European Journal of Integrative Medicine - Articles in Press

Acupuncture for tension-type headache in pregnancy: A prospective, randomized, controlled study - Corrected Proof

J.B. Guerreiro da Silva, M.U. Nakamura, J.A. Cordeiro, L. Kulay — 2012-05-18

Abstract: Acupuncture for tension-type headache in pregnancy: a prospective, randomized, controlled study.Aim: This study was undertaken to test, under real-life conditions, the effects of acupuncture on headaches during pregnancy and compare this with a group of patients undergoing conventional treatment alone.Methodology: Forty-three conventionally treated (lifestyle modifications and stretching) pregnant women were randomly allocated into two groups to routine care or acupuncture. The severity and disability caused by this pain and its affect on mood, sleep and work were assessed using a Numerical Rating Scale (NRS). The main end-point was the mean difference between the first and the last interview after eight weeks of treatment. Secondary end points were the changes over time in the NRS assessments of pain intensity, disturbances in mood, sleep and working and the use of medications.Differences between initial and final sessions were analyzed by a two-sample test. Changes over time in the NRS assessment were analyzed by the Fisher exact test. Mood's test for medians was used and a p-value<0.05 indicated a significant difference.Results: All women completed the treatment. No important adverse effects related to acupuncture treatment or to pregnancy's outcome were reported. Significant improvements were demonstrated for pain at the end of the trial in the study group, 3.9 vs 1.7 difference in favor to acupuncture group (p<0.05). This group also used less medication and had a greater improvement in mood and sleep when compared with the control group.Conclusions: This study suggests acupuncture alleviates tension-type headaches during pregnancy.

Thermotherapy self-treatment for neck pain relief—A randomized controlled trial - Corrected Proof

2012-05-09

Abstract: Aim of the study: To evaluate the potential of thermotherapy self-treatment in relieving pain and improving sensory function in patients with chronic mechanical neck pain.Materials and methods: Fifty patients (74% female; mean age 57.18±12.3years) with chronic mechanical neck pain were randomized to either treatment group (n=25) or control group (n=25). Treatment group used a mud heat pad once a day for 20min over a period of 14days while the control group was left untreated. Both groups were allowed to continue self-directed usual care. Primary outcome measure was neck pain intensity as assessed by a 100mm visual analog scale (VAS) after 14days. Secondary outcome measures included a pain diary (daily measure of pain intensity on a 100mm VAS), functional disability (neck disability index; NDI) and health-related quality of life (short form-36; SF-36). Physiological measures included mechanical detection threshold (MDT), pressure pain threshold (PPT) and vibration detection threshold (VDT) at the site of maximal pain and in the adjacent region.Results: Significant group differences occurred for pain intensity (mean difference −16.00mm; 95% confidence interval −26.07; −5.92; P=0.003) and pain diary (P=0.013). Group differences for MDT and VDT occurred at the site of maximal pain (MDT: P<0.001; VDT: P=0.035) and in the adjacent region (MDT: P=0.042; VDT: P=0.008). No group differences were found in NDI, SF-36 or PPT.Conclusions: Thermotherapy self-treatment seems to be effective in relieving pain and improving sensory functioning in patients with chronic mechanical neck pain. Further research is needed to underpin these preliminary results.

Fertility and estrogenic activity of Turraeanthus africanus in combination with Lepidium meyenii (Black maca) in female mice - Corrected Proof

Dieudonné Massoma Lembè, Manuel Gasco, Gustavo F. Gonzales — 2012-04-16

Abstract: Aim of the study: The effect of Black maca (Lepidium meyenii) and Turraeanthus africanus on fertility and estrogenic activity in female mice was investigated.Materials and methods: Thirty female mice were treated daily with extracts of Black maca plus T. africanus (BM+TA), T. africanus alone (TA) or vehicle (control) at dose 1g/kg BW for 30days.Results: The length of the estrous cycle inside the group of (BM+TA)-treated mice significantly (p<0.001) shorten (4.08±0.06 days) when compared to control (4.53±0.05). On the proestrous stage, the oestradiol level for animals treated with TA (27.3±0.5pg/ml) and (BM+TA) (36.0±0.9pg/ml) significantly increased when compared to control (24.0±0.4pg/ml), while in the estrous stage only the estradiol level of (BM+TA) treated animal (28±2pg/ml) significantly increased (p<0.01). The uterine weight of ovariectomized of TA-treated animals was higher (p<0.05) than those observed in controls while no change in the (BM+TA) group was observed. The weight of uterus of non pregnant mice of both treated TA and (BM+TA) extract significantly increased (p<0.001) in the proestrous and estrus stage when compared to control.The number of fetuses in the uterus after (BM+TA) treatment (14.66±0.25) was significantly higher (p<0.05) than the TA treated alone (13.60±0.45) and the control (9.5±1.10) one at day 15 of pregnancy.No significant difference between groups (p>0.05) was observed for the two treatments concerning the Fertility index.Conclusions: TA can affect the number of embryo implantation and the uterine weight. This effect increased in association with BM. BM could regulate estrous cycle.

