Volume 18, Issue 1

Objectives Since 70’s, scientific research has analyzed how many acute and chronic issues can affect body systems. In case of depression, chronic pain and overtraining, centrals and peripherals systems act to manage and maintain body adaptations. The aim of this study is to evaluate if the osteopathic treatment can increase the release of Cannabinoid receptor (CB) and promote the linkage with their receptors. Content Documents research is based on PubMed and Google Scholar databases. Keywords used were “osteopathic treatment”, “manual therapy”, “endocannabinoid”, “beta endorphin (BE)”, and “ CB1” “massage”. From 70 articles collected (published in the last 10 years) 52 were excluded as non-relevant to the study aim. Summary The Key points have been the similar results found by different authors during different treatment periods and with different doses. From 22 articles examined, 13 have established positive effects on CB increasing post osteopathic treatment, three articles have indicated the most targeted tissues in which the substances are most expressed, two articles indicate how physical activities produce antalgic effects by increasing CB’s values. Outlook As a result of this review, osteopathic manipulation treatment seems to be a valid and effective instrument for the treatment of a series of pathologies such as chronic low back pain, fibromyalgia, spinal cord lesions, myofascial graft point, migraine, GI tract dysfunctions, and depression.

Natural products are increasing used in preventing and treating various diseases. Mangiferin belongs to the xanthone family, and has potential antiangiogenic, anticancer, immunomodulatory and anti-inflammatory activity along with the antioxidant activity. It is also used in the treatment of cardiac problem, diabetes and neurodegenerative disease. Finding of various researchers proves that mangiferin has a broad spectrum therapeutic application. Motive of this review is to describe the various studies performed on mangiferin for its different pharmacological activities. It also discusses various challenges associated with mangiferin such as stability and bioavailability. Strategies and approaches to improve bioavailability of mangiferin have also been discussed. Both research and review articles were used to write the manuscript. They were collected from various search engines like Pub Med, Science Direct and Google Scholar, using keywords like mangiferin, polyphenol, bioavailability enhancement, solubility enhancement, and antioxidant. Mangiferin being a potent antioxidant is effective in the treatment of various diseases. With novel drug delivery approaches we can overcome poor solubility and bioavailability problem which eventually can result to better utilisation of mangiferin in treating a variety of diseases and make mangiferin a revolutionary drug.

Objectives Homeopathy remains one of the most sought after therapies for urological disorders. The aim of this paper was to systematically review the available clinical researches of homeopathy in the said conditions. Content Relevant trials published between Jan 1, 1981 and Dec 31, 2016 (with further extension up to Dec 31, 2017) was identified through a comprehensive search. Internal validity of the randomized trials and observational studies was assessed by The Cochrane Collaboration’s tool and methodological index for non-randomized studies (MINORS) criteria respectively, homeopathic model validity by Mathie’s six judgmental domains, and quality of homeopathic individualization by Saha’s criteria. Summary Four controlled (three randomized and one sequentially allocated controlled trial) trials were reviewed and 14 observational studies alongside – all demonstrated positive effect of homeopathy. Major focus areas were benign prostatic hypertrophy and renal stones. One of the four controlled trials had ‘adequate’ model validity, but suffered from ‘high’ risk of bias. None of the non-randomized studies was tagged as ‘ideal’ as all of those underperformed in the MINORS rating. Nine observational studies had ‘adequate’ model validity and quality criteria of individualization. Proof supporting individualized homeopathy from the controlled trials remained promising, still inconclusive. Outlook Although observational studies appeared to produce encouraging effects, lack of adequate quality data from randomized trials hindered to arrive at any conclusion regarding the efficacy or effectiveness of homeopathy in urological disorders. The findings from the RCTs remained scarce, underpowered and heterogeneous, had low reliability overall due to high or uncertain risk of bias and sub-standard model validity. Well-designed trials are warranted with improved methodological robustness. Funding None; Registration web-link: https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018081624&ID=CRD42018081624.

As time goes on, a greater number of people experience an age of more than 60 years old and subsequently geriatric syndromes are increasingly more common. Despite recent improvements in modern healthy living, literature on traditional Persian medicine (TPM) about the prevention and treatment of such syndromes and healthy living of the elderly is hardly known. We aimed, in this study, to explore some traditional Persian sources and briefly explain their writers' beliefs on keeping healthy living for old people. We used several TPM sources and literature, and then based on these texts, we collected issues about geriatric temperament and syndromes and classified the results including exercise, nutrition, massage, bathing, aromatherapy, and sleeping. Our search yielded some recommendations about a healthy lifestyle for the elderly, which are in fact equivalent to primary, secondary, and tertiary preventive measures in modern medicine. Our results also showed that they believed such modifications would help the elderly to improve their geriatric conditions. In general, TPM provides some pieces of advice to prevent and treat geriatric syndromes that may be helpful in practice although the scope of their effectiveness remains to be examined in carefully designed randomized controlled trials.

