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We aimed to assess the unresolved health issues experienced by a cohort of snakebite survivors and their health-seeking behaviours during the first three months after the snakebite. Patients from the Anuradhapura snakebite cohort admitted to the Teaching Hospital Anuradhapura, Sri Lanka, from July 2021 to June 2022 were recruited. Patients were interviewed over the telephone three weeks and three months post-bite to collect data on unresolved health problems post-discharge, patient's adherence to the review plan, newly experienced health issues, health-seeking behaviours and the effect on daily routine. Only snakebite survivors who could be contacted at both three weeks and three months were included. Of 710 eligible patients, 384 (54%) were contactable at both reviews. On discharge from the hospital, 248/384 (65%) had unresolved effects of the snakebite, including 224/384 (58%) who had local effects. The unresolved health problems were reported by patients bitten by H. hypnale (54%), D. russelii (23%), and unidentified snakes (19%). At three weeks and three months, 98/384 (26%) and 52/384 (14%) still had unresolved local effects of envenoming, respectively. Of 144/384 (38%) who were advised to attend review visits post-discharge, mostly to assess renal function, 118 (82%) complied. 112/384 (29%) patients reported self-motivated treatment seeking for unresolved effects of snakebite over the three months. Of them, 87 (78%) visited Sri Lankan indigenous medical practitioners. Patients missed a median of two working days (IQR: 2–4 days) post-discharge. 26 (6.7%) were unable to return to work at 3 weeks, and five patients at 3 months. In rural Sri Lanka, a significant number of viper bite patients leave hospital with mild persistent local effects, which commonly leads to them seeking further treatment. Despite that, almost all snakebite survivors had returned to work at three months post-bite. [Display omitted] • Health-seeking behaviours after hospital discharge is rarely reported. • We followed up 384 snakebite patients after hospital discharge in rural Sri Lanka. • 58% of snakebite patients have unresolved health effects when leaving the hospital. • The patients seek treatment for these effects from both indigenous and allopathic practitioners. • Arranging adequate pain relief, wound care and physiotherapy after hospital discharge is important. [ABSTRACT FROM AUTHOR]

Abstract Objectives To highlight legal and regulatory advances relating to South African traditional health practitioners (THPs) over the past 10 years and discuss the implications for the translation of health policies into guidelines for sustainable practice supporting public health. Study design This is a rapid, structured literature review. Methods A rapid, structured literature review was undertaken to identify relevant studies related to South African THPs involving a search of peer-reviewed literature from three databases and a grey literature internet search. The identified citations were screened, critically appraised, and narratively synthesized. Results Efforts to regulate THPs in South Africa are underway; however, the lack of a regulatory framework for traditional practices is hampering progress. Several efforts to collaborate with THPs have been made over the years, many of which were not systematically evaluated and not based on principles of mutual respect. Existing collaborative examples need to be further supported by cost-effective evidence to suit the South African public health budget. Furthermore, small collaborative research efforts do not take into consideration the scale up of interventions. Conclusions THPs in South Africa represent an important healthcare resource. However, the current policy environment does not support indicators to describe, monitor, and/or evaluate the role of THPs in the healthcare system. Highlights • Regulation of traditional health practitioners (THPs) in South Africa is underway. • The number of THPs testifies to the importance and resilience of their practice. • Focused public health policies of THPs in health care are lacking. [ABSTRACT FROM AUTHOR]

Background The 2007 United Nations Declaration on the Rights of Indigenous Peoples states that Indigenous peoples have the right to self-determination for social and cultural development. This fundamental right has been impeded worldwide through colonisation where many Indigenous peoples have had to adapt to ensure continuation of cultural knowledge and practice. In South East Australia colonisation was particularly brutal interrupting a 65,000 year-old oral culture and archives have increasing importance for cultural revival. Aim The aim of this research was to collate archival material on South East Australian Aboriginal women’s birthing knowledge and practice. Methods Archivist research methods were employed involving a search for artefacts and compiling materials from these into a new collection. This process involved understanding the context of the artefact creation. Collaborative yarning methods were used to reflect on materials and their meaning. Findings Artefacts found included materials written by non-Aboriginal men and women, materials written by Aboriginal women, oral histories, media reports and culturally significant sites. Material described practices that connected birth to country and the community of the women and their babies. Practices included active labour techniques, pain management, labour supports, songs for labour, ceremony and the role of Aboriginal midwives. Case studies of continuing cultural practice and revival were identified. Conclusion Inclusion of Aboriginal women’s birthing practices and knowledge is crucial for reconciliation and self-determination. Challenging the colonisation of birthing, through the inclusion of Aboriginal knowledge and practice is imperative, as health practices inclusive of cultural knowledge are known to be more effective. [ABSTRACT FROM AUTHOR]