The impact of Ephedra and green tea combination mesotherapy on localized fat: A randomized-controlled clinical trial - Corrected Proof

Mi-Young Song, Shambhunath Bose, Ho-Jun Kim, Myeong-Jong Lee, Chi-Yeon Lim — 2012-04-16

Abstract: Aim of the study: The goal of this study was to evaluate the efficacy of mesotherapy treatment with Ephedra and green tea extract in combination on localized fat of overweight women subjects.Materials and methods: Twenty-five overweight women, 20–35-years-of-age, body mass index ≥ 23kg/m2 were randomly assigned into active (Ephedra+green tea, n=13) and placebo (saline, n=12) groups. A total eight herbal or saline mesotherapy administrations were performed into the thighs alternatively in two phases, each one comprising of four consecutive treatments on one thigh on weekly basis. Body composition parameters, circumference and subcutaneous fat area of thighs were measured before and after each phase, in addition to evaluating fasting free fatty acid (FFA) level of blood as well as adverse events of the therapy in volunteers.Results: There were no significant changes in the body weight, BMI, body fat, and subcutaneous fat area of thigh within or between the groups, but the change in thigh circumference within the active group was significantly lower compared to that within the placebo group. The blood FFA level at 1h after the first herbal therapy was significantly higher than that recorded at other time points of pre- and post-treatment measurements.Conclusions: The herbal mesotherapy treatment produced a significant effect on thigh circumference and fasting-FFA level within the active group. Future studies that compensate for the limitations of this trial are required to fully ascertain the efficacy and safety of the proposed mesotherapy, and a very careful consideration is needed until then.

Incorporation of traditional Chinese medicine pattern diagnosis in the management of rheumatoid arthritis - Corrected Proof

Chi Zhang, Miao Jiang, Gao Chen, Aiping Lu — 2012-03-29

Abstract: Introduction: Traditional Chinese medicine (TCM) has been continuously developing over thousand years of practice and refined through observations. TCM pattern diagnosis plays an important role in rheumatoid arthritis (RA) treatment and recovery.Methods: This paper provides a comprehensive review of literature and subsequent case study related to the historical evolution on the integration of the TCM pattern and RA disease diagnosis in biomedicine, the methodology of pattern diagnosis for RA, and the biological basis of TCM pattern.Results: TCM pattern is used to classify the patient in the practice of RA treatment, and has been recently incorporated with biomedical diagnosis, resulting in the increasing research interest of TCM pattern among various disciplines of integrative medicine.Conclusion: It is conceivable that incorporation of TCM pattern diagnosis in the management of RA provides better ways to improve efficacy and could yield new insights into the biological sciences.

The impact of eurythmy therapy on fatigue in healthy adults—A controlled trial - Corrected Proof

2012-03-23

Abstract: Introduction: Fatigue is considered a principal side effect of cancer and other chronic illnesses, and has also been reported in the healthy population characterised by reduced motivation and tiredness. The present study was conducted to evaluate the impact of eurythmy therapy (EYT) as a promising mind–body therapy on fatigue symptoms, to assess the participants’ subjective evaluation of the EYT and the correlation with heart rate variability (HRV) parameters.Methodology: Sixty-eight healthy adults (mean age: 42.2; SD: 8.2) performed 10h of EYT in a group setting over a period of six weeks. A non-randomised control group (n=22; mean age: 43.6; SD: 13.7) received no intervention. Fatigue was assessed by questionnaire (multidimensional fatigue inventory, MFI) before and after the intervention. Twenty-three females from the EYT group participated in two additional HRV assessments over 24h.Results: The two groups showed statistically significant changes in fatigue symptoms over time (multivariate: F(1/72)=17.43; p<0.001). Furthermore, the decrease of fatigue symptoms correlated with a proportional enhancement of the higher frequency and a decrease in the ultra and very low frequency components after EYT. Although half of the participants did not expect positive effects of the EYT at baseline, all participants reported that they did profit from the EYT.Conclusion: The psychometric data match the participants’ subjective assessment of the EYT and correlates with improvements of HRV, which is probably an indicator for an improvement of autonomic regulation process by a more relaxed physical activity.

