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Affiliation(s)
- Patricia Egwumba
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
- The Nottingham Centre for Evidence‐Based Healthcare: a JBI Centre of ExcellenceNottinghamUK
| | - Laura Nellums
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
| | - Manpreet Bains
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
- The Nottingham Centre for Evidence‐Based Healthcare: a JBI Centre of ExcellenceNottinghamUK
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Hoosen M, Roman NV, Mthembu TG, Naseer M. Unani Tibb practitioners' perceptions and attitudes towards spirituality and spiritual care in Unani Tibb practice in South Africa. BMC Complement Med Ther 2023; 23:189. [PMID: 37296450 DOI: 10.1186/s12906-023-04002-y] [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] [Received: 01/21/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Unani Tibb is an Arabic term which means Greek medicine. It is an ancient holistic medical system based on the healing theories of Hippocrates, Galen and Ibn Sina (Avicenna). Despite this, spirituality and spiritual care practices are deficient in the clinical setting. METHODS This cross-sectional descriptive study was used to describe Unani Tibb practitioners' perceptions and attitudes regarding spirituality and spiritual care in South Africa. A demographic form, Spiritual Care-Giving Scale, Spiritual and Spiritual Care Rating Scale and Spirituality in Unani Tibb Scale were used to collect data. RESULTS A response rate of 64.7% (n = 44 out of 68) was achieved. Positive perceptions and attitudes regarding spirituality and spiritual care were recorded for Unani Tibb practitioners. The spiritual needs of their patients were considered vital towards enhancing the Unani Tibb treatment approach. Spirituality and spiritual care were regarded as fundamental to Unani Tibb therapy. However, most practitioners agreed that adequate training in spirituality and spiritual care was lacking and future training initiatives were imperative for Unani Tibb clinical practice in South Africa. CONCLUSION The findings of this study recommends further research in this field by means of qualitative and mixed methods approaches to provide a deeper understanding to this phenomenon. Clear guidelines on spirituality and spiritual care for Unani Tibb clinical practice are essential to ensure the integrity of the holistic approach required by the profession.
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Affiliation(s)
- Mujeeb Hoosen
- School of Natural Medicine, Faculty of Community and Health Sciences, The University of the Western Cape, Bellville, South Africa.
| | - Nicolette Vanessa Roman
- Centre for Interdisciplinary Studies of Children, Family and Society, Faculty of Community and Health Sciences, The University of the Western Cape, Bellville, South Africa
| | - Thuli Godfrey Mthembu
- Department of Occupational Therapy, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Mursaleen Naseer
- Department of Moalejat, Ajmal Khan Tibbiya College, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, India
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Viale M, Vicol M. Conserving traditional wisdom in a commodified landscape: Unpacking brand Ayurveda. J Ayurveda Integr Med 2022; 14:100667. [PMID: 36411197 PMCID: PMC10105222 DOI: 10.1016/j.jaim.2022.100667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/19/2022] Open
Abstract
As Ayurveda continues to gain global recognition as a sanctioned system of health care, the essence of Ayurveda's identity has become prey to commoditization and commodification for commercial undertakings in the holistic health milieu of India, but also in emerging markets such as Europe. This paper critically assesses the commodification of Ayurveda as a cultural signifier within Europe that separates the indigenous artefact from its Vedic origins. Often presented as an elite commodity in Western settings, Ayurveda has become embedded as a cultural artifact within consumer society as the epitome of holistic care with an emphasis on its spiritual attributes, yet simultaneously isolating it from the customary elements that motivated its inception. The paper argues that Ayurveda's discursive detachment from its ontological tenets facilitates its rearticulation as a malleable experience as it crosses national boundaries, and in this process fosters the misinterpretation of the ancient healing tradition. This process may provide Ayurvedic treatments and principles with increased visibility in Europe's health sector. However, brands are exploiting this niche with push-marketing strategies to capitalize on the budding Ayurveda industry, turning traditional medicines into emblematic commodities. To advance this argument, we examine product diversions in the commodification of classical Ayurvedic medicines in the Netherlands and Germany, focusing on the over-the-counter (OTC) segment. We present an interpretive analysis of the processes that are (de)constructing traditional practices and principles as Ayurveda travels beyond India, and how this complicates issues of authenticity and expertise as herbal medicines diverge from the indications ratified in Ayurveda's classical compendiums.