Objectives In African traditional medicine, Distemonanthus benthamianus (Caesalpiniaceae) is used to treat many diseases including gastric ulcers. We evaluated in this study, the cytoprotective and antisecretory properties of the methanolic extract of the stem bark of this plant using different technics of gastric lesion induction. Methods Cytoprotective and antisecretory activity of the methanolic extract of D. benthamianus stem bark was evolved through six methods of gastric lesion induction in experimental Wistar male rats (150–200 g): (1) gastric lesions induced by HCl/ethanol, (2) gastric lesions induced by Indomethacin- HCl/ethanol, (3) gastric lesion induced by Indomethacin, (4) gastric lesions induced by Pylorus ligation, (5) gastric lesions induced by histamine-Pylorus ligation, (6) gastric lesions induced by carbachol-Pylorus ligation. Mucus and gastric mucosal ulceration were evaluated. pH, gastric volume, and acidity were quantified in all pylorus ligation induction technics. Nitric oxide (NO) level was determined in indomethacin induced gastric ulcers. Results At different doses (125, 250 and 500 mg/kg), extract reduced significantly the ulcer index. In all models used, that is 100.00% with HCl/ethanol; 100.00% with HCl/ethanol/indomethacin; 95.70% with Indomethacin; 74.79% with pylorus ligation, 95.94% histamine-Pylorus ligation, 99.54% carbachol-Pylorus ligation at the highest dose of 500 mg/kg. The lesion formation reduces in all the methods used followed by a significant increase of mucus production. The pylorus ligation technic revealed that the extract has an antisecretory activity. Conclusions The methanolic extract of D. benthamianus stem bark has both cytoprotective and antisecretory effects. This extract exerts its antisecretory effect trough cholinergic and histaminergic pathways.

Objectives Aqueous leaves extracts of Murraya koenigii (M. koenigii) and Aegle marmelos (A. marmelos) were prepared and effect of the extracts on inhibiting alpha-amylase playing essential roles on converting starch into glucose have been examined using in vitro assays. Methods Alpha amylase inhibitory assay was used to asses the in vitro antidiabetic activity of the extracts. Gas chromatography-mass spectrometry (GC-MS) analysis was performed to identify the volatile molecules of the extracts. Identified molecule were converted as ligand and docked against human pancreatic α -amylase (0.95 Å; PDB ID: 5U3A) using Autodock tool. Results The data analyzes suggested that the alpha-amylase inhibition potential of the extract obtained from M. koenigii was stronger than that of the A. marmelos at low concentrations (<1 mg/mL), whereas both the extracts depicted similar inhibition effects on the enzyme at high concentration (>1 mg/mL). The phytochemicals present in both the plant extracts were identified by using their respective GC-MS data and the data analyzes revealed that the extracts of M. koenigii and A. Marmelos seemed to consist of about 20 and 24 diverse chemical molecules, respectively. Through the molecular docking studies, azulene of M. koenigii and hydroxycyclodecadiene of A. marmelos showed higher binding affinity on alpha-amylase. Conclusions Concentration-dependent alpha-amylase inhibition effects of the extracts were observed and M. koenigii contains more alpha-amylase inhibitory effects due to the presence of azulene. This is primary lead to find out the better anti diabetic natural based drug to the society after clinical trial.

Objectives Ayurvedic formulations are becoming the prior choice of people as health care supplements. The increasing demand for these formulations has led to extensive development of Ayurvedic pharmaceutical industries worldwide. The reaction between the preservatives (sodium benzoates and ascorbic acid) used in these formulations could generate benzene. Benzene is classified as class-1 human carcinogen and responsible for various short and long term health effects. Methods In this study, 25 formulations (containing ascorbic acid and sodium benzoate) of various manufacturers available as over the counter products were obtained and their benzene content were determined using gas chromatograph with flame ionization detector. Results The result showed that 64% of the formulations were free from benzene contamination whereas 36% of formulations were found to be contaminated with benzene. A simple, less time-consuming, economic, and validated gas chromatographic method for estimation of benzene in Ayurvedic formulations was also developed successfully in present study. Conclusions The data revealed that the level of benzene was within permissible limits, yet the presence of a carcinogen in the marketed formulations intended for internal use is an alarming situation.

