Volume 20, Issue 2

Objectives The construct of the osteopathic structure-function models is reported as a cornerstone of clinical reasoning and treatment processes. Nevertheless, there are no shared procedures described for their use in clinical practice. The present narrative review aims to analyze a more comprehensive perspective on the phenomenon. Methods A structured narrative review was conducted . A database search was conducted using Pubmed, ScienceDirect, and Google Scholar. Peer-reviewed papers without specifying limits on dates and design were included. Results Twenty-five findings were reported and grouped into two main themes: 1) Debate on models and theoretical frameworks for osteopathic care; 2) Clinical reasoning and decision-making process in the osteopathic field. Conclusions An integrated osteopathic care approach based on the structure/function models represents a starting point to establish a shared osteopathic diagnostic and clinical reasoning and an evidence-informed practice promoting health in an interdisciplinary person-centered care process. The present review highlights the limited amount of literature on using osteopathic conceptual models in decision-making and treatment strategies. A research plan is required to develop a common framework for an evidence-based osteopathic practice that promotes well-being in an interdisciplinary person-centered care process.

Objectives The long-term consequences of COVID-19 survivors care and post-coronavirus infection are not yet well understood. The review aims to see whether homoeopathy can help COVID-19 survivors recover from its consequences and improve their quality of life. Content A systematic search of published articles for post-COVID sequelae and the impact of Homoeopathy were conducted. For the literature search, the major electronic bio-medical database PubMed/MEDLINE was used. In addition, supplementary searches were conducted through the references of those published articles. Summary A total of 113 records were identified of which 61 studies included for this review. Homoeopathy is effective in the treatment of mental disorders including anxiety and depressive disorder (ADD), some research studies have found, although systematic reviews disagree. Likewise, some medical societies denounce homoeopathy for pain management; other literature shows that it can be used to treat pain effectively. Homoeopathy can aid in the treatment of cardiovascular diseases, as Crataegus, a homoeopathic medication, was found to be just as effective as a standard angiotensin-converting enzyme (ACE) inhibitor and diuretic treatment for minor cardiac insufficiency. The outcomes for Chronic Fatigue Syndrome (CFS), Influenza, and Acute Respiratory Tract Infections (ARTIs) are also promising. Outlook Based on the results of homoeopathy in non-COVID conditions, it can be thought of in the management of post-COVID-19 outcomes. Consequently, we propose that while investigating post-COVID-19 patient rehabilitation, homoeopathic management may be included as part of the follow-up route and as much data as possible in the context of homoeopathy should be collected, so that in future, the role of homoeopathy in dealing with it can be better demonstrated. Highlights – The long-term consequences of post coronavirus infections are poorly understood. –The Aim of this review is to understand how Homoeopathy may aid COVID 19 survivors in regaining function and improving their quality of life. – Based on non-COVID conditions, Homoeopathy has the potential to play an important role in the treatment of post-COVID 19 survivor complaints such as psychiatric illness, pain management, fatigue syndrome, and cardiovascular complications.

Objectives To provide a broad evaluation of the efficacy and safety of Ayurveda interventions for the management of sinusitis. Methods Five electronic databases for published research articles, three databases for the dissertation/doctoral thesis works, clinical trial registries, and hand searches were done till May 2021. All comparative clinical trials recruiting sinusitis patients of any age group, receiving Ayurveda intervention, regardless of forms, dosages, and ingredients, for not less than one week were included. The data extraction and the risk of bias (RoB) assessment were done by two reviewers independently. Results A total of 2,824 records were identified, of which 09 randomized parallel arms trials met inclusion criteria. No studies were found comparing Ayurveda vs. placebo or non-Ayurveda interventions. Combined Ayurveda therapy (CT) was statistically more beneficial compared with either procedural or non-procedural Ayurveda therapy alone in reducing symptoms nasal discharge (standardized MD −0.71, 95% CI −1.16 to −0.26, I 2 58%, 210 participants) and headache (standardized MD −0.44, 95% CI −0.86 to −0.02, I 2 56%, 218 participants), however, no significant difference was found in reducing symptoms nasal obstruction and loss of smell. No data related to the safety of Ayurveda intervention was found. All the trials (09) were having ‘high’ to ‘some concern’ overall bias. Conclusions Although individual studies appeared to produce positive results, very low certainty of total effect hindered to arrive at any conclusion regarding efficacy or safety of Ayurveda interventions for sinusitis. There is a need for well-designed-executed-reported clinical studies on clinically relevant outcomes. Trial registration mumber CRD42018103995

