Alternative & Integrative Medicine

Background: Homeopathic products are sold over the counter and are often used for treatment of self-limiting complaints in children such as painful teething. Objective: To investigate the effectiveness, safety and tolerability of the homeopathic product ChamBell-5-02, in the treatment of children with painful teething in comparison to another homeopathic product. Design: A multicenter, randomized, open, comparative clinical trial with two parallel treatment groups at three outpatient pediatric clinics in Russia. Methods: Children aged ≤ six years with painful teething were enrolled from March-July 2009 in the study and randomized to receive either ChamBell-5-02 tablets (Dentokind®; intervention group) or homeopathic suppositories (Viburcol®; control group). Exclusion criteria were: fever of ≥38°C and severe comorbidity. Primary effectiveness endpoints were change of total severity scores of subjective complaints (TSSC) and clinical signs (TSCS) rated by investigators after seven days of treatment. Treatment satisfaction and safety (via number of adverse events (AEs)) were assessed. Results: A total of 200 children (100 per group) were included and analyzed. TSSC/ TSCS decreased after the 7- day treatment period from median 7.0 to 1.0/6.0 to 1.0 points in the intervention group and from median 5.0 to 1.0/5.5 to 1.0 points in the control group. Compared to the control group children receiving ChamBell-5-02 had about five/2.5 time higher odds of showing improvement (TSSC/TSCS: odds ratio resulting from proportional odds model was 5.1 (95%-CI: 2.7-9.4, p<0.0001) / 2.5 (95%-CI: 1.5-4.4, p=0.0011). Furthermore the intervention group showed a more favorable outcome regarding treatment satisfaction (ratings very satisfied: intervention group: n=94; control group: n=58). No AEs were recorded in the intervention group. In the control group three mild to moderate, nonserious AEs occurred. Conclusions: Overall it can be concluded that in this study ChamBell-5-02 tablets showed to be effective, safe and well tolerated.

Background: Traditional medicine is the ancient and culture bound medical practice which existed in human societies before the application of modern science to health. Around 80% of Ethiopians relies on traditional medicines. Although some traditional medical practices in children are useful and contributing positively and need to be strengthen, some are harmful from the perspective of health. In Ethiopia, studies conducted so far are very limited and focused on adults. As a result, this study was conducted to assess the prevalence and factors associated with parental traditional medicine practice for children. Objective: The aim of this study was to assess prevalence and factors associated with parental traditional medicine use for children in Motta Town. Methods: Community based cross-sectional study design was used. Data was collected using structured interviewer administered questionnaire. The study was conducted among 381 households selected using systematic random sampling method. Both descriptive and inferential statistics were used to present the data. Odds ratio, binary and multiple logistic regression were used to assess the association between dependent and independent variables. Result: It was found that 88.2% of parents had used either forms of traditional medicine for their children. The top therapies used were herbs (66.9%), religious therapies (52.8%), massage (22.8%), bone settler (21.8%) and traditional birth attendants (13.1%). Female parents, low educational level, accessibility of traditional medicine, low price and perceived effectiveness were significantly associated with parental traditional medicine use for children. Conclusion and recommendation: There was high parental traditional medicine practice for children in this study. Female parents, low educational status, easily accessibility, cheap in price and perceived effectiveness were significant predictors. The integration of traditional medicine as part of modern medicine and controlling mechanism should be strengthen. Community education and further research on its efficacy and safety should also be done.

Ayurveda is the science of healthy life. In Aurvedic texts there are brief description of Human body and its anatomical structures. In that order acharya shushrut has described the Sira in sharir sthana chapter seven. Charak has defined the Sira as Sarnat sira in Sutra sthan chapter thirty. Shushrut has mentioned four types of Sira-Aruna, Neela, Sweta, Lohita. These are relevant respectively with the Dosha Vatta, Pitta, Kapha Rrakta. We can regard “Neela sira” as the veins which collect impure blood from all over the body towards the Heart. The blood flow in these Sira by slow velocity is called Saran kriya. These Sira are basically of two types - one of them can be punctured for curing the disease is called Vedhya siras, 602 in number. Another type of Siras are Avedhya siras, 98 in number, which are strictly prohibited for puncturing, if by mistake or by stupidity of the Chikitsak these are punctured the it leads to harmful results. There are several examples of disease those are cured by that Venupucture or Sira Vedhan process like Gradharasi, Vishvachi, Unmad, Apasmar etc. In this paper Avedhya Sira are very well discussed W.S.R to the anatomical structures involved in modern medical science. These are divided in three regions Shakhagat-16, Kosthgat-32, and Urdhavjatrugat-50.