Background Dietary phenolic compounds intake have been reported to have an inverse relationship to the prevalence of hypercholesterolemia. The objective of this study is to determine the effect of caffeic acid (CFA) and chlorogenic acid (CGA) on rats fed with high cholesterol diet (HCD). Methods Experimental animals were fed with high cholesterol diet (HCD) for a period of 21 days while simvastatin (0.2 mg/kg BWT), CFA and CGA (10 and 15 mg/kg BWT) were administered daily. Results Activity of acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and arginase were significantly (P<0.05) higher in the rats fed with HCD alone. Also, level of malondiadehyde equivalent compounds (MDA) was significantly (P<0.05) elevated in hypercholesterolemic rats. Nevertheless, treatment with simvastatin, CFA and CGA normalized altered AChE, BChE and arginase activities as well as improved antioxidant status in hypercholesterolemic rats. Conclusion CFA and CGA could offer protective role in hypercholeseterolemic rats via their antioxidant potentials as well as restoring altered activity of acetylcholinesterase, butrylcholinesterase and arginase. Based on our findings chlorogenic acid exhibits better attribute.

Objective The present study aimed to evaluate cytotoxic, apoptotic, and anti-inflammatory properties of bee venom (BV) as well as changes in cytokine secretion levels and nitric oxide (NO) production using three different cancer cell lines [liver (Hep-G2), breast (MCF-7), and cervical (HPV-18 infected HeLa cells)] and two normal cells (splenocytes and macrophages (MQ). Methods Cytotoxic activity of BV against tumor cell lines and normal splenocytes/MQ was tested by MTT assay. By ELISA (ELISA); Tumor necrosis factor (TNF-α), Interleukine (IL-10) and interferon (IFN-γ) were measured. Caspase three expressions was evaluated using reverse transcription-polymerase chain reaction (RT-PCR). Nitric oxide (NO) was estimated using a colorimetric assay. Results BV has a significant cytotoxic effect on all cell lines in a dose- and time-dependent manner; none of them was toxic for normal cells. Treating Hep-G2 cells with BV showed a reduction in IL-10, elevation in TNF-α with no change in IFN-γ level. MCF-7 cells have low IL-10 and TNF-α and high IFN-γ production level. Elevation of IL-10 and IFN-γ coincides with a reduction in TNF-α level was demonstrated in HeLa cells. The expression of Caspase three was dramatically increased with elevation in BV concentration in all tested cancer cell lines. A gradual decrease in NO production by MQ with increasing BV dose was observed. Conclusion Taken together, our results stressed on the importance of BV as a potent anti-tumor agent against various types of cancers (Liver, Breast, and Cervix). Further steps towards the use of BV for pharmacological purposes must be done.

Background The folkloric claim that Cnidoscolus aconitifolius (Chaya) could ameliorate anaemia requires scientific revalidation in anaemic models. Objective The aim of this study is to investigate the anti-anaemic effect of Cnidoscolus aconitifolius on cyclophosphamide-induced anaemia in rats. Methods The leaves of Cnidoscolus aconitifolius were collected, dried and extracted with ethanol. Twenty five Wistar Albino rats weighing 120–180 kg were used. Anaemia was induced in groups 2, 3, 4 and 5 with a single injection of cyclophosphamide, while group 1 served as a negative control without anemia and was treated with 0.5 mL of normal saline, Group 2 rats were treated with 100 mg/kg body weight of Cnidoscolus aconitifolius. Group 3 rats were treated with 500 mg/kg body weight of Cnidoscolus aconitifolius. Group 4 served as the positive control rats and was treated with 0.5 mL of normal saline. Group 5 which served as the standard control rats and were treated with 5 mg/kg body weight of standard drug Chemiron. The treated lasted for two weeks during which blood samples were collected from each rat for haematological analysis. Results The result shows that hematological parameters were elevated in groups 2, 3 and 5 rats treated with 100 mg/kg and 500 mg/kg body weight of ethanol extract of Cnidoscolus aconitifolius and chemiron respectively. Conclusions Ethanol leaf extract of Cnidoscolus aconitifolius at a graded dose of 500 mg/kg body weight had higher ameliorative effect on the haematological parameters of cyclophosphamide-induced anemia in rats.