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Affiliation(s)
- Marine Viale
- Wageningen University, Hollandseweg 1, 6707KN, Wageningen, the Netherlands
| | - Mark Vicol
- Wageningen University, Hollandseweg 1, 6707KN, Wageningen, the Netherlands.
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A Buddhist Biography Project: Story-Telling, Spiritual Connection, and Intergenerational Exchange. RELIGIONS 2022. [DOI: 10.3390/rel13070576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This descriptive article discusses the development, delivery, and impact of the “Biography Project”. The project is a research and teaching initiative focused on both enhancing the quality of life of older persons, and providing university students across diverse degree programs the opportunity to learn about and engage first-hand with the challenges that confront older adults living in residential aged care. In accounting for the project and its objectives, the article explores the Buddhist values that underpin the project’s approach to teaching, and the important role of spirituality in training students to engage older people in telling the stories of their lives.
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Scherbaum CR, Frank T, Suárez V. [Severe lead poisoning caused by ayurvedic medicine]. Dtsch Med Wochenschr 2022; 147:253-257. [PMID: 35226924 DOI: 10.1055/a-1743-6718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
HISTORY We report the case of a young patient who presented to our emergency department with reduced general condition, anemia, and crampy abdominal pain. A previous inpatient workup including abdominal imaging and bone marrow aspiration had not yielded a diagnosis. On inquiry, the patient reported oral ingestion of an Ayurvedic remedy over the course of one month. FINDINGS 24-year-old circulatory stable patient in reduced general condition with gray skin coloration and a dark gingival margin. Laboratory testing revealed an increase in transaminases and normocytic anemia. A peripheral blood smear showed basophilic stippling of the erythrocytes. Significantly elevated lead levels were detected in the patient's blood and hair. Toxic lead levels were detected in the ingested preparation. DIAGNOSIS Severe lead poisoning caused by self-medication with an Ayurvedic remedy. Analysis revealed a daily oral lead load of 136 times the maximum permissible dose. THERAPY AND COURSE By means of chelation therapy, the blood lead levels were significantly reduced, and there was a complete regression of the complaints as well as a normalization of the laboratory findings. CONCLUSION Lead has toxic effects on all organ systems of the body and is stored in the bone for decades. Symptoms of poisoning are nonspecific; a thorough history and generous indication for measuring lead levels are helpful for the diagnosis.
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Affiliation(s)
- Christina Rebecca Scherbaum
- Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln
| | - Thorsten Frank
- Klinik für Innere Medizin II (Gastroenterologie und Hepatologie, Diabetologie und Stoffwechselstörungen), St.-Katharinen-Hospital Frechen
| | - Victor Suárez
- Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln.,Klinische Akut- und Notfallmedizin, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln
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Dutta T, Anand U, Saha SC, Mane AB, Prasanth DA, Kandimalla R, Proćków J, Dey A. Advancing urban ethnopharmacology: a modern concept of sustainability, conservation and cross-cultural adaptations of medicinal plant lore in the urban environment. CONSERVATION PHYSIOLOGY 2021; 9:coab073. [PMID: 34548925 PMCID: PMC8448427 DOI: 10.1093/conphys/coab073] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
The discipline 'urban ethnopharmacology' emerged as a collection of traditional knowledge, ancient civilizations, history and folklore being circulated since generations, usage of botanical products, palaeobotany and agronomy. Non-traditional botanical knowledge increases the availability of healthcare and other essential products to the underprivileged masses. Intercultural medicine essentially involves 'practices in healthcare that bridge indigenous medicine and western medicine, where both are considered as complementary'. A unique aspect of urban ethnopharmacology is its pluricultural character. Plant medicine blossomed due to intercultural interactions and has its roots in major anthropological events of the past. Unani medicine was developed by Khalif Harun Al Rashid and Khalif Al Mansur by translating Greek and Sanskrit works. Similarly, Indo-Aryan migration led to the development of Vedic culture, which product is Ayurveda. Greek medicine reached its summit when it travelled to Egypt. In the past few decades, ethnobotanical field studies proliferated, especially in the developed countries to cope with the increasing demands of population expansion. At the same time, sacred groves continued to be an important method of conservation across several cultures even in the urban aspect. Lack of scientific research, validating the efficiency, messy applications, biopiracy and slower results are the main constrains to limit its acceptability. Access to resources and benefit sharing may be considered as a potential solution. Indigenous communities can copyright their traditional formulations and then can collaborate with companies, who have to provide the original inventors with a fair share of the profits since a significant portion of the health economy is generated by herbal medicine. Search string included the terms 'Urban' + 'Ethnopharmacology', which was searched in Google Scholar to retrieve the relevant literature. The present review aims to critically analyse the global concept of urban ethnopharmacology with the inherent plurality of the cross-cultural adaptations of medicinal plant use by urban people across the world.