Induction of labor by using available, inexpensive and non-invasive methods with the least side effects is particularly important. A systematic review was conducted to assess the effect of evening primrose oil on cervical ripening in term pregnancies. In this systematic review and meta-analysis of clinical trials, a search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, Clinical Trials.gov, Google Scholar and Persian databases (Magiran, SID, and IRCT.ir) for published related articles without any time limit. The Cochrane handbook was used to determine the risk of bias of the included articles. The obtained data were analyzed in RevMan and reported in forest plots. The Odds Ratio (OR) was used to find the effect of the dichotomous data and the Mean Difference (MD) for the continuous data. The heterogeneity of the studies was assessed using I 2 , T 2 and Chi 2 . The random effect was used instead of fixed effect if I 2 >40%. A total of 28 titles and abstracts were extracted, 9 articles entered into the meta-analysis. The meta-analysis results showed significant differences between EPO and control groups in terms of bishop score (MD=1.32; 95% CI: 0.98 to 1.66), reducing caesarean section rate (OR= 0.61; 95% CI: 0.43 to 0.86), duration of first stage of labor (MD= -98.67; 95% CI: -140.98 to -56.38) and duration of second stage of labor (MD= -10.98; 95% CI: -21.86 to -0.09). There were no significant differences in terms of birth weight (MD= 100.97; 95% CI: -11.91 to 213.84) and the frequency of induction with oxytocin (OR= 0.53; 95% CI: 0.27 to 1.01). It seems evening primrose oil be effective for cervical ripening, reducing cesarean section rate and shortening the duration of labor. Due to the high heterogeneity of the studies, the researchers recommend further researches on the subject using a standard tool based on the CONSORT statement.

Mobile phones have been increasingly used in the past decade and have become a cultural instrument. There is a great concern over the harmful effects of electromagnetic and radiofrequency waves as well as microwaves generated by mobile phones and their telecommunication stations on health. The saliva plays an important role in preserving oral homeostasis as the first defensive line against the microbial invasion which protects oral mucosa mechanically and immunologically. A search was run in PubMed, Goggle Scholar, Medline, and Web of Science databases using the following keywords: cell phone, mobile phone, antioxidant profile, saliva, oxidative stress, interleukin, and inflammation. Sixty-five published articles were identified. Studies on the use of cell phones as educational aids, the use of immune histochemistry on salivary glands, or the evaluation of saliva in individuals with specific conditions, such as the use of orthodontic brackets, were excluded. In addition, duplicate articles are eliminated, and finally, 14 articles were included in the present study. Nowadays mobile phone is very popular, causing concern about the effect it has on people’s health. Parotid salivary glands are in close contact with a cell phone while talking with the phone and the possibility of being affected by them; so this study was designed to investigate the effect of cell phone use on salivary components.

Objectives Obesity, diabetes mellitus, insulin resistance (IR), and hypertriglyceridemia are common features observed in non-alcoholic fatty liver diseases (NAFLD). There is a critical medical necessity to find novel therapeutics that can halt the development of NAFLD. Methods Bombax ceiba Linn. leaf extract was prepared and its phytochemical profile was determined. Standard and high carbohydrate high-fat diets (HCHF) were prepared. Rats were fed HCHF for 18 weeks to induce a non-alcoholic fatty liver (NAFL) model. Forty male rats were divided into control, B. ceiba Linn. leaf extract, NAFL, prophylactic, and treated groups. Serum fasting blood sugar (FBS), insulin, insulin resistance (HOMA-IR), cholesterol, high-density lipoprotein (HDL), triglycerides (TG), low density lipoprotein (LDL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), intelectin-1 (ITLN1), p38 MAP kinase (MAPK), peroxisome proliferator-activated receptor alpha (PPAR-α), and interleukin-6 (IL-6) were evaluated. Results Data obtained showed that HCHF-induced NAFL resulting in a significant increase in FBS, serum insulin, HOMA-IR, cholesterol, LDL, TG, ALT, AST, and IL-6 and a significant decrease in serum levels of HDL, ITLN1, p38 MAP kinase, and PPAR-α compared to the control group. The analysis of B. ceiba Linn. leaf extract showed high content of phenol compounds which may cause a significant decrease in the levels of FBS, insulin, HOMA-IR values, lipid profile, and levels of IL-6 while a significant increase in serum levels of LDL, ITLN1, p38 MAP kinase, and PPAR-α compared to the NAFL group. Conclusions B. ceiba Linn. Leaf extract is a highly protective and promising therapeutic agent against inflammation and oxidative stress in the NAFLD model induced by HCHF.