Background: Prior research confirms that insomnia is highly prevalent in patients with psychiatric disorders. Benzodiazepine hypnotics, causing serious disadvantages, have been widely used in psychiatry for a long time. Sansoninto (SNT), Japanese herbal medicine, is used for patients with weakness and fatigue, annoyance, insomnia, amnesia, and neurotic symptoms.
Objective: The efficacy and safety of SNT was examined in adult psychiatric disorder patients with insomnia symptoms.
Methods: Eighty-one adults with sleep disturbance meeting DSM-IV-TR diagnostic criteria for psychiatric disorders (schizophrenia: 17; monopolar depression: 20; bipolar depression: 10; adjustment disorder: 12; anxiety disorder: 5; others: 17) were treated openly for four weeks with SNT (2.5-7.5 g) at bedtime. Patients maintained sleep throughout the study. Efficacy was analyzed using a repeated measures methodology. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes were the Insomnia Severity Index (ISI), Athens Insomnia Scale (AIS), Clinical Global Impression-Improvement (CGI-I), and change of dosage of benzodiazepine hypnotics (diazepam equivalent).
Results: After 4 weeks of SNT therapy, significant symptom reduction was observed on all parameters (PSQI: 10.22 ± 3.23 vs. 3.11 ± 3.52; ISI: 20.63 ± 4.86 vs. 3.38 ± 5.10; AIS: 17.41 ± 4.69 vs. 2.85 ± 4.23; dosage of benzodiazepine hypnotics [diazepam equivalent, mg]:10.5 ± 4.71 vs. 2.98 ± 3.37). No withdrawal involved treatmentrelated adverse events.
Conclusion: Data from this 4-week open-label study suggests SNT was an effective and generally well tolerated treatment for insomnia symptoms in this sample of adult patients with psychiatric disorders.
Trial Registration: controlled-trials.com Identifier: UMIN000014156.

In Nigeria, the practice of traditional bone setting (TBS) is extensive as in other developing nations. Traditional bonesetters play an imperative role in fracture care. Though, the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient in the future. This study seeks to examine the activities of traditional bone setters on fracture care in Ekiti State, Nigeria. Survey method was applied in the study. 250 questionnaires were administered to owners of traditional bone centres and their clients respectively. Ten (10) of such centres were selected for the study in Ekiti. The findings indicated that majority of the bone setters had little or no formal education. Many of them acquired the schema used through ancestral/supernatural power. The TBS lack basic knowledge of investigations and wound care while most of their clients patronized them because of poverty, ignorance and superstitious beliefs. Provision of adequate basic equipment in health institutions may reduce the rate at which people utilize Traditional bone centres against medical advice.

Cupping is an ancient remedy that is known in many parts of the world. Wet cupping in specific is more popular in the Arab region, since was a recommended treatment in Islam. Despite of that, it still needs more research to prove its efficacy on many diseases, and hypertension is one of them. The objectives of this study are to determine the efficacy of wet cupping on high blood pressure among hypertension patients. Also, to assess the incidence of wet cupping side effects in the intervention group. This pilot study is a two-armed randomised controlled trial with 10 participants assigned to the intervention group and 8 in the control group. The intervention group were high blood pressure patients who performed 3 sessions of wet cupping in addition to their usual anti-hypertension management, and the control group were high blood pressure patients who received their usual anti-hypertension management only. The results after 4 weeks of follow up showed no significant difference between the intervention and control group in both the mean difference of systolic and diastolic blood pressure. There were no serious side effects of wet cupping in this study. In conclusion, wet cupping therapy was found to be efficient in reducing blood pressure in previous similar studies, but this finding was not shown in this study maybe because of the small sample size, since this is a pilot study. More research is still recommended in that area.

