Search

In der supportiven Onkologie werden zunehmend Verfahren aus dem Bereich der Naturheilkunde erganzend eingesetzt, um Nebenwirkungen zu lindern. Dieser Artikel beschreibt am Beispiel der oralen Mukositis, welche naturheilkundlichen Therapien sich in der Praxis bewahrt haben. In supportive oncology, methods from the field of naturopathy are increasingly being used to alleviate side effects. Using the example of oral mucositis, this article describes which naturopathic therapies have been successfully proven in practice.

Extrapyramidal symptoms (EPSs) are common adverse reactions to antipsychotics in patients with schizophrenia. The purpose of this study was to investigate the effects of edible horticultural therapy (EHT) on EPSs in schizophrenic patients. This study assessed the changes in psychopathological symptoms and extrapyramidal symptoms in patients with schizophrenia before and after participating in a six-session EHT. Forty schizophrenic patients, recruited from Wuhan Wudong Hospital, were randomly assigned to the EHT group (average age: 45.40 ± 13.960 years) or the control group (average age: 49.30 ± 12.516 years). The EHT program held weekly sessions from May 2020 to June 2020. A psychiatrist assessed the psychopathological symptoms and extrapyramidal symptoms of schizophrenic patients in both groups with the Chinese version of the Positive and Negative Syndromes Scale (PANSS) and the Rating Scale for Extrapyramidal Side Effects (RSESE). After six courses of horticultural therapy, the terms of positive, negative, and general symptoms on the PANSS significantly improved in the EHT group. Moreover, the EPSs were also significantly improved in the EHT group. However, there was no change in the PANSS and RSESE scores in the control group. This study shows that EHT has the potential to improve not only psychopathological symptoms but also EPSs in psychiatric patients. This adds new evidence for EHT as an adjunct to treatment for schizophrenia.

Introduction : The mechanism of breast cancer is the cells growing and breeding become appear abnormal tissue of breast. One of the common treatments for it is chemotherapy using cytotoxic drugs. However, chemotherapy may cause nausea and vomiting as its side effects. Lemon aromatherapy is a complementary therapy in patients with breast cancer who experience nausea or vomiting. The study’s purpose was to know the effect of lemon aromatherapy on the intensity of nausea and vomiting experienced by the breast cancer patients as an effect of chemoterapy in the Chemo Center Room of RSAL Dr. Ramelan Surabaya. Material and Methods : The study was the pre-experimental design with pre-post test without control group. There are two variables, lemon aromatherapy is independent, and the intensity of nausea and vomiting is dependent. The sampling technique was nonprobability purposive sampling, with 34 breast cancer patients taken as the sample. A questionnaire was the instrument for collecting the data. The Data collected were analyzed using the Wilcoxon Test (α = 0,05). Results : The study’s result indicated that the lemon aromatherapy was effectively to decrease of the intensity of nausea and vomiting exeperienced by the respondents, with the value of Wilcoxon test p < 0.001. Conclusion : Lemon aromatherapy stimulates the raphe nucleus to produce serotonin. Which function to generate a sense of comfort and calm. For that reason, it can be used as an alternative for taking care of nausea and vomiting experienced by patients with breast cancer as the side effect of chemotherapy. Keywords: Lemon Aromatherapy, Nausea, Vomiting, Chemotherapy

Introduction: Epilepsy is one of the most common disorders of the nervous system and affects people of all ages, races, and ethnic backgrounds, and seen more commonly in children. Atypical febrile seizure with Status epilepticus is a disorder known for significant morbidity and mortality. Despite newer antiepileptic drugs, 30 % of subjects are refractory to the conventional treatment with a risk of recurrence and neuro-developmental disorder. This paper presents one such case of a child handled successfully by Yoga Prana Vidya (YPV) Energy healing complementarily to conventional therapy. Materials and Methods: This is a prospective case study of a 2-month-old infant, an emergency case of atypical febrile seizures with status epilepticus, where YPV Healing intervention was done from the beginning while admitting doctors had given a guarded prognosis. Result: This case study reports the normal physical, mental & psychological development of the subject following YPV Healing with 3-year follow up, and the subject was observed to be normal without any recurrence of the disease or neuro-developmental abnormality. Conclusion: Although the use of Complementary and Alternative Medicine (CAM) has been evaluated globally, there are few studies available on the use of Energy healing in various ailments. YPV Healing has been emerging as an effective modality of treatment for various physical, psychological ailments without any side effects. It can be effectively used from distance even without physically examining the subject. It has been used as a complementary or alternative modality of treatment in some severe life-threatening emergency conditions, and further studies may be conducted with appropriate sample sizes. Keywords: Complementary and alternative therapy, Epilepsy, Atypical seizures, Yoga Prana Vidya healing.

Background: Emesis gravidarum is a feeling of nausea that appears in pregnant women, especially in the morning. Pregnant women experience nausea, vomiting, 2% in the morning, 80% throughout the day and 18% progress to delivery. In Indonesia, there are 50-75% cases of nausea and vomiting experienced by pregnant women. The cause is an increase in the hormones estrogen, progesterone and the secretion of hCG. The content in ginger (Zingiber OffIcinale) and mint leaves (Mentha Piperrita L) can reduce the incidence of emesis gravidarum thereby preventing bad health conditions of pregnant women that interfere with fetal growth and development. Purpose: To know the effectiveness of giving ginger and mint leaves to reduce emesis gravidarum for pregnant women. Methods: The research method used is the Quasy Experiment method with the Two Group Pre and Post-Test Design approach. The population of first trimester pregnant women is 60 people. The number of samples in each group was 4 women using the 2 free sample formula and purposive sampling technique. The results of the normal distribution test with the Saphiro Wilk test, the data are normally distributed so that it uses the paired t-test and the independent t-test. Results: Based on the univariate test, it was found that the average before infusion of ginger was 9.25 and 5.25 after being given steeped ginger. On average, before being given the mint leaf steeped was 10.0 and after being given the mint leaf steeped was 7.00. Based on the paired t-test, it was found that the p-value of steeped ginger was 0.011

OBJECTIVE: The purpose of this study is to determine the effect of Apis dorsata Honey as a complementary therapy on IL-37 levels and fatigue in breast cancer patients undergoing chemotherapy. METHOD: The study used a quasi-experimental pretest-posttest design with a control group. A total of 30 subjects were recruited using a concurrent sampling technique. The intervention group consisted of 15 subjects who received oral honey at a dose of 13 ml (1 tablespoon × 3) for 15 days, and the control group consisted of 15 subjects. The groups’ samples were chosen at random. The Fatigue Symptom Inventory (FSI) was used to assess the side effects of chemotherapy. RESULTS: Although the effect of Apis dorsata Honey on IL-37 levels was not statistically significant (p > 0.05), the group given honey experienced a clinically significant increase in IL-37 levels, with a mean before (632.37514.93) and post (632.37514.93). (1,003.021,248.88). Fatigue decreased statistically significantly in the group given mean honey values prior to 13.205.59 and after 11.805.07 (p = 0.004). CONCLUSION: Honey administration increases IL-37 levels clinically, though the increase is not statistically significant. Giving honey to patients with breast cancer can help alleviate fatigue caused by chemotherapy.