Objectives Gladiolus psittacinus (GP) is an important medicinal plant in folk medicine where its corm is used for treatment of diabetes mellitus. Despite this, there is paucity of scientific information to justify its use as antidiabetic drug. Hence, this study was designed to explore antidiabetic, antihyperlipidemic and effects of aqueous extract of Gladiolus psittacinus (AGP) on hyperglycemia-associated oxidative stress in pancreas, kidney and liver of diabetic rats. Methods Diabetes mellitus (DM) was induced in rats using streptozotocin 50 mg/kg (i.p.). Normal and diabetic rats were treated orally with AGP once a day for 14 days. Antidiabetic effects were evaluated on body weight, fasting blood glucose concentration (FBGC), lipid profiles and serum chemistry. Also, protective effects of AGP were also determined on markers of oxidative stress, antioxidant enzymes and histopathology of pancreas, kidney and liver of diabetic rats. Results Treatment with AGP emanated to significant decrease of FBGC (552.67–157.33 mg/dL), increase in body weight (100.01–133.76 g) and positive modulation of lipid parameters in diabetic rats. The alteration in the contents of markers of liver and kidney function were significantly modulated in the diabetic rats upon treatment. Also, oxidative damage and antioxidant depletions in pancreas, kidney and liver were significantly mitigated in treated diabetic rats. Structural aberrations in the histopathology slides of pancreas, kidney and liver were improved upon treatment. Conclusions It can be concluded that AGP could be used in the treatment of diabetes mellitus and its related ailments, thereby justifying its usage in traditional medicine.

Objectives The objective of this study is to determine the activity of Garcinia cowa Roxb. n-hexane, ethyl acetate, and butanol fractions as an immunomodulator in vitro and obtain the fraction that has the potential as an immunomodulator. Methods Raw 264.7 macrophages were used to asses G. cowa Roxb. immunomodulatory activity. The MTT assay was chosen to measure cell viability to evaluate the cytotoxic effect on cells. ELISA method was used to measure the concentration of Interleukin-6 (IL-6) and Tumor Necrosis Factor Alpha (TNF-α) secreted by cells after being treated with G. cowa Roxb. fraction. The neutral red uptake assay determined the effect of Garcinia cowa Roxb. on the phagocytic activity. Results After Raw 264.7 macrophages were given the Hexan fraction (Hex) at concentrations of 12.5 and 25 μg/mL, there was a decrease in the concentration of IL-6, TNF-α, and the phagocytosis index of cells. Administration of the Ethyl Acetate fraction (EtOAc) at concentrations of 12.5 and 25 μg/mL on cells caused a decrease in IL-6 and TNF-α levels but did not affect the phagocytosis index. There was an increase in the level of TNF-α and the phagocytosis index after being given the Butanol fraction (BuOH) with concentrations of 12.5 and 25 μg/mL but there was a slight decrease in the level of IL-6. Conclusions Both Hex and EtOAc fractions could suppress immune responses through decreasing IL-6, TNF-α, and slightly decreased phagocytic activity. BuOH fraction could stimulate immunomodulatory activities through enhanced TNF-α levels and phagocytic index, but less potent in enhancing IL-6 production. The BuOH fraction could be developed as an immunostimulant.

Objectives Euphorbia prostrata is traditionally used alongside antidiabetic agents to manage diabetes. Bioactive ingredients of medicinal herbs may alter the overall pharmacokinetics of antidiabetic agents. Methods We assessed hypoglycemic activities of ethanolic plant extract (EPE) singly and its effects on antidiabetic properties of gliclazide, glibenclemide and metformin in allaxonized rats. Varying concentrations of EPE (250 and 500 mg/kg) with or without metformin (10 mg/kg), glibenclemide (2 mg/kg) and gliclazide (5 mg/kg) were orally administered to evaluate herb-drug interaction. Results The levels of blood glucose declined significantly after treatment with metformin, glibenclemide and gliclazide singly (p<0.01) or concomitantly with EPE (p<0.001). Concentration dependent mild to moderate reduction (5.2 and 10.0%) was registered in blood glucose for 250 and 500 mg/kg of EPE respectively. The overall reduction in blood glucose due to combined treatment with EPE and standard agents was additive. On the other hand, synergistic herb-drug interaction was registered for insulin levels in rats that received glibenclamide and gliclazide alongside EPE. Extract with metformin had antagonistic insulin outcome. Regarding the duration of hypoglycemic activities, periodical changes were similar in case of glibenclamide and gliclazide separately or in combination with EPE. However, in case of metformin with extract, the blood glucose continued to decline for 14 h and retained at 15.0% below the baseline values even after 24 h of treatment. Conclusions In conclusion, the extract itself had weak hypoglycemic effects but prolonged the therapeutic duration of metformin to more than 24 h when administered combinedly.