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Affiliation(s)
- Tusheema Dutta
- Ethnopharmacology and Natural Product Research Laboratory, Department of Life Sciences, Presidency University, 86/1 College Street, Kolkata, 700073, West Bengal, India
| | - Uttpal Anand
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Suchismita Chatterjee Saha
- Department of Zoology, Nabadwip Vidyasagar College (Affiliated to the University of Kalyani), Nabadwip, West Bengal, 741302, India
| | - Abhijit Bhagwan Mane
- Department of Zoology, Dr. Patangrao Kadam Mahavidyalaya, Sangli, (Affiliated to Shivaji University of Kolhapur), Maharashtra, 416308, India
| | - Dorairaj Arvind Prasanth
- Department of Microbiology, School of Biosciences, Periyar University, Salem, 636011, Tamilnadu, India
| | - Ramesh Kandimalla
- CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, 500007, Telangana, India
- Department of Biochemistry, Kakatiya Medical College, Warangal, 506007, Telangana, India
| | - Jarosław Proćków
- Department of Plant Biology, Institute of Environmental Biology, Wrocław University of Environmental and Life Sciences, Kożuchowska 5b, 51-631 Wrocław, Poland
| | - Abhijit Dey
- Ethnopharmacology and Natural Product Research Laboratory, Department of Life Sciences, Presidency University, 86/1 College Street, Kolkata, 700073, West Bengal, India
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Gyawali D, Vohra R, Orme-Johnson D, Ramaratnam S, Schneider RH. A Systematic Review and Meta-Analysis of Ayurvedic Herbal Preparations for Hypercholesterolemia. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:546. [PMID: 34071454 PMCID: PMC8229657 DOI: 10.3390/medicina57060546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/28/2021] [Accepted: 05/18/2021] [Indexed: 01/15/2023]
Abstract
Background and Objectives: Cardiovascular disease (CVD) is the leading cause of death globally and hypercholesterolemia is one of the major risk factors associated with CVD. Due to a growing body of research on side effects and long-term impacts of conventional CVD treatments, focus is shifting towards exploring alternative treatment approaches such as Ayurveda. However, because of a lack of strong scientific evidence, the safety and efficacy profiles of such interventions have not been well established. The current study aims to conduct a systematic review and meta-analyses to explore the strength of evidence on efficacy and safety of Ayurvedic herbs for hypercholesterolemia. Methods: Literature searches were conducted using databases including Medline, Cochrane Database, AMED, Embase, AYUSH research portal, and many others. All randomized controlled trials on individuals with hypercholesterolemia using Ayurvedic herbs (alone or in combination) with an exposure period of ≥ 3 weeks were included, with primary outcomes being total cholesterol levels, adverse events, and other cardiovascular events. The search strategy was determined with the help of the Cochrane Metabolic and Endocrine Disorders Group. Two researchers assessed the risk of each study individually and discrepancies were resolved by consensus or consultation with a third researcher. Meta-analysis was conducted using the inverse variance method and results are presented as forest plots and data summary tables using Revman v5.3. Results: A systematic review of 32 studies with 1386 participants found randomized controlled trials of three Ayurvedic herbs, Allium sativum (garlic), Commiphora mukul (guggulu), and Nigella sativa (black cumin) on hypercholesterolemia that met inclusion criteria. The average duration of intervention was 12 weeks. Meta-analysis of the trials showed that guggulu reduced total cholesterol and low-density lipoprotein levels by 16.78 mg/dL (95% C.I. 13.96 to 2.61; p-value = 0.02) and 18.78 mg/dL (95% C.I. 34.07 to 3.48; p = 0.02), respectively. Garlic reduced LDL-C by 10.37 mg/dL (95% C.I. -17.58 to -3.16; p-value = 0.005). Black cumin lowered total cholesterol by 9.28 mg/dL (95% C.I. -17.36, to -1.19, p-value = 0.02). Reported adverse side effects were minimal. Conclusion: There is moderate to high level of evidence from randomized controlled trials that the Ayurvedic herbs guggulu, garlic, and black cumin are moderately effective for reducing hypercholesterolemia. In addition, minimal evidence was found for any side effects associated with these herbs, positioning them as safe adjuvants to conventional treatments.