Background: Movement-based mind–body interventions (MMBIs) have been identified as an alternative and complementary therapy to ameliorate symptoms associated with osteoarthritis (OA). However, ther...

INTRODUÇÃO: A paroxismia de tronco encefálico, descrita em pacientes com esclerose múltipla (EM), caracteriza-se por episódios rápidos de vertigem e nistagmos evocados por movimentos cefálicos. A neuromodulação tem apresentado sucesso terapêutico em várias disfunções da EM, mas ainda não foi utilizada na paroxismia. OBJETIVO: Avaliar o efeito aditivo da neuromodulação por estimulação elétrica neural transcutânea (TENS) na musculatura periocular em paciente com EM e paroxismia de tronco encefálico não responsiva à reabilitação clássica associada à medicação. MATERIAL E MÉTODOS: Avaliação do nistagmo com videonistagmógrafo, da sensibilidade cutânea facial com estesiômetro, do blefaroclônus por gravação em vídeo e da sensação dolorosa de forma subjetiva (descrição pessoal da paciente); execução de 10 sessões consecutivas semanais de exercícios oculares associados à TENS na musculatura do oblíquo inferior e reto lateral direitos. RESULTADO: Melhora da algia, do blefaroclônus, da vertigem e do nistagmo ocular direito. CONCLUSÃO: A neuromodulação com TENS parece ser uma terapia complementar válida para pacientes com EM e paroxismia de tronco não responsivos aos demais tratamentos clínicos, porém mais estudos são necessários para confirmar esse achado.

Objective . A case study was used to discuss the effects of Traditional Chinese Medicine (TCM) treatments on Sjogren's syndrome. Clinical features and outcomes . A 45-year-old woman suffered from dry eyes, dry mouth, and fatigue for six months and was diagnosed with Sjogren's syndrome. She had received regular treatment with hydroxychloroquine (HCQ) and artificial tears as well as artificial saliva for nearly one year, but the results were unsatisfactory. Therefore, she sought CHM for further intervention. After 7 months of Yi-Guan-Jian with Huai-Xiao-Mai (Triticum aestivum Linn.) and Tian-Hua-Fen (Trichosanthis Radix), on the seventh treatment with TCM, she reported no fatigue or sleep dysfunction and relief of dry eyes and mouth. Neither complications nor side effects were noted during the CHM treatment. Conclusions . From this case, we concluded that CHM may be an effective and safe alternative therapy for the treatment of Sjogren's syndrome.

Background and Aim Medication nonadherence is common in patients with inflammatory bowel disease (IBD) and has been associated with worse outcomes. The coronavirus disease 2019 (COVID‐19) pandemic led to significant consumer and medical concern regarding the possible risks of immunosuppressive medications during the pandemic. This study aimed to examine medication adherence and complementary and alternative medicine (CAM) usage during the COVID‐19 pandemic. Methods An online survey was sent to patients from two tertiary IBD units. The survey included medication nonadherence attributed to the COVID‐19 pandemic, complementary therapy, and IBD medication use. Validated measures of IBD disease activity, medication adherence, and beliefs about medicines were obtained. Results Of 262 respondents (median age of 46, 58% female) 14 (5%) patients reported self‐initiated missed doses or dose reduction of IBD medications directly attributed to the COVID‐19 pandemic. Positive associations with medication nonadherence included current corticosteroid requirement (P = 0.022), higher disease activity scores (P = 0.026), and higher concern about medicines score (P = 0.04). CAM usage was common, aimed at treating mental health in most cases, and infrequently attributed to the COVID‐19 pandemic. Conclusions Even in the setting of low COVID‐19 prevalence, the pandemic reduced IBD medication adherence in 1 in 20 patients. This reduced adherence was co‐associated with increased disease activity and corticosteroid use. Understanding the underlying beliefs driving suboptimal IBD medication adherence is critical to prevent avoidable adverse IBD outcomes., The coronavirus disease 2019 (COVID‐19) pandemic resulted in widespread concern that inflammatory bowel disease (IBD) medications may result in higher infection risk and poor outcomes. The rate of medication nonadherence attributed to the COVID‐19 pandemic in an Australian IBD population was low and associated with increased IBD disease activity, corticosteroid use, and patient concern over medications. Understanding the underlying beliefs driving suboptimal IBD medication adherence is critical to prevent avoidable adverse IBD outcomes.

PURPOSE: Poor sleep is one of the most common side effects of cancer treatment. One increasingly popular approach to manage side effects of cancer treatment is use of medicinal cannabis (MC). DESIGN: Cancer patients using MC participated in semi-structured interviews to assess their experiences with MC (n = 24). A multi-stage thematic analysis was applied to interview transcripts. Themes related to use of MC for sleep were extracted. FINDINGS: The majority reported MC use for sleep. These participants reported that MC improved sleep initiation and continuity, resulted in decreased use of sleep medications, and that improved sleep led to better health. No participant reported MC was ineffectual for sleep or caused undesirable side effects when used for sleep. CONCLUSIONS: Cancer patients often utilize MC to specifically manage poor sleep. There is a need for rigorous studies assessing prevalence of use for this indication and clinical trials to assess comparative efficacy and safety.

Though Yoga has originated in India, its scientific use to alleviate the sufferings of cancer patients in India is thin. There are very few published studies on yoga intervention for cancer patients from India. The objective of this review was to analyze the studies that have used yoga as an adjuvant for cancer treatment. Literature searches were made in PubMed, CINAHL, Google Scholar, Proquest and Science Direct for retrieving the related studies. Data were analyzed according to the objective. The compiled results show that yoga and pranayama interventions for cancer patients in India focused mostly on psychological aspects like anxiety and depression. Few studies have explored deep into the mechanisms by which the interventions produce the desired effects. Only very few researchers have analyzed the genetic or biochemical changes that occur in the human body as a result of practicing yoga. Currently, the focus is generally on breast cancer. Researches with yoga and pranayama as an adjuvant for other cancers also need to be experimented.