Objectives Polycystic ovary syndrome (PCOS) is an endocrinopathy affecting 5–20% of women of childbearing age. There is no single drug for the treatment of PCOS and current therapies have significant side effects. This study evaluated the ability of Milica excelsa to improve PCOS symptoms in rats. Methods Induction of PCOS was achieved using letrozole (a reversible aromatase inhibitor; 1 mg/kg; given orally for 21 days). From day 22, PCOS rats received the aqueous extract of M. excelsa roots (14 and 140 mg/kg). Clomiphene citrate (1 mg/kg) was administered to the positive control. The negative and the normal controls received the vehicle (5% DMSO). Treatments were given orally for 7 or 14 days. Vaginal smears were scrutinized daily during the experiment. Body weight was measured hebdomadal. Animals were sacrificed after the two treatment periods for biochemical and histological analyses. Results Aromatase inhibition caused hyperandrogenism (p<0.001), overweight (p<0.001) and fat accumulation (p<0.001). It also blocked the estrous cycle at the diestrus phase and altered ovarian dynamics as evidenced by the accumulation of cystic (p<0.001) and atretic (p<0.001) follicles. In contrast, M. excelsa induced weight loss (p<0.001), reduction in fat weight (p<0001), and lower serum androgen and LH levels (p<0.001). It also restored the estrous cycle and improved ovarian dynamics by increasing the amount of Graafian follicles (p<0.001) and corpora lutea (p<0.001), and decreasing that of cystic and atretic follicles (p<0.001). Conclusions Milica excelsa corrected hyperandrogenism and overweight in PCOS animals, and reduced cyst formation and follicle atresia in their ovaries.

Objectives Regarding neurocognitive and immunomodulatory properties of cinnamon (Cinn) we aimed to investigate whether cinnamon regulates acetylcholinesterase (AChE) activity, and oxidative abnormalities with concomitant memory dysfunction in streptozotocin (STZ)-induced diabetes. Methods Forty-seven male adult rats were divided into seven groups (n=8 animals): Control group: in these non-diabetic rats only saline 0.9% NaCl was gavaged, Diabetic (Dia) group: diabetic rats in them saline 0.9% NaCl was gavaged for six weeks. Dia-Cinn 100, Dia-Cinn 200, and Dia-Cinn 400, Dia-Met groups: in these diabetic rats the extract (100, 200, 400 mg/kg respectively) or metformin (300 mg/kg) was gavaged for six weeks. Passive avoidance performance, AChE enzyme activity, and oxidative indicators were examined among the groups. Results Vs. the control group, blood glucose level and stay time in the dark were remarkably increased in Dia group whereas the latency time was decreased. Meanwhile, antioxidant levels (superoxide dismutase, catalase, and thiols) noticeably decreased in the Dia group compared to the Control group. On the other hand, Cinn extract espicailly at the highest dose recovered the changes similar to those found in the metformin-treated group. Conclusions These findings proposed that the cinnamon hydro-ethanolic extract promotes memory recovery in diabetic conditions through the atteuation of the AChE activity and oxidative injury.

Objectives In ancient times Terminalia arjuna (Roxb.) Wight & Arn. (TA) was used for fast healing of fracture and to strengthen the bone. However, no scientific study has been done to validate its usefulness in the alleviation of osteoporosis. To investigate the efficacy of stem bark TA against post-menopausal osteoporosis using bilateral ovariectomized rat model. Methods Aqueous (TAA) and methanolic (TAM) extracts of TA was evaluated for its anti-osteoporotic activity. Sham control rats were allotted as Group I (Normal control); Group II animals acted as OVX control (Disease control); Group III OVX rats were treated with estrogen (Standard group – 2 mg/kg) Group IV and V OVX rats give treatment to TAA (250 and 500 mg/kg, p.o.), respectively. This treatment is continue for the four weeks and at the end, serum biochemical parameters such as serum calcium and alkaline phosphate were evaluated. Femoral bone parameters (Compression of vertebrae, femoral neck load testing, Three point bending of tibia, Femur length and weight), histology, body weight, and fifth lumbar vertebra breaking strength were also assessed after the sacrificing the animal. Results In OVX rats, atrophy of uterus and descent of BMD were suppressed by treatment with TAA and TAM. In addition, TAM 500 completely corrected the decreased serum concentration of Calcium, Phosphorus, ALP and TRAP observed in OVX rats. TAA and TAM both increased biomechanical strength significantly in comparison to the sham group. Histological results also revealed its protective action through elevation of bone formation. TAM significantly increase the uterine and femoral bone weight The TAM showed maximum anti-osteoporotic activity in in vivo study as compare to TAA. Conclusions The results, evaluated on the basis of biochemical, bone mineral density, biomechanical, and histopathological parameters, presented that TAA and TAM has a definite antiosteoporotic effect, like to estrogen, especially effective for inhibition bone fracture induced by estrogen deficiency.