This case study describes the effects of the use of curanderismo, an indigenous healing modality combining techniques in massage, sound, and aromatherapy, on a patient with chronic pain. Despite being a commonly used health practice in certain populations, little is reported in the medical literature about the use of curanderismo. Case report as part of a larger randomized trial of curanderismo for chronic pain. Setting was a community-based hospital affiliated primary care clinic. An adult patient with chronic, opioid dependent back pain following an injury, and subsequent spinal fusion was treated. Intervention was the patient received 33 curanderismo treatment sessions over 10 months in addition to ongoing conventional treatment at a community-based chronic pain management clinic. Main outcomes measures were self-reported assessments of pain, functional ability, mood, insomnia, and narcotic usage. Secondary outcome measure was qualitative interview. Although there was no change in quantitative self-reported pain measures, the patient reported improved function, mood, and sleep as well as decreased narcotic usage. Curanderismo, in addition to conventional pain management, improved patient reported symptoms and functional ability, led to healthy lifestyle changes, and decreased narcotic usage. Controlled studies are needed to confirm the benefit of curanderismo as safe, non-interventional, and cost-effective adjunct for chronic pain management. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance The rich flora of Guinea-Bissau, and the widespread use of medicinal plants for the treatment of various diseases, constitutes an important local healthcare resource with significant potential for research and development of phytomedicines. The goal of this study is to prepare a comprehensive documentation of Guinea-Bissau’s medicinal plants, including their distribution, local vernacular names and their therapeutic and other applications, based upon local notions of disease and illness. Materials and methods Ethnobotanical data was collected by means of field research in Guinea-Bissau, study of herbarium specimens, and a comprehensive review of published works. Relevant data were included from open interviews conducted with healers and from observations in the field during the last two decades. Results A total of 218 medicinal plants were documented, belonging to 63 families, of which 195 are native. Over half of these species are found in all regions of the country. The medicinal plants are used to treat 18 major diseases categories; the greatest number of species are used to treat intestinal disorders (67 species). More than thirty ethnic groups were identified within the Guinea-Bissau population; 40% of the medicinal plants have been recorded in the country’s principal ethnic languages (i.e. Fula and Balanta). Conclusions This multi-disciplinary, country-wide study identifies a great diversity of plants used by indigenous communities as medicinal, which constitute an important common reservoir of botanical species and therapeutic knowledge. The regional overlap of many indigenous species, the consensual nature of disease groups based upon local perceptions of health conditions, and the relevance of local vernacular including Guinean Creole are key factors specific to the country which enhance the potential for the circulation and transmission of ethno-botanical and therapeutic knowledge. [ABSTRACT FROM AUTHOR]

December 2013 marked a significant shift in Bolivia with the enactment of a law for the inclusion of indigenous doctors in the National Health System. This article traces the constellation of forces that led to the institutionalization of indigenous medicine in Bolivia. It identifies three factors contributing to this health policy change. The first factor is the crystallization of a strong indigenous movement fighting for the recognition of cultural rights through the foundation of civil society organizations. Second is the rise to power of Evo Morales, the first Latin American president of indigenous origin, who has promoted multicultural policies, formally supported through the promulgation of a new constitution. Lastly is the influence of the global acceptance of alternative medicine. Indigenous doctor organizations in Bolivia have been highly involved throughout the entire process of institutionalization and have played a crucial role in it. An analysis of the relationship between these civil society organizations and the Bolivian government reveals a strong partnership. This dynamic can be described in terms of Interdependence Theory, as each party relied on the other in the promotion and practice of the law to achieve the integration of indigenous medicine as part of the Bolivian Health System. [ABSTRACT FROM AUTHOR]