Background Recent ethnomedicinal studies on Bridelia ferruginea Benth (family Phyllanthaceae) as an antiplasmodial remedy have established its potency as a strong prophylactic and chemosuppressive agent. Human consumption of medicinal herbs without adequate evaluation of its efficacy and safety can result in grave physiological and pathological consequences. Therefore, this study assessed the antiplasmodial bioactivity, biochemical, hematological, histopathological and toxicity profile of the ethanolic stem bark extract of B. ferruginea in mice. Methods Ethanolic stem bark extract of B. ferruginea (200, 400 and 800 mg/kg) were orally administered to Plasmodium berghei -infected mice in models and were subsequently observed for mortality, behavioral changes and signs of toxicity. Acute evaluation was experimented at 1,000 mg/kg for 28 days. Occult blood obtained from the euthanized mice were subjected to biochemical and hematological assays. A comprehensive assessment of the histology of the liver and kidney was also ascertained. The median lethal dose (LD 50 ) was determined and extrapolated using the regression equation obtained from the plot of the probits of mortalities (y) and the log of doses (log 10 C). Results Different concentrations of the phytochemical secondary metabolites were revealed. Antiplasmodial bioactivity was established at the 200, 400 and 800 mg/kg of the herbal extract with a dearth in parasitemia at different days post-treatment. The 800 mg/kg group responded by exhibiting a dose-dependent decrease in parasitemia comparable with the chloroquine bi-phosphate group. Significant alterations in the histology of the liver and kidney of the 1,000 mg/kg group was documented. There was a reduction in the titers of LDH, ALT, AST, and urea in the treated group when compared with the control (p < 0.05). Antioxidant profiles were also highly significant with elevation in SOD, GPx, and CAT, but a reduction in MDA. LD 50 was established at 424 mg/kg. Conclusion B. ferruginea Benth (family Phyllanthaceae) is a potent antiplasmodial, antioxidant, regenerative and ameliorative herbal remedy if administered in controlled dosage.

Objectives In order to explore Coffea canephora green seeds as natural extract for application in the functional-food industry, we focused this study to the evaluation of the antioxidant and the antiadhesion effect of C. canephora green seeds extracts. Methods The analysis of C. canephora green seeds extracts was carried out by RP-HPLC-PDA. These extracts were screened for antioxidant activities by ABTS and phenanthroline assays. The antibacterial activity was determined by microdilution method against three reference bacteria. The inhibition of bacterial adhesion at 1/8 MIC was carried out against three reference bacteria. Results The RP-HPLC-PDA revealed the presence of gallic acid, vanillin, quercetin, chlorogenic acid, and P-coumaric acid. The n-buatnol extract have the highest activity ABTS assays (3.96 ± 0.08 μg/mL). For this extract, the A 0.5 was 1.90 ± 0.05 μg/mL for phenanthroline assay. The n-butanol extract and the methanolic extract have the higher antibacterial activity against Staphylococcus aureus ATCC 25923 (40 µg/mL).At MIC/8, the extracts of C. canephora showed 70% higher antidhesive activity against S. aureus ATCC 25923. Conclusions Our finding provides an effective and specific new approach to the search of antioxidant and antiadhesive compounds for different uses.

Background To evaluate the safety, efficacy and tolerability of a combination micronutrient and polyherbal preparation ( GoutFighter TM ) for gout management. Methods A single arm, open-label pilot study was conducted at the National Hospital for Traditional Medicine in Vietnam. Participants (n=35 recruited) diagnosed with chronic gout received four tablets of GoutFighter TM daily over a 45-day period. Efficacy was assessed by changes in pain, swelling and blood uric acid levels, with concurrent safety and tolerability assessments. Results A total of 27 (85.2% male) participants (mean ± SD age, 54.2 ± 12.5 years; BMI, 24.2 ± 3.6 kg/m 2 ) with gout (median [IQR], years since diagnosis 4.0 [3.0–8.0]) completed intervention. In relation to safety, there were no significant changes in vital signs, blood biochemistry or cell counts. In regard to efficacy, the degree of perceived pain and frequency of joint swelling significantly declined after 15 and 30 days of treatment, respectively, and remained so until the end of trial. Mean blood uric acid levels also declined by 25.8 μmol/L (95% CI, 3.7 to 48.0, p=0.024). Overall, the predominance of participants (96.3%) responded favorably to treatment (p<0.0001) and GoutFighter TM was well tolerated, with no serious adverse events. Conclusion Clinically relevant doses of GoutFighter TM were found to be generally safe, well-tolerated and effective for the short-term, symptomatic relief of chronic gout. GoutFighter TM appears to be suitable as an adjunctive treatment in lifestyle programs for gout management, and further investigation in placebo-controlled trials is therefore warranted.