Head and neck cancer is more common after 40 years of age with 60 years being the average age at onset. Tumors can be classified as benign or malignant. In general benign neo plasms are well differentiated and the malignant neoplasms range from well differentiated to UN differentiated. Treatment protocols vary according to the type and stage of the cancer. Besides conventional treatments, complementary therapy and alternative therapies are harmonious with many values in nursing. A study was undertaken to assess the effectiveness of music therapy on selected physiological and psychological symptoms. By quantitative approach with quasi experimental pre- and post-control group design 200 samples are selected. After collecting the demographic data patients were asked to rate their physiological and psychological symptoms. Instrumental music therapy was given to the patients. Post test was conducted by same tool. The data were analyzed by inferential and descriptive statistics. The study concluded that music therapy was very effective in reducing physiological and psychological symptoms.

The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO2 on children with Down syndrome over six months and to compare it with a conventional respiratory physiotherapy program. Eighteen children, with Down Syndrome, aged 6 - 11 years (9.53 ± 0.454), divided into two groups of nine, the intervention group (IG), that participated in the hydrotherapy program and the control group (CG) participated in the classical physiotherapy program. We calculated mean values of FVC, FEV, PEF, RR and SaO2 before and after six months intervention for both groups. There was a statistically significant improvement in all factors for both groups. However, were statistically more significant for the intervention group (IG). Based on a specific protocol of intervention in the water and at the same time with a group of children who participated in a similar program of classical respiratory physiotherapy, it was found to be statistically more important than the second group in improving respiratory function. We recommend the use of hydrotherapy as a complementary therapy that should be part of the weekly program of these children in addition to the existing treatments they attend.

Objective: This study aimed to investigate quality of life (QOL) improvement in long-term cancer survivors using complementary therapy (CT) as mind–body practice. Methods: A quasi-experimental study including intervention and control groups was conducted. Participants in the intervention group engaged in CTs, including music therapy, progressive muscle relaxation, and deep-breathing exercises for 8 weeks at home. QOL was evaluated in both the groups using Short Form-8 (SF-8) questionnaire before the experiment and at 4 and 8 weeks after starting the experiment. To examine QOL, we compared SF-8 subscale scores, the physical and mental component summaries of QOL. Results: Cancer survivors were assigned to the intervention and control groups, comprising 69 and 59 individuals. There were no significant differences in QOL between the two groups with low scores, but there was a significant difference in the mental aspect of QOL in 4 weeks, indicating that the intervention group was lower than the control group. Meanwhile, the intervention group tended to experience increased changes in the mental aspect of QOL in 8 weeks compared to 4 weeks, although there was no significant difference. Conclusions: CT did not exhibit an effect on QOL among cancer survivors, especially in 4 weeks. This might have been due to sample size, participants' potential low compliance resulting in an inability to confirm whether the CTs were performed accurately and continuously, and consideration of what CT suited them. Meanwhile, CT may require a longer time to increase QOL. We recommend further studies to address these factors when conducting CT as mind–body practice.

The purpose of this research was to evaluate the efficacy of carsil (CAR) either alone or in combination with α-tocopherol (α-TOCO) and/or turmeric (TUMR) against tetrachloromethane (TCM)-induced cardiomyocyte injury in rats. Administration of CAR either alone or in combination with α-TOCO and/or TUMR post-TCM injection, significantly mitigated the increases in serum troponin T, creatine kinase-MB (CK-MB) as well as interleukin-6 (IL-6), interferon γ (IFN-γ), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP). They also decline the elevation of caspase-3, vascular endothelial growth factor (VEGF) protein expression as well as DNA damage in cardiac tissues induced by TCM. The biochemical results were confirmed by histopathological investigation. Conclusion: The combination of the three antioxidants showed greater cardioprotective potential, compared to individual drugs. Therefore, this combination may be recommended as a complementary therapy to antagonize cardiac injury induced by different insults.

The objectives were to compare patients with and without cancer who sought an integrative health (IH) consult and reasons for seeking a consult. Descriptive cross-sectional study that employed a secondary analysis of an integrative health database supplemented by a retrospective medical record review. Integrative Medicine and Health program in a Southwestern United States academic medical center. Eight hundred thirty-nine adults over the age of 18 seeking IH consultation. The number of complementary therapies reported prior to consult were not significantly different between groups. The most reported complementary therapies used by cancer survivors were multivitamins, exercise, and turmeric. Patients without cancer reported significantly higher pain levels than cancer survivors. Cancer survivors reported significantly higher energy, sleep levels, overall health, spiritual wellbeing, and significantly better relationships compared to patients without cancer. Cancer survivors reported fatigue and cancer as the top reasons for IH consult. Participants without cancer reported higher levels of pain and lower levels of energy, sleep, overall health, spiritual wellbeing, and relationships compared to cancer survivors. However, cancer survivors still reported levels of unmanaged symptoms. Complementary therapy use prior to IMH consult was similar between groups; however, IMH providers recommended more treatments for patients without cancer. Our results highlight that more evidence is needed to guide IMH recommendations, especially for cancer survivors who may still be in treatment. Additionally, our results support evidence-based recommendations that all cancer survivors should be assessed for complementary therapy use and provided counseling by qualified providers on their advantages and limitations.

Este trabajo propone un protocolo de intervención musicoterapéutica para pacientes con polimicrogiria, una enfermedad rara que cursa con un incorrecto patrón de pliegues en la corteza cerebral. Tras realizar una revisión sobre esta patología, se han analizado las necesidades del colectivo abordables desde la musicoterapia estableciéndose unos objetivos terapéuticos. Según estos, se han diseñado las actividades. El protocolo diseñado, se ha testado en una paciente con polimicrogiria (13 meses de edad). Los resultados han sido favorables, ya que las sesiones han potenciado su atención mantenida, disminuido su frecuencia cardiaca, y estimulado su motricidad. También se valoraron los conocimientos previos sobre musicoterapia de los padres a través de un cuestionario, concluyéndose que esta terapia no está considerada oficialmente dentro de las terapias complementarias en polimicrogiria, pero ante los esperanzadores resultados obtenidos, se hace necesario realizar estudios con muestras mayores para poder obtener resultados representativos y establecer un protocolo sólido y validado.

El Trastorno por Déficit de Atención e Hiperactividad es considerado el trastorno del neurodesarrollo con más predominancia en el mundo, afectando el rendimiento académico de escolares, su desarrollo socioemocional y autoestima. El tratamiento incluye el uso de fármacos estimulantes cuyos efectos secundarios aún no se encuentran claramente definidos. Es aquí donde la musicoterapia como terapia complementaria adquiere importancia, al mostrar beneficios en las distintas dimensiones de la persona. El objetivo de este trabajo es tener un panorama general del TDAH y de acuerdo con esto generar una propuesta de intervención. Para ello se ha realizado una revisión bibliográfica en diferentes bases de datos utilizando los documentos más recientes. De esto se ha podido observar la necesidad de mayores estudios experimentales a través de la musicoterapia para establecer un protocolo de actuación en esta población.

