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Journal of Complementary and Integrative Medicine

Editor-in-Chief: Jeremy Y. Ng, PhD

Language: English

First published: January 1, 2004

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Objective
The Journal of Complementary and Integrative Medicine (JCIM) focuses on evidence concerning the efficacy and safety of complementary medical (CM) whole systems, practices, interventions and natural health products, including herbal and traditional medicines.

Topics
Quality, efficacy, and safety of natural health products, dietary supplements, traditional medicines and their synthetic duplicates // Efficacy and safety of complementary therapies // Evidence-based medicine and practice, including evidence of traditional use // Curriculum development, educational system and competency of complementary health programs // Methodologies on research and evaluation of traditional medicines and herbal products // Integrative medicine: basic and clinical research and practice // Innovation in CAM Curriculum // Educational Material Design

Article formats
Basic and Clinical Research Articles, Review Articles, Mini Reviews, Discussion/Opinion Papers, Short Communications, Editorials

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Authors have the option of publishing their articles under the Creative Commons Attribution (CC-BY-4.0) open access license. Open access allows authors to retain copyright and share their findings with the scientific community without restrictions. Authors who belong to an institution that has an agreement with the publisher can publish open access without paying an article processing charge (APC) or at a considerable discount

Open Access
Guava (Psidium guajava L.) leaf extract improves the prognosis of nonalcoholic fatty liver and biochemical parameters in rats with metabolic syndrome

December 18, 2025

Eduardo Rivadeneyra-Domínguez, Socorro Herrera-Meza, María F. Almanza- Domínguez, Héctor G. Acosta-Mesa, Daniel Hernández-Baltazar, Isaac Zamora-Bello, Juan F. Rodríguez-Landa

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Objectives To evaluate the effects of chronic oral administration of commercial guava ( Psidium guajava L.) leaf extract on biochemical markers and liver histology in a model of metabolic syndrome in rats. Methods 35 Wistar rats were assigned to five independent groups (n=7 per group): the control group (CG), which received a diet with standard rodent food (Nutri-Cubos ® ) and water ad libitum ; the metabolic syndrome group (MS), MS + P . guajava (Pg) low-dose (PgL; 100 mg/kg), MS + Pg medium-dose (PgM; 200 mg/kg), and MS + Pg high-dose (PgH; 300 mg/kg) groups. MS was induced with a rich diet of fat and carbohydrates, in addition to the intake of a 30 % sucrose solution ad libitum for 14 weeks. From week 15 onward, guava leaf extract or vehicle was administered orally every 24 h for 30 consecutive days without changing the experimental diet. At the end of the treatment, biochemical tests, liver histopathological analysis and adipose tissue analysis were performed. Results The MS group presented levels above the reference ranges for biochemical tests, weight gain, waist circumference gain, arterial hypertension, atypical liver cells and aberrant appearance in adipose rat tissue. The PgM and PgH groups presented opposite effects of MS on biochemical parameters, such as increased blood pressure and liver damage. Conclusions Chronic treatment with Pg leaf extract attenuated MS in Wistar rats, restoring the levels of biochemical parameters and exerting hepatoprotective effects. These findings suggest that guajava extract could be used in the development of therapeutic agents to improve the biochemical and histological alterations induced by MS.
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Impact of the nitric oxide substrate l-arginine alone and combined with atropine on malathion neuro and hepato-toxicity

October 28, 2025

Amany A. Sleem, Eman R. Youness, Nermeen Shaffie, Heba A. Farid, Omar M. E. Abdel-Salam

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Objectives We investigated the impact of the nitric oxide substrate l -arginine on the neuro- and hepato-toxic effects of malathion in rats. Methods Rats were treated intraperitoneally with malathion (150 mg/kg) alone or combined with l -arginine (100, 200 or 400 mg/kg), atropine (2 mg/kg) or l -arginine (200 mg/kg) combined with atropine (2 mg/kg). Rats were euthanized 4 h later, and their brains and livers analyzed for malondialdehyde, nitric oxide (NO), reduced glutathione (GSH), paraoxonase-1 (PON-1). Moreover, butyrylcholinesterase (BChE), interleukin-15 (IL-15) and anti-apoptotic protein B cell/lymphoma-2 (Bcl-2) were determined in brain tissue. Histopatholoy was also performed. Results Malathion significantly raised brain NO and malondialdehyde alongside with a notable drop in PON-1 activity and GSH levels relative to the saline control. Brain BChE and Bcl-2 were markedly inhibited whereas IL-15 significantly increased by malathion. In brain, l -arginine treatment resulted in a significantly increased malondialdehyde, decreased GSH, and increased IL-15. A significant decrease in liver malondialdehyde occurred by l -arginine/atropine or atropine. In contrast, l -arginine, l -arginine/atropine or atropine caused a significant decrease in brain and liver NO levels and increased PON-1 activity. Bcl-2 in brain significantly increased by atropine. Malathion induced brain neuronal and liver degeneration showed marked improvement after atropine alone. Conclusions These results indicated that exogenously administered l -arginine did not protect against the neuro- and hepto-toxic effects of malathion. Meanwhile, the ability of atropine to mitigate the deleterious effects of a toxic dose of malathion provides a strong support to the role of excessive stimulation cholinergic pathways in inflicting such damage.
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Efficacy of traditional medicine in the management of sickle cell disease: a scoping review of current evidence