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Affiliation(s)
- Dinesh Gyawali
- College of Integrative Medicine, Maharishi International University, Fairfield, IA 52557, USA
| | - Rini Vohra
- School of Science of Consciousness, Maharishi University of Information Technology, Noida 201304, India;
| | | | | | - Robert H. Schneider
- College of Integrative Medicine, Maharishi International University, Fairfield, IA 52557, USA
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Joseph E, Voeks R. Indian Diaspora Gastronomy: On the Changing Use of Herbs and Spices Among Southern California's Indian Immigrant Women. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.610081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Southern California has witnessed a burgeoning Indian immigrant population in recent decades. And among the cultural features that most distinguishes Indians is their cuisine. Their use of herbs and spices in food and medicine, in particular, is tightly bound to language, religion, gender, and overall cultural identity. Identifying how Indian immigrants' culinary choices adapt to southern California's varied and often fast-food based gastronomy, particularly impacts on the inter-generational transmission of traditional culinary knowledge, is important in terms of understanding the role of cultural retention and assimilation, as well as culturally-defined notions of food in physical and psychological well-being. We explored these questions by means of interviews with 31 Indian immigrant women in southern California. Participants were selected by means of snowball sampling. Our working hypothesis was that problems with sourcing and cultural assimilation pressures would have eroded the use of traditional herbs and spices. A total of 66 herbs and spices (and associated seasonings) were reported. Of these, the highest frequency of use was recorded for turmeric (100% of respondents) followed by cilantro, cinnamon, clove, cumin, curry leaves, and ginger (all 97%). The highest Species Medicinal Use Values were recorded, in descending order, for turmeric, ginger, fenugreek seeds, clove, cinnamon, curry leaves, and Tulsi. Contrary to expectations, there was no significant association between years resident in the United States and decreasing use of herbs and spices. Indeed, in some cases the confluence of northern and southern Indian immigrant women with a new identity simply as “Indian” resulted in an increase in the knowledge and use of herbs and spices. Spices are nearly all locally sourced, and where specific herbs are not readily accessible, they are cultivated in homegardens or brought directly from India. Many Indian immigrants are relatively prosperous and able to travel frequently to and from India, thus maintaining close cultural ties with their homeland. Indian immigrant women are fully aware of the health benefits associated with the use of traditional herbs and spices, and all participants reported that Indian food is a healthier choice than American cuisine. Knowledge is passed via vertical transmission, primarily through mothers and grandmothers to daughters. Overall, there is little concern among female Indian immigrants to southern California that knowledge and use of their traditional herbs and spices are in a state of decline.