Periode masa nifas adalah masa kembalinya organ reproduksi seperti keadaan sebelum hamil dalam waktu enam minggu setelah melahirkan. Infeksi nifas merupakan masalah yang sering terjadi pada masa nifas, salah satunya disebabkan oleh luka jalan lahir. Penyembuhan luka dapat dilakukan secara medis konvensional atau dengan terapi komplementer. Terapi komplementer juga dikenal dengan obat tradisional atau obat herbal untuk kesehatan dan keefektifannya diakui melalui beberapa jenis penelitian. Studi ini merupakan suatu tinjauan literatur yang mencoba menggali pemanfaatan herbal dalam penyembuhan luka perineum. Metode literatur dalam artikel ini yaitu dengan mengumpulkan jurnal terkait tanaman yang digunakan untuk menyembuhkan luka perineum. Hasil review dari 5 penelitian menunjukkan beberapa tanaman seperti lidah buaya, kayu manis, daun sirih merah, daun pegagan, dan daun teh hijau dapat digunakan sebagai alternatif penyembuhan luka perineum.

In recent years, the development of new pharmaceutical formulations for the treatment of sporotrichosis has become a relevant research field. In this work, we aimed to develop an emulgel containing itraconazole and clotrimazole to ensure therapeutic effectiveness against Sporothrix brasiliensis. The topical use of a formulation that combines both drugs represents an interesting option for the complementary treatment of sporotrichosis. The emulgel formulation was prepared and evaluated for its zeta potential, viscosity, in vitro antifungal activity and stability at different storage conditions. The results showed that the newly developed emulgel displayed promising physicochemical characteristics, as well as a good in vitro inhibitory activity against S. brasiliensis yeasts. The results obtained in this work suggest that the emulgel containing itraconazole and clotrimazole might highly be efficient and a complementary therapy to oral administration in the treatment of sporotrichosis.

This first Special Issue collects fifteen original research and up-to-date review articles addressing the beneficial properties of herbal products, nutrient supplements, dietary regimens, and functional food for the complementary therapy of human pathologies. In these articles, renowned scholars present and discuss the curative effects and the molecular mechanisms of action of nutraceuticals, medicinal herbs, and dietary regimens that have been proven effective in the treatment of cancers, metabolic syndrome, fatty liver disease, hearth arrythmia and neurodegenerative disorders.

Background Biqi capsule is a traditional Chinese medicine widely used as a complementary and alternative treatment for rheumatoid arthritis (RA). The objective is to understand the efficacy, safety and mechanism of Biqi combined with methotrexate (MTX) in RA. Methods We present a randomized, controlled pilot trial on Biqi combined with MTX against patients with active RA. Seventy patients were randomized 1:1 to receive Biqi + MTX or Leflunomide (LEF) + MTX for 24 weeks, and were assessed at baseline, 4, 12 and 24 weeks. Serum and urine samples were collected for metabolomics. Results Overall, 81.2% patients in Biqi group achieved ACR20 at 24 weeks. No statistically significant differences were observed in primary or secondary outcomes between the two groups. A better safety profile was observed for Biqi with significantly fewer adverse effects reported (11.4%) compared to LEF group (40%, P Conclusions Our study suggests that Biqi capsule can be a promising alternative option in combination with MTX for RA treatment, and demonstrates the capability of using metabolomics to interrogate mechanism of action for traditional Chinese medicine. Trial registration This trial is registered with ChiCTR, No. ChiCTR-IPR-16009029. Registered August 15, 2016. http://www.chictr.org.cn/showprojen.aspx?proj=15034

The magnolia tea has been used in traditional oriental medicine for multiple purposes including sleep aid. Postpartum depression is a mental illness that adversely affects the health and well‐being of many families with newborns. Given the known effectiveness and relative safety, herein we aimed to investigate whether magnolia tea has a palliative effect on postpartum depression. The qualified participants were randomly assigned to the intervention group or the control group. The participants in the intervention group drunk magnolia tea, while the control group received regular postpartum care only. The outcome variables including Postpartum Sleep Quality Scale (PSQS), Edinburgh Postnatal Depression Scale (EPDS), and Postpartum Fatigue Scale (PFS) were assessed and compared. In comparison with the control group, the intervention group demonstrated significant difference for physical‐symptom‐related sleep inefficiency (PSQS Factor 2) at 3 weeks post‐test (t = −2.10, p = .03). The comparison results also revealed significant differences for PFS at both 3 weeks post‐test (t = −2.02, p = .04) and 6 weeks post‐test (t = −1.99, p = .04). Further, magnolia tea intervention significantly alleviated the symptoms of depression, reflected by the EPDS scores at 3 weeks post‐test (t = −2.38, p = .02) and 6 weeks post‐test (t = −2.13, p = .02). Our trial results suggested that drinking single‐ingredient magnolia tea for a 3‐week duration has positive effects on postpartum women. Magnolia tea is recommended as a supplementary approach to ameliorate sleep quality of postpartum women, while alleviating their symptoms of depression., Our trial results suggested that drinking single‐ingredient magnolia tea for a 3‐week duration has positive effects on postpartum women. Magnolia tea is recommended as a supplementary approach to ameliorate sleep quality of postpartum women, while alleviating their symptoms of depression.

Background: Hypertension remains one of the most important preventable contributors to morbidity and mortality. Physical activity of moderate intensity has been recommended for the prevention and c...

A number of studies show that acupuncture may help with labour and delivery. An NHS maternity acupuncture service providing birth preparation acupuncture has assessed its routine hospital maternity annual data from 2014 to 2016 to see what effect it had on labour and delivery outcomes. The data from this service was analysed and women who had birth preparation acupuncture were compared with those who did not receive it. Maternal age, parity and socio-economic status were considered confounders and were adjusted for in the analysis. Women who received acupuncture had more normal births (less surgical births) [OR 0.76 (0.64, 0.91)], required less intrapartum analgesia [OR 0.74 (0.63, 0.86)], fewer components of an induction of labour [OR 0.74 (0.61, 0.91)] and a reduced length of a hospital stay [OR 0.91 (0.87, 0.95)]. The patients highly valued the availability of acupuncture within the maternity service as it enhanced their patient journey.Impact statementWhat is already known on this subject? Numerous studies provide evidence for the effects of acupuncture in normalising pregnancy and birth. These effects include musculoskeletal preparation of the pelvis, cervical ripening, enhancing endogenous oxytocin release, and analgesic properties.What do the results of this study add? Our analysis shows that women who received birth preparation acupuncture had fewer surgical births, required less intrapartum analgesia, less components of induction of labour and had a reduced length of hospital stay, supporting the use of maternity acupuncture in normalising birth outcomes.What are the implications of these findings for clinical practice and/or further research? The findings show that acupuncture, by potentially normalising birth, may lead to reductions in costs of service. Further, additional research is required to see whether acupuncture is cost effective and could have an adjunctive role as a complementary therapy for improving birth outcomes and a woman's experience of childbirth.