October 28, 2025

Danish Javed, Amit Kumar Rai, Athulya TH, Sai Thejesh Molakapuri, Azeem Ahmad, Gaurav Dhingra

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Introduction While conventional medicine (CM) has improved outcomes for individuals with sickle cell disease (SCD), issues with accessibility, affordability, and potential adverse effects limit its widespread use. As a result, many patients and caregivers turn to traditional medicine (TM) as an alternative approach to managing SCD. This scoping review aims to systematically evaluate the efficacy, safety, and potential mechanisms of action of TM in SCD, while exploring its integration with CM. Content A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, EMBASE, and AYUSH Research Portal. Clinical trials, observational studies, in vitro and in vivo studies, and ethnopharmacological surveys investigating TM interventions in SCD were included. Summary and Outlook Of the 27 selected studies, 11 were in vitro , four in vivo , six clinical trials, and six qualitative surveys. Several medicinal plants demonstrated promising anti-sickling, antioxidant, anti-inflammatory, and immunomodulatory properties. Formulations such as Niprisan ® , Ciklavit ® , and T-AYU-HM™ Premium showed potential in reducing vaso-occlusive crises and improving hematological parameters. However, limitations include variability in herbal formulations, lack of standardization, and inadequate RCTs. While preliminary findings are promising, further well-designed RCTs are needed to establish the efficacy of TM in SCD. Integrating evidence-based TM with CM options could provide a holistic and patient-centered strategy for SCD.
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Experimental evaluation of the Anti-inflammatory and anti-arthritic potential of Saccharum officinarum node extract in FCA-induced arthritic models

August 15, 2025

Priyanka Nanasaheb Khamkar, Snehal Ambadas Gojare, Deepti Dinesh Bandawane, Shakuntala Narayan Kawhale

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Background Saccharum officinarum has been traditionally utilized to treat different types of inflammation in ayurvedic medicine. Scientific investigation into the therapeutic potential of plant nodes remains limited and has not been extensively explored. Objectives To investigate the pharmacological efficacy of ethanolic extract of S. officinarum node (EESO) in reducing inflammation and arthritis in experimental models. Methods EESO was obtained via ethanol extraction and analysed for its phytochemical constituents. Rat paw edema was used to check for anti-inflammatory activity by carrageenan induced model, with Methotrexate (1 mg/kg) employed as the conventional reference drug. The EESO node was administered orally to experimental animals at doses of 50, 100, and 200 mg/kg. Measurements of paw thickness were taken at 0, 1, 2, 4, and 6 h. The anti-arthritic activity was assessed in the rat through induction of arthritis using Freund’s complete adjuvant (FCA). Parameters assessed included paw edema, motor coordination, nociceptive threshold, and, post-sacrifice, biochemical (CRP, RF, ALP, AST, ALT), haematological (Hb, RBC, WBC, ESR), cytokine (TNF -α, IL -1, IL -6), radiological, and histopathological markers. Results EESO at 200 mg/kg significantly reduced paw edema by inhibiting inflammatory mediator release and downregulating pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) in FCA-induced arthritic rats. Histopathology showed decreased synovial hyperplasia and cartilage erosion due to reduced immune cell infiltration and joint inflammation. These inhibiting inflammatory mediator release, downregulating pro-inflammatory cytokines, reduced immune cell infiltration and joint inflammation scientifically validate the traditional use of EESO in managing arthritis and inflammation. This data sufficiently support the assertion that EESO can be utilized for the treatment of arthritis and inflammation. Conclusions EESO at a dose of 200 mg/kg demonstrated significant anti-inflammatory and anti-arthritic activity in the study, scientifically validating its traditional use. The findings provide adequate preclinical evidence supporting its potential therapeutic role. These results suggest that EESO could serve as a natural treatment option for managing arthritis and inflammation.
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The protective effect of hydrolyzed collagen gel from mackerel scad (Decapterus macarellus) to attenuate chronic UVB-induced photodamage

July 10, 2025

Elisa Herawati, Rizki S. Titisari, Helen Kristin, Filosofia F. T. A. Prasasti, Pipin Agnesia, Okid P. Astirin, Shanti Listyawati, Evi Susanti, Nuniek Herdyastuti, Noer Laily, Fatim Illaningtyas

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Objectives Hydrolyzed collagen (HC) extracted from fish skin is a safe and effective native collagen alternative that can potentially protect skin from experiencing photoaging. This study is among the first to explore HC from mackerel scad ( Decapterus macarellus ) application via in vitro and in vivo approaches. Methods The protective effects of HC were investigated on Mouse Embryonic Fibroblasts (MEFs) induced by acute and chronic UVB, followed by testing of HC gel on UVB-induced photoaging models of mice. Cell viability test using the MTT method was performed on UVB-induced MEFs treated with HC concentrations of 10, 20, 50, and 100 g/mL. A gel form HC was applied topically in UVB-induced skin tissues of animal models and analyzed with ELISA to evaluate the inhibitory effect of MMP-1 and IL-6 expression. Results In vitro analysis showed that HC (10, 20, 50 μg/mL) could increase the viability of acute UVB-induced MEFs at a 60 mJ/cm 2 dose. In chronic UVB exposure, all HC concentrations could protect the viability of induced MEFs at 40 mJ/cm 2 dose. HC gel effectively inhibited the increased expression of MMP-1 and IL-6 in UVB-exposed skin, which may be related to its ability to suppress the activation of MAPK and NF-κB signaling pathways. Furthermore, HC gel intervened in the development of epidermal thickening and dermal layer damage in photoaged skin. Conclusions These findings indicated that HC from mackerel scad skin effectively provided a protective effect against the photoaging process.
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Apitherapy for drug-induced kidney disease: a narrative review on its mechanisms

