A systematic review and meta-analysis focusing on the use of ayurvedic medicine in cerebral palsy.

Integrative practices have been incorporated into palliative care to provide holistic and multidimensional care for patients. This study aims to identify the scope of integrative practices, specifically whole medical systems, and demonstrate its safety and efficacy, specially in children with cerebral palsy. Key databases, including Embase, Cochrane, Medline/PubMed, Scopus, Google Scholar, Lilacs and Scielo were searched using specific terms. Only randomized and non-randomized clinical trials were included for meta-analysis purposes. Case-control, cohort, cross-sectional or retrospective observational studies were also included for the systematic review. Participants included children aged 0-18 years receiving palliative care for cerebral palsy and undergoing Ayurvedic Medicine practices. Descriptive analysis was conducted, including data such as year; author; design; sample size; intervention and comparison; outcomes and conclusion. Two interventional studies compared Ayurvedic practices with each other or with physiotherapy in children with cerebral palsy. The meta-analysis demonstrated an improvement in spasticity for children using Ayurvedic medicine. However, there were limitations in terms of heterogeneity in interventions, control groups, and assessed outcomes. Integrative practices, including Ayurvedic medicine have the potential to improve quality of life, manage disease symptoms and provide emotional support. However, more robust evidence is needed to support their widespread use. The use of Ayurvedic medicine showed evidence of improvement in spasticity for children with cerebral palsy. REGISTRATION NUMBER: Prospero CRD 42020198399.

Effect of Plantago major on cough severity in acute bronchitis: A double-blind randomized clinical trial.

Background: Treatments for acute bronchitis is usually a supportive care to relieve upper respiratory symptoms. This study aimed to evaluate the effect of Plantago major syrup (PMS) on cough severity in acute bronchitis. Methods: Patients (20-75 years-old) referred to the clinic of infectious diseases in Ayatollah Rouhani Hospital, Babol, Iran with a complaint of cough and the Bronchitis Severity Scale (BSS) ≥5 entered the study. The patients randomly received PMS or placebo 30 ml/day for 10 days. Patients were visited before treatment and on days 5 and 10 after treatment. The primary outcome was BSS score and secondary outcome was the life quality that was measured by means of the Persian version of the Leicester Cough Questionnaire (LCQ) at the first visit and on the 10th day. Results: Of the 121 patients diagnosed with acute bronchitis, 80 eligible patients (42.87±11.75 years-old) were randomly divided into PMS and placebo groups. The BSS score in the PMS group after 10 days was significantly lower than that of the placebo group (P=0.001). Frequency of cough (P=0.001), sputum production (P=0.005), and chest wall pain (P=0.008) were significantly lower in the PMS group than in the placebo group. In terms of quality of life, all items, including psychological, physical, and social domains, as well as total scores, were altered significantly in the PMS group compared to placebo. During monitoring of side effects, no significant adverse effects were stated in either group. Conclusion: The study indicates the palliative effects of PMS in relieving the symptoms of acute bronchitis and improving quality of life.

Identifying common conditions of pregnancy for women, including women from culturally and linguistically diverse backgrounds, at an Australian hospital: A survey.

PROBLEM: Research that explores the prevalence and range of treatments sought for common conditions of pregnancy is limited, particularly for culturally and linguistically diverse (CALD) women. BACKGROUND: During pregnancy, physical and psychological conditions affect participation in the home, workplace, and community. However, treatment options may be limited, particularly for CALD women. AIM: To establish the prevalence of physical and psychological conditions experienced during pregnancy, and ascertain treatments options sought by women attending a hospital in a multicultural area of Sydney (Australia), including medical, allied health and complementary medicines. METHODS: A cross-sectional survey of pregnant women attending an outpatient antenatal clinic (July-December 2019). The survey was conducted in the most common language groups, English, Arabic and traditional Chinese (inclusive of Cantonese and Mandarin). Univariate and bivariate analysis was conducted. FINDINGS: A total of 154 women participated. CALD women most frequently reported lower-back pain (41.5 %), constipation (34 %), nausea (28 %), and anxiety (7.5 %) . English-speaking women reported lower-back pain (43.5 %), difficulty sleeping (37 %), severe tiredness (35 %), and anxiety (15.8 %), and were more likely to seek treatment (p < 0.01). Practitioners most consulted were massage therapists, physiotherapists, community nurses and counsellors. Doctors were least consulted overall. CONCLUSIONS: Pregnant women most commonly reported lower-back pain, however conditions were reported and treated less frequently by CALD women, including psychological conditions. It is vital that women can access hospital-based treatment for common physical and psychological conditions of pregnancy. The implication for clinicians is to establish routine asking, adequate care provision and referral to culturally safe and appropriate services.