Objectives Menorrhagia can be defined as heavy uterine bleeding which comes at regular intervals or uterine bleeding extending more than seven days during menses which has become a considerable problem for females, causing discomfort, anxiety, and poor quality of life. In this study we aimed to compare the effect of Myrtus communis fruits with tranexamic acid in the treatment of menorrhagia. Methods In this prospective patient blinded standard controlled study, 40 patients of menorrhagia were randomly assigned to receive either test drug (powdered M. communis fruits) or active control drug (tranexamic acid) for first five days of menstrual cycle consecutively for two cycles. The primary outcome measure was reduction in heavy flow during menses determined by pictorial blood loss assessment chart (PBAC), while improvements in quality of life (QOL) by using short form-36 questionnaire and increase in hemoglobin percentage were kept as secondary outcome measures. Results Both the groups were similar at baseline. Test and control drugs significantly reduced the PBAC score during treatment cycles with p-value <0.001 and these changes were not significantly different between the groups. During second treatment cycle significant difference was found in PBAC score (p = 0.024) between the groups. After treatment significant improvement in hemoglobin percentage was noted and marked improvement in overall quality of life was observed in both the groups. Conclusion These data suggest that M. communis fruits can be an effective alternate in reducing heavy menstrual bleeding. There is need to confirm these results by designing a trial on large number of patients. Trial Registration No CTRI/2017/09/009937.

Objectives Phytomedicine is widely suggested for the prevention of chronic disease, but evidence for a favorable effect on bone health is lacking. The present study will investigate the Zingiber officinale (ZO) and Curcuma longa L. (CL) supplementation effects on quality of life, body composition, bone mineral density (BMD) and osteoporosis related biomarkers and micro-RNAs in women with postmenopausal osteoporosis (PMO). Methods This study protocol is designed as prospective triple-blind randomized controlled trial. One hundred and 20 patients with PMO will be enrolled in a 4 month, prospective, triple-blind, placebo-controlled trial and randomly assigned to four groups: ZO (500 mg b.i.d.) + CL (500 mg b.i.d.) (ZO + CL); ZO (500 mg b.i.d.) + placebo CL (b.i.d.) (ZO + P); placebo ZO (b.i.d.) + CL (500 mg b.i.d.) (CL + P); and placebo ZO (b.i.d.) + placebo CL (b.i.d.) (P + P). Quality of life, body composition and BMD will be defined as the primary endpoints and osteoporosis related serum biomarkers and circulating micro-RNAs will be defined as the secondary endpoints. The ANCOVA statistical method will be used to investigate the effect of the interventional variables on the response variable. Conclusion To our knowledge, this trial is the first clinical study exploring the effect of Ginger and turmeric on quality of life, body composition, BMD and osteoporosis related biomarkers and micro-RNAs in women with PMO. The findings of this trial could be the basis for the development of harmless and inexpensive preventive and therapeutic approaches for PMO.

Background Hasat-ul Kilya (Nephrolithiasis) is one of the most common chronic conditions and has been known to the mankind since antiquity. The incidence is increasing globally with geographic, racial and gender variation in its occurrence. Medical management of Nephrolithiasis still poses a considerable challenge for modern medical practice. Unani drugs possessing lithotriptic activity are not only cost effective but also have least side effects. Safūf Hajar-al Yahūd has been used since long for the treatment of Hasat-ul Kilya (Nephrolithiasis) but no documentary evidence based on scientific parameters as to its safety and efficacy are available. Objective To validate the safety and efficacy of Safūf Hajar-al Yahūd in the treatment of Hasat-ul Kilya . Methodology An open prospective clinical trial was carried out on 107 subjects of renal calculi of 3–7 mm diameter diagnosed by Ultrasonogram-KUB (USG-KUB). Subjects were evaluated by clinical history & examination, laboratory investigations followed by USG-KUB for confirmation. The safety was assessed by reporting of adverse events and by pathological and biochemical investigations. Assessment of efficacy was based on improvement observed in VAS score and expulsion/reduction of stone size as detected by USG-KUB. Results Substantial reduction (53%) in the size of calculi confirmed by USG-KUB and considerable lowering of VAS score (75%) were observed with the active intervention in majority of the cases Conclusion The trial has revealed that the Unani pharmacopoeal formulation Safūf Hajar-al Yahūd was well tolerated and has the therapeutic potential in the reduction and expulsion of renal calculi.

Background and objectives Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries. Globally, diabetes is among the top 10 causes of death. Unani system argued the effectiveness of several anti-hyperglycemic drugs, and all such drugs looked-for to be validated on scientifically. Hence a clinical trial was contemplated to evaluate the clinical efficacy of Qurs-e-Gulnar in the management of Diabetes Mellitus. Methods This study was conducted as single blind randomized control, on 40 patients of type 2 diabetes with the test (n=20) and control (n=20) groups for 45 days. Test group received Qurs-e-Gulnar at the dose of three Qurs twice a day, and control group received two capsules Diabeat ® twice a day before meal. Subjective (at 0, 15th, 30th, and 45th) and objective parameters were assessed as pre-post treatment respectively. Results After treatment with test compound significant reduction was observed in all the subjective parameters viz. polyuria, polydipsia, polyphagia and tiredness in comparison of control group. The objective parameters FBS and PPBS was found to be significantly reduced (p<0.001) in both the groups where as HbA1c was found unchanged in test group but control drug showed highly significant reduction in HbA1c (p<0.001).The results were assessed statistically using two tailed Student’s t -test, and Fischer exact test. Conclusion On the basis of above observation it is concluded that the test compound Qurs-e-Gulnar has significant anti-diabetic effect which is evidentially observed both in subjective and objective parameters in test group in comparison of control group ( CTRI/2017/07/009060 ).