April 4, 2025

Andrés Jagua-Gualdrón, Nicolai Andrés García-Reyes, Holman Leonardo Africano-Lopez

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Objectives The use of medications for the treatment of various diseases often results in kidney damage. Apitherapy is a natural therapeutic tool with potential utility for this purpose. This narrative review analyzes and summarizes the scientific evidence on the use of apitherapy in drug-induced kidney disease. Content This review summarizes and analyzes recent advances in drug-induced kidney disease and explores, based on the available scientific evidence, how apitherapy can modify these mechanisms and be utilized for prevention and treatment. Summary Apitherapy (the complementary and integrative use of beehive products) is a potentially useful therapeutic system for the treatment of various diseases. This review examines the preclinical and clinical evidence available regarding its potential use in drug-induced kidney disease. Outlook Apitherapy has effects on various pathophysiological mechanisms of drug-induced kidney disease, including oxidative stress, inflammation, decreased renal blood flow, glomerular damage, increased membrane permeability, activity of the renin-angiotensin-aldosterone axis, mitochondrial dysfunction, and apoptosis. Further studies in humans are needed to evaluate its efficacy in the clinical setting, but the available evidence is promising.
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Chronic toxicity and modulatory effects of Deprungsith formulation in Wistar Albino rats

August 8, 2025

Yosita Kasemnitichok, Monthaka Teerachaisakul, Tullayakorn Plengsuriyakarn, Kesara Na-Bangchang

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Objectives Psoriasis is a systematic skin disease. Treatment choice is limited due to unsatisfactory clinical efficacy. The study evaluated the safety of Deprungsith formulation following long-term administration (chronic toxicity test) and its potential modulatory effect on hepatic cytochrome P450 (CYP) enzymes in rats. Methods Wistar rats were randomly grouped to receive Deprungsith (125, 500, and 1,000 mg/kg/day) and the satellite (1,000 mg/kg bw) to observe reversibility, as well as distilled water (untreated control) for 9 months. The sentinel-1 group was for environmental risk assessment after 6 months, and the sentinel-2 group was for environmental risk assessment after 9 months). Clinical and behavioral signs, mortality, and histopathology were monitored. Results The chronic toxicity study of Deprungsith revealed no evidence of mortality or serious clinical signs at any dosage level. However, changes in WBC count, serum albumin, and sodium, were observed. Histopathological examination identified mild to moderate liver necrosis and renal interstitial inflammation. Low-dose (125 mg/kg bw) significantly induced CYP1A2 and CYP3A1, while high-dose (1,000 mg/kg bw) inhibited CYP1A2 and CYP3A1 activities. Conclusions Deprungsith formulation was well-tolerated with an MTD (maximum tolerated dose) and NOAEL (no-observed-adverse-effect level) of 1,000 mg/kg bw. Long-term use of Deprungsith formulation in psoriasis patients should be carefully monitored for therapeutic outcomes (side effects from accumulated levels or unsatisfactory efficacy from inadequate CYP1A2 and CYP3A1-mediated metabolism) and potential herb-drug interactions.
Open Access
Patients’ perceived benefit and side effects from the use of medicinal cannabis – a cross-sectional survey study from Denmark

December 2, 2025

Frederik Rosenbæk, Line Bjørnskov Pedersen, Sonja Wehberg, Jesper Bo Nielsen, Jens Søndergaard

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Objectives Medicinal cannabis (MC) has recently been legalized in a growing number of countries. While MC is considered a potentially safe alternative or add-on to conventional treatments for pain, spasms, neuropathy, and chemotherapy-induced nausea/vomiting, evidence of its effectiveness and safety remains limited. This study aimed to assess patients’ perceived benefits and side effects of MC and explore patterns in side effect experiences. Methods We conducted a Danish nationwide online survey in 2020 among two groups of MC users: one with predefined diagnostic indications (neuropathic pain, chemotherapy-induced nausea/vomiting, or painful spasms from multiple sclerosis/paraplegia) (n=258) and one with other indications (n=786). Perceived benefit and side effects were measured using self-reported responses. We compared perceived benefit to the number of side effects and used a heat plot correlation matrix and exploratory factor analysis to identify patterns. Predicted factor scores were used to compare perceived benefit relative to side effect profiles, stratified by indication group. Results Most patients (67 %) reported a moderate to large effect of MC. Over half experienced side effects, with more than 10 % reporting three or more. Side effects were equally common among patients reporting a moderate to large vs. no to minor effect (p=0.27 and 0.68 for predefined and other indications). Side effects clustered into four groups: cognitive dysfunction, dizziness, xerostomia, and feeling “high.” These were not related to perceived benefit. Conclusions Most patients reported a moderate to large effect from MC. Over one in ten experienced three or more side effects, which were unrelated to perceived treatment effect.
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Evaluating the effectiveness of pterostilbene in improving memory and offering neuroprotection in a rat model of Alzheimer’s disease induced by aluminum chloride