Objectives A polyherbal formulation with hepatoprotective and choleretic properties combining pharmacological potential of eight medicinal plants was developed in Nargiz Medical center (Republic of Azerbaijan) for the use as herbal tea. To explore the effect of polyherbal composition on the metabolism of LPS-stimulated macrophages in vitro . Methods The qualitative and quantitative phytochemical analysis was conducted using specific color reactions and gas chromatography-mass spectrometry (GC–MS). Nitric oxide (NO) assay was determined using the Griess reaction. Reactive oxygen species (ROS) generation was measured using ROS-sensitive fluorescence indicator, H2DCFDA, by flow cytometry. Arginase activity was examined by colorimetric method. Results The studied polyherbal formulation exerted anti-inflammatory activity in LPS-stimulated macrophages which was evidenced by dose-dependent decrease of ROS generation and by shift of arginine metabolism to the increase of arginase activity and decrease of NO release. Conclusions Our findings suggest that the herbal tea reduces macrophage inflammatory activity, that provide an important rationale to utilize it for the attenuation of chronic inflammation typical of hepatobiliary disorders.

Objectives Salmonella typhimurium is a pathogen responsible for causing a wide range of infectious diseases. The emergence of multi-drug resistance (MDR) in this microbe is a big challenge. L -asparaginase (less explored drug target) is selected as a drug target because it is actively involved in the virulence mechanism. To block this virulent enzyme, curcumin that is traditionally renowned for its medicinal properties was examined. However, its pharmacological behavior and targeting property is less understood because of its poor bioavailability. Therefore, the present work explores the antimicrobial effect of both curcumin and its degradation product against the MDR pathogen. Methods Molecular docking studies were carried out to evaluate the inhibitory effect of curcumin and its degradation product against the L -asparaginase enzyme using Schrodinger Maestro interface tools. The Absorption, Distribution, Metabolism, Excretion and Toxicity (ADMET) profile of all the test ligands was also performed. Results The docking score of curcumin was −5.465 kcal/mol while its degradation product curcumin glucuronide has the lowest i.e., −6.240 kcal/mol. All the test ligands showed better or comparable docking scores with respect to control (Ciprofloxacin). Arg 142 and Asn 84 amino acid residues of L -asparaginase were found to be interacting with test ligands inside the binding pocket of the target protein. ADME/toxicology study also indicated the potency of curcumin/curcumin degradation products as a potent inhibitor. Conclusions It was found that both curcumin and its degradation products have the potential to inhibit Salmonella . This information could be valuable for futuristic drug candidate development against this pathogen and could be a potential lead for mitigation of MDR.

Objectives To study the inhibitory effect of β-elemene on invasion and metastasis of colorectal cancer cells and its possible mechanism. Methods Human colon cancer HCT116 cells were treated with different concentrations of β-elemene. The proliferation inhibition rate of the cells was detected by MTT assay, cell migration rate was detected by scratched assay, and cell invasion rate was evaluated by Transwell cell invasion assay. The expressions of Vimentin, E-cadherin, N-cadherin, and β-catenin were detected by Western blotting. The mRNA expressions of Vimentin, E-cadherin, N-cadherin, and β-catenin were detected by real-time PCR. Results Compared with the control group, the expressions of migration rate, invasion rate, scratch healing rate, N-cadherin, and Vimentin protein of HCT116 cells were decreased after β-elemene treatment, while the expression of E-cadherin protein was increased, and the inhibition rate of cell proliferation was increased (p<0.05). Conclusions β-Elemene may inhibit cell proliferation and invasion and metastasis by inhibiting EMT signaling pathway in human colon cancer cell line HCT116.

Objectives The primary aim of the study is to explore the knowledge and use of palpatory tests in detecting somatic dysfunction, the second is to assess the knowledge about the inhibitory tests among osteopathic practitioners in Italy, England, and France. Methods A quantitative survey was conducted, between March and May 2021, through the administration of a semi-structured questionnaire. The participants had to answer 8 questions. Results A total of 2,223 e-mails were sent: 423 manual therapy professionals participated in the survey. Subsequently, only the responses of the 385 osteopaths (280 Italian, 23 French and 82 British) were included in the data processing; the 38 excluded were physiotherapists and chiropractors. The most significative outcomes for the total sample were found to: years of working experience and knowledge of a palpatory test that allows to discriminate two dysfunctional anatomical structures was significant with a χ 2 =12.509 (p-value <0.006); 68.5% answered in the affirmative to this last question. It was found that less work experience is associated with knowledge of a palpatory test to discriminate two dysfunctional structures. The correlation between years of work experience and knowledge of the inhibitory test was explored with the result being statistically significant (p-value <0.001). 64.4% know and use the inhibitory test. 39.1% base the inhibitory test on tissue change. Conclusions The clinical practice of Italian and French professionals, makes possible to establish the hierarchy between two somatic dysfunctions with respect to English sample. The osteopaths reported a wider use of the tissue change parameters rather than pain reported by the patient. Furthermore, more than half of the sample-based their discriminatory test on the musculoskeletal and fascial systems. There is a vast knowledge of the inhibition test among osteopaths.