Indigenous groups of the Amazon have developed intricate methods for the application of psychoactives, among which particularly the dieta or diet method of Peruvian-Amazonian traditional medicine stands out. It is a retreat-like intervention involving lengthy periods of social, behavioural, and alimentary restrictions, while ingesting specially prepared plant substances. The interplay of the dietary conditions and plants ingested sensitizes the dieter to receive healing, strength, guidance, and knowledge. From a clinical scientific point of view, the method has remained largely underexplored, but seems more pertinent than ever given the increasing interest in Amazonian psychoactive preparations including ayahuasca (Banisteriopsis caapi) and the burgeoning field of psychedelic-assisted therapies in general. This study offers a descriptive account and emic interpretation of the Peruvian-Amazonian dieta. More specifically we document in detail the procedure, its context and purpose of application, effects, modes of action, adverse effects, and risks, from the perspectives of a sample of Peruvian traditional healers. The Peruvian-Amazonian dieta is a multi-purpose method for making use of medicinal plants, many of which (but not all), are psychoactive; the current work especially focuses on its therapeutic applications in conjunction with psychoactives. We interviewed 16 healers working in the Ucayali, San Martín, and Loreto provinces of Peru using a semi-structured interview approach. Interviews were audio-recorded and transcribed verbatim. The extensive data derived from these interviews were analysed by means of computer-assisted manifest qualitative content analysis using a theory-advancing approach. Over 500 coded text segments were categorized, resulting in 7 main theme clusters and corresponding sub-themes. The interviewed healers described a complex intervention with multifaceted applications (treatment, prevention, training) and effects in various domains (body, mind, spirit, energy). The process was portrayed as transformative, with benefits attributed to the effects of the so-called teacher plants in conjunction with the diet's conditions, along with the skill of the healer guiding the intervention. Further, a detailed risk assessment revealed sophisticated safety measures and tools designed to address adverse responses. The importance of adequate training of the healer that administers the diet was particularly highlighted in this context. The dieta is a central therapeutic concept and tool in Peruvian-Amazonian traditional medicine and a unique method for using psychoactive plants. Multidisciplinary health research that includes traditional treatment methods from Indigenous cultures, Amazonian and other, should not be neglected in the current global interest in psychedelic therapies; such research may in the long-term contribute to a more inclusive psychedelic research paradigm as well as healthcare practice in countries where rich traditional healing systems exist, and perhaps beyond. It may also contribute to the recognition of the Indigenous healers as not only historical forerunners, but also current leading experts in psychedelic medicine. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: The vast genus Rhododendron includes species that have been used in traditional medicine for the treatment of inflammatory conditions, pain, gastro-intestinal disorders, common cold, asthma, skin disease, etc. Rhododendrons are also well known for their toxicity and some species have been traditionally used as poison. Aim of the review: The work reviews and analyses the traditional use, biological activities with the corresponding chemical constituents, and toxicological data on Rhododendron species. The review aims at characterizing the ethnopharmacology of the genus in relation to its toxicity in order to identify the therapeutic potential of Rhododendron species and future directions for research. Methods: Data regarding Rhododendron spp. was collected using electronic databases (SciFinder, PubMed, Google Scholar) and library search for selected peer-reviewed articles. Plant taxonomy was validated by the databases The Plant List, Tropicos, eFloras, Flora Iberica and Flora Europaea (RBGE). Additional information on traditional use and botany was obtained from published books. The review encompasses literature, mainly regarding biological activity and toxicological data, from 1898 to the end of December 2012. Results: Rhododendrons have been used in Asian, North American and European traditional medicine mainly against inflammation, pain, skin ailments, common cold and gastro-intestinal disorders. In vivo and in vitro testing of plant extracts and isolated compounds determined diverse biological activities including anti-inflammatory, analgesic, anti-microbial, anti-diabetic, insecticidal and cytotoxic activity. Rhododendron spp. can cause intoxications in humans following intake of rhododendron honey or medicinal preparations. The toxicity is due to grayanotoxins, diterpenes which activate voltage-gated sodium channels and lead to gastro-intestinal, cardiac and central nervous system symptoms. Conclusion: Rhododendron species are useful traditional remedies for the treatment of inflammation, pain, skin ailments, common cold and gastro-intestinal disorders. Pharmacological data has validated most indications of rhododendrons in ethnomedicine and toxicology studies have confirmed the toxicity observed by traditional use. Ethnopharmacological data point to the therapeutic potential of the genus Rhododendron for the treatment of inflammatory conditions and pain and, thus, research should focus on identification of active compounds and related mechanistic studies. Prolonged and high dose intake of traditional formulations containing rhododendrons should be avoided until more in depth toxicity studies become available. [Copyright &y& Elsevier]

Abstract: Approximately 60 species of Bridelia, (Phyllanthaceae) are found throughout tropical and subtropical regions of the world, mainly in Africa and Asia. Several Bridelia species are used in popular medicines as antiamebic, antianemic, antibacterial, anticonvulsant, anti-diabetic, antidiarrhoeal, antihelmintic, anti-inflammatory, antimalarial, antinociceptive, antiviral, hypoglycemic and for abdominal pain, cardiovascular, gynecological and sexual diseases. The present paper reviews the traditional usage, the biological activities and the correlated chemical compounds of Bridelia species with emphasis on the validation of the ethnopharmacological uses. The findings in some Bridelia species of, for example, gallocatechin-(4′-O-7)-epigallocatechin (1), quercetin (2), myricetin glycosides (5–6), bridelone (11), bridelonine (12), isoflavone may justify the uses of these species against pains in African and Asian traditional medicines. [Copyright &y& Elsevier]