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Big Data Analysis of Traditional Knowledge-based Ayurveda Medicine. PROGRESS IN PREVENTIVE MEDICINE 2018. [DOI: 10.1097/pp9.0000000000000020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Juckel G, Hoffmann K. [The Indian Ayurveda medicine-a meaningful supplement to psychiatric treatment?]. DER NERVENARZT 2018; 89:999-1008. [PMID: 29876598 DOI: 10.1007/s00115-018-0538-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ayurveda is a traditional Indian system of medicine that is more than 3000 years old, consisting mostly of a specific diet, oily infusions mainly in the area of the head, enemas, medicinal plants and yoga. It is based on a naturopathic and anthropological belief in association with the hinduistic religion. Ayurveda has been practiced very successfully in India but so far it has only been insufficiently appreciated by western medicine, especially psychiatry. An exception is Scharfetter from Zürich who wrote a review article on this topic in 1976. Nevertheless, it is probable that particularly the immunological mechanisms of psychotic and affective disorders can be influenced by the application of ayurvedic methods; however, the empirical data source, particularly with respect to randomized controlled trials and meta-analyses regarding psychiatric disorder symptoms is limited. Even if Ayurveda is applied in a highly individualized manner, this should be rapidly improved for further evidential assessment. First positive experiences in the neuropsychiatric field in Germany are already available.
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Affiliation(s)
- G Juckel
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum Bochum der Ruhr-Universität Bochum, Alexandrinenstr. 1-3, 44791, Bochum, Deutschland.
| | - K Hoffmann
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum Bochum der Ruhr-Universität Bochum, Alexandrinenstr. 1-3, 44791, Bochum, Deutschland
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Traditional Knowledge-based Medicine: A Review of History, Principles, and Relevance in the Present Context of P4 Systems Medicine. PROGRESS IN PREVENTIVE MEDICINE 2017. [DOI: 10.1097/pp9.0000000000000011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kessler CS, Eisenmann C, Oberzaucher F, Forster M, Steckhan N, Meier L, Stapelfeldt E, Michalsen A, Jeitler M. Ayurvedic versus conventional dietary and lifestyle counseling for mothers with burnout-syndrome: A randomized controlled pilot study including a qualitative evaluation. Complement Ther Med 2017; 34:57-65. [PMID: 28917376 DOI: 10.1016/j.ctim.2017.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Ayurveda claims to be effective in the treatment of psychosomatic disorders by means of lifestyle and nutritional counseling. DESIGN In a randomized controlled study mothers with burnout were randomized into two groups: Ayurvedic nutritional counseling (according to tradition), and conventional nutritional counseling (following the recommendations of a family doctor). Patients received five counseling sessions over twelve weeks. MAIN OUTCOME MEASURES Outcomes included levels of burnout, quality of life, sleep, stress, depression/anxiety, and spirituality at three and six months. It also included a qualitative evaluation of the communication processes. RESULTS We randomized thirty four patients; twenty three participants were included in the per protocol analysis. No significant differences were observed between the groups. However, significant and clinically relevant intra-group mean changes for the primary outcome burnout, and secondary outcomes sleep, stress, depression and mental health were only found in the Ayurveda group. The qualitative part of the study identified different conversational styles and counseling techniques between the two study groups. In conventional consultations questions tended to be category bound, while counseling-advice was predominantly admonitory. The Ayurvedic practitioner used open-ended interrogative forms, devices for displaying understanding, and positive re-evaluation more frequently, leading to an overall less asymmetrical interaction. CONCLUSIONS We found positive effects for both groups, which however were more pronounced in the Ayurvedic group. The conversational and counseling techniques in the Ayurvedic group offered more opportunities for problem description by patients as well as patient-centered practice and resource-oriented recommendations by the physician. TRIAL REGISTRATION NCT01797887.
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Affiliation(s)
- Christian S Kessler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany
| | - Clemens Eisenmann
- University of Konstanz, Department of History and Sociology, Konstanz, Germany
| | - Frank Oberzaucher
- University of Konstanz, Department of History and Sociology, Konstanz, Germany
| | - Martin Forster
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Nico Steckhan
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Larissa Meier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany
| | - Elmar Stapelfeldt
- Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany
| | - Andreas Michalsen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany
| | - Michael Jeitler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany.
