Traditional and Integrative Medicine

The Prevalence of Using Traditional, Complementary, and Integrative Medicine by Patients with Epidermolysis Bullosa

Mohammad Mahdi Parvizi — 2024-12-28

Epidermolysis bullosa (EB) is an inherited disease that causes widespread symptoms characterized by extreme epithelial fragility. This study examined traditional, complementary, and integrative medicine (TCIM) usage among EB patients referred to clinics at Shiraz University of Medical Sciences between 2019 and 2020. We enrolled the patients with EB whose diseases were approved by a dermatologist and registered in the dermatology department and Molecular Dermatology Research Center affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. A researcher-made data gathering form, including knowledge, beliefs, practice, and the experience of the safety of TCIM, was used to collect the data. Interviews were done by phone calls, and oral consent was obtained from patients or their parents. Overall, 68 patients were included in this study. In this regard, 79.4% of the patients used TCIM by themselves or their families to manage EB. Approximately, half of the patients were not aware of the effects of the herbal medicines they used. Among medicinal plants, chicory (20.6%), thyme (16.2%), and Persian cornflower (14.7%) had the most consumption. More than half of these patients believed that medicinal plants were a less harmful treatment, and 48.5% considered them effective. In conclusion, the study revealed high medicinal plant usage among EB patients, but limited knowledge about their effectiveness. Public awareness about the benefits and risks of these remedies needs to be increased.

The Motives behind the Skepticism of Conventional Medicine Advocates towards Traditional Persian Medicine: An Expert Opinion

Majid Nimrouzi — 2024-12-28

The conflict between conventional medicine and traditional medicine is an issue worldwide. Various factors contribute to this dissent. In our study, we have explained that there are several denunciations about traditional medicine mentioned by proponents of conventional medicine. A search of important databases utilized related keywords to describe this purpose. Furthermore, the main Persian medicine resources were reviewed. Some critiques are because of a knowledge gap between ontology and epistemology of complementary medical approaches and conventional medicine. The other issue is the inadequate self-presentation of traditional medicine modalities to unwrap its obscure points for contemporary paradigm advocates to promote its points of strength. Traditional and conventional medicine share many abilities, but they cannot address all healthcare requirements alone. If we delineate medicine as a distinct system, it is a knowledge-based art for palliating physical and mental pains, and the traditional/conventional classification of medicine and separating these two schools is the first terrible impediment. It is believed by many that personalized medicine improves the management of patients. To achieve medicine's true objective - preserving and restoring health - we should move towards integrative medicine and validate patients' priorities and human values. The objective of this viewpoint is to enhance health awareness in both academia and the public sphere.

The Effects of Foot Reflexology Massage on the Sleep Quality of Nurses Working in the Selected Hospitals of Sabzevar University of Medical Sciences

Mojgan Gholitabar Omrani — 2024-12-29

Poor sleep quality has always caused problems for nurses in providing healthcare. Today, foot reflexology massage is considered adjunctive therapy in improving sleep quality. Therefore, this study aimed to evaluate the effects of foot reflexology massage on the sleep quality of nurses. This controlled clinical trial was conducted on 80 nurses working in the selected hospitals of Sabzevar University of Medical Sciences. The nurses meeting the inclusion criteria were selected using the available sampling method and divided into two intervention and control groups, each containing 40 subjects using the permuted block technique. In the intervention group, foot reflexology massage was conducted by each research unit for 12 sessions, each for 30 minutes for six weeks. Both groups performed the Pittsburgh sleep quality index at the beginning of the study and five days after the intervention. Data were analyzed using SPSS 24 using descriptive and deductive tests. The mean sleep score in the control and intervention groups was 9.22±3.30 and 9.90±3.47, which was 9.05±3.35 and 6.97±2.68 after the intervention, indicating a significant difference in reducing the overall score of the intervention group compared to the control (p=0.000). Moreover, decreased sleep quality, sleep latency, sleep efficiency, and sleep duration scores were significant after the intervention (p<0.05). Based on the results, foot reflexology massage can enhance nurses' sleep quality. Therefore, nurses are advised to utilize it as a valuable and practical approach to improve their sleep quality.