Why do cancer patients use Chinese Medicine?—A qualitative interview study in China - Corrected Proof

He Yu, Sicheng Wang, Jianping Liu, George Lewith — 2012-03-16

Abstract: Objectives: To describe the reasons why cancer patients use Chinese medicine (CM) in terms of their expectations, knowledge, attitudes and barriers. To generate an understanding of the interrelationships between these factors which could explain the cancer patient's healthcare seeking behavior.Method: Twenty-six in-depth interviews and one focus group were carried out in oncology wards in Xiyuan Hospital, China Academy of Chinese Medical Sciences. Twenty-three cancer patients participated in an in-depth interview and a focus group after providing informed consent. Interviews and focus group were tape recorded, transcribed. Atlas.ti6.0 was employed and thematic analysis was used to code and theme the information.Results: A total of 249 codes were identified, which resulted in three main themes: (1) Better outcome—most of participants reported that they believed that they would have a better outcome by using CM treatment. (2) Safe and cheap—CM appeared not to have major side effects and so could be used in the long term and CM remedies cost less. (3) Understandings of CM—Chinese people understand about CM due to its long cultural and historical context and this affected their attitude positively. They trusted CM and used it based on their understandings.Conclusions: Chinese cancer patients expected CM to improve their quality of life and contribute to achieving a better overall outcome. It is safe and relative cheap to use in the long term. Chinese patients appear to trust CM because of its cultural and historical context. More qualitative research is needed to further assess the role of CM in China.

Investigating a multidisciplinary and patient-centred approach to obesity - Corrected Proof

Kate Fismer, Sam Watts, Katherine Bradbury, George Lewith — 2012-03-09

Abstract: Obesity is set to become one of the biggest health problems facing governments in Europe. With a significant sequela of associated chronic conditions, treatment and prevention must become priorities in healthcare provision and policy. The cause and treatment of obesity is complex. However, evidence supports the patient-centred approach, which was the focus of discussion at a multidisciplinary educational event for healthcare students and patients held at the University of Southampton. The aim was to increase existing knowledge, promote shared learning and facilitate a better understanding of strategies needed to address the growing prevalence of obesity. The necessity for improved research strategies and a more integrated, multidisciplinary approach to treatment were echoed by the panel of expert researchers and practitioners who spoke. There was also a consensus that obesity needs to be seen as a chronic health concern by governments and health practitioners. In addition, the event provided a locus for inter-professional student groups to work collaboratively with obese (or formerly obese) patients to explore the patients’ perspective regarding obstacles to health improvement and possible solutions. Feedback indicated that both students and patients found this experience valuable and rewarding. Some patients were motivated to join other community health initiatives as a result, whilst students indicated that their understanding, future practice and research would be enhanced. Therefore it seems that this experiential approach to collaborative learning may provide a model for further educational events with a focus on patient-centred treatment of similar long term chronic health problems.

Acupuncture for dysphagia following stroke: A systematic review - Corrected Proof

Ivy S.Y. Wong, K.F. Ng, Hector W.H. Tsang — 2012-02-27

Abstract: Background: This systematic review reports an update evaluation and critically appraise on available randomized controlled trials (RCTs) which investigated the effectiveness of acupuncture on dysphagia in stroke rehabilitation.Methods: A literature search was performed to identify all RCTs that investigated the therapeutic effect of acupuncture on dysphagia after stroke from 1966 to 2011. The recruited studies were classified according to the types of participants, types of intervention, outcome measures and results. The corresponding methodological qualities of the recruited studies were also evaluated using Cochrane risk-of-bias criteria and the Physiotherapy Evidence Database (PEDro) scale.Results: The current review was based on nine RCTs that showed a positive effect of acupuncture and conventional rehabilitation on dysphagia compared to conventional rehabilitation alone. All the studies reported short-term effect of acupuncture on dysphagia and no follow-up data were available.Conclusions: The current review appeared to reveal that acupuncture together with conventional rehabilitation has positive effect on dysphagia after stroke. However, with the concerns in the methodology of the studies in this systematic review, a larger sample, multi-centre, well designed RCTs with homogeneity of outcome measures needs to be carried out before recommending acupuncture as a standard treatment to patients with dysphagia after stroke.