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Baars EW, Hamre HJ. Whole Medical Systems versus the System of Conventional Biomedicine: A Critical, Narrative Review of Similarities, Differences, and Factors That Promote the Integration Process. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2017; 2017:4904930. [PMID: 28785290 PMCID: PMC5530407 DOI: 10.1155/2017/4904930] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/10/2017] [Accepted: 06/08/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is an increasing need for a worldwide professional integration of conventional medicine and traditional/complementary whole medical systems (WMSs). However, the integration is perceived by conventional medicine as problematic or unacceptable, because of a supposed lack of evidence for specific effects of WMSs therapies and supposed prescientific or unscientific paradigms of WMSs. OBJECTIVES To review the literature on the features of WMSs, similarities and differences between conventional medicine and WMSs, and scientific and clinical practice issues that should be dealt with in order to promote the integration process. METHODS A critical, narrative review of the literature on six WMSs. RESULTS AND CONCLUSIONS Key factors for the integration of WMSs and conventional medicine are as follows: legal frameworks, quality standards, high-quality research on safety and efficacy of WMS interventions, infrastructure, and financial resources. For scientific assessment of WMSs, there are unresolved ontological, epistemological, and methodological issues and issues of diagnostics, therapy delivery, and outcome assessment in clinical practice. Future research not only should be directed at quality assurance and generating the necessary data on safety and efficacy/effectiveness but also should address more fundamental (ontological, epistemological, and methodological) issues, in order to overcome the differences between WMSs and conventional medicine.
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Affiliation(s)
- Erik W. Baars
- European Scientific Cooperative on Anthroposophic Medicinal Products (ESCAMP), Zechenweg 6, 79111 Freiburg, Germany
- Louis Bolk Institute, Hoofdstraat 24, 3972 LA Driebergen, Netherlands
- University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK Leiden, Netherlands
| | - Harald J. Hamre
- European Scientific Cooperative on Anthroposophic Medicinal Products (ESCAMP), Zechenweg 6, 79111 Freiburg, Germany
- Institute for Applied Epistemology and Medical Methodology, Witten/Herdecke University, Zechenweg 6, 79111 Freiburg, Germany
- Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
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Sagner M, McNeil A, Puska P, Auffray C, Price ND, Hood L, Lavie CJ, Han ZG, Chen Z, Brahmachari SK, McEwen BS, Soares MB, Balling R, Epel E, Arena R. The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan. PROGRESS IN PREVENTIVE MEDICINE 2017. [DOI: 10.1097/pp9.0000000000000002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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16
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Sagner M, McNeil A, Puska P, Auffray C, Price ND, Hood L, Lavie CJ, Han ZG, Chen Z, Brahmachari SK, McEwen BS, Soares MB, Balling R, Epel E, Arena R. The P4 Health Spectrum - A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan. Prog Cardiovasc Dis 2016; 59:506-521. [PMID: 27546358 DOI: 10.1016/j.pcad.2016.08.002] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/10/2016] [Indexed: 02/06/2023]
Abstract
Chronic diseases (i.e., noncommunicable diseases), mainly cardiovascular disease, cancer, respiratory diseases and type-2-diabetes, are now the leading cause of death, disability and diminished quality of life on the planet. Moreover, these diseases are also a major financial burden worldwide, significantly impacting the economy of many countries. Healthcare systems and medicine have progressively improved upon the ability to address infectious diseases and react to adverse health events through both surgical interventions and pharmacology; we have become efficient in delivering reactive care (i.e., initiating interventions once an individual is on the verge of or has actually suffered a negative health event). However, with slowly progressing and often 'silent' chronic diseases now being the main cause of illness, healthcare and medicine must evolve into a proactive system, moving away from a merely reactive approach to care. Minimal interactions among the specialists and limited information to the general practitioner and to the individual receiving care lead to a fragmented health approach, non-concerted prescriptions, a scattered follow-up and a suboptimal cost-effectiveness ratio. A new approach in medicine that is predictive, preventive, personalized and participatory, which we label here as "P4" holds great promise to reduce the burden of chronic diseases by harnessing technology and an increasingly better understanding of environment-biology interactions, evidence-based interventions and the underlying mechanisms of chronic diseases. In this concept paper, we propose a 'P4 Health Continuum' model as a framework to promote and facilitate multi-stakeholder collaboration with an orchestrated common language and an integrated care model to increase the healthspan.