Objectives Kapalbhathi Pranayam (Kapal = forehead; bhati = shining) is a breathing exercise that has been practiced to cleanse the frontal brain in traditional practices like yoga. Still, there exists a dearth of literature on the effect of Kapalbhathi pranayama on physiological systems. So this present study was carried out to find the immediate effect of “ kapalbhathi Pranayam ” practice for the period of 5 min on cardiac autonomic function among the healthy volunteers. Materials and methods Apparently 50 healthy volunteers includes both sex were participated. They were randomly divided into Pranayama (n−25) and control (n−25) group. Pranayama group was practiced kapalbhathi pranayama 5 min (5 cycles) and control group was allowed to do normal breathing (12–16 breath/min). Lead II ECG was recorded for 5 min using simple AD converter before, immediately after practice and 20 min of recovery period. Results One way Analysis of variance (ANOVA) followed by post hoc test was done using R statistical software. There was a significant (p < 0.05) parasympathetic withdrawal (Root Mean Square of the Successive Differences (RMSSD) – p < 0.04 and HF n.u – p < 0.05) was found in the pranayama group immediately after practice and its was changed to parasympathetic domination (RMSSD – p < 0.04 and HF n.u – p < 0.05) after 20 min of recovery period. Conclusion The present study suggested that though there was parasympathetic withdrawal immediately after practicing kapalbhathi pranayama , 20 min after the recovery period showed a parasympathetic domination in the pranayama group subjects. However, further studies are required to warrant the findings of this study.

Objectives Obesity is a condition of increased adipose tissue in the body, which is commonly associated with various comorbidities like diabetes, hypertension, arthritis, back pain, and many others. Yoga modules have been designed and validated for obesity; however, we couldn't find any specific module for metabolic syndrome, a condition which includes obesity, diabetes mellitus type 2 and/or hypertension together. Keeping this in view, our study aimed to develop and validate a specific generic yoga-based intervention module for metabolic syndrome patients. Materials and methods A yoga module was designed based on traditional and contemporary yoga literature as well as published studies. We derived the yoga practices for the module, from these yoga texts and research evidence were already available. The yoga module was sent to 40 yoga experts for their validation. Results Twenty-two experts gave their opinion on the usefulness of a yoga module for patients with metabolic syndrome with some suggestions. Of these experts, 73% were males, and 27% were females. Yoga therapy practices with content validity ratio (CVR) >0.08 were included in the final module. In total, 86% (31 of 36 items) of the items in the initial module were retained. Conclusion A specific yoga-based module for metabolic syndrome was designed and validated by experts. Further studies are needed to confirm the efficacy and clinical utility of the module. Additional clinical validation is suggested.

Background Progressive muscle relaxation (PMR) and autogenic training (AT) are effective relaxation techniques to reduce depressive symptoms. However, no studies on their effectiveness have been conducted among people living with HIV and depressive symptoms. The primary aim of this pilot study was to assess the feasibility and acceptability of PMR and AT interventions among people living with HIV who have depressive symptoms. A secondary aim was to assess the potential effectiveness of these interventions on depressive symptoms and quality of life. Methods This study was a three-arm pilot randomized control trial with mixed methods. Participants were randomized to PMR, AT, or a control group (CG), with four assessments (baseline, and at one, three, and six months). The PMR and AT interventions consisted of six 1 h sessions of individual training over 12 weeks, plus home practice. Recruitment, attrition, and completion rates were calculated. Depressive symptoms and quality of life were assessed at all times. Participants' perceptions of the interventions were collected in semi-structured interviews. Results Following the screening, 54/63 people met the inclusion criteria, and 42/54 were randomly allocated to the PMR group (n=14), AT group (n=14), and CG (n=14). Six participants (43%; 95% CI 18–71%) in the PMR group and 10 (71%; 95% CI 42–92%) in the AT group completed the intervention. Participants reported better emotion management and improvements in depressive symptoms and quality of life. Conclusions The pilot study suggests that a randomized trial to test the effectiveness of these interventions is feasible. Trial registration ClinicalTrials.gov NCT01901016

Objectives The aim of this study was to identify different physical and mental characteristics among three common Sasang types, Tae-eum, So-yang, and So-eum (except scarce type, Tae-Yang) in preschoolers, to improve constitutional diagnoses. Methods Our study included 65 boys and 67 girls from six kindergartens in South Korea. The number of children who were categorized as Tae-Yang, Tae-Eum, So-Yang, and So-Eum types were 1, 56, 40, and 35, respectively. We measured height, weight, mid-parental height, predicted adult height, ponderal index (PI), and findings from the junior temperament and character inventory 3 to 6. Results The Tae-eum type exhibited higher weight percentiles and PIs than the other types (p < 0.001), and the So-eum type displayed higher harm avoidance (HA) scores than the Tae-eum type (p = 0.033). Conclusions Children with high PIs and low HA scores have a higher probability of being classified as the Tae-eum type than as the So-eum type.