Aim: To investigate the effect of nurse-led home-based biofeedback intervention on the blood pressure levels among patients with hypertension. Background: Nurse-led interventions are emerging as cost-effective as well as clinically proven in chronic illness management. Hypertension, a leading long-term cardiovascular condition, has autonomic dysregulation and increased sympathetic tone as its pathophysiological background. Complementary interventions evidenced to interplay hypertension pathophysiology. Design: A pretest–posttest design. Materials and Methods: Uncomplicated primary hypertension outpatients were randomly assigned as study group (n = 173) and control group (n = 173) at a tertiary care hospital. Sociodemographic, clinical, and outcome variables [the baseline blood pressure and galvanic skin response (GSR)] were collected. Study group patients were given four teaching sessions of abdominal breathing-assisted relaxation facilitated by GSR biofeedback. Daily home practice was encouraged and monitored to measure the effects on blood pressure and GSR at the end of the 1st, 2nd, and 3rd month of intervention. Results: The study group participants showed significant decrease in mean (SD) systolic [140.77 (8.31) to 136.93 (7.96), F = 469.08] and diastolic blood pressure [88.24 (5.42) to 85.77 (4.66), F = 208.21]. In contrast, control group participants had a mild increase in the mean systolic (F = 6.02) and diastolic blood pressure (F = 4.70) values from pretest to posttests. GSR showed a significant increase from 559.63 (226.33) to 615.03 (232.24), (F = 80.21) from pretest to posttest III. Conclusions: Use of home-based biofeedback-centered behavioral interventions enabled BP reduction among hypertensive patients. Further studies should use biochemical markers of sympathetic nervous system activity to endorse this home-based chronic illness intervention.

Background: Diabetes mellitus has a significant impact on public health. Oxidative stress plays a major role in the pathophysiology of type 2 diabetes mellitus (T2DM), leading to various complications of T2DM. Yoga is being widely used in the management of T2DM. The primary objective of this systematic review and meta-analysis is to understand the effects of yoga on oxidative stress parameters among adult patients diagnosed with T2DM. Materials and methods: Electronic databases such as PubMed, Scopus, Cochrane Library and Science Direct from start of the study till March 2020 were searched to obtain eligible studies. Study designs of all nature were included (except case studies and reviews). The primary outcome was malondialdehyde (MDA) and secondary outcomes included fasting plasma glucose, HbA1C and superoxide dismutase (SOD) levels. Results: A total of four trials with a total of 440 patients met the inclusion criteria. The results of meta-analysis indicated that yoga significantly reduced MDA (SMD: -1.4 ; 95% CI -2.66 to -0.13; P = 0.03; I2 = 97%), fasting plasma glucose levels (SMD: –1.87: 95% CI -3.83 to -0.09; P = 0.06;I2= 99%), and HbA1c (SMD: -1.92; 95% CI - 3.03 to -0.81; P = 0.0007; I2 = 92%) in patients with T2DM. No such effect was found for SOD (SMD: -1.01; 95% CI -4.41 to 2.38; P = 0.56; I2= 99%). Conclusion: The available evidence suggests that yoga reduces MDA, fasting plasma glucose and HbA1C, and thus would be beneficial in the management of T2DM as a complementary therapy. However, considering the limited number of studies and its heterogeneity, further robust studies are necessary to strengthen our findings and investigate the long-term benefits of yoga.

Mesenchymal stem cells (MSCs) have remarkable immunomodulatory properties, low immunogenicity, and paracrine properties as well as the ability to differentiate into multiple cell lines. These properties make them potential candidates for clinical applications in the treatment of neurodegenerative, cardiovascular, and lung diseases, which may be occupational diseases. Preclinical studies using experimental animal models have demonstrated regenerative properties of MSCs in diseases such as silicosis and occupational asthma. Currently, treatment of the novel disease COVID-19 could be enhanced by using MSC therapies. This disease affects many professional groups with great intensity and its consequences might be considered as an occupational disease. It is a significant public health problem and a therapeutic challenge. Despite the development of vaccines against COVID-19, there is growing concern about the emergence of new mutations of the SARS-CoV-2 virus in addition to the known alpha, beta, gamma, and delta variants. There is still no effective COVID-19 treatment and the existing ones only play a supporting role. MSCs offer treatment possibilities as an alternative or complementary therapy. The clinical trials to date using MSCs in patients with COVID-19 give hope for the safe and effective use of this stem cell population. Med Pr. 2021;72(6):693-700.

Com o passar dos anos, a dor crônica deixou de ser apenas um sintoma e passou a ser considerada como uma doença que afeta grande parte da população, principalmente a senil. Após receber atenção dos maiores órgãos da saúde mundiais e ser considerada um problema de saúde pública devido aos altos custos na produtividade do sujeito e no sistema de saúde, novas estratégias que vão para além da monoterapia medicamentosa de analgésicos opioides vêm se mostrando necessárias. Seguindo esse caminho, essa pesquisa tem como objetivo investigar o papel da meditação no cuidado do sujeito com dor crônica, a partir do entendimento de que o analgésico opioide não está sendo suficiente para o manejo dessa doença. A partir do método da revisão bibliográfica e de pesquisas nos principais bancos de artigos online, foi trilhado um caminho de entendimento que vai desde a discussão dos efeitos psicossociais que uma doença crônica pode ter no indivíduo até uma coletânea de revisões sistemáticas e meta-análises cujo objetivo foi o de entender os efeitos da meditação no manejo da dor crônica a partir da análise de diversos estudos. Os resultados mistos e inconclusivos levam à conclusão de que são necessárias mais pesquisas para que os efeitos da meditação sejam melhor compreendidos pela comunidade científica, mas a partir da quantidade de estudos que inferem efeitos positivos, essa pesquisa entende que a meditação e o analgésico opioides podem se potencializar, uma vez que a medicação alivia o sintoma doloroso e abre espaço para um investimento de energia na tarefa de ressignificação da dor para o sujeito, ação que tem o poder de aliviar o sintoma e/ou melhorar a relação do paciente com a própria medicação opioide, evitando possíveis abusos e dependência química, efeito colateral que muitas vezes levam os profissionais de saúde a não receitarem tais remédios.