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Affiliation(s)
- Michael Sagner
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA; SARENA Clinic, Medical Center and Research Institute.
| | - Amy McNeil
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Pekka Puska
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Charles Auffray
- European Institute for Systems Biology and Medicine, Paris and Lyon, France
| | | | - Leroy Hood
- Institute for Systems Biology, Seattle, WA, USA
| | - Carl J Lavie
- Department of Cardiovascular Diseases, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | - Ze-Guang Han
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhu Chen
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Samir Kumar Brahmachari
- Academy of Scientific and Innovative Research, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Bruce S McEwen
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY, USA
| | | | - Rudi Balling
- Luxembourg Centre for Systems Biomedicine (LCSB), Esch-sur-Alzette, Luxembourg
| | - Elissa Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Ross Arena
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA; SARENA Clinic, Medical Center and Research Institute
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17
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Niemi M, Ståhle G. The use of ayurvedic medicine in the context of health promotion--a mixed methods case study of an ayurvedic centre in Sweden. Altern Ther Health Med 2016; 16:62. [PMID: 26888547 PMCID: PMC4756420 DOI: 10.1186/s12906-016-1042-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 02/12/2016] [Indexed: 11/25/2022]
Abstract
Background Ayurveda has its historical roots in India, but has also been internationalised, partly via migration and partly through an increased interest in alternative medicine in the West, where studies point toward increased use. However, there is to date scarce knowledge about the use and experiences of ayurveda in Sweden. Methods We have conducted a case study of a center for ayurvedic healthcare in Sweden. We have collected information on client background data from the center’s documentation, and compiled data from all clients who visited the centre for ayurvedic consultation during spring 2014. In total, 55 individuals were included in the study, and 18 of them were chosen for individual semi-structured interviews, to gain a deeper understanding of their motives for seeking, and experiences of ayurvedic health care. The material was analysed and compiled through a mix of qualitative and quantitative methods. Results Among the 55 clients, 91 % were female the mean age was 47 years, and 64 % gave a specific illness as a reason for seeking ayurveda. The most common illnesses were respiratory, musculoskeletal, circulatory, tumor, and cutaneous illnesses. The qualitative results showed that ayurveda was being used in combination with other methods, including various diets, other alternative medicine methods and conventional medicine. Some participants recounted having sought ayurveda as a complement to conventional medicine, or in cases when conventional medicine had been experienced as insufficient in terms of diagnosis or treatment. However, some participants experienced it as difficult to follow the ayurvedic life-style advice in the midst of their everyday life. Many participants reported positive experiences of pulse diagnostics, which was the main diagnostic method used in ayurvedic consultation. Some reported concrete, physical improvement of their symptoms. Conclusions This study points towards important aspects of participant experience of ayurveda, that may be subject to further research. The positive effects experienced by some clients should be studied more systematically in order to discern whether they are specific or non-specific. In addition, interesting knowledge may be gained through further study of the reported positive experiences of pulse diagnosis.