July 31, 2025

Ameer Raheem Waheed, Bahir Abdul Razzaq Mshimesh

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Background and Objectives Alzheimer’s disease (AD) is a neurodegenerative disease and is the predominant etiology of dementia. We hypothesize that the naturally occurring pterostilbene (PTE) at doses of 50 and 100 mg/kg would yield dose-dependent neuroprotective effects, reducing cognitive deficits and pathological hallmarks by modulating biomarkers (Amyloid Beta protein (Aβ), Phosphorylated tau protein (P-tau), Brain-Derived Neurotrophic Factor (BDNF), acetylcholinesterase (ACHE), glutamate (GLU)) and a novel synaptic marker neurogranin (NRGN) in rats induced by aluminum chloride (AlCl 3 ). This current research aims to evaluate the neuroprotective effects of pterostilbene (PTE) against neurobehavioral and pathological alterations induced by aluminum chloride (AlCl 3 ) in rats with Alzheimer’s. Methods 40 rats were divided into five groups, eight in each group. They received 70 mg/kg of body weight AlCl3 intraperitoneally for 30 days, followed by oral administration of PTE at 50 mg/kg or 100 mg/kg, or donepezil at 1 mg/kg for 14 days. The Y-maze and novel object recognition tests were used for the neurobehavioral evaluation of the rats. This was followed by a biochemical evaluation using ELISA kits to demonstrate the impact of PTE on the levels of Aβ, P-tau, BDNF, NRGN, AChE, and GLU. Additional validations were conducted through histopathological evaluation of the cortex and basal ganglia in the rat brain. Using GraphPad Prism 10, statistical data were obtained by ANOVA and Tukey’s multiple comparisons test. The histopathologic score system was determined using the non-parametric Kruskal-Wallis one-way ANOVA k-samples (all pairwise) test. Results PTE at 50 mg/kg significantly increases spontaneous alternation percentage (SAP) by 35.7 % and discrimination index (DI) by 79.7 %, while also considerably lowering Aβ by 70.6 %, P-tau by 33.9 %, BDNF by 59.7 %, NRGN by 40 %, ACHE by 28.8 %, and GLU by 28.4 %. Moreover, PTE at 100 mg/kg significantly increases SAP by 42.9 % and DI by 83.4 %, and substantially decreases Aβ by 83.8 %, P-tau by 45.5 %, BDNF by 69 %, NRGN by 42.5 %, ACHE by 69 %, and GLU by 50.9 % compared to the AlCl3 group. Histopathological evaluation of the cortex and basal ganglia in AlCl3-induced rat brains revealed pathological alterations absent in rats treated with PTE. Conclusions This study supports the hypothesis that PTE can reverse memory loss and pathological markers.
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Effects of resveratrol on CYP450-derived arachidonic acid metabolites and mRNA gene expression in human endothelial HUVEC cells

December 23, 2025

Yazun Bashir Jarrar, Mansour Al-Sayed Ahmad, Arwa Althaher, Wesam Nasser, Fatima Khirfan, Ala’a S. Shraim, Su-Jun Lee

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Objectives This study aims to investigate the expression of arachidonic acid (ARA)-metabolizing cytochrome P450 (CYP450) enzymes and their metabolites, as well as the effects of resveratrol, a compound known for its cardiovascular benefits, on these enzymes in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were cultured and treated with 10 µM resveratrol for 24 h. The mRNA expression of key ARA-metabolizing CYP450 enzymes was analyzed using real-time polymerase chain reaction. ARA metabolites produced by CYP450s were identified and quantified in cell culture media and lysates using liquid chromatography coupled with mass spectrometry. In addition, in silico docking was done to evaluate the effect of resveratrol on the identified CYP450s in HUVECS. Results CYP2J2, CYP2U1, and epoxide hydrolase were expressed in HUVECs; however, their mRNA expression levels were not significantly altered following resveratrol treatment. The metabolite 20-hydroxyeicosatetraenoic acid (20-HETE) and its synthesizing CYP450 genes were not detected or below the lower limit of detection in HUVECs. Additionally, several epoxyeicosatrienoic acids (EETs) and dihydroxyeicosatrienoic acids (DHETEs) were present in significantly higher amounts in the cell culture media compared to the cell lysates. Resveratrol treatment significantly reduced (p<0.05, t-test) the levels of EETs and DHETEs. In addition, in silico analysis showed resveratrol has a moderate affinity to interact with CYP2J2, the major EETs producer. Conclusions These findings suggest that resveratrol significantly reduces the levels of EETs and DHETEs possibly through direct interaction with CYP2J2. Furthermore, HUVECs may not be a suitable in vitro model for studying ARA metabolism to 20-HETE.
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Study on a non-pharmacopeial formulation for its hepatoprotective activity against drug induced hepatotoxicity in animal model