Muscle architectural parameters play a crucial role in the rate of force development, strength, and sports performance. On the other hand, deteriorated muscle architectural parameters are associated with injuries, sarcopenia, mortality, falls, and fragility. With the development of technology, exergames have emerged as a complementary tool for physical therapy programs. The PRISMA 2020 statement was followed during the systematic review and meta-analysis. CENTRAL, CINAHL, PROQUEST, PubMed, and OpenGrey databases were searched last time on 22 September 2021. In total, five controlled trials were included in the systematic review. Twelve weeks of virtual dance exercise (Dance Central game for Xbox 360®) showed a medium effect on the improvement of hamstrings (g = 0.55, 95% CI (−0.03, 1.14), I2 = 0%) and the quadriceps femoris muscle cross-sectional area (g = 0.58, 95% CI (0.1, 1.00), I2 = 0%) in community-dwelling older women. Additionally, a four-week virtual balance-training program (the ProKin System) led to significant increments in the cross-sectional areas of individual paraspinal muscles (14.55–46.81%). However, previously investigated exergame programs did not show any medium or large effects on the architectural parameters of the medial gastrocnemius muscle in community-dwelling older women. Distinct exergame programs can be used as a complementary therapy for different prevention and rehabilitation programs.

Purpose Side-effects of adjuvant endocrine therapy (AET) are common in breast cancer survivors, and can affect adherence to treatment. We synthesised the evidence for strategies to self-manage these side-effects. Methods We searched for systematic reviews and clinical guidelines on self-management strategies for AET side-effects (arthralgia, fatigue, hot flashes, gastrointestinal discomfort, nausea, vulvovaginal symptoms, and sleep disturbance). We searched oncology organisation’s websites and eight databases (Inception-November 2020). Screening, data extraction and quality assessment were completed independently in duplicate. PROSPERO: 2019CRD4201914001. Results We identified 33 systematic reviews and 18 clinical guidelines. 21% of reviews were high quality, and the average quality score for guidelines was 44%. Evidence for most strategies was absent or weak. There was consensus from a low-quality review and multiple guidelines to recommend moisturisers, gels and lubricants for vulvovaginal symptoms. Evidence was weak for physical activity for self-managing most symptoms, although two high-quality reviews indicated yoga and aerobic exercise could reduce fatigue. Primary research was often biased by weak and underpowered study designs. Eleven reviews did not report information on adverse events. Conclusions Most self-management strategies for breast cancer survivors experiencing side-effects from AET lack evidence. Primary research is needed using high-quality well-powered designs focusing on implementable strategies. Implications for Cancer Survivors Patients and clinicians should be aware that although the risk of harm is low for these self-management strategies, the likelihood of benefit is often unclear. Women should consider moisturisers, gels or lubricants for self-managing vulvovaginal symptoms, and yoga or aerobic exercise for alleviating fatigue.

Several compounds based on short chain fatty acids and/or probiotics/prebiotics have shown promising results in the therapy of ulcerative colitis (UC), possibly due to its key role in restoring gut homeostasis as well as intestinal barrier integrity. Here, we investigated the efficacy of a patented preparation based on calcium butyrate, Bifidobacterium bifidum, Bifidobacterium lactis, and fructooligosaccharides (FEEDColon®, Princeps, Cuneo, Italy) in maintaining remission and improving subjective symptoms and inflammatory indices in patients with UC receiving 5-ASA therapy. A total of 42 patients were prospectively recruited and randomized in 21 patients receiving combination therapy with mesalamine (5-ASA) plus FEEDColon® and 21 patients treated with standard 5-ASA therapy. Patients were assessed at baseline, at 6-month, and 12-month follow-up (FU). Therapeutic success (defined as Mayo partial score ≤ 2 and faecal calprotectin (FC) &lt, 250 µg/g at 12-month FU) was reached by 32 (76%) patients: 20 (95%) among those treated with 5-ASA + FeedColon®, and 12 (57%) among those treated with 5-ASA only (p = 0.009). Consistently, patients treated with combination therapy improved subjective symptoms (quality of life, abdominal pain, and stool consistency) and reduced FC values, while those treated with 5-ASA alone, improved neither subjective symptoms nor FC during the FU. In conclusion, FEEDColon® supplementation appears to be a valid add-on therapy for the maintenance of remission in patients with UC. Further multicentre, placebo-controlled, double-blind clinical trials are needed to validate our results on larger cohorts of patients with UC.

A case study of a male British Muslim of Pakistani descend with severe cluster headache was presented. The patient only responded to morphine treatment but his condition continued to deteriorate. He resorted to ruqyah complementary therapy, which is based on incantations of the Quran, after seeking advice with a local imam (Islamic cleric). His condition improved significantly and continued to have weekly preventative ruqyah therapy. Since resorting to ruqyah, he has not any morphine treatment and the level and duration of pain have reduced significantly. Ruqyah is popular for the treatment of jinn possession but has also been found to have therapeutic effect on non-mental health problems. The case illustrates that complementing mainstream medicine with ruqyah can bring many benefits especially within the Muslim community. Cooperation between mainstream health service and faith healers is needed.

Helicobacter pylori (H. pylori) has so far infected more than half the global population. It is the most important and controllable risk factor for gastric cancer. The elderly, who are at a higher incidence of the infection, are also commonly found to develop antibiotic resistance. The symptoms, diagnosis, clinical features (of gastric or extra-digestive diseases), and treatment of H. pylori infection in the elderly, are different from that in the non-elderly. Health conditions, including comorbidities and combined medication have limited the use of regular therapies in elderly patients. However, they can still benefit from eradication therapy, thus preventing gastric mucosal lesions and gastric cancer. In addition, new approaches, such as dual therapy and complementary therapy, have the potential to treat older patients with H. pylori infection.