Self-reported Health Service Utilization and Barriers to Care Among US Adults with a History of Post COVID-19 Condition.

BACKGROUND: Millions of US adults continue to experience symptoms of post COVID-19 condition (PCC). More data on health service utilization patterns and barriers to care in this population are needed to understand how to care for people with PCC. OBJECTIVE: To evaluate health service utilization and barriers to medical care among individuals with a history of PCC compared with other US adults. DESIGN: Data were analyzed from the 2022 National Health Interview Survey (NHIS), a nationally representative, cross-sectional survey of the US population. PARTICIPANTS: US adults. MAIN MEASURES: Health service utilization and the presence of financial and nonfinancial barriers to care in the preceding 12 months. KEY RESULTS: There were 24,905 individuals included in the analysis, representing approximately 230 million US adults. The weighted prevalence of those with a history of PCC was 6.9% (95%CI, 6.5-7.3). Compared to other US adults, participants with a history of PCC were more likely to have had an urgent care visit (adjusted odds ratio (aOR) 1.52 [95%CI, 1.34-1.72]), emergency room visit (aOR 1.94 [95%CI 1.71-2.21]), hospitalization (aOR 1.48 [95%CI, 1.24-1.77]), rehabilitation services (aOR 1.35 [95%CI, 1.14-1.60]), home care (aOR 1.55 [95%CI, 1.66-2.26]), mental health counseling (aOR 1.39 [95%CI, 1.17-1.65]), and complementary and integrative medicine services (aOR 1.29 [95%CI, 1.13-1.49]). Furthermore, respondents with a history of PCC were more likely to report at least one financial barrier to care (aOR 1.71 [95%CI, 1.48-1.97]) and at least one nonfinancial barrier (aOR 1.77 [95%CI, 1.56-2.00]). A greater proportion of participants with a history of PCC reported a financial barrier and nonfinancial barrier than adults with most other chronic conditions captured by NHIS. CONCLUSIONS: Individuals with a history of PCC were more likely to use a variety of health services and report barriers to medical care. Health systems should consider developing accessible, multidisciplinary care pathways for this population.

National Trends in the Utilization and Expenditure of Chiropractic Care in U.S. Adults: Analysis of the 2007-2016 Medical Expenditure Panel Survey.

OBJECTIVE: This study aimed to examine the trends in the utilization and expenditure of chiropractic care in a representative sample of US adults, aged ≥18 years. METHODS: Serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey (MEPS) were examined. Weighted descriptive statistics were analyzed to obtain national estimates of chiropractic utilization and expenditure, and time-series linear regression was used to assess trends over time. Socio-demographic characteristics and musculoskeletal diagnoses associated with chiropractic use were also reported. RESULTS: A statistically significantly increasing trend was observed for the number of adults receiving chiropractic care (p < .05), number of visits (p < .05) and utilization rate (P < .05) from 2007 to 2016. A similar trend was not found for chiropractic expenditure during this period (P > .05). The mean number of visits was 8.3 visits per year, with a mean expenditure of $86.94 USD per visit and $721.43 USD per person per year. Mean age of adult chiropractic users each year ranged between 48.6 and 51.2 years old, and users were primarily female (56.3%-60.4%), White persons (90.1%-93.5%), and privately insured (77.3%-82.8%). The most prevalent musculoskeletal diagnoses associated with chiropractic use were low back conditions (45.4%-58.1%), inflammatory/degenerative disc or joint conditions (21.2%-26.8%) and head and neck complaints (9.8%-13.7%). CONCLUSION: The findings showed statