Prevalence of complementary and alternative medicine (CAM) use in Brazil

A new methodology for a rapid and high-throughput comparison of molecular profiles and biological activity of phytoextracts

To robustly discover and explore phytocompounds, it is necessary to evaluate the interrelationships between the plant species, plant tissue, and the extraction process on the extract composition and to predict its cytotoxicity. The present work evaluated how Fourier Transform InfraRed spectroscopy can acquire the molecular profile of aqueous and ethanol-based extracts obtained from leaves, seeds, and flowers of Cynara Cardunculus, and ethanol-based extracts from Matricaria chamomilla flowers, as well the impact of these extracts on the viability of mammalian cells. The extract molecular profile enabled to predict the extraction yield, and how the plant species, plant tissue, and extraction process affected the extract's relative composition. The molecular profile obtained from the culture media of cells exposed to extracts enabled to capture its impact on cells metabolism, at a higher sensitivity than the conventional assay used to determine the cell viability. Furthermore, it was possible to detect specific impacts on the cell's metabolism according to plant species, plant tissue, and extraction process. Since spectra were acquired on small volumes of samples (25 µL), after a simple dehydration step, and based on a plate with 96 wells, the method can be applied in a rapid, simple, high-throughput, and economic mode, consequently promoting the discovery of phytocompounds.

Historical Perspective of Homeopathy in the Brazilian Public Health System

Homeopathy was introduced in Brazil with the French doctor Benoît Jules Mure's arrival in 1840 and was officially recognised in 1980 as a medical specialty by Brazilian regulatory authorities. Public health policies played an important role in incorporating homeopathy into the Brazilian Unified Health System (SUS), emphasising homeopathy's coherence with SUS's fundamental principles and with other national health policies. Homeopathy is supported by the guidelines of the National Primary Health Care Policy and the National Policy on Integrative and Complementary Practices, and its offer in the SUS has been recognised since 2006. Challenges persist, however, such as the low prevalence of the use of homeopathy, lack of investment in professional training and under-reporting of homeopathy outpatient appointments. Investments in disseminating information on homeopathic philosophy and raising awareness among managers and health professionals are essential to strengthen its presence in the Brazilian public health system.

Sleep During Menopause

Postmenopause is defined retrospectively after 12 consecutive months of amenorrhea. It represents the end of the reproductive period and ovarian failure. A decrease in estrogen leads to several changes in the short and long term. Among the early changes, vasomotor symptoms (hot flashes) are particularly common, occurring in about 70% of women. In addition, there are changes in mood, anxiety, depression, and insomnia. Insomnia occurs in almost 60% of postmenopausal women. Psychosocial aspects may also affect sleep. Proper diagnosis may lead to adequate treatment of sleep disturbances during menopause. Hormonal or other complementary therapies can improve sleep quality.

Sustaining Traditional Ethnomedicinal Knowledge and Protected Areas in Synergy: A Case Study of Overa-Aru Wildlife Sanctuary in Kashmir Himalaya

The ethnic communities living near protected areas are critically dependent on medicinal plants for their healthcare. Although several ethnomedicinal studies are available from the Himalaya, quantitative studies focusing on protected areas in this region are largely overlooked. In this study, we aimed to document the ethnomedicinal plants of the Overa-Aru wildlife sanctuary in Kashmir Himalaya. We conducted a systematic field survey in the study area during 2020 - 2021 to collect primary data from 110 participants through semi-structured interviews and questionnaires. The data was analyzed using quantitative indices and Pearson's correlation. We recorded 64 plant species used against 8 human disease categories, including some first-time reports from the region. Asteraceae and Lamiaceae were the most dominant families and herbs were the dominant growth form. The most common plant part used were leaves, and the main method of preparation was decoction. Plant species with the highest relative frequency of citation was Achillea millifolium (0.83). Informant consensus factor for each disease category ranged from 0.94 to 0.97. We found a strong positive correlation between participants' age and citations (r = 0.85), but a negative correlation between the participants' education status and citations (r = - 0.11). Our results revealed that the younger generation possesses the least ethnomedicinal information. We recommend that the species with high use values and fidelity level merit priority in phytochemical and pharmaceutical studies. Our findings highlight that protected areas, besides their prime importance in biodiversity conservation, play a pivotal role in providing the healthcare provisioning ecosystem services to the ethnic communities.