Complementary and alternative medicine (CAM) has been defined as a group of diverse medical and health care systems, practices, and products not considered in conventional medicine. Efficacy and safety of many of CAM therapies for Juvenile Idiopathic Arthritis (JIA) have not been clearly demonstrated. The objective of this study was to assess the effectiveness and safety of Bach flowers remedies as a CAM therapy in children with Juvenile Idiopathic Arthritis. Methods: Prospective, randomized, double-blind, placebo-controlled trial in 30 patients with JIA assigned to receive Bach flowers therapy (Healing HerbsO, United Kingdom) or placebo. Both groups underwent five medical visits over the course of 5 months follow up. At first and last visit, the American College of Rheumatology Pediatric 30 (ACR Pedi-30) criteria for improvement were applied. At all medical visit, clinical evaluation, symptoms, adverse events, changes in conventional medication and parents and patient’s perception of the therapy were evaluated. Results: We found that 67% (10/15) of patients in the flower solution group and 77% (10/13) in the placebo group improved according to ACR-30 score, difference was not statistically significant (p=0.83). Ten children had no changes in drug regimen, 5 were of the flower therapy group (p>0.05). Nine children were able to decrease their use of medications; 6/9 in the flower therapy group, difference was not significant (p=0.43). About of opinion of the complementary therapy received, 75% (21/28) patients or family members rated the therapy as good or very good, 14 from the flower therapy group and 8 from the placebo group with no significant differences between groups (p= 0.19). Conclusions: Bach flower therapy in JIA was not able to demonstrate greater effectiveness than a placebo in this study. Conventional therapy for JIA should not be replaced by CAM therapy, however, this study shows this type of therapy to be safe and therefore it may be used as a complement to traditional therapy. Bach flower therapy can help and support patients and families with emotional disturbances. Pediatricians could have an open relationship with families on this topic, allowing for discussion, information sharing, and research on chronic diseases.

Background: Increasingly, patients with cancer are asking for additional, complementary therapy options for treating the side effects of oncological therapy. Thus, the members of the Breast and Bowel Center Nahe at the Sankt Marienwörth Hospital Bad Kreuznach decided to define the content of this type of counseling for patients before treatment. Methods: In 2018, a team of internal oncologists, gynecological oncologists, radio-oncologists, nutritionists, psycho-oncologists, and study nurses met several times to define the content of counseling. To inform the team, an intensive literature review was conducted. Results: Counseling content was determined for complementary treatment options for the most frequent side effects of oncological therapies. Counseling sessions were formulated as frontal lectures (slide presentations), given at regular intervals for patients and relatives. These lectures were highly appreciated by patients. Conclusion: These counseling sessions increased patient understanding of both useful complementary measures and harmful measures they should not use.

Chinese herbal medicine has a long history of use for treating epilepsy. Because of the side effects of Western antiepileptic therapy and the quest for more accessible treatment, complementary and alternative medicines have become popular. Traditional Chinese medical diet therapy appears to be safe and effective. We searched PubMed and the Cochrane Library through November 2020 for the use of traditional Chinese medicine in clinical settings, including plants, fungi, and animals. Combinations of keywords included “epilepsy,” “seizure,” “antiepileptic,” “anticonvulsive,” “Chinese herbal medicine,” “Chinese herb,” and each of the Latin names, English names, and scientific names of herbs. We also summarized the sources and functions of these herbs in Chinese medicine. Different herbs can be combined to increase antiepileptic effects through various mechanisms, including anti-inflammation, antioxidation, GABAergic effect enhancement, modulation of NMDA channels and sodium channel, and neuroprotection. Despite reports of their anticonvulsive effects, adequate experimental evidence and randomized controlled clinical trials are required to confirm their antiepileptic effects.

Background Pain is common in older adults. To maintain their quality of life and promote healthy ageing in the community, it is important to lower their pain levels. Pharmacological pain management has been shown to be effective in older adults. However, as drugs can have various side effects, non-pharmacological pain management is preferred for community-dwelling older adults. This systematic review evaluates the effectiveness, suitability, and sustainability of non-pharmacological pain management interventions for community-dwelling older adults. Methods Five databases, namely, CINHAL, Journals@Ovid, Medline, PsycInfo, and PubMed, were searched for articles. The criteria for inclusion were: full-text articles published in English from 2005 to February 2019 on randomized controlled trials, with chronic non-cancer pain as the primary outcome, in which pain was rated by intensity, using non-pharmacological interventions, and with participants over 65 years old, community-dwelling, and mentally competent. A quality appraisal using the Jadad Scale was conducted on the included articles. Results Ten articles were included. The mean age of the older adults was from 66.75 to 76. The interventions covered were acupressure, acupuncture, guided imagery, qigong, periosteal stimulation, and Tai Chi. The pain intensities of the participants decreased after the implementation of the intervention. The net changes in pain intensity ranged from − 3.13 to − 0.65 on a zero to ten numeric rating scale, in which zero indicates no pain and ten represents the worst pain. Conclusions Non-pharmacological methods of managing pain were effective in lowering pain levels in community-dwelling older adults, and can be promoted widely in the community.

This article discusses the scientific literature review on Chinese acupuncture and "GI" acupuncture as an attempt therapy many cases, besides that specifically studied the effectiveness of traditional acupuncture china to stress with "GI" acupuncture. Chinese acupuncture is an acupuncture method that was developed in China since ± 2000 years ago, while "GI" acupuncture is a method of acupuncture that was developed at the Institute Technology Bandung by acupuncturists Gunawan Ismail (Alm) is slightly different from the traditional Chinese acupuncture, where acupuncture "GI "based on a 7 acupuncture points on the body for ase points determined based of Java massage. Each method studied acupuncture and its role as a therapeutic efforts on a variety of cases, and the results of the study showed some success in handling cases of diseases such as fibromyalgia, stroke and stress. The role of acupuncture GI who want to see here is give the same effectiveness with traditional acupuncture originated from China or even better.

La lesión traumática cerebral es considerada un problema de salud pública, con altas tasas de morbi-mortalidad a nivel mundial. El conocimiento de su fisiopatología ha permitido determinar que no sólo los procesos primarios o directos generan daño neuronal, sino también los procesos secundarios caracterizados por una cascada de mecanismos moleculares que inician al momento del trauma y evolucionan posterior a este. Dentro de ellos se destaca el estrés oxidativo y el agotamiento de antioxidantes. En este contexto, el N -Acetilcisteína se ha propuesto como terapia complementaria en el tratamiento de este tipos de lesiones traumáticas cerebrales, al ser un proveedor de cisteína y éste a su vez un precursor de glutatión que participa en la protección contra el daño oxidativo causado por las especies reactivas de oxígeno.

BACKGROUND: Proper treatment of cancer can make it easier for the healing process. Delay in patients seeking treatment is a problem that often occurs today. Handling of complementary and alternative therapies, which is not appropriate is one of the causes of delay in seeking treatment, which worsens the patient's condition. Patients usually come to health services already diagnosed with advanced cancer. AIM: The purpose of this study is to explore the experience of advanced cancer patients in seeking treatment. METHODS: This study is qualitative research with descriptive phenomenology approach. Participants in this study were 15 advanced cancer patients who were treated in the chemotherapy room at Adam Malik General Hospital Medan and Murni Teguh Hospital using purposive sampling technique. Data collection was done with in-depth interviews. All interviews were first recorded and then transcribed. This study was analysed using the Colaizzi approach method. RESULTS: The six main themes indicated that advanced-stage cancer patients for seeking treatment. Themes such as 1) choose the complementary and alternative treatment rather than medical treatment, 2) seek medical treatment as a final decision, 3) integrating complementary treatment as supportive therapy in addition to medical treatment, 4) external sources influence patient decisions, 5) reduce negative feelings by surrendering to God, and 6) lack of involvement of basic health services. CONCLUSION: Advanced cancer patients have experience using complementary and alternative therapies, which are not appropriate before using a medical treatment on the grounds of distrust of medical treatment and advice from the environment around patients. The importance of nurses in providing appropriate education related to complementary and alternative treatment to cancer patients according to the stage of the disease.