Quality of life and assessment after local application of sulphurous water in the home environment in patients with psoriasis vulgaris: A randomised placebo-controlled pilot study - Corrected Proof

2012-02-13

Abstract: Aim: Psoriasis one of the most common dermatological diseases and has been treated in the Sulphurous Mineral Waters (SMW) Balneary or Spa. This study aims to assess the effectiveness of a short-term treatment with SMW and to assess this treatment's impact on the quality of life of the patients with psoriasis vulgaris.Materials and methods: The present study is a pilot, randomised, triple-blind study that was conducted over a month and a half with patients from the province of Zaragoza (Spain). The patients were divided randomly into two groups that were treated simultaneously: the treatment group (TG) that received SMW from a spring known as “Platea”, which was located in the town of Calatayud (Spain), and the control group (CG) that received distilled water. The patients applied the water on the affected areas of their skin at home by themselves using a spray. Assessment was done by a physician and a psychologist trained with PASI and DLQI at days 1, 8, and 15 of the treatment.Results: In the TG the percentage of patients who arrived at PASI50, was 21.05%, whereas in the CG of 16.66%; however, no significant differences were observed between the treatments or their clinical efficacies as defined by the increases in the index percentages.Conclusions: This pilot study demonstrates that there is sufficient patient acceptance for future research with larger sample sizes should evaluate the effects of SMW in psoriasis versus that of the placebo.

A single case report of physiotherapy and acupuncture treatment for cervical radiculopathy - Corrected Proof

Megan Drakeley, Jennie Longbottom — 2012-02-13

Abstract: Aim of the study: To present the use of acupuncture, alongside manual and exercise therapy, in a single case report of a patient with a C6/7 disc prolapse and radiculopathy. To clinically reason and evaluate the rationale and effects of acupuncture, according to current evidence, in this example.Method: A case report following six sessions of acupuncture administered over 4weeks, alongside manual therapy and exercise, for the treatment of a single patient with cervical radiculopathy. Outcome measures used were numeric pain rating scale (NPRS) and active range of motion (AROM) of the cervical spine.Results: NPRS improved from 8/10 to 2/10. Cervical left rotation improved from 30° to 60°, and left side flexion from 15° to 30°.Conclusion: Acupuncture was beneficial in reducing pain originating from cervical radiculopathy in this example. AROM improved with acupuncture alongside manual and exercise therapy.

Active fraction from Ganoderma lucidum with apoptosis activity on peripheral blood mononuclear cells from chronic lymphocytic leukemia - Corrected Proof

2012-02-13

Abstract: Aim of the study: B-cell chronic lymphocytic leukemia (B-CLL) is a neoplasia of the immune system due to an accumulation of clonal B lymphocytes resistant to apoptosis. B-cell abnormal infiltration impairs normal architecture of lymph nodes and other organs of the immune system and therefore the defense against infectious diseases. Single new therapeutic strategies are currently under investigation for triggering specific death of malignant B-CLL cells. Moreover, therapies including combination of several new antitumor agents more effective against tumor processes are being developed.Methods: We used an active fraction obtained from Ganoderma lucidum fruiting bodies. This fraction was isolated by methanol extraction and column chromatography on silica gel using butanol:acetic acid:water for elution. This fraction was collected at an Rf of 0.74.Results: In this study, we show induction of cytotoxicity, DNA fragmentation and apoptosis on fresh human B-CLL cells by this active fraction from G. lucidum. Different dose-dependent cytotoxic effects were observed depending on the individual immunophenotypes. Even at low concentration, this fraction induced cell death with DNA fragmentation and changes in phosphatidylserine localization in cell membrane on B-cells from CLL patients. It is at low concentration where this active fraction shows a balance between the apoptotic effect and cell viability.Conclusion: The high cytotoxic effect observed in peripheral blood mononuclear cells from B-CLL patients as compared with the effect on healthy donors’ cells support its potential antileukemia role in combined therapeutic strategies.