Assessing the safety and use of medicinal herbs during pregnancy: a cross-sectional study in São Paulo, Brazil

Background: Despite the lack of evidence supporting the safety and clinical efficacy of herbal medicine (HM), its use among pregnant women continues to increase. Given the high prevalence of contraindicated herbs among the pregnant population in Brazil, it is crucial to examine the use of HM and evaluate its safety based on the current scientific literature to ensure that women are using HM appropriately. Methods: A cross-sectional study was conducted from October 2022 to January 2023 at a public teaching hospital in São Paulo, Brazil. A total of 333 postpartum women in the postnatal wards and postnatal clinic were interviewed using a semi-structured questionnaire. The survey instrument consisted of 51 items covering the use of HM during pregnancy, sociodemographic and health-related characteristics, COVID-19 experiences, and pregnancy outcomes. For data analysis, chi-square and multivariate logistic regression were conducted using SPSS ver. 26.0. Results: Approximately 20% of respondents reported using HM during their most recent pregnancy, with a higher use observed among women from ethnic minority groups and those with prior HM experience. Among the 20 medicinal herbs identified, 40% were found to be contraindicated or recommended for use with caution during pregnancy. However, only half of the women discussed their HM use with obstetric care providers. Conclusion: This study emphasizes the continued public health concern regarding the use of contraindicated or potentially harmful HM among pregnant women in Brazil, highlighting the need for sustained efforts to reduce the risk of inappropriate HM use. By updating antenatal care guidelines based on the latest scientific evidence, healthcare providers can make informed clinical decisions and effectively monitor pregnant women's HM use, ultimately promoting safer and more effective healthcare practices.

Inequalities in access to integrative and complementary health practices in Brazil: National Health Survey, 2019

Aim

Integrative and complementary practices (PICs) can be important health care strategies, mainly because they consider the integrality of the person. The objective of this article was to verify the inequality in the access to PICs of the Brazilian population based on data from the National Health Survey (PNS).

Subject and methods

This is a population-based cross-sectional study, with data from the 2019 PNS. The use of PICs in the past 12 months was investigated. Adjusted analysis was performed using Poisson regression and the Slope Index of Inequality (SII) and the Concentration Index (CIX) were used to assess absolute and relative inequality.

Results

The prevalence of PIC use in Brazil was 5.4% (95%CI 5.3; 5.5). Individuals from the richest quintile, with higher education and with health insurance were more likely to use PICs in general, except for medicinal plants/herbal medicine. When observing the magnitude of inequalities, this was more positively accentuated in those with higher education and who had a private health plan.

Conclusion

The results reveal social inequalities in the access to integrative practices, where the most elitist are more accessed by people with better socioeconomic conditions.

Perceptions of Health Professionals on the Implementation of Integrative and Complementary Practices at a University Pediatric Hospital in Brazil: A Qualitative Interview Study

BACKGROUND

Despite an increase in use of pediatric complementary and integrative health (PCIH), many healthcare professionals still have an inadequate understanding of such practices and consider their use inappropriate, which might thwart implementation processes. In a qualitative interview study we examined the feedback of conventional healthcare professionals about the integrative practices provided to pediatric patients by an integrative team in a pediatric oncological hospital.

METHODS

Fifteen semi-structured interviews were carried out with various conventional healthcare professionals in an university pediatric hospital in São Paulo, Brazil. The interviews were audio-recorded, transcribed and pseudonymized. DSCsoft® and MAXQDA® software assisted in a profound qualitative analysis using the collective subject discourse and thematic analysis method in order to display participants' perspectives on PCIH and the project in their hospital.

RESULTS

Interviewees acknowledged their lack of knowledge about PCIH practices and reflected on the limits of their care as well as on new possibilities PCIH could offer. PCIH was perceived by interviewees as an effective supportive tool of care to promote patients' wellbeing, assist overall compliance, strengthen cooperation between professionals, children and their relatives and hence facilitated general patient care. Since PCIH was implemented in their clinic, perceptions led interviewees to wish for increased PCIH offering and a more profound integration of its therapists into the standard of care.