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Gyawali D, Schneider RH, Orme-Johnson DW, Ramaratnam S. Ayurvedic herbal preparations for hypercholesterolaemia. Hippokratia 2016. [DOI: 10.1002/14651858.cd012076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Dinesh Gyawali
- Maharishi University of Management; Department of Physiology and Health; MR 515, 1000 North Fourth Street Fairfield Iowa USA 52557
| | - Robert H Schneider
- Maharishi University of Management; Institute for Natural Medicine and Prevention/Department of Physiology and Health; Fairfield Iowa USA 52556
| | | | - Sridharan Ramaratnam
- SIMS Hospitals; Department of Neurology; 100 feet Road Vadapalani Chennai Tamil Nadu India 600026
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Angeletti M. Opposites attract: holistic emotional regulation using dance/movement therapy and the doshas in Ayurveda. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2016. [DOI: 10.1080/17432979.2015.1106977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Phytochemical Profile and Biological Activity of Nelumbo nucifera. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:789124. [PMID: 27057194 PMCID: PMC4710907 DOI: 10.1155/2015/789124] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 11/29/2015] [Accepted: 12/07/2015] [Indexed: 12/30/2022]
Abstract
Nelumbo nucifera Gaertn. (Nymphaeaceae) is a potential aquatic crop grown and consumed throughout Asia. All parts of N. nucifera have been used for various medicinal purposes in various systems of medicine including folk medicines, Ayurveda, Chinese traditional medicine, and oriental medicine. Many chemical constituents have been isolated till the date. However, the bioactive constituents of lotus are mainly alkaloids and flavonoids. Traditionally, the whole plant of lotus was used as astringent, emollient, and diuretic. It was used in the treatment of diarrhea, tissue inflammation, and homeostasis. The rhizome extract was used as antidiabetic and anti-inflammatory properties due to the presence of asteroidal triterpenoid. Leaves were used as an effective drug for hematemesis, epistaxis, hemoptysis, hematuria, and metrorrhagia. Flowers were used to treat diarrhea, cholera, fever, and hyperdipsia. In traditional medicine practice, seeds are used in the treatment of tissue inflammation, cancer and skin diseases, leprosy, and poison antidote. Embryo of lotus seeds is used in traditional Chinese medicine as Lian Zi Xin, which primarily helps to overcome nervous disorders, insomnia, and cardiovascular diseases (hypertension and arrhythmia). Nutritional value of lotus is as important as pharmaceutical value. These days' different parts of lotus have been consumed as functional foods. Thus, lotus can be regarded as a potential nutraceutical source.
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Kessler C, Stapelfeldt E, Michalsen A, Kowalcek I, Kronpaß L, Dhruva A. The Effect of a Complex Multi-modality Ayurvedic Treatment in a Case of Unknown Female Infertility. Complement Med Res 2015; 22:251-8. [PMID: 26278074 DOI: 10.1159/000437376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Treatment of female infertility has been growing globally in recent years. In spite of improvements in medical strategies and the improved outcomes for infertile couples, treatment attempts remain largely unsuccessful. A growing number of patients pursue complementary and alternative medicine treatment options like Ayurveda that offers a variety of inpatient and outpatient treatments for infertility. CASE REPORT A case of a 38 year-old woman with infertility of unknown origin is presented. She received 18 conventional fertility treatments in 5 different fertility centers and 3 different countries. After several complications, the patient quitted conventional treatment and admitted to an Ayurvedic outpatient clinic where she received a complex Ayurvedic treatment, which included botanicals, dietary and lifestyle advice, manual therapy, yoga, and spiritual elements. The patient then became pregnant and gave birth to a healthy boy in 2012. CONCLUSIONS Ayurveda may be a useful complementary option in the case of futile conventional treatment attempts in female infertility. Nevertheless, the evidence base for Ayurvedic interventions remains weak and requires well-designed clinical trials. This case raises some questions, such as whether the exposure to a large number of assisted reproduction procedures can lead to more health problems than health benefits. The Ayurvedic approach to fertility strives first to improve the health of the patient leading to a higher likelihood of pregnancy. As this is a case report, we are not able to exclude temporal factors stimulating the pregnancy. However, the chronology suggests that this approach might have been an important factor in the eventual pregnancy.
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Affiliation(s)
- Christian Kessler
- Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany
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A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:613182. [PMID: 26339267 PMCID: PMC4539059 DOI: 10.1155/2015/613182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 04/02/2015] [Accepted: 04/02/2015] [Indexed: 12/14/2022]
Abstract
Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.
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