Valuing research – the young researcher - Corrected Proof

Nicola Robinson, George Lewith — 2012-02-13

An understanding of research is necessary for preparing healthcare practitoners – both in terms of being able to interpret research as well as being critically aware of its significance and the implications for practice. It is particularly important that healthcare professionals are encouraged to engage early on in their careers. However, it is difficult to engage practitioners in research and research on integrative practice is still in its infancy methodologically and conceptually.

Relation between body mass index and resting metabolic rate, cardiorespiratory fitness and insulin sensitivity in Sasang typology for young male persons: An observational study - Corrected Proof

Duong Duc Pham, JaeChul Lee, Bon Cho Ku, Yun Young Kim, Jong Yeol Kim — 2012-02-10

Abstract: Introduction: Metabolic efficiency and low physical fitness may be determined by inherited genetic factors and implicated in the increasing prevalence of obesity and metabolic disorders.Aim of the study: This study examines the distinctive characteristic in energy expenditure (EE) profile, physical fitness, and obesity-linked biomarkers across Sasang types.Methodology: EE at fasting and postprandial states, physical fitness including maximal oxygen consumption (VO2max) and time to exhaustion (Te) were measured by an indirect calorimeter in 51 young male participants. Plasma insulin concentration and HOMA-IR indices before and after eating were analyzed.Results: No difference was found in resting metabolic rate (RMR), thermic effect of food (TEF), VO2max, Te, and in plasma insulin and glucose concentration, and HOMA-IR indices before and after eating. Body mass index (BMI) contributed to the increase of RMR in the SoYang (SY) type (n=17), but not in the TaeEum (TE) (n=17) and SoEum (SE) (n=17) types, whereas BMI was inversely associated with the physical fitness in the TE and SE types, but not in SY type, and BMI was positively related to the plasma insulin concentration and insulin sensitivity in the TE type before and after eating, but not in the SE and SY types.Conclusion: Together, it can be assumed that high BMI is related to health risk in the TE and SE types, especially in the TE type, but not in the SY type.

The fundamental study for the standardisation and objectification of pattern identification in traditional Korean medicine for stroke (SOPI-Stroke): Development and interobserver agreement of the Korean standard pattern identification for stroke (K-SPI-Stroke) tool - Corrected Proof

2012-02-10

Abstract: Objectives: The aim of this study was to verify the reliability of the ‘Korean Standard Pattern Identification for Stroke (K-SPI-Stroke), by investigating the level of interobserver agreement.Methods: Interobserver agreement was studied among physicians from 11 Korean oriental medical hospitals from September 2006 to December 2010. Each patient was independently diagnosed by two physicians from the same site using Pattern Identification (PI). The interobserver agreement of PI for K-SPI-Stroke was assessed using simple percentage agreement and Cohen's kappa coefficient statistics.Results: A total of 4012 patients were included in the study. The interobserver agreement for PI in all subjects was considered as ‘moderate to good’ (k=0.66). The interobserver agreement in each site ranged from ‘moderate to good’ to ‘excellent’ (k=0.52–0.83). Five sites were rated as ‘excellent’ (k≥0.75) with respect to their interobserver agreement.Conclusion: This article's results indicated a satisfactory interobserver agreement for PI in Korean stroke patients. The results of this study will help develop quantitative measures to evaluate and standardise the scientific criteria in traditional Korean medicine.

The Fundamental Study for the Standardization and Objectification of Pattern Identification in Traditional Korean Medicine for Stroke (SOPI-Stroke): An overview of phase I - Corrected Proof

2012-02-10

Abstract: Objective: The purpose of this article was to introduce our project, a Fundamental Study for the Standardization and Objectification of Pattern Identification in Traditional Korean Medicine (TKM) for Stroke.Design: The total time period for this project is nine years from April 2005 to December 2013. These nine years are divided into three phases, with three years per phase. This article reports the first phase, which had three subprojects; the Korean Institute of Oriental Medicine was responsible for the first and the third subproject, and KyungHee University for the second subproject. The objective of this first phase was to standardize stroke diagnosis using pattern identification (PI), to create a standard clinical chart using a combination of TKM and Western medicine, and to construct a biobank and find biomarkers associated with patterns of stroke.Results: At the end of the first phase, we obtained five patterns (Fire-Heat, Dampness-Phlegm, Qi-Deficiency, Yin-Deficiency, and Blood Stasis), 60 pattern indicators and a unified clinical chart with a combination of 60 pattern indicators from TKM and 47 diagnostic indicators from Western medicine. In addition, 32 single nucleotide polymorphisms related with patterns were identified by genome-wide assay, and using proteomic analysis via the surface-enhanced laser desorption/ionization-TOF, we identified specific plasma proteins associated with varying patterns of stroke. We also developed a tool of PI for stroke and a prediction program for stroke risk ratio in Korean people.Conclusions: This study will advance the scientific knowledge of physicians, enhancing the accuracy of PI in TKM.