DISCUSSION

The coexistence of integrative and conventional practices in the conventional healthcare setting is important to give visibility to the possibilities offered by the integrative pediatrics field. Regular and constant encounters with integrative practices, as well as information access seem crucial to reach a wider openness for PCIH and subsequently a broader application and dissemination of it.

Prevalence and associated factors with homeopathy use in Brazil: a population-based study

Despite the controversy about its efficacy, homeopathy is considered a medical practice alternative to the conventional medical model. Prevalence of homeopathy use varies greatly among countries and the literature has conflicting evidence about the relation between sociodemographic factors and health conditions associated with homeopathy use. We aim to estimate the prevalence of homeopathy use and its association with self-perceived health status, depression, and sociodemographic factors. We used data from 90,846 participants in the 2019 Brazilian National Survey of Health (PNS 2019), a population-based study with complex and probabilistic sampling. Sociodemographic and clinical data and information on homeopathy use during the last 12 months were collected. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression. All variables were categorized. Logistic regression models were built to obtain crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI). The prevalence of homeopathy use was 0.99% (95%CI: 0.98-1.00). In the adjusted analysis, the following variables were associated with higher use of homeopathy: female gender, age above 51 years, white ethnicity, higher socioeconomic and educational attainment, residence in Southern/Southeastern Brazil, poorer self-reported health status, and depression. Brazil shows increased offer of complementary medicine, including homeopathy. Nevertheless, the use of homeopathy treatment is very low and clearly associated with a higher socioeconomic status, poorer self-reported health status, and depression.

Evaluation of the healing properties of Garcinia brasiliensis extracts in a cutaneous wound model

ETHNOPHARMACOLOGICAL RELEVANCE

Wound healing is a complex process that can leave pathological scars, especially in case of infections from opportunistic microorganisms. In this context, herbal medicines open up great possibilities for investigation. One of the species of interest native to Brazil is Garcinia brasiliensis ("bacupari"). Traditionally known for treating wounds and ulcers, G. brasiliensis presents anti-inflammatory, antioxidant and antimicrobials properties. But, its wound healing profile in experimental models, in order to validate its efficacy, is still litle studied.

AIM OF THE STUDY

Thus, the objective of this work was to evaluate, in an infected cutanous wound model, the potential of formulations incorporated with G. brasiliensis leaves extracts.

MATERIALS AND METHODS

Crude extract (CE), Ethyl Acetate Fraction (EAF) and Hexanic Fraction (HF) were submitted to phytochemical assays, high performance thin layer chromatography (HTPLC) and cytotoxicity studies. CE and EAF were also tested for microbicidal properties and incorporated in cream and gel formulations at 10% concentration. After stability testing, the gel formulations with CE or EAF at 10% were selected and applied to skin wounds infected or not with Staphylococcus aureus in Wistar rats. The healing potenttial of the extracts was verified by the expression of the protein Annexin A1 (AnxA1), related to the processes of inflammation and antifibrotic function, the cells immunostaining for Gasdermin-D (GSDM-D), a marker of pyroptotic cell death, and the dosage of interleukin-10 (IL-10) and monocyte chemotactic protein (MCP)-1 inflammatory mediators.

RESULTS

Phytochemical studies indicated the presence of compounds of pharmacological interest, including Catechin, Quercetin and Berberine in addition to low cytotoxicity of CE and EAF at 10%. After the 6-day topical treatments, CE and EAF gel formulations demonstrated to control the pruritus formation process. The treatments decreased AnxA1 expression and the amount of cells immunostained for GSDM-D, and increased the expression of MCP-1 in infected wounds.

CONCLUSIONS

Together, the results show important anti-inflammatory profile and skin healing potential of CE and EAF from G. brasiliensis leaves, even in infected lesions, with therapeutic perspectives.

Prevalence of complementary and alternative medicine use in Brazil: results of the National Health Survey, 2019

BACKGROUND

In recent decades, it has been possible to observe an increase in Complementary and Alternative Medicine (CAM) usage globally for both disease prevention and health promotion purposes. we aim to estimate the prevalence of CAM use and analyze associated factors in Brazil.