October 17, 2025

Syeda Asma Firdose, Abdul Wadud

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Objectives This study assessed the hepatoprotective efficacy of a non-pharmacopeial formulation (NPF) against rifampicin-induced hepatotoxicity, aiming to expand the repertoire of hepatoprotective agents in Unani medicine. Methods An acute toxicity study and HPTLC analysis were performed. The experiment utilized 42 Wistar rats, each weighing between 150 and 200 g. The rats were systematically allocated into seven distinct groups, each containing six animals, identified as negative, positive, standard, and test groups A, B, C, and D. Liver damage was induced by oral administration of rifampicin at a dose of 500 mg/kg daily for 30 days, following a 2-hour interval after the administration of standard and test drugs. The standard and test groups received Silymarin (100 mg/kg), NPF, Afsanteen , Kasni , and Asaroon at doses of 167, 117, 167, and 217 mg/kg, respectively, orally once daily for 30 days. Serum levels of marker enzymes (SGOT, SGPT, and ALP), total protein (TP), and albumin (S. Alb) were evaluated. All groups underwent biochemical and histopathological analysis. Results The formulation was deemed safe at a dose of up to 2000 mg/kg. Compared to the standard drug, test groups A and D demonstrated potential protective effects on the liver enzymes. Test groups B and C exhibited normal liver architecture. Conclusions Asaroon (test group D) demonstrated greater efficacy than NPF. Histopathologically, Afsanteen and Kasni were found to be effective. The study indicated that formulations by Unani scholars were more effective than non-pharmacopeial formulations, although the tested NPF remained effective and safe in this study.
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Avocado oil protects the gastric tissue in favism from oxidative stress, inflammation, and apoptosis

December 22, 2025

Khaled M. M. Koriem, Safaa M. N. El-Gammal

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Objectives Favism is a severe hemolytic anemia, while avocado oil has anti-inflammatory and antioxidant properties. The objective is to determine if avocado oil can improve blood parameters, liver function, gastric antioxidants, inflammatory cytokines, and the apoptotic genes p53 and bcl-2 in favism-induced rats. Methods Thirty-six male albino rats were divided into two main (normal and favism-induced) groups. Normal group (18 rats/group) subdivided into three subgroups (6 rats/group); control, avocado oil (1.5 mL/rat)-treated, and avocado oil (3 mL/rat)-treated subgroups: normal rats orally administrated once with 1 mL distilled water/rat, 1.5 mL of avocado oil/rat, and 3 mL of avocado oil/rat, respectively. Favism-induced group (18 rats/group) subdivided into three subgroups (6 rats/group); Favism, avocado oil (1.5 mL/rat) + favism, and avocado oil (3 mL/rat) + favism; favism-induced rats orally administrated once with 1 mL distilled water/rat, 1.5 mL of avocado oil/rat, and 3 mL of avocado oil/rat, respectively prior to favism induction. Results Favism reduced blood parameters, liver function, gastric NADPH oxidase, glutathione peroxidase, catalase, superoxide dismutase, interleukin-10, and ATPase levels but increased gastric malondialdehyde, conjugated dienes, oxidative index, tumor interleukin-1β, interleukin-6, nuclear factor kappa B values, and necrosis factor-α compared to the control group in the male rats that were induced with favism. After four weeks of oral administration of avocado oil, all of these measures approached control levels in favism-induced rats, suggesting that a higher dose was more beneficial than a smaller one. Conclusions Avocado oil improved blood parameters, liver function, gastric antioxidants, inflammatory cytokines, and the apoptotic genes p53 and bcl-2 in favism-induced rats. These findings indicate that avocado oil may help reduce gastric damage associated with favism by lowering oxidative stress and inflammation, suggesting a need for further clinical investigation.
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Exploring the neurological pathways of P. ginseng memory-enhancing effects

October 14, 2025

Mahdiyeh Hedayati-Moghadam, Fatemeh Seyedi, Hadis Eftekhari, Mohammad Dalfardi, Yousef Baghcheghi

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Panax ginseng , a widely studied herbal remedy, has garnered significant interest for its potential cognitive-enhancing effects, particularly in memory improvement. This narrative review, adhering to the SANRA (Scale for the Assessment of Narrative Review Articles) criteria, collected evidence via a search across PubMed, Scopus, Web of Science, and EMBASE (2000–2023). Key findings suggest that P. ginseng enhances memory through multiple molecular pathways, including modulation of neurotransmitter systems such as acetylcholine, serotonin, dopamine, and glutamate. The herb’s active components, known as ginsenosides, interact with these neurotransmitter systems to regulate synaptic plasticity, neuronal communication, and memory formation processes in the brain. Furthermore, P. ginseng demonstrates antioxidant and anti-inflammatory properties, attenuating oxidative stress and neuroinflammation, which are known contributors to cognitive decline and memory impairment. By reducing neuronal damage and preserving brain health, P. ginseng helps support optimal cognitive function and memory retention. Moreover, P. ginseng influences various signaling pathways involved in memory consolidation and retrieval, including the CREB pathway, BDNF signaling, and the mTOR pathway, through these molecular pathways. P. ginseng promotes neuronal survival, synaptic plasticity, and LTP, ultimately enhancing memory performance. This review underscores the need for standardized methodologies and longitudinal studies to optimize therapeutic applications of P. ginseng in memory-related disorders.
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Traditional formulation-Vanari Gutika treatment improves the testosterone biosynthesis and sperm quality in adult male mice

December 12, 2025

Arti Rajpoot, Anupam Yadav, Shubhanshu Yadav, Nikita Nikita, Neha Dhar Dubey, Gyaneshwer Chaubey, Raghav Kumar Mishra