Compatibility of multiple herbal components in Erxian Decoction, a Chinese medicinal formula, for treating osteoporosis - Corrected Proof

2012-02-10

Abstract: Introduction: Estrogen deficiency during menopause would increase the risk of osteoporosis. Erxian Decoction (EXD), an anti-menopausal Chinese medicinal formula with anti-osteoporotic effect, appears to be an attractive alternative for treating menopausal osteoporosis. However, the drug compatibility of component herbs in EXD according to traditional Chinese medicine theory has not been explored. In this study, the drug compatibility of EXD according to the organizing principle of Chinese medicinal formula was investigated, using anti-osteoporotic properties as a study model.Methodology: Proliferation of RAW 264.7 osteoclast precursor cells and hFOB 1.19 human fetal osteoblasts was determined by MTT assay. Osteoclastogenesis of RAW 264.7 cells was assessed by tartrate-resistant acid phosphatase (TRAP) staining. Osteoprotegerin secretion from hFOB 1.19 cells was determined by ELISA. The protein levels of NF-κB, IκB, c-Fos and NFATc1 involved in osteoclastogenesis were studied by immunoblotting analysis.Results: EXD inhibited the proliferation of RAW 264.7 cells while it stimulated the proliferation of hFOB 1.19 cells, which was mainly mediated by the Monarch herb (Herba Epimedii) and the Minister herbs (Radix Morindae officinalis) respectively. EXD also stimulated secretion of osteoprotegerin from hFOB 1.19 cells. EXD exerted an inhibitory effect on the differentiation of RAW 264.7 cells into mature osteoclast, as revealed in TRAP staining, which was probably mediated by the Assistant herb (Cortex Phellodendri) through down-regulation of NFATc1 protein.Conclusions: EXD inhibited proliferation and differentiation of osteoclast precursor cells, while it stimulated proliferation of osteoblasts and osteoprotegerin secretion. The drug compatibility of EXD according to Chinese medicine theory was also demonstrated.

Randomized controlled trial of Sajabalssuk (Artemisia princeps Pampanini) to treat pre-diabetes - Corrected Proof

2012-02-10

Abstract: Introduction: Alternative complementary therapy with medicinal herbs may help restore normal fasting glycemia in pre-diabetes and therefore delay or prevent T2D. The aim of this randomized controlled trial was to assess the efficacy of Sajabalssuk (Artemisia princeps Pampanini) extract to improve fasting glycemia in pre-diabetes.Methodology: Ninety-nine subjects with pre-diabetes (100mg/dL

Protective effects of Echinops echinatus on testosterone-induced prostatic hyperplasia in rats - Corrected Proof

Manish Agrawal, Alok Nahata, Vinod Kumar Dixit — 2012-02-06

Abstract: Aim: Echinops echinatus is one of the plants marketed as ‘Brahmadandi’ in India. Brahmadandi has the reputation of a potent aphrodisiac and hence it should have an androgenic mode of action. Previous reports on E. echinatus suggest an antiandrogenic action for the plant. The present study was undertaken to find out whether E. echinatus can be used as clinically effective medicine for the treatment of benign prostatic hyperplasia (BPH) where antiandrogenic agents are useful.Methodology: In vitro studies were conducted to assess the 5α-reductase inhibitory potential of E. echinatus. This was followed by in vivo studies on the potent extracts. Testosterone (3mgkg−1, s.c.) was administered to the rats along with the test extracts (50 and 100mgkg−1, p.o.) for a period of 28 days. Finasteride was used as positive control (1mgkg−1, p.o.).Results: E. echinatus extracts attenuated the increase in the prostatic/body weight ratio induced by testosterone. Butanolic fraction of ethanolic extract exhibited the best activity. Testosterone levels measured weekly and prostate-specific antigen (PSA) levels measured at the end of the study support our postulations. Further histological studies have shown a considerable improvement in the prostatic histoarchitecture in the extract-treated groups when compared with testosterone treated group.Conclusion: Our studies suggest that the use of E. echinatus as Brahmadandi is not justifiable in light of its antiandrogenic action. E. echinatus proved to be a promising agent for the treatment of BPH.