METHODS

Observational study with data from the 2019 National Health Survey that evaluated a sample of Brazilian adults. The outcome was CAM use, such as acupuncture, homeopathy, medicinal plants and herbal medicines, meditation, and yoga in the last 12 months. A logistic regression model with a 99% confidence interval was used to assess factors associated with CAM use.

RESULTS

The prevalence of CAM use in 2019 was 5.2% (CI99% = 4.8-5.6%), the most used modalities: medicinal plants and herbal medicines, with a prevalence of 3.0% (CI99% = 2.7-3.33) followed by: acupuncture 1.4% (CI99% = 1.3-1.6) homeopathy 0.9% (CI99% = 0.7-1.0), meditation 0.7% (CI99% = 0.6-0.8) and yoga 0.4% (CI99% = 0.4-0.5). We observed important geographical differences in CAM use in Brazil, with a higher prevalence in the North Region, 3.7% (CI99% = 2.81-4.75), where herbal medicines were more frequent the in the other regions. After estimating an adjusted model, women, older people, and people with a higher level of education and per capita income were the ones who used all types of CAM the most. The practice of yoga stands out among women 3.6% (CI99% = 2.49-5.28) and among individuals with higher per capita income 7.5% (CI99% = 2.97-18.93); meditation among individuals with higher educational level 13.4% (CI99% = 6.41-28.33) and acupuncture for those who declared regular or poor health 1.9% (CI99% = 1.51-2.39).

CONCLUSIONS

We recommend that the Ministry of Health expand CAM access to Unified Health System users and promote health professionals' conscious and guided use for the Brazilian population.

COMPLEMENTARY AND ALTERNATIVE MEDICINE USE IN BRAZILIAN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

BACKGROUND

The conventional treatment of inflammatory bowel disease (IBD) is based on drug therapy, but different studies have shown a progressive increase in the use of complementary and alternative medicine (CAM). The most used CAM comprises of acupuncture, traditional Chinese medicine, Ayurvedic medicine, homeopathy, and herbal medicine, as well as more modern practices, including aromatherapy and reflexology. Data from CAM use in Brazil has previously been scarce and there are no studies among Brazilian patients with IBD.

OBJECTIVE

The aim of the study was to evaluate the frequency of, and factors associated with the use of CAM among IBD patients in Brazil, in addition to estimating the satisfaction with CAM use.

METHODS

A cross-sectional study was performed in adult IBD outpatients from two Southeastern Brazilian referral centers, with a total a sample of 227 individuals. A semi-structured questionnaire was used containing CAM products - tea, probiotics, omega 3 or glutamine, homeopathy, and herbal therapy, and factors associated with CAM use and patient satisfaction. We used descriptive statistics, association tests (P<0.05) and logistic regression for statistical analyses.

RESULTS

In total, 126 patients with Crohn's disease and 101 with ulcerative colitis were included. The mean age was 41.19±14.49 years and 57.27% were female. The time since diagnosis was 10.58±7.5 years, and most patients were in clinical remission. Twenty-nine patients (12.8%) reported having used CAM for IBD treatment, such as tea (5.29%), probiotics (5.29%), omega-3 or glutamine (1.76%), homeopathy (0.88%), and herbal therapies (0.44%). Despite the low frequency, patients were satisfied (>50%). There was no difference between CAM use in Crohn's disease as compared to ulcerative colitis patients (P=0.1171). The factors associated with the use of CAM were regular or poor quality of life (odds ratio 2.084; 95% confidence interval 1.147-3.786, P=0.0159) and a shorter time since diagnosis (odds ratio 0.956; 95% confidence interval 0.918-0.995; P=0.0260).

CONCLUSION

The prevalence of CAM use was low, but satisfactory among Brazilian IBD patients. The application of CAM has been associated with poor quality of life and shorter disease duration compared to patients with no use of CAM.