Article number: 20250305

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Objectives Vanari Gutika (VG), an Indian traditional formulation containing Mucuna pruriens as a principal component, is traditionally used for the management of male reproductive disorders. However, there is a significant lack of evidence-based research validating its effects on male fertility and testosterone biosynthesis. This study aimed to investigate the impact of VG on testicular steroidogenesis, lipid peroxidation, and sperm quality in male mice. Methods Adult male mice were orally administered VG at 75, 150, or 300 mg/kg body weight/day for 35 days. Testicular function was assessed through sperm morphology and viability, lipid peroxidation and expression of key steroidogenic and oxidative stress-related proteins. Results VG at 150 and 300 mg/kg significantly increased testis weight and serum testosterone, with a concurrent reduction in estradiol. VG (150 mg/kg) improved normal sperm morphology and reduced abnormalities. Markers of oxidative stress status improved, evidenced by reduced LPO and increased Nrf-2 expression. VG treatment enhanced the expression of steroidogenic markers (SF-1, CYP11A1, 3β-HSD, StAR, and 17β-HSD) at higher doses. Conclusions Higher doses of VG (150 and 300 mg/kg BW) promote testicular androgenesis, reduces oxidative stress, and improves sperm quality. Consequently, our results provide robust and compelling evidence supporting its potential as a dietary supplement for boosting the testosterone level and sperm quality.
Open Access
Effects of the intravenous application of sodium ascorbate in patients with the diagnosis of sepsis in the intensive care unit – observational, analytical, retrospective, comparative study

July 17, 2025

Adlay Martinez Ramos, Hugo Mario Galindo Salom, Helber Armando Prieto Lozano, Paulo Andres Lopez Posada, Juan Manuel Martinez, Marixa Guerrero, Carlos Alberto Carrillo Bravo

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Objectives To evaluate whether high-dose intravenous sodium ascorbate improves inflammatory markers in patients with sepsis. Methods A retrospective, observational, analytical, and comparative study was conducted on patients diagnosed with sepsis and admitted to the ICU at Clínica Estrios (Cartagena, Colombia) between July 1 and 30, 2024. Patients receiving standard treatment were compared with those who also received high-dose intravenous sodium ascorbate (>462 mg/kg/day), supplied by Biological Therapies, Australia. The main outcome was the duration of altered SIRS and SOFA scores. Results Patients treated with sodium ascorbate showed a statistically significant reduction in the duration of altered SIRS and SOFA scores ( X 2 =9.00, p=0.003) compared to those who received standard therapy. Conclusions High-dose sodium ascorbate may serve as an effective adjuvant therapy in sepsis.
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Interoception and eating behavior in participants at risk for hypertensive disorders of pregnancy

December 18, 2025

Naomi Deokule, Ghada Bourjeily, Anna Palatnik, Nina K. Ayala, Nicole R. Nugent, Amanda Desmarattes, Margaret H. Bublitz

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Objectives Disordered eating during pregnancy can impact maternal and fetal health. Disordered eating has been linked to higher cardiovascular risks including hypertensive disorders of pregnancy (HDP). Interoceptive awareness, the ability to perceive and respond to bodily sensations, is reduced among people with disordered eating and may be associated with blood pressure (BP). This study tested these associations in pregnant women at risk for HDP. Methods Ninety-five pregnant women at risk for HDP participated in the study. At ∼18 weeks’ gestation we measured 24-hour BP, interoceptive awareness, and disordered eating. Linear regression analyses were used to test associations, adjusting for covariates (BMI, education, income, race). Results Greater interoceptive awareness—specifically lower anxiety about bodily sensations (“Not Worrying”)—was significantly associated with lower daytime diastolic BP (B=–0.21, p=0.05), lower uncontrolled eating (B=–0.52, p<0.001), and lower emotional eating (B=–0.51, p<0.001). Higher scores on the “Not Worrying” subscale were associated with less Uncontrolled Eating (B=−0.52, p<0.001) and less Emotional Eating (B=−0.51, p<0.001). Higher scores on the “Attention Regulation” subscale were associated with less Uncontrolled Eating (B=−0.24, p=0.02) and less emotional eating (B=−0.25, p=0.02). Cognitive Restraint was associated with higher nighttime diastolic BP (B=0.27, p=0.04) but not interoceptive awareness. Conclusion Increased interoceptive awareness was associated with both healthier eating behaviors and lower BP in pregnant women at risk for HDP. Interventions that enhance interoceptive awareness may offer a promising strategy for reducing risk for cardiovascular complications in pregnancy.
Open Access
Patient experiences and perspectives regarding medicinal cannabis: a qualitative scoping review

December 29, 2025

Frederik Rosenbæk, Jesper Bo Nielsen, Line Bjørnskov Pedersen, Sif Schmidt Stewart-Ferrer, Jens Søndergaard, Jessica Joan Williams, Elisabeth Assing Hvidt