Objectives Oregon Medicaid (Oregon Health Plan, or OHP) implemented an innovative policy in 2016 that increased coverage of evidence-based non-pharmacologic therapies (NPT, including physical therapy, massage, chiropractic, and acupuncture) while restricting opioids, epidural steroid injections, and surgeries. The objective of this study was to compare the perspectives of clinicians who see back pain patients and can prescribe pharmacologic therapies and/or refer to NPTs and clinicians who directly provide NPT therapies affected by the policy. Methods A cross-sectional online survey was administered to Oregon prescribing clinicians and NPT clinicians between December 2019 and February 2020. The survey was completed by 107 prescribing clinicians and 83 NPT clinicians. Results Prescribing clinicians and NPT clinicians had only moderate levels of familiarity with core elements of the policy. Prescribing clinicians had higher levels of frustration caring for OHP patients with back pain than NPT clinicians (83 vs. 34%, p<0.001) and were less confident in their ability to provide effective care (73 vs. 85%, p = .025). Eighty-six percent of prescribing clinicians and 83% of NPT clinicians thought active NPT treatments were effective; 74 and 70% thought passive NPT treatments were effective. Forty percent of prescribing clinicians and 25% of NPT clinicians (p<0.001) thought medically-light therapies were effective, while 29% of prescribing clinicians and 10% of NPT clinicians thought medically-intensive treatments were effective (p=0.001). Prescribing clinicians thought increased access to NPTs improved outcomes, while opinions were less consistent on the impact of restricting opioid prescribing. Conclusions Prescribing clinicians and NPT clinicians had varying perspectives of a Medicaid coverage policy to increase evidence-based back pain care. Understanding these perspectives is important for contextualizing policy effectiveness.

Objectives Adjuvant chemotherapy for breast cancer is undeniably effective in increasing survival rates but many breast cancer survivors (BCS) exhibit side effects including nausea, fatigue, stress, and neurocognitive deficits, known as “chemobrain.” This pilot study explored how neurotherapy, or EEG biofeedback, a non-pharmacological approach, improved neurocognitive, behavioral, and neurophysiological deficits associated with BCS who underwent chemotherapy. Methods Subjects underwent 18 sessions of EEG biofeedback training, in which audio and visual feedback occurred with successful shifting of EEG patterns. Results Quantitative EEG and assessment tests demonstrated neurophysiological, cognitive, and behavioral deficits in all nine subjects prior to training. EEG biofeedback resulted in significant improvements in neurophysiological, neurocognitive, and psychological functions in all nine subjects after training. Conclusions We propose that this intervention and related forms of EEG biofeedback have the potential to significantly alleviate common side effects of chemotherapy in BCS and therefore merits additional research attention.

Objectives Effective pain control after oral surgeries including periodontal flap surgery is one of the biggest problems in the periodontology field. The use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) to reduce pain after periodontal flap surgery is common, but these have some adverse side effects such as impaired platelet function and causing digestive problems. Today, the tendency to use omedicinal plants is more than synthetic drugs due to their safety. Therefore, we designed a split-mouth randomized controlled clinical trial to evaluate the effects of Lactuca Sativa ( L. Sativa ) syrup as an adjunct therapy in reducing pain after periodontal flap surgery. Methods This split-mouth, randomized, double-blind, placebo-controlled trial was performed on 26 subjects. Patients were assigned for two surgery. Primary surgery was performed on the right maxilla and after 30 days, secondary surgery was performed on the left maxilla. In primary surgery, patients consumed L. Sativa syrup (3 times a day for 72 h) and in secondary surgery, patients consumed placebo syrup (3 times a day for 72 h). Pain intensity was measured at 6, 12, 24, 48, and 72 h after a periodontal flap surgery in both surgeries using the Visual Analogue Scale (VAS). All patients received their routine drugs, including analgesics. The number of analgesics used after surgery was recorded. Statistical analysis of t-test was used to compare the results of the two surgery. Results The results showed that the mean pain based on VAS score at 6, 12, 24, 48 and 72 h after primary periodontal flap surgery was significantly reduced compared to the secondary periodontal flap surgery (p<0.001). The results also showed that the use of analgesics after 72 h of surgery was significantly reduced in the primary periodontal flap surgery compared to the secondary periodontal flap surgery (p<0.001). Conclusions According to the results of this study, L.Sativa syrup can be effective as adjuvant therapy in reducing pain after periodontal flap surgery.