Factors Associated with the Utilization of Traditional Health Services among People with Non-Communicable Diseases in Indonesia: Findings from a Nationwide Survey

Iwan Abdi Suandana — 2024-12-29

Globally, there is an increasing trend of morbidity and mortality from non-communicable diseases (NCDs). Traditional health service is one of the new approaches to support NCDs program. This study aimed to determine the prevalence and factors associated with the use of traditional health services among people with NCDs in Indonesia. We conducted a secondary analysis of integrated nationwide health and socio-economic survey data in 2018. Of the 127,198 people with NCDs included in the analysis, 38.7% of people with NCDs have ever used traditional health services, with the most common type being those that involve manual therapies. Compared to the reference group, likelihood of higher utilization of the traditional health service was among those aged 45-54 years (adjusted odds ratio (AOR) 1.19; p <0.001), from highest socioeconomic (AOR = 1.13, p <0.001), employed (AOR> 1, p <0.05), married/divorced (AOR> 1, p <0.001), has two type of NCDs (AOR 1.06, p 0.023), knows the existence of the nearest doctor/clinic (AOR 1.36, p <0.001) and hospital (AOR = 1.13, p 0.002) and has very easy access to health facility (AOR 1.34, p <0.001). Better socialization of traditional health services especially to the groups who have low utilization is important. The information should include the availability of traditional health services types, benefits, and advantages of using these services. It is also necessary to improve the quality and standardization of traditional health services to enhance public trust and increase the utilization of the services. Since a certain proportion of people with NCDs rely on traditional health services, improvement of the traditional health services quality is crucial, as well as engagement of these services to NCDs programs.

Effect of a Yogic Breathing Technique on Immune Parameters among Healthcare Workers: A Randomized Controlled Pilot Study

Archana Balasubramanian — 2024-12-29

Healthcare workers (HCWs) have faced challenging situations globally with increased stress and its related inflammatory/immune disorders, leaving behind a deficit in the number of HCWs worldwide. An increased focus on their physical and mental well-being is strongly warranted. Relaxation techniques such as yoga, pranayama, and meditation have great potential to promote health and prevent diseases. This study aims to determine the effects of Sudarshan Kriya Yoga (SKY) on inflammatory and immune parameters among HCWs. This pilot randomized controlled trial includes recruiting HCWs from a single centre in South India in 2022. We excluded any form of medical illness and recruited regular volunteers. The SKY intervention was delivered and followed up for 12 weeks. Baseline and post-SKY intervention blood investigations were compared between study and control groups (1:1 ratio) and analyzed. Thirty-eight subjects were recruited for the pilot study. Among them, 27 were females (71%) and 11 males (29%). Pro-inflammatory markers such as erythrocyte sedimentation rate, C-reactive protein and neutrophil-to-lymphocyte ratio showed a decrease in mean values after 12 weeks in both groups, which was not statistically significant. A slight increase in interleukin (IL)-6 values and a higher IL-4 mean values was observed in the study group compared to controls. CD56 and CD8 counts were higher in the study group compared to controls. However, no such difference was noted in cortisol levels. This pilot study provides data for further large-scale studies to examine the effect of easily deliverable mindfulness-based interventions among the healthcare community to improve their health and well-being.

Combination of Mangosteen (Garcinia mangostana L.) Pericarp Extract and Physical Exercise Decreases Atherosclerotic Lesions in Atherogenic Diet-Fed Rats

Andreas Arie Setiawan — 2024-12-29

The mangosteen pericarp (MP) has xanthone compounds, particularly alpha-mangostin (α-MG), which have been shown to exhibit potent antioxidant and anti-inflammatory activities. Physical exercise (PE) has also been shown to have atheroprotective effects. To date, their combined effect on atherosclerosis has not been studied histologically. This study aimed to investigate the effect of MP extract combined with PE on atherosclerotic changes in rats fed an atherogenic diet. Twenty-five male Wistar rats (Rattus norvegicus) aged 6-8 weeks were randomly divided into five groups of five rats each: C (control, normal diet), CH (atherogenic diet), T1 (atherogenic diet plus MP extract 800 mg/kg/day in three divided doses with PE), T2 (atherogenic diet plus MP extract-loaded nanoemulsion 50 mg/kg/day with PE), and T3 (atherogenic diet plus atorvastatin 1.44 mg/day with PE). The PE protocol involved daily treadmill running for 60 min at 12 m/min, 5 days/week. All rats were treated for eight weeks. Following eight weeks of treatment, the animals were sacrificed and the aortic tissues were taken for histological study. The histological features in groups CH, T1, T2, and T3 were consistent with type Vc atherosclerotic lesion (fibrotic lesion) with intimal thicknesses of 11.99 ± 0.88 μm, 3.61 ± 0.53 μm, 3.48 ± 0.47 μm, and 2.96 ± 0.20 μm, respectively. A comparative analysis revealed a significant reduction in intimal thickness in groups T1, T2, and T3 compared to the CH group (p <0.001). Group T2 exhibited a non-significant decrease compared to group T1 (p = 0.691). Moreover, neither the T1 nor T2 groups significantly differed from the T3 group (p = 0.052 and 0.128, respectively). In conclusion, the combination of MP extract (and its nanoemulsion) and PE decreases atherosclerotic lesions and provides comparable results to the atorvastatin-treated group, indicating their potential as alternative options for preventing atherosclerosis.