Semeando saúde

Problema: Atualmente, o paradigma da produção de saúde é prodigalizado por uma miríade de interesses mercantis galanteadores do modelo biomédico, que supervaloriza o conhecimento científico moderno. Mesmo que seja desprestigiado pela soberania científica, cerca de 70% do uso popular das plantas medicinais é confirmado cientificamente, e esses saberes não institucionais são frequentes nas práticas cotidianas. Segundo dados da Organização Mundial da Saúde (OMS), 80% da população de países em desenvolvimento utiliza-se de práticas tradicionais na atenção primária à saúde e, desse total, 85% fazem uso de plantas medicinais. No Brasil, 82% dos brasileiros usam produtos à base de plantas medicinais para cuidar da saúde. Perante este descompasso, a atenção primária à saúde destaca-se como espaço estratégico para adubar o terreno das práticas fitoterápicas. Metodologia: Trata-se de um estudo descritivo, qualitativo, do tipo relato de experiência, sobre o desenvolvimento de um jardim medicinal localizado numa Unidade de Saúde da Família do município de Recife, Pernambuco. Utilizou-se um registro sistemático das atividades por meio da confecção de um diário de campo com registro fotográfico, complementado por levantamento bibliográfico e pesquisa documental. Resultados: O projeto perpassou pelas etapas informacional, estrutural e de plantio, constelando vários saberes com base no espírito da multiprofissionalidade e da participação comunitária. Ao fim, os esforços culminaram na efetivação de um jardim medicinal, propiciando um espaço para a troca de conhecimentos e experiências. Conclusão: Conclui-se que a estruturação de um jardim medicinal no âmbito da atenção primária à saúde conclama um prodigioso potencial no fortalecimento dos princípios que norteiam esse nível de atenção, reposicionando o usuário no centro do modelo de cuidado e ampliando as opções terapêuticas eficazes e de baixo custo.

Integrative oncology: Addressing the global challenges of cancer prevention and treatment

The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.

Complementary and Integrative Medicine in academic health education

OBJECTIVE

To analyze academic education in Complementary and Integrative Medicine (CIM) according to university students from the health area.

METHODS

Cross-sectional study with 1399 students from six public and private Brazilian universities, with online and in-person collection of socioeconomic, demographic, educational and academic data, carried out in 2019. The bivariate analysis was applied for the outcome "presence of CIM in academic health education", using the SPSS Statistic program, version 23.0™.

RESULTS

The prevalence of the presence of CIM in academic health education was 52.3%, being 31.1% in the compulsory and 8% in the non-compulsory curricular education, 2.0% in scientific research and 4.7% in university extension activities. There was an association of the outcome with knowledge of the national CIM policy (OR = 5.258; p = 0.000), of which knowledge can be indicated and used in one's professional area (OR = 4.836; p = 0.000), interest and/or use of CIM by the teachers/tutors of the course (OR = 3.955; p = 0.000), stimulus by the university to carry out scientific research (OR = 3.277; p = 0.000) and university extension projects with CIM (OR = 3.686; p = 0.000).

CONCLUSION

Academic education using CIM in health area courses is not very prevalent in teaching, research and university extension in Brazil, but when present in the curricular and non-curricular educational processes, it shows a significant association with knowledge, skills and their use by university students. The creation of a National Educational Planning in CIM is a vital imperative.

Natural Compounds With Antimicrobial and Antiviral Effect and Nanocarriers Used for Their Transportation

Due to the increasing prevalence of life-threatening bacterial, fungal and viral infections and the ability of these human pathogens to develop resistance to current treatment strategies, there is a great need to find and develop new compunds to combat them. These molecules must have low toxicity, specific activity and high bioavailability. The most suitable compounds for this task are usually derived from natural sources (animal, plant or even microbial). In this review article, the latest and most promising natural compounds used to combat bacteria, filamentous fungi and viruses are presented and evaluated. These include plant extracts, essential oils, small antimicrobial peptides of animal origin, bacteriocins and various groups of plant compounds (triterpenoids; alkaloids; phenols; flavonoids) with antimicrobial and antiviral activity. Data are presented on the inhibitory activity of each natural antimicrobial substance and on the putative mechanism of action against bacterial and fungal strains. The results show that among the bioactive compounds studied, triterpenoids have significant inhibitory activity against coronaviruses, but flavonoids have also been shown to inhibit SARS-COV-2. The last chapter is devoted to nanocarriers used to improve stability, bioavailability, cellular uptake/internalization, pharmacokinetic profile and reduce toxicity of natural compunds. There are a number of nanocarriers such as liposomes, drug delivery microemulsion systems, nanocapsules, solid lipid nanoparticles, polymeric micelles, dendrimers, etc. However, some of the recent studies have focused on the incorporation of natural substances with antimicrobial/antiviral activity into polymeric nanoparticles, niosomes and silver nanoparticles (which have been shown to have intrinsic antimicrobial activity). The natural antimicrobials isolated from animals and microorganisms have been shown to have good inhibitory effect on a range of pathogens, however the plants remain the most prolific source. Even if the majority of the studies for the biological activity evaluation are in silico or in vitro, their internalization in the optimum nanocarriers represents the future of “green therapeutics” as shown by some of the recent work in the field.