Background Complementary and alternative medicine (CAM) is used often by patients with different diseases. While some authors subsume religiousness and spirituality to CAM, others do not. The objective of the present study was to assess the prevalence and types of CAM usage as well as the participants' spirituality/religiousness in an outpatient department for endocrinology and metabolic diseases. Methods All individuals visiting the outpatient department at a German university hospital from April to June 2009 were offered a standardized questionnaire on the use of dietary supplements and alternative therapies as well as their religiousness/spirituality. Demographic and clinical data of 428 respondents were taken from the electronic health record. Results Of the respondents, 16.4% (n = 66) classified themselves to be religious/spiritual and 67.9% (n = 273) as not religious/spiritual. Women were more religious/spiritual than men (p = 0.02). 41.4% of the respondents used supplements and 27.4% additional therapies. The use of supplements and additional therapies was more frequent in people with higher religiousness/spirituality (p = 0.005 and p = 0.01,resp.) but there were no associations between religiousness/spirituality and the number of consultations, costs for drugs, appraisal of the physicians treatment methods, the perceived effectiveness of prescribed drugs, fear of late complications or of side effects. Conclusions A higher religiousness/spirituality is associated with a more frequent use of supplements or additional therapies in individuals with endocrinopathies or metabolic diseases. As CAM has been shown to be associated with worse outcome, addressing religiousness/spirituality which stresses the responsibility of the person for his life might offer an additional resource and should be further studied.

Objectives Fatigue, regardless of the causes, could leave a negative impact on individual performance. The aim of this study was to compare the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue among hemodialysis patients. Methods This study was a randomized controlled trial. The patients (96 patients) were allocated to three groups (control, an inhalation aromatherapy, and an aromatherapy massage group). A demographic questionnaire as well as the rhoten fatigue scale (RFS) was used to collect the data. The data were analyzed by descriptive and analytical statistics using SPSS version 18. Results Before the intervention, there was no significant difference among the groups regarding fatigue level (p=0.54). However, eight and 16 weeks after the study, the levels of fatigue in both experimental groups were significantly lower than the control group (p < 0.05). Conclusions Interventions with essential oils are effective in reducing fatigue in hemodialysis patients, although the effects of aromatherapy massage on fatigue are stronger than the effects of inhalation aromatherapy.

Background Wintering is associated with distress to humans who work in the isolated and confined environment of Antarctica and yoga has been proved helpful for coping with stress. Therefore, a study was conducted on 14 winter expedition members of Indian Scientific Antarctic Expedition (2016) to find out the effects of yoga on stress-related markers. Methods Participants were divided into yoga, and control (non-yoga) groups. The yoga group practiced yoga for 10 months (from January to October 2016) daily in the morning for an hour. The Resilience test questionnaire was administrated at baseline and endpoint of the study. Blood samples were collected during the study at different intervals for the estimation of 8-hydroxydeoxyguanosine (8-OHdG), brain-derived neurotrophic factor (BDNF), serotonin and cortisol using ELISA. Results A trend of improvement was observed in the resilience test score in the yoga group. From January to October, 8-OHdG serum values in the yoga group declined by 55.9% from 1010.0 ± 67.8 pg/mL to 445.6 ± 60.5 pg/mL (Mean ± SD); in the control group, the decline was 49.9% from 1060.4 ± 54.6 pg/mL to 531.1 ± 81.8 pg/mL. In serotonin serum levels in the yoga group, there was a 3.1% increase from 6.4 ± 1.6 ng/mL to 6.6 ± 0.4 ng/mL while no increase was noticed in the control group. Cortisol values in the yoga group decreased by 19.9% from 321.0 ± 189.6 ng/mL to 257.1 ± 133.8 ng/mL; in the control group it increased by 2.8% from 241.2 ± 51.8 ng/mL to 247.8 ± 90.9 ng/mL. Conclusions It could be concluded from the present study that following 10 months yoga practice may be useful for better resilience and management of stress-related blood markers for the polar sojourners.