Plasma Metabolite Profiles of Healthy Volunteers after Administration of a Thai Herbal Formula for Dizziness

Ranida Boonrak — 2024-12-30

The Thai herbal Yahom 20 formula (YHF20), is traditionally used for dizziness and fainting and off-label use for sleep aid, with inadequate substantial evidence afterward. This study’s primary objective is to employ metabolomics to investigate YHF20's effects, comparing it with lorazepam and a placebo in healthy volunteers. Phytochemical and metabolite profiling were performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and LC/MS Q-ToF, respectively, on plasma samples from 90 healthy participants aged 20 to 60 years. These participants were randomized into three groups: YHF20 (n=30), Lorazepam (n=30), and Placebo (n=30). Principal Component Analysis (PCA) and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) were then conducted to identify differential metabolites and pathways. Six phytochemicals, including ellagic acid, glycyrrhizic acid, (E)-ferulic acid hexacosyl ester, 6-aldehydo-7-methoxy-isoophiopogonone B, melianol, and myristic acid were identified in YHF20. Despite PCA showing no significant overall metabolite profile differences among the groups, OPLS-DA pinpointed eight YHF20-associated metabolites, such as DHA ethyl ester, α-linolenic acid, (9Z)-9-octadecenamide, ricinoleic acid methyl ester, idazoxan, 13-HPODE, 12,13-DiHODE, and myristoleic acid, implying at anti-inflammatory pathway involvement, especially in α-linoleic and linoleic acid metabolism. No direct impact on sleep-related metabolites was found, the anti-inflammatory effects suggested by YHF20 could indirectly improve sleep quality by mitigating inflammation, a common sleep disruptor. These results highlight YHF20's potential for enhancing life quality through anti-inflammatory mechanisms. They offer a scientific basis for its traditional and anecdotal uses and suggest a novel approach to sleep quality improvement not previously documented.

Effectiveness of Plant Adaptogens in Sports: Bibliometric Study and Prospects for Use

Igor V. Goncharenko — 2024-12-29

Rehabilitation of professional athletes faces objective difficulties associated with excessively intense loads and a short period between competitions. The use of plant adaptogens can improve the quality of the recovery process and reduce the time required for athletes to recover. The main purpose of the study was to review the use of adaptogens in sports; to analyze the dynamics of scientific publications over a 50-year period (1970-2024), and to determine the highest priority areas for their use in sports. The analysis was carried out using a bibliometric approach based on the PubMed / Scopus resources with the classification of outcomes by year, branch of science and individual adaptogens. The share of publications for the last 5 years was calculated as an indicator of the current research trend. An exponential trend of increasing the number of publications has been established, and over the past 5 years, their share has amounted to 28.3% of the number over a 50-year period. Despite the traditional popularity of Panax ginseng, other plant adaptogens have also recently shown an increase in publication activity, especially in studies of the adaptogenic properties of Rhodiola rosea (38.8% of publications over the last 5 years). The analysis of publications allowed us to classify the most promising directions of their use in sports. Various publications have noted effects such as increased athletic performance, normalization of stress hormones after competitions, acceleration of healing of injuries, stimulation of muscle mass gain, an antidepressant effect, as well as acclimatization during intercontinental flights and preparation for competitions in unfavourable conditions.

Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions

Zahra Moeinipour — 2024-12-29

Medicinal herbs have recently received considerable public attention for their therapeutic properties. Traditional healing systems such as Ayurveda, traditional Chinese medicine, and traditional Persian medicine highly rely on medicinal plants to treat many diseases. However, herbal medicines are usually not standardized and despite their widespread use, there is limited scientific evidence on their safety and interactions. Ginkgo biloba L. is a medicinal plant whose biological properties have been confirmed in previous studies. Its leaf extract exhibited anti-inflammatory, antioxidant, neuroprotective, and anti-apoptotic properties. Nevertheless, G. biloba contains various pharmacologically active components, such as terpene lactones and flavonoids that could cause drug interactions through multiple mechanisms, including the effect on cytochrome isozymes and p-glycoprotein (P-gp). Thus, conducting studies to evaluate this plant's safety profile and drug interactions seems necessary. In the current paper, we reviewed the pharmacokinetics, drug interactions, and pharmacological properties of G. biloba plant. According to the included studies, bioactive compounds found in G. biloba extract have antagonistic activity against platelet aggregation and could inhibit human thrombin, thereby increasing the risk of severe bleeding. We also identified several other potential drug interactions for G. biloba, including risperidone, thiazides, mycophenolic acid, and diltiazem. Data on drug interactions between G. biloba and digoxin, simvastatin, nicardipine, and midazolam were less consistent. Therefore, caution should be taken in consuming this plant with anticoagulants or platelet inhibitors such as warfarin, ticlopidine, clopidogrel, and aspirin. However, patients’ age, gender, and dosage forms of medicine seem to play an essential role in drug interactions. In summary, further clinical and laboratory research is necessary to elucidate the risk of G. biloba drug interactions. Also, the use of technologies such as genomics, metabolomics, and transcriptomics can provide a more comprehensive understanding of how G. biloba interacts with drugs at the molecular level.

Promising Neuroprotective Effects of Dracocephalum Species: Mechanistic Perspectives

Marjan Talebi — 2024-12-29

Neurological diseases have important effects on morbidity and mortality rates. Natural products offer various health benefits, and Dracocephalum species, belonging to the Lamiaceae family, have been traditionally used for several therapeutic values. The genus Dracocephalum and its metabolites have demonstrated numerous pharmacological activities such as antioxidative, anti-inflammatory, antiviral, antiparasitic, antibacterial, antifungal, nephroprotective, hepatoprotective, neuroprotective, gastroprotective, cardioprotective, antiapoptotic, and anticancer effects. Dracocephalum spp. contain phytosterols, polysaccharides, coumarins, alkaloids, phenolic acids, flavonoids, and terpenes. This review explores the potential neuroprotective effects of Dracocephalum spp. by evaluating the mechanisms and signaling pathways involved. The role of the genus Dracocephalum was investigated in relation to various neurological conditions such as Alzheimer's disease, insomnia, Parkinson's disease, vascular dementia, cerebral ischemia, pain, depression, and glioblastoma. These findings suggest that Dracocephalum spp. and their phytochemicals have neuroprotective effects by targeting the regulation of various pathways. Therefore, clinical trials should be performed to confirm the in vitro and animal findings.

A Narrative Review of Effective Herbal and Traditional Medicines on Management of Autism

Neda Orouji — 2024-12-28

Autism is a complex neurodegenerative disorder that affects people from birth. Through dietary approaches, sensory integration, rehabilitation training, education and finally medication management, the autistic disorder symptoms can be reduced. Of course, this does not mean that the main features of autism can be treated in general, but with medication control and education, these symptoms can be managed. In the last decade, treatment with herbal medicines has attracted special attention and promising results have been reported in the treatment of various diseases. In this review, it is tried to collect the plants that have been studied for the treatment of autism and herbal medicines with a possible effect on the symptoms of autism in the literature. The results show some few medicinal herbs and natural/ traditional formulations like Gingko biloba, Centella asiatica, Humulus japonicus, Salvia leriifolia, Vitis vinifera, Hazelnut, Ukgansan and Kwakhyangjungkisanhapyukmijihwangtang-gamibang have beneficial effects on different features of autism and could be helpful for the patients. More investigations are needed to prove their efficacy in more clinical studies in the future.

Exploring the Ancient Persian/Unani Theory of Connection between Gastrointestinal and Respiratory Tracts: Current Evidence and Future Directions

Shahin Saeidinejat — 2024-12-28

The theory of connection between respiratory and gastrointestinal systems is a key topic in different types of traditional medicine. In this study, we discussed the history, main concepts of this theory along with related studies and its possible clinical applications. In this regard numerous scattered studies have shown a relationship between upper and lower respiratory disorders and gastrointestinal symptoms. Numerous epidemiologic, pathophysiologic and clinical evidence confirm the interrelationship and integrated functioning of the respiratory and gastrointestinal tracts. It seems that the holistic approach that emphasizes the link between the respiratory and gastrointestinal systems in traditional Persian medicine, is in line with the theory of united mucosa that has been considered in recent years. The interaction between the respiratory and gastrointestinal systems can occur through several mechanisms, including commonalities in embryonic sources, role of identical mediators and receptors, influence of common pathogens in the lungs and gut, similarity of microbiota patterns and changes, and same inflammatory and mucosal responses. We believe that this theory can provide new insight for the approaches to respiratory and gastrointestinal disorders in the light of holistic medical knowledge. Also, further research should be conducted to identify the exact paths and mechanisms of communication between respiratory and gastrointestinal systems.