Self-Healing: A Concept for Musculoskeletal Body Pain Management - Scientific Evidence and Mode of Action

Traditionally, musculoskeletal pain management has focused on the use of conventional treatments to relieve pain. However, multi-modal integrative medicine including alternative/complementary treatments is becoming more widely used and integrated into treatment guidelines around the world. The uptake of this approach varies according to country, with generally a higher uptake in developed countries and in females aged more than 40 years. Integral to the concept described here, is that the body has an innate ability to self-heal, which can be optimized by the use of integrative medical strategies. Stress triggers for acute or recurring musculoskeletal pain are diverse and can range from physical to psychological. The mechanism by which the body responds to triggers and initiates the self-healing processes is complex, but five body networks or processes are thought to be integral: the nervous system, microcirculation/vasodilation, immune modulation, muscular relaxation/contraction and psychological balance. Multi-modal integrative medicine approaches include nutritional/dietary modification, postural/muscular training exercises, and cognitive behavioral mind/body techniques. This article will review the self-healing concept and provide plausible scientific evidence where available.

Traditional and Complementary Medicine use and beliefs during COVID-19 outbreak: A cross-sectional survey among the general population in Turkey

Objective

Coronavirus disease 2019 (COVID-19) caused a universal psychosocial impact, with many individuals exposed to threats preferring to try self-care interventions and non-conventional approaches such as traditional and complementary medicine (T&CM) for preventive purposes. This study was conducted to determine the use of and beliefs about T&CM among a subset of the general Turkish population during the COVID-19 outbreak.

Method

A cross-sectional online survey was carried out among the general population (aged ≥ 18 years) of Adana, Turkey during the strict lockdown period (April 11 to April 30, 2020). The survey instrument included details about sociodemographic characteristics, general information, T&CM use and beliefs. It was distributed among eligible participants via social media channels (Instagram, WhatsApp and Facebook accounts).

Results

Out of a total 389 participants, 39.3% (n = 153) used T&CM and 60.7% were non-T&CM users during COVID-19. Of those using T&CM, 61 (39.8%) reported the usage of more than one form of T&CM, mostly herbal medicine (30.8%), followed by nutritional supplements/vitamins (23.8%). 33.9% (n = 52) of participants using T&CM did not report T&CM use to theirmedical physicians. A statistically significant difference was observed between T&CM users and non-T&CM users in gender, age, marital status, level of education, income, and prior use of T&CM (p < 0.05). Social media (n = 204; 52.4%) was the primary source of information for T&CM use. Overall, 33.7%, 54.8% and 39% of participants in this stduy believed that T&CM therapies are effective, have fever side-effects/safe and should be use for COVID-19, respectively.

Conclusion

During the outbreak of COVID-19, a significant proportion of the population reported the use of T&CM, with different beliefs about T&CM being observed. Better-structured T&CM-specific educational programs, enhanced physician-patient communication and access to reliable information are needed to ensure appropriate T&CM use during pandemics in Turkey.

Salvadora persica: Nature's Gift for Periodontal Health

Salvadora persica (SP) extract, displays very valuable biotherapeutic capacities such as antimicrobial, antioxidant, antiparasitic and anti-inflammatory effects. Numerous investigations have studied the pharmacologic actions of SP in oral disease therapies but its promising outcomes in periodontal health and treatment are not yet entirely described. The current study has been planned to analyze the reported effects of SP as a support to periodontal therapy to indorse regeneration and healing. In consort with clinical trials, in vitro investigations show the advantageous outcomes of SP adjunctive to periodontal treatment. Yet, comprehensive supplementary preclinical and clinical investigations at molecular and cellular levels are indispensable to reveal the exact therapeutic mechanisms of SP and its elements for periodontal health and therapy.