Clinical efficacy of a Unani formulation ‘Safoof Habis’ in menorrhagia: A randomized controlled trial - Corrected Proof

Arifa Fathima, Arshiya Sultana — 2012-02-06

Abstract: Aim: To evaluate the efficacy and safety of Safoof Habis in Kasrate Tams (menorrhagia) with validated menstrual pictogram.Materials and methods: A single blind, randomized, standard controlled trial was conducted in the gynaecological outpatient of National Institute of Unani Medicine Hospital. Clinically diagnosed patients (n=52) were randomized to the test (n=35) and control (n=17) groups. In the test group, Safoof Habis (Ingredient are Silicate of alumina and Iron oxide, Hydrated magnesium silicate and Vateria indica L.) 5g twice daily and in the control group, tranexamic acid 500mg, thrice daily were administered from day 1 to day 5 of menstrual cycle and Qurs Kushta Faulad, one tablet twice daily was administered in both the groups for three consecutive months. The primary outcome measure was to assess the efficacy and safety of this Unani formulation in menorrhagia with menstrual pictogram. The secondary outcome measures were to assess the effectiveness of test drug formulation on dysmenorrhea and hemoglobin concentration. The results were analyzed by Student's ‘t’ test and Fisher exact test.Results: The groups were homogenous in the terms of age, parity, socioeconomic status, marital status and biochemical parameters (P>0.05). Post treatment when compared to baseline in same group showed significant reduction in menstrual blood loss in both the groups (P<0.001). The comparison between test and control group showed that both groups were equally effective (P=0.265). There was improvement in hemoglobin concentration in the test group (P=0.04) and dysmenorrhea was reduced in both groups (P<0.001).Conclusion: Safoof Habis was found to be effective in reducing menstrual blood loss in menorrhagia.

Effects of Stachys tibetica essential oil in anxiety - Corrected Proof

2012-02-03

Abstract: Ethnopharmacological relevance: Stachys tibetica (Lamiaceae) is an important medicinal plant in the folk medicine of Ladakh, India and Tibet for the treatment of various mental disorders.Aim of the study: Present study is aimed to characterize the essential oil of S. tibetica and its anxiolytic properties.Materials and methods: The oil was extracted from the plant by hydrodistillation method. The isolated oil (0.7%) was subjected to GC–MS for identification of its constituents and evaluated for anxiolytic effects by employing the social interaction, hole-board, elevated plus maze and light/dark arena tests in rats.Results: GC–MS of S. tibetica essential oil (SEO) indicated the presence of 33 constituents. Aciphyllene (66.415%), fenchyl alcohol (8.897%), α-pinene (8.188%), caryophyllene oxide (4.648%), menthol (1.69%) and geraniol (1.315%) are the major constituents of SEO. All the anxiolytic studies were conducted at doses of 25 and 50mg/kg body weight. In the social interaction test, SEO decreased aggressive behaviors of the animals (albino rats) while the same significantly increased social interaction time of the high light, familiar as well as unfamiliar test conditions. In the hole-board test, SEO significantly increased head-dipping counts and its duration. The SEO significantly increased number of entries and time spent in open arms on the elevated plus maze test while as in the light/dark arena test, SEO showed an increase in number of crossings and time spent in light arena.Conclusion: Results indicate that SEO has a wide range of anxiolytic properties and pave a way for new drug search for anxiety.