Background & Objectives The douche, one of the hydrotherapeutic treatment modality is commonly used by Naturopathy physicians as a treatment of choice in the management of several ailments. This study was done to assess the effect of full body neutral douche in the management of pain and systemic symptoms in adult females with primary dysmenorrhoea. Methods 68 subjects of age 18-22 years with primary dysmenorrhoea were recruited for the study and were randomly divided into two groups: the experimental group (n = 34) and the control group (n = 34). The experimental group received whole body neutral douche, whereas the control group followed the routine as usual. Assessments for the pain, systemic symptoms and menstrual cramps were done by using McGill Pain Questionnaire, Verbal multidimensional scoring system and analog scale for severity of pain and menstrual cramps respectively at baseline, day 30 and day 60 of intervention. Two- way repeated measures of ANOVA was performed to understand the between group changes, adjusted for the respective baseline values and age. Result Data was analyzed with SPSS (Version 21.0) package. Neutral douche resulted in significant improvement in pain [F(2,66) = 114.564, p < 0.0005, partial ?2 = 0.771], severity of pain [F(2,66) = 70.418, p < 0.0005, partial ?2 = 0.681], cramps [F(2,66) = 75.986, p < 0.0005, partial ?2 = 0.697] and systemic symptoms [F(2,66) = 14.64, p < 0.0005, partial ?2 = 0.307] as compared to the control group. Conclusion Findings suggest that neutral douche can be used as a non-pharmacological intervention in the management of pain and systemic symptoms in primary dysmenorrhea.

Objectives Information on sleep quality and its effective factors in the patients undergoing hemodialysis are important factors in future planning for improving sleep quality and ultimately the quality of life in these patients. The present study investigated the effect of omega-3 on the sleep quality of hemodialysis patients. Methods The 52 hemodialysis patients were randomized into two groups and underwent two different treatment modes (A and B). The first group was given omega-3 and cetirizine and the second group only received cetirizine for six weeks. After one week wash out, the study was followed by crossover treatment in both groups for six weeks. Sleep quality and pruritus severity were evaluated in patients before the intervention and at the end of each treatment period using the Pittsburgh Sleep Quality Index and the Yosipovitch Itch Questionnaire. The collected data was analyzed using repeated measures ANOVA and the Pearson correlation coefficient. Results The results of the study showed that majority of the patients (94.2%) had poor sleep quality (sleep score > 5 based on the questionnaire) and 5.8% of the patients had favorable sleep quality (sleep score < 5). Repeated measures ANOVA showed that sleep quality scores were different in two groups in phases 0, I and II (p <0.001). Conclusions Sleep quality improved in both modes but more improvement was observed in mode A. Therefore, omega-3 fatty acids can be used as a suitable method for improving sleep quality in hemodialysis patients.

Objectives Keratosis pilaris (KP) is the condition of the skin with extensive keratin follicular plugging. It may be associated with the erythema. The upper arm extensor area, shoulders, back of neck and thighs, as well as face and the upper trunk are the areas of presentation. Available medications for KP give only symptomatic relief, while some produce serious side effects. There is no proven universal treatment for the disease that can provide complete recovery. Āyuṛveda management of KP is not yet reported. Case presentation A 26-year-old male patient, presented with main complaints started with papular lesions over his right shoulder, chest and upper back along and later with pustular lesions in the past 2 weeks. The condition was associated with redness, mild swelling and itching. The case was diagnosed as Keratosis pilaris based on its presentation, site, and pathogenesis. Also by analyzing the extent of vitiation of doṣas (morbidities), the Vata kapha pitta hara line of treatment was adopted, which was accomplished in two phases i. e. Śodhana Cikitsa and Śamana Cikitsa. Conclusion Both internal and external treatments along with diet restrictions were found effective in arresting the pathogenesis and recovery in a short period. All the symptoms associated with the condition were completely cured with no signs of re-occurrence.

Objectives Neck stiffness could lead to impaired ocular accommodation. We report two cases that visual function was improved by relieving neck stiffness. Case presentation (Case 1) A 34-year-old female complained of neck stiffness and visual problems after computer work. She was treated by parietal acupoint therapy (PAPT), which is a new scalp micro-acupuncture system. The evaluation of accommodative micro-fluctuations (the Fk-map) showed that increased bilateral ciliary muscle tension in the middle to near distance was relieved bilaterally, accompanied by relief of neck stiffness after treatment. (Case 2) A 43-year-old female complained of a visual problem with pressure pain on the bilateral posterior cervical muscles. Performing with PAPT improved impaired ciliary muscle tension noticeably with relief of neck stiffness after treatment. Conclusions This is the first report on the improvement of impaired ocular accommodation with treating neck stiffness by using PAPT.