Objectives Individuals have multiple, competing identities that vary in importance to the self. Professional identity is a way in which individuals attribute meaning to their contribution to society and is influenced by complex factors. Globally, the roles and responsibilities of massage therapists (MTs) vary, making it challenging to articulate a cohesive professional identity. This article describes the investigation into the variables which influenced response regarding MTs’ professional identity in Ontario, Canada. Methods An online questionnaire was distributed to active MTs with available email addresses in the public register of the College of Massage Therapists of Ontario. Chi-square tests of independence were used to compare dependent variables with independent variables. Significance was adjusted post hoc, using Bonferroni’s correction, to reduce the chance of a type I error occurring. The threshold for significance was adjusted from p≤0.05 to p≤0.01 as multiple analyses were conducted with a high response rate. Results The results provided insight into the variables associated with differences in responses. Variation was seen based on gender, primary practice setting, length in practice, additional education, additional roles within the profession, additional designation as a healthcare provider, and membership in the RMTAO (Registered Massage Therapists’ Association of Ontario). Conclusions While previous studies sought to describe the common and unifying features of MTs’ identity, these findings provide insight into variables that determine differences in responses. These findings are valuable for the development of future studies. They provide a priori assumptions regarding the inclusion of these demographic items that can inform decisions regarding enrollment of the sample and data analysis.

Objectives This randomized controlled trial evaluated the stress, anxiety, and burnout of professionals exposed to complementary spiritist therapy (CST), which consists in therapeutic resources as prayer, Spiritist passe , fluidic water and spiritual education or control. Methods Seventy-six professionals were randomized to CST or control: to maintain the routine for 5 weeks. The ISSL scale, anxiety and depression Beck’s indices, Maslach instrument, subjective well-being and WHOQOL-BREF were used at baseline and five-week. Blood count and cytokine dosage were collected at baseline, one-week and five-week. Analysis using the intention to treat approach. Results The means of variation of stress (exhaustion phase) between baseline and five-week were −1.50 ± 3.31 in the CST and 0.72 ± 3.50 in the control (p=0.036), effect size for CST group was d=0.65, which is considered medium effect. CST showed decrease in emotional exhaustion and negative affects, and increase in lymphocytes, erythrocyte parameters and platelets between the baseline and five-week (p<0.05). Reduction in IL-1β and increase in total lymphocyte count were observed with 2–3 sessions per week, but that does not maintain when the number of sessions is decreased. Participants receiving ≥7 sessions reduced emotional exhaustion, depersonalization and stress, and improved hematological parameters throughout the study (p<0.05). Conclusions CST may be effective in reducing stress (exhaustion phase) compared to control. Higher frequency of interventions promotes better psychic state, evidenced by large effect size for emotional exhaustion in burnout, and improves hematological parameters of professionals.

Objectives Imprisoned people usually have a poor health status and an increase risk to suffer chronic debilitating conditions, co-infection due to their limitations in physical activity and mental disturbances. This study was carried to find out the health impacts of Yogic practice of Indian healthy jail inmates. Methods It was interventional single group pre-post design study. A total no of 30, Jail inmates including 08 female were participated in this study and practiced Yoga for six months. Body Mass Index, Heart Rate, Blood Pressure, Salivary alpha amylase activity (SAA) a stress marker were assessed before, after three months and after completion of six months of Yogic practice. Results Improvement was noted in all parameters, but significant improvement was noted in systolic blood pressure, diastolic blood pressure, mean blood pressure, double product a index of load in the heart and SAA following Yogic practice in total participants. Significant improvement was also noted in systolic blood pressure, diastolic blood pressure, mean blood pressure, double product a index of load in the heart and SAA following Yogic practice in male group. No significant effect was noted in female group. Conclusions The present study revealed that regular Yogic practice resulted in reduction blood pressure, load in the heart and stress in mail jail inmates, when it is practiced regularly and carefully.