Objectives: To evaluate the efficacy of polyherbal Unani formulation for cervical ripening and induction of labour Material and Methods: A prospective, study was conducted in Govt. Nizamia Tibbia Hospital, Hyderabad. Pregnant women (n=38) with gestation age of 38-42 weeks were recruited. A polyherbal Unani formulation powder of Cinnamomum tamala 3 g, Gentiana lutea 1 g, Pinus longifolia 1 g and Peganum harmala 5 g was administrated orally at an interval of 6 hours maximum of 4 doses and a pessary of Gossypium herbaceaum 2 g, Euphorbia resinifera 0.5 g and borax 3 g, was placed in the vagina at an interval of 6 hours, maximum of 4 doses. The main outcome measure was to observe mean induction to delivery interval and spontaneous vaginal delivery. The secondary outcomes were to evaluate rate of induction failure, women given cerviprime or/and oxytocin, cesarean delivery, Apgar score and admission to the neonatal unit. Results: The mean induction to delivery interval was 12.3 ± 4.7 hours. Thirty two (84.2%) pregnant women had spontaneous vaginal deliveries. Among induction failure (15.8%), 7.8%, delivered vaginally after instillation of cerviprime and/or oxytocin and 7.8% delivered by caesarean. Apgar scores at 1 and 5 minutes were 8.9 and 9.9 respectively. None of the babies were admitted in the neonatal unit. Conclusion: The present study shows that the polyherbal Unani formulation was useful for reducing mean induction to delivery interval, and good perinatal outcome.

Background: Food borne diseases continue to be a major global health problem and are the leading causes of morbidity and mortality in developing countries. Food handlers play a major role in the transmission of food borne pathogens via hands. This study aimed to assess the bacterial hand contamination and associated factors among food handlers working in the student cafeterias of Jimma University main campus. Methods and materials: A cross-sectional study was conducted from May 2012 to April 2013 among food handlers working in the student cafeterias of Jimma University main campus. The data was collected by using structured questionnaire and observational checklist. Hand rinse samples was collected from participants and microbiologically examined for the presence of potential food borne bacterial contaminants using standard laboratory methods. The data was entered into a computer and analyzed using SPSS version-16.0 software. Result: Among 230 food handlers, 114(49.6%) were tested positive for one or more potential food borne bacterial contaminants, and 73(31.7%) were tested positive for enteric pathogens. A total of 171 bacterial hand contaminants were isolated. S. aureus 54(23.5%), Klebsiella spp. 37(16.1%), E. coli 25 (10.9%), Enterobacter spp. 21(9.1%), Citrobacter spp. 10(4.3%), Serratia marcescens 6 (2.6%), Pseudomonas aeruginosa 8(3.5%), Proteus spp. 5(2.2%), Providencia rettegri 3(1.3%), and salmonella spp. 2(0.9%) were isolated with their corresponding prevalence rate. Bacterial hand contamination rate have significant association with service years (Chi-square=13.732, DF=4, P=0.008), age (χ2=11.308, P=0.010) and cleanness of outer garments (χ2=7.653, P=0.006). Conclusion: The findings of this study emphasized the importance of food handlers’ hands as a potential vector for potential food borne bacterial contaminants which could constitute a potential risk to food borne outbreaks. New employees and young and inexperienced food handlers should be well trained on personal hygienic practices pointing out on the importance of hand hygiene and appropriate hand washing techniques.

Background: Preserving traditional environmental knowledge about herbal medicine in the face of rapid environmental, economic and cultural change depends in part on the identification of traditionally used medicinal plants to their Latin binomial. When financial, legal, and/or time constraints prevent the collection of voucher specimens or the use of advanced molecular technologies, arguably the “gold standards” for plant identification, alternative methods such as photography and morphological descriptions may still be able to assist identification. There are unknowns about the relative accuracies of these different techniques. This paper compares the efficacy of several methods to correctly identify plants across five separate site visits in the province of Manabí, Ecuador. Methods: Plants that were identified to genus-, and species-level accuracy during each of the five site visits were totaled, and the type of data (expert consultation, written, photographic, and morphological) leading to the identification noted. Percentage accuracy was calculated as the number of unambiguous identifications to Latin binomial divided by the total number of common plant names recorded for each site visit. Results: Ninety-six common plant names were recorded across the five site visits, while each individual visit yielded information about 26-54 plants, reflecting significant overlap. In addition to interview data, site visit 4 uniquely collected additional photographic (34 plants) and morphological data (12 plants). Photographs were more effective in aiding identification to both genus (12) and species (4) than morphological data (4 genus and 0 species identifications). Percentage accuracy for the first four site visits ranged from 27-36%; site visit 5 yielded 91% accuracy, but only when considering a limited subset of the plants. Conclusions: Photographic, and morphological data can aid identification of medicinal plant species to Latin binomial when time, money and/or collection permits are lacking, but should not be considered reliable substitutes for plant voucher specimens or advanced molecular technologies.