The prevalence of complementary and alternative medicine use in the general population of Babol, North of Iran, 2018

Background

Complementary and Alternative Medicine (CAM) have recently become more popular and accepted worldwide. One principal step to identify the status and organize strategies of CAM is evaluating the manner and the prevalence of its usage among people. This study aimed to investigate the prevalence of CAM modalities usage by the people of Babol, a central city in the North of Iran, in 2018.

Methods

Using the original International CAM Questionnaire (I-CAM-Q), a questionnaire was redesigned in Persian (Farsi) with some changes such as adding special modalities in Iran and its validity and reliability were assessed. Six hundred households were evaluated using a cluster sampling method in 2018 spring by 12 trained interviewers.

Results

Finally, 1770 questionnaires were correctly completed. A total of 110 participants (6.21% of the completed questionnaires) had visited CAM therapists in the last year, 109 persons (6.15%) had received prescriptions from physicians and paramedics to use CAM, and a total of 1032 people (58.30%) used herbs and herbal medicines in the last 12 months. Also, 1265 individuals (71.46%) had used CAM throughout their lives. The most popular methods were herbal medicine (65.76%), Persian Medicine (13.78%), water therapy (10.45%) and music therapy (8.36%). The use of CAM was more popular among women.

Conclusions

The general use of CAM in Babol was similar to other studies, but there were fewer visits by CAM therapists and less frequent adoption of common methods including homeopathy, acupuncture, and energy therapy. It was found that CAM was mostly used for non-serious diseases such as cold and transient gastrointestinal disorders, a pattern that is different from other studies in this field.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-021-03281-7.

Broadening the horizon for children's health - A qualitative study on the Centro Latino-Americano de Medicina Integrativa Pediátrica

OBJECTIVES

The aim of this article is to analyze the recently established structure of the unit for pediatric integrative medicine (Portuguese: Unidade de Pediatria Integrativa, UPI), its aims and activities at the Children and Adolescent's Institute and the Institute for the Treatment of Childhood Cancer of the Medical Faculty of the University of São Paulo. To give a complete overview, opinions and views of stakeholders were reflected in the analysis.

DESIGN

An ethnographic approach was chosen to provide an overview of the work of UPI through semi-structured qualitative interviews and participant observation. Observational notes, informal conversations and informational material complemented the collected data. The analysis of the transcribed interviews focused on specific questions regarding the unique role of pediatric integrative medicine in a conventional hospital setting and a perspective for the future.

RESULTS

The UPI is making use of Complementary and Integrative Medicine based on three major pillars - treatment, research and teaching. The unit is a pioneer for the field of Integrative Medicine in Latin America. Its goal is to improve the health and treatment of children using the methods of Integrative Medicine by generating positive outcomes in patient care and evidence-based research. Further expansion of the activities is planned for the future to promote the exchange and further dissemination of pediatric integrative medicine based on stringent research.

CONCLUSIONS

UPI is a novelty on the Latin-American continent and has the potential to contribute significantly to the acceptance and expansion of integrative models by introducing complementary methods in conventional medicine.

Nigella sativa and Thymoquinone: A Natural Blessing for Periodontal Therapy

Thymoquinone (TQ), the chief active constituent of Nigella sativa (NS), shows very valuable biomedical properties such as antioxidant, antimicrobial, anticancer, anti-inflammatory, antihypertensive, hypoglycemic, antiparasitic and anti-asthmatic effects. Several studies have examined the pharmacological actions of TQ in the treatment of oral diseases but its potential role in periodontal therapy and regeneration is not yet fully defined. The present investigation has been designed to review the scientific studies about the effects of TQ as an adjunct to periodontal treatment to promote healing and periodontal regeneration. Along with clinical experiments, in vitro studies exhibit the beneficial effects of TQ during periodontal therapy. Nevertheless, additional comprehensive clinical and preclinical studies at cellular and molecular levels are essential to examine the particular action mechanisms of Nigella sativa and its elements, particularly TQ, during periodontal treatment or regeneration.