Modified Ling-Gui-Zhu-Gan decoction combined with short-term fasting improves therapeutic response in type 2 diabetic patients - Corrected Proof

2012-01-25

Abstract: Objective: To evaluate the effects of a Traditional Chinese Medicine herbal decoction (modified Ling-Gui-Zhu-Gan decoction) combined with short-term fasting/very-low-calorie-diet (VLCD) on the therapeutic response in type 2 diabetes mellitus (T2DM) patients.Materials and methods: A randomized controlled pilot-study was conducted with 60 T2DM patients (age 52.1±13.4y, BMI 25.7±3.7kg/m2) with a lack of glycemic control. Patients were randomly allocated to the intervention group (n=30) or the control group (n=30). All patients received in-hospital treatment for one week followed by lifestyle recommendation. Patients in the intervention group participated in a 5-day modified fasting/VLCD combined with an intake of Ling-Gui-Zhu-Gan decoction. Patients in the control group received standard treatment only. Outcomes were assessed at baseline and at 3-months.Results: Fasting plasma-glucose, 2-h plasma-glucose after oral glucose tolerance-test, HbA1C, and the use of anti-diabetic medication decreased significantly in the intervention group compared to the control group after three months. Body weight also decreased significantly.Conclusions: A combined integrative treatment approach including fasting/VLCD and a Traditional Chinese Medicine decoction might be superior to standard treatment in T2DM patients. This therapeutic concept should be further evaluated.

Comparing two questionnaires for eliciting CAM use in a multi-ethnic US population of older adults - Corrected Proof

Sara A. Quandt, Edward H. Ip, Santiago Saldana, Thomas A. Arcury — 2012-01-24

Abstract: Introduction: The NAFKAM International CAM Questionnaire (I-CAM-Q) was designed to facilitate cross-study comparisons of CAM usage. This research presents the first empirical study of the I-CAM-Q's performance.Materials and methods: Data were collected in two studies in a multi-ethnic (African American, American Indian, and white) population of older adults in the US. In 2010, 564 adults 60+ years were recruited. The I-CAM-Q was interviewer-administered. Data were compared to those collected in 2002 from a random sample of 701 Medicare recipients 65+ years. The 2002 survey included an extensive inventory of specific CAM therapies derived from local ethnographic research. Comparisons of the responses for 14 CAM modalities common to the two studies used logistic regression adjusted for demographics.Results: There were no significant differences between the 2002 and 2010 surveys in the proportions reporting 10 modalities, including use of chiropractors, homeopaths, acupuncturists, herbalists, spiritual healers, vitamins, minerals, homeopathic remedies, Qigong, visualization, and prayer for health. Significantly less use of physicians and more use of relaxation techniques were reported in 2010. Herb use and garlic, as a specific herb, were reported significantly less in 2010.Conclusions: Overall, the I-CAM-Q obtained results similar to those produced by a population-specific questionnaire. Those differences observed appear to reflect differences in the studies’ inclusion criteria or secular trends in CAM. This study supports the intention of the I-CAM-Q to substitute for local and regional surveys in order to allow cross-study comparisons of CAM use. Further tests, preferably through contemporaneous data collection are needed in other populations.

Acupuncture for Whiplash-associated disorder: A randomized, waiting-list controlled, pilot trial - Corrected Proof

2012-01-09

Abstract: Introduction: Whiplash-associated disorder (WAD) is a general after-effect of motor vehicle collisions or sporting accidents. Acupuncture is a common intervention for pain conditions such as musculoskeletal disease. We conducted a pilot trial to determine the efficacy and safety of acupuncture for patients with WAD.Methodology: Forty participants were randomly allocated to an acupuncture group or a waiting-list group. The acupuncture group received acupuncture treatment three times per week for 2 weeks.Symptoms were evaluated before random allocation and after 2 weeks. The primary outcome measure was pain intensity. Secondary outcome measures were the SF-36, cervical range of motion (ROM), Self-Rating Depression Scale (SDS), and the Cornell Medical Index (CMI).Results: The results demonstrated that the change in visual analogue scale (VAS) in the acupuncture group was −1.85 [−2.67 to −1.02], compared to −0.40 in the waiting-list group [95% CI: −1.18 to 0.38] (p=0.001). VAS significantly improved from 4.59 [3.67–5.48] at baseline to 2.74 [2.08–3.37] at the endpoint (p<0.001) in the acupuncture group. No significant changes in secondary outcomes such as SF-36, Cervical ROM, SDS and CMI within either group were observed, and the scores from baseline revealed no significant differences between the groups. There were no reports of serious adverse events related to acupuncture treatment.Conclusions: Acupuncture treatment was associated with a significant alleviation of pain. This pilot study provided preliminary data on the efficacy and safety of acupuncture treatment for WAD. A full-scale randomized controlled trial is required to provide firm evidence of the effectiveness of this intervention.