El principal objetivo de este estudio ha sido evaluar si la actividad física mejora la función cognitiva de pacientes en edad escolar (segundo ciclo de infantil, primaria y secundaria) con trastorno por déficit de atención con hiperactividad (tdah). En este trabajo, se estudia el efecto de una actividad física deportiva dirigida de 6 semanas de duración consistente en 2 sesiones de 1 hora de duración por semana realizando juegos aeróbicos a una intensidad aproximada de 60%-70% de VO2máx. Un total de 13 participantes de edades entre 5 y 15 años, han realizado las sesiones deportivas (grupo de intervención) mientras que otros 11 (de 5 a 15 años) continuaban en clase haciendo las actividades escolares rutinarias (grupo control). Tras la aplicación de la Escala Magallanes de Atención Visual (EMAV), se encuentra una mejora significativa en la calidad de la atención en los participantes del grupo de intervención, pero no en los del grupo control. Los resultados por tanto sugieren un efecto positivo de la realización de ejercicio físico sobre la calidad de la atención. Se recomienda usar una intervención físico-deportiva como terapia complementaria en el tratamiento del tdah y para mejorar los síntomas del trastorno.

Complementary therapies provide cancer survivors and clinicians with options for managing chronic pain. Recent published clinical guidelines and research findings support the use of relaxation therapy for managing chronic pain in cancer survivors. However, translating research findings into clinical practice remains a challenge. Using theory to guide implementation of a new practice can increase the likelihood of successful adoption. This article uses relaxation therapy for cancer survivors to describe how clinicians could use Rogers’ Diffusion of Innovation Theory and the related Collaborative Research Utilization Model to implement a complementary therapy and ensure that it becomes standard practice.

Yoga has been increasingly used as a complementary therapy for eating disorders. However, it is still not clear whether yoga is effective in the prevention and treatment of eating disorders, as some studies suggest that yoga practitioners show elevated levels of disordered eating behaviours. The goal of this systematic review is, thus, to analyse the occurrence of disordered eating behaviours and correlates in yoga practitioners. PRISMA guidelines for systematic reviews were used. Search was conducted in several databases and specific journals. Twelve articles, all cross-sectional, were identified, following PRISMA guidelines. Results across studies were inconsistent. Yoga practice was usually associated with healthier eating behaviours, lower disordered eating symptoms, and higher positive body image and body satisfaction, suggesting that yoga practitioners may be at a lower risk of developing eating disorders. However, other studies suggested that a high dosage of yoga practice may be associated with a higher prevalence of disordered eating behaviours. As yoga is increasingly used as therapy for eating disorders, understanding the relationship between yoga dosage and disordered eating behaviours is critical to guide treatment recommendations and establish yoga as a valuable complementary therapy. Level I, systematic review.

Objective: To determine frequency and factors leading to CAM use in diabetic patient visiting tertiary care hospitals in Karachi. Methods: A cross-sectional study was conducted at diabetic clinics of Civil Hospital and National Institute of Diabetes (NIDE, OJHA campus) from March 2015 to April 2016. The sample size of 400 adult Type II diabetic patients above 18 years of age were included in the study by purposive sampling technique after taking the informed consent. Data were collected through predesigned and pre-tested questionnaire, consisted on socio-demographic variables and use of CAM. Data were entered and analyzed by using SPSS version 21. Frequencies and percentages were calculated; regression analysis was performed to determine the factors associated with CAM use. Results: Mean age of study participants was 51.5±14.1 S.D. There were 30.5% males and 69.5% females' participants in the study. Half (53.5%) of diabetic patients were using CAM. Forty-eight percent (48%) of the diabetic patients were using herbal medicines. The odds of using CAM was more (AOR.=1.949, 95% C.I. 1.196-3.174) in diabetic patients who had total household income more than 10,000 rupees as compared to those who had monthly income less than 10,000 rupees. Similarly, the odds of using CAM was more (AOR.=1.802, 95% C.I. 1.13-2.87) in diabetic patients who had education level less than 10 years as compared to those who had educational level more than 10 years. Conclusion: The CAM use was high among diabetic Patients. Educational status, income and chronic kidney disease were found to be associated with CAM use.

Background: Knee osteoarthritis is known as one of the common causes of disability worldwide. Despite the elderly tendency towards the use of traditional medicine, there is no clear consensus regarding acupressure efficacy to manage symptoms of knee osteoarthritis. Objective: This study aimed to determine the effect of acupressure on knee osteoarthritis symptoms in the elderly. Methods: This double-blind randomized clinical trial was performed from February 2017 to July 2018. Ninety-six patients were selected from comprehensive health care centers in Rafsanjan, Iran, according to inclusion criteria and then equally allocated into three groups (acupressure, sham and control) randomly, by the minimization method. The acupressure group received acupressure bilaterally at 6 points in 10 sessions for two minutes for each point in 10-seconds pressure and 2-seconds rest periods. Subjects In the sham group received only touches without any pressure with the same pattern as the acupressure group and the control group received no intervention. The osteoarthritis symptoms were measured before, immediately and one month after intervention on WOMAC scale. Data was analyzed by IBM-SPSS version 22 using Chi-square goodness of fit and repeated measure ANOVA at 0.05 level of significance. Results: There were no significant differences between-groups regarding demographic characteristics. The mean of WOMAC score were significantly different between the three consecutive measurements (the time effect), (p=0.001, effect size = 0.082). But there was no significant difference between-groups (group effect) (p=0.852, effect size = 0.003). There was a significant difference in the interaction between time and group (p=0.001, effect size = 0.106). Conclusion: The study showed that acupressure was able to correct the WOMAC and pain scores in long and short term and improve physical function in short term in patients with knee osteoarthritis. Accordingly, acutherapy as an effective approach can be applied in self-care programs for knee osteoarthritis symptom management in the elderly, but in the sham groups, the selection of acupoint positions could be a crucial factor. Trial registration: This trial was registered at the Iranian Registry of Clinical Trials with clinical trial registration number: IRCT20180114038366N1. Funding: This study was financially sported by Deputy of Research and Technology of Rafsanjan University of Medical Sciences (Ref: 20.1056).