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Introduction The objective was to synthesise existing qualitative research on patients’ experiences and perspectives regarding medicinal cannabis and cannabis-based prescription medications. Content A systematic search of EMBASE, Scopus, PubMed, and the Cochrane Library identified peer-reviewed articles. Characteristics and findings were organised using a predesigned data charting form. Thematic analysis identified key themes. Reporting followed PRISMA-ScR guidelines. Summary From 849 records, 40 met inclusion criteria. Themes highlighted therapeutic potential and tolerability across various conditions. Patients described diverse administration methods and dosing strategies tailored to individual needs. Barriers included stigma, high costs, and bureaucratic delays in access and reimbursement. Facilitators involved support from healthcare providers, family, peers, and communities. Patients expressed a need for more education, information, and research. Many viewed prescription cannabis as superior to conventional medicines, though concerns about safety persisted. Outlook A gap exists between generally positive patient-reported experiences and the cautious stance of the medical community, which calls for more definitive research. Patients often face stigma and bureaucratic hurdles, though support from physicians and social networks can ease access. Views on safety and effectiveness vary, as some see medicinal cannabis as natural and safe, while others remain sceptical.
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The effect of ethanolic extract Panax ginseng roots on hypothyroidism-induced memory impairment, inflammation, and hippocampal tissue oxidative damage in rats

December 30, 2025

Hedyeh Askarpour, Mahdiyeh Hedayati-Moghadam, Faezeh Mirzaee, Sobhan Eslami, Yousef Baghcheghi

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Objectives Panax ginseng is rich in ginsenosides, which possess antioxidant, anti-inflammatory, and neuroprotective effects. This study aimed to evaluate the effects of ethanolic extract P. ginseng roots (GSNG) on memory deficits, inflammation, and oxidative damage in the hippocampal tissue of male rats subjected to hypothyroidism. Methods Male Wistar rats were divided into four groups: Control, PTU, PTU-GSNG 50 (50 mg/kg), and GSNG100 (100 mg/kg). Over 42 days, PTU was provided in drinking water at a concentration of 0.05 %. GSNG was administered via gavage during the PTU treatment and throughout the behavioral testing phase. In fifth week the behavioral tests including water maze and shuttle box were conducted. After 42 days, hippocampal tissues were harvested post-euthanasia for analysis of oxidative stress markers and interleukin-6. Results Administration of GSNG significantly ameliorated memory impairment and reduced oxidative damage and inflammation in the hippocampus of hypothyroid rats. Behavioral assessments using the water maze and shuttle box indicated marked improvements in memory impairment induced by hypothyroidism (p<0.01 and p<0.001). Biochemical analyses revealed significant modulation of oxidative stress markers, including MDA, total thiol groups, SOD activity, catalase levels, and interleukin-6, with both doses of Ginseng demonstrating beneficial effects. Notably, the higher dose (100 mg/kg) exhibited superior efficacy compared to the lower dose (50 mg/kg) across all measured parameters. Conclusions The findings suggest that P. ginseng effectively mitigates hypothyroidism-induced memory impairment by attenuating oxidative stress and neuroinflammation, highlighting its potential as a therapeutic agent for cognitive deficits associated with thyroid dysfunction.
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Pharmacokinetic, toxicological, and antidiabetic evaluation of a novel polyherbal formulation

October 27, 2025

Sony Rajan, Ratheesh Mohanan, Svenia P. Jose, Sheethal Sreevallabhan, Sandya Sukumaran, Aditya Ashish

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Objectives The current study aimed to formulate and analyze a novel polyherbal formulation (NPF) comprising of Terminalia arjuna, Centella asiatica and Embelia ribes . Methods NPF was prepared and subjected to preliminary phytochemical screening and FTIR to characterize its bioactive compounds and functional groups. To assess the safety, oral toxicity studies were carried out in Wistar rats. The antidiabetic efficacy was evaluated using the OGTT. Additionally, computational ADME analysis was carried out for the major active molecules – arjunolic acid, embelin, and asiaticoside – to evaluate the pharmacokinetic properties and drug-likeness. Results Presence of various secondary metabolites such as alkaloids, flavonoids, phenolic compounds, saponins, terpenoids, cardiac glycosides, and carbohydrates were confirmed by the phytochemical screening. Key prominent functional groups such as hydroxyl, amine, carbonyl, and alkyne stretching vibrations were detected upon FTIR analysis. Toxicity evaluations indicated no adverse effects, confirming the safety of NPF. Among diabetic rats, groups treated with 200 mg/kg body weight of NPF indicated a significant improvement in glucose tolerance as demonstrated by the OGTT results. ADME profiling showed favorable drug-likeness properties for arjunolic acid and embelin compared to asiaticoside. Conclusions NPF exhibited significant antidiabetic potential and demonstrated safety in animal models.
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Assessing the impact of massage and herbal therapies on chronic low back pain: a randomized controlled trial

November 25, 2025

Yuwadee Manjit, Pranee Sriraj, Areeya Changthong, Tichanon Promsrisuk, Ranuka Kamolrattanakul, Ratchadawan Aukkanimart