Objectives To assess the immediate/short-term outcomes of a maqui berry-based nutraceutical (MBN) supplementation on the autonomic nervous system (ANS), resilience level, metabolism and body composition. Methods A randomized controlled single-blind study was performed on healthy subjects. Throughout 30 days, one group took 1,000 mg/day of an MBN (Maqui 500 ® ), the control group had no supplementation. On day 0 (T0) and 30 (T3) all subjects performed blood tests, bioimpedance spectroscopy and questionnaires for resilience, perceived stress and short-form 12 (SF12). At T0, 75′ after T0 (T1), on day 7 and at T3 the subjects underwent biometric parameter measurement and heart rate variability (HRV) test to investigate psycho-physical resilience. Results Fifteen subjects per group were included; abnormal seasonal high temperatures altered individuals’ lifestyle and nutrition, influencing the trial’s outcomes. Biometric parameters, blood pressure, oxygen saturation and blood tests did not differ between T0 and T3 in both groups. In the MBN group the HRV analysis showed a significant increase of ANS coordination (p=0.05), parasympathetic activity at 75′, very low frequencies and total power at T3, whereas these parameters decreased in the control group. SF12 mental score improved in the maqui group (p=0.02); the questionnaire-based outcomes showed no further variations. In the control subjects bioimpedance showed an increase of resistance and fat mass, with decreased total body water and lean mass (p=n.s.). Conclusions The maqui-based nutraceutical improved HRV, namely ANS activation/coordination, and SF12 mental component. Blood tests and bioimpedance/biometric parameters mildly varied. The elapsed hot weather likely biased many investigated variables.

Objectives Understanding and validating the science behind traditional diagnostic methods is a niche area to be explored. Iris diagnosis is one such valuable diagnostic tool used in Naturopathy. In the current study, we have assessed and documented the iris changes observed among patients with hemiplegia with respect to the iridology chart. Methods We recruited 35 patients with hemiplegia which includes both genders. Iris image was captured by Angel Kiss New 5.0MP Iridology Camera with Pro Iris Analysis Software. Lesion characters, such as open lesion, closed lesion, spot, furrow, radii solaris, intestinal crypts etc., in the iris were noted along with its various characteristics in an excel sheet in numerical order for analysis. Results Majority of the included patients were male (n=30) and the mean age of the patients was 46 years. The most common iris lesions noted were radii solaris and intestinal crypt in the cerebrum and cerebellum regions. Other notable lesions include open lesion, closed lesion, brown spot, hole and nerve ring. ROC analysis for selected iris lesions showed that intestinal crypt (AUC=0.82, p=0.01) and radii solaris (AUC=0.62, p=0.04) to be potential markers for hemiplegia. Conclusions Two common lesions observed in patients with hemiplegia are radii solaris and intestinal crypt, corresponding to the cerebrum and cerebellum regions of the iris. Future studies with larger sample size would help warrant our current findings, and also the possible application of iris diagnosis as an early diagnostic marker for hemiplegia.

Objectives Atopic dermatitis (AD) is a chronic inflammatory skin disorder that has the immunoallergological characteristics of atopy and is characterised by itchy dermatitis with a recurrent-relapsing course and skin hyperreactivity. Official therapy involves topical anti-inflammatory and antimicrobial drugs for the skin but, as it is a recurrent and relapsing disease, the use of systemic anti-inflammatory and immunosuppressive drugs is eventually necessary to control the disease and prevent clinical exacerbation. However, systemic treatment may have a major impact on the patient, induce adverse reactions and not resolve the disease. The aim of the study is to establish whether the use of plant extracts may play a role in improving the quality of life of AD patients. Case presentation We describe the clinical case of a 27-year old Caucasian woman with dry, lichenified, slightly reddened and scaly skin lesions (EASI score 1.6), with anamnesis of atopy and multiple allergies, who was treated with an alternative therapeutic strategy to her previous ones, with three herbal-based parapharmaceuticals ( Ribes nigrum L. buds, Piper longum L. fruits, Perilla frutescens L. Britton leaves and seeds in LUXFITOAL; Arctium lappa L. radix , Helychrisum italicum (Roth.) G. Don. flos, Viola tricolor L. herba cum floribus in LUXDERM; Trigonella foenum grecum seed extract, Hypericum perforatum extract in LUXTRIGONELLA cream). Two weeks after taking the drops and applying the cream the dry, lichenified skin lesions were no longer present and an eudermic state of the skin is restored (EASI score 0). Furthermore, six months after the beginning of the therapy, the good condition of the skin was maintained. The patient has never had such a long lapse of time without dermatitis reappearing on the anatomical sites observed at the first follow-up. After nine months, the patient was treated again for a dermatitis that had developed at another anatomical site, spreading frontally at the border between the lower margin of the neck and the upper margin of the thorax and at the chin (EASI value 3.2), achieving a marked improvement and a return of the eudermic state after two days (EASI value 0). Conclusions The patient was satisfied with the “clean hands” with no inflammation, with the resolution of the dermatitis in the other body sites and stated that the therapy has improved her perceived quality of life. These botanicals may be effective and play a role in improving the quality of life of a person with AD.