Abstract Study background: Use of CAM is increasing not only in adult population, but also in pediatric age groups. Concurrent use of CAM with conventional medicine is also widespread and poses a potential risk of drug interaction. Studies regarding CAM use have been done in other countries, but only few have been reported in India and very few have observed CAM use among patients attending outpatient department of a general hospital. Objective: To find out the pattern of CAM use in patients as well as their attitude and perception regarding CAM therapies. Methods: A cross sectional, observational, questionnaire based study was conducted from May 2013 to May 2014 and included 1000 patients attending OPD of different departments of hospital. A pre-decided questionnaire was provided to them which included thirteen questions for assessment of pattern of CAM use and attitude of patients towards CAM therapy. All data collected were analyzed using appropriate statistical tests. Results: Ayurveda (56%) was the most commonly used CAM therapy followed by homeopathy (34%). 76% patients did not inform their physicians about CAM use. 57.2% patients started using CAM on advice of a relative or friend. 'No or less adverse effects' (69.6%) was the most common reason for CAM preference over conventional medicines. 59% patients were ignorant about the fact that CAM and conventional medicines can interact, and 65.5% patients believed that CAM therapy do not cause any adverse effect. Conclusion: Disclosure rate to concerned physicians about CAM use is low. Patients are largely unaware about the fact that CAM medicines can cause adverse effects and can interact when combined with conventional medicines

This paper described the establishment of a Protocol for the clinical trial, using a traditional herbal formula, for the treatment of Menopausal symptoms among women after menopause. Generally, the traditional practitioners would prefer sticking to their classical practice of a dynamic day to day choice of treatment, according to patients’ “pattern” of physiological state. However, in the standard hospital setting of limited resources, the traditional way of dynamic treatment, according to patient responses and the subsequent comprehensive analysis of variable data would not be possible. As a result, we decided to design a standard protocol following the requirements of Good Clinical Practice. Our experiences demonstrated that it is feasible to perform a well-designed Traditional Chinese Medicine (TCM) clinical trial although there were many challenges such as placebo preparation, outcome determination and batchto- batch consistency of TCM medication.

Hahnemann observed that the non-venereal chronic diseases originate from a diseased condition or disposition to disease transferring from generation to generation for thousands of years. He named the diseased condition as Psora behaving as the fostering soil for almost all possible disease. According to Hahnemann Psora developed from suppression of itch disease by external application in ancient times. Hahnemann considered the peculiar cutaneous eruption was the outward manifestation of internal itch disease, the Psora. Therefore, any external treatment to remove the skin manifestation is detrimental to the patient and should be avoided. Some eminent dermatologist’s perspicacious observation reveals that suppression of some kinds of skin diseases result in virulent internal disorder. It is again justified by another instance that under proper homoeopathic treatment of a chronic disease having history of suppressed skin manifestation in the past, the old eruption definitely reappear satisfying Dr. Hering’s law of cure. Health is the result of the dynamic equilibrium among the disease agent, human host and the environment. Human host possessing hereditary factors have an immense role in the production of large number of diseases. Thus to bring cure to any disease especially chronic disease, one should focus one’s attention towards the patient [host] to find out the fundamental cause without ignoring the disease agents and the environmental factors acting as exciting or maintaining cause. Hahnemann’s ‘Theory of Chronic Disease’ serves as a pioneer to the key of ideal cure of innumerable chronic diseases. Until and unless, Miasm [the fundamental cause of all natural diseases] is done away with by dint of antimiasmatic treatment, the permanent cure of chronic disease is not possible.