Context: Gua Sha, therapeutic surface frictioning that intentionally raises transitory petechiae and ecchymosis, is a traditional East Asian healing technique also known as cao gio, coining, scraping, and spooning. There are case reports in Western literature but no studies on the physiological effects of Gua Sha. Objective: To study the microcirculatory effects of Gua Sha on the skin and subcutis in humans to elucidate physiological mechanisms responsible for the clinically observed pain-relieving effect of this treatment Design: Laser Doppler imaging (LDI) was used to make sequential measurements of the microcirculation of surface tissue before and after Gua Sha treatment in 11 healthy subjects. The effect of Gua Sha treatment on the microcirculation of surface tissue was expressed as changes from baseline in arbitrary perfusion units (PU). Setting: The study was conducted at the Department of Nephrology, Unit of Circulation Research, University Hospital of Essen, Germany. Subjects: Subjects were volunteers from the nursing and physician staff of the Kliniken Essen. Intervention: A single Gua Sha treatment was applied to an area of each subject’s back. Outcome Measures: Change in microcirculation was measured in PUs. Change in myalgia was subjectively reported and confirmed by manual palpation. Results: Gua Sha caused a fourfold increase in microcirculation PUs at the treated area for the first 7.5 minutes following treatment and a significant increase in surface microcirculation during the entire 25 minutes of the study period following treatment (P < .001). Females showed significantly higher rates of response than males (P = .003). Each subject experienced immediate decrease in myalgia in both the site treated, in the related distal control site, and in some cases, other distal sites. Pain relief persisted to some extent up to the follow-up visit. There were no adverse reactions. Conclusion: Gua Sha increases microcirculation local to a treated area, and that increase in circulation may play a role in local and distal decrease in myalgia. Decrease in myalgia at sites distal to a treated area is not due to distal increase in microcirculation. There is an unidentified pain-relieving biomechanism associated with Gua Sha. [Copyright &y& Elsevier]

Abstract: Approximately 500 species of Ardisia (Myrsinaceae) are found throughout tropical and subtropical regions of the world. Several of those Ardisia species have been used as ornamental plants, food and medicines. Due to taxonomic confusions, correct identification and acquisition of plant materials remain difficult for some species. Although species of Ardisia are a rich source of novel and biologically potent phytochemical compounds, such as bergenin and ardisin, the utilization of Ardisia species or their phytochemical constituents have not been fully explored, resulting in underexploitation of their uses. The present article reviews the usage and biological activities of Ardisia compounds, as well as recent progress regarding the use of this genus in clinical research. The information presented here also illustrates the potential of the genus as a source of therapeutic agents. [Copyright &y& Elsevier]

Traditional pharmacopeias have been developed by multiple cultures and evaluated for efficacy and safety through both historical/empirical iteration and more recently through controlled studies using Western scientific paradigms and an increasing emphasis on data science methodologies for network pharmacology. Traditional medicines represent likely sources of relatively inexpensive drugs for symptomatic management as well as potential libraries of new therapeutic approaches. Leveraging this potential requires hard evidence for efficacy that separates science from pseudoscience. We performed a review of non-Western medical systems and developed case studies that illustrate the epistemological and practical translative barriers that hamper their transition to integration with Western approaches. We developed a new data analytics approach, in silico convergence analysis, to deconvolve modes of action, and potentially predict desirable components of TM-derived formulations based on computational consensus analysis across cultures and medical systems. Abstraction, simplification and altered dose and delivery modalities were identified as factors that influence actual and perceived efficacy once a medicine is moved from a non-Western to Western setting. Case studies on these factors highlighted issues with translation between non-Western and Western epistemologies, including those where epistemological and medicinal systems drive markets that can be epicenters for zoonoses such as the novel Coronavirus. The proposed novel data science approach demonstrated the ability to identify and predict desirable medicinal components for a test indication, pain. Relegation of traditional therapies to the relatively unregulated nutraceutical industry may lead healthcare providers and patients to underestimate the therapeutic potential of these medicines. We suggest three areas of emphasis for this field: First, vertical integration and embedding of traditional medicines into healthcare systems would subject them to appropriate regulation and evidence-based practice, as viable integrative implementation mode. Second, we offer a new Bradford-Hill-like framework for setting research priorities and evaluating efficacy, with the goal of rescuing potentially valuable therapies from the nutraceutical market and discrediting those that are pseudoscience. Third, data analytics pipelines offer new capacity to generate new types of TMS-inspired medicines that are rationally-designed based on integrated knowledge across cultures, and also provide an evaluative framework against which to test claims of fidelity and efficacy to TMS made for nutraceuticals. Schematic grouping of traditional medicine approaches. Schematic representation of out-grouping of formalized phytomedicines and phytopharmacopeias from other traditional medicine approaches and pseudoscientific approaches. The potential of each group of approaches to be evaluated and distributed across axes of the potential or actual scientific proof of efficacy, plausibility of mechanism of action, and the potential for placebo effect (likely related to perceived complexity). Image 1 [ABSTRACT FROM AUTHOR]