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Objectives Chronic low back pain (cLBP) is prevalent among agricultural workers in Surin Province, Thailand. This study evaluated the efficacy and safety of Thai massage combined with the traditional herbal formula Ya Thamlai Phra Sumeru (YTPS) in reducing pain and improving mobility in individuals with cLBP. Methods A single-blind, randomized controlled trial was conducted with 66 participants assigned to three groups (n=22 each): (1) herbal remedy (Hr) group, receiving 2,000 mg of YTPS twice daily for seven days; (2) Thai massage (Tm) group, receiving massage therapy three times per week; and (3) combined therapy (Tm+Hr) group, receiving both interventions. The active compounds of YTPS were identified by HPLC, and antioxidant capacity was evaluated using DPPH and ABTS assays. Pain and functional outcomes were assessed using the Numerical Rating Scale (NRS), Goniometer (GOM), Flexible Ruler (FR), and Oswestry Disability Index (ODI). Biochemical safety parameters (BUN, creatinine, AST, ALT) and oxidative stress markers (MDA, CAT, GSH, SOD) were analyzed before and after treatment. Results HPLC revealed piperine (19.6 µg) and cannabidiol (5.09 µg) as key active constituents with antioxidant potential. All groups demonstrated improved oxidative profiles, with increased CAT, GSH, and SOD levels and reduced MDA concentrations. The combined therapy group (Tm+Hr) showed the greatest improvements in NRS, GOM, and ODI scores (p<0.05). No significant adverse biochemical changes were observed. Conclusions A seven-day regimen combining Thai massage with YTPS safely and effectively reduced pain and disability while enhancing antioxidant activity. This integrative approach may serve as a practical and culturally relevant therapy for managing chronic low back pain in community healthcare settings.

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CiteScore	3.2	2024, Scopus (Elsevier B.V., 2025)
SCImago Journal Rank	0.321	2024, SJR (Scimago Lab, 2025; Data Source: Scopus)
Source Normalized Impact per Paper	0.583	2024, CWTS Journal Indicators (CWTS B.V., 2025; Data Source: Scopus)

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Editor-in-Chief
Jeremy Y. Ng, PhD, Centre for Journalology, Ottawa Hospital Research Institute, Ottawa, Canada; and Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany

Editors
Dennis Anheyer, University Hospital Tuebingen, Tuebingen, Germany, dennis.anheyer@uni-tuebingen.de
Kieran Cooley, University of Toronto, Toronto, ON, Canada, kcooley@ccnm.edu
Robert Kam-Ming Ko, Hong Kong University of Science and Technology, Hong Kong, China, bcrko@ust.hk
Zacharias Suntres, Northern Ontario School of Medicine, Thunder Bay, ON, Canada, zacharias.suntres@nosm.ca
Phoebe Zhou, Western Sydney University, Sydney, NSW, Australia, p.zhou@westernsydney.edu.au

Editorial Board
Terje Alraek, The National Research Center in Complementary and Alternative Medicine (NAFKAM), Faculty of Medicine at UiT the Arctic University of Norway, Bergen, Norway
John T. Arnason, Department of Biology, University of Ottawa, Ottawa, ON, Canada
Steven K.H. Aung, Associate Clinical Professor, Departments of Medicine and Family, Medicine University of Alberta, ALB, Canada
Robert Banner, Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, ON, Canada
Zhao Xiang Bian, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
Heather Boon, Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
Alieen P. Burford-Mason, DRS Consulting, Toronto, ON, Canada
Harpal S. Buttar, Senior Scientist and Adjunct Professor, Reproduction and Urology Division, Therapeutic Products Directorate, Ottawa, ON, Canada
Dennis Chang, NICM Health Research Institute and Professor of Pharmacology at Western Sydney University, Sydney, NSW, Australia
Alistair Dias, Chemistry Department, University of Toronto, Toronto, ON, Canada
Barbara Findlay, Integrated Health Care Consultant, Richmond, BC, Canada
Gerhard Franz, Faculty of Chemistry and Pharmacy, University of Regensburg, Regensburg, Germany
Daniel F. Gallego-Pérez, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Mahabir Gupta, Facultad de Farmacia, Universidad de Panama, Rep. de Panamá
Cory Harris, Department of Biology, University of Ottawa, Ottawa, ON, Canada
Jennifer Hunter, NICM Health Research Institute, Perth, WA, Australia
Connie Kehler, Canadian Herb, Specialty Agriculture and Natural Health Product Coalition, Saskatoon, SK, Canada
Francis C.P. Law, Faculty of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada
Ye-Seul Jennifer Lee, Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, South Korea
Myeong Soo Lee, KM Science Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, South Korea
Brenada Leung, University of Lethbridge, Lethbridge, ALB, Canada
P.C. Leung, Institue Of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China
Jian-Ping Liu, Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
Maria Luz Lara-Marquez, Allergist and Immunologist, Integrative Medicine Specialist, San Diego, CA, USA
Candace Necyk, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, ALB, Canada
Siyaram Pandey, Department of Chemistry & Biochemistry, University of Windsor, Windsor, ON, Canada
Michael Smith, National Center for Natural Product Research, University of Mississippi; Oxford, MS, USA; National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
Amie Steel, Australian Research Consortium in Complementary and Integrative Medicine (ARCCIM), University of Technology, Sidney, Ultimo, NSW, Australia
Jerome Yager, Research Integrative Health Institute, University of Alberta, Edmonton, ALB, Canada
Linda Zhong, Biomedical Sciences and Chinese Medicine, School of Biological Sciences at Nanyang Technological University in Singapore, Singapore

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Farida Akhter, ON, Canada
Managing.Editor.JCIM@degruyter.com

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Heike Jahnke, Berlin, Germany
Heike.Jahnke@degruyterbrill.com

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eISSN:

1553-3840

ISSN:

2194-6329

Language:

English

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De Gruyter

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First published:

January 1, 2004

eISSN: 1553-3840

ISSN: 2194-6329

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researchers in the field of medicine, medical sciences, traditional medicine and commercialization; complementary & integrative healthcare providers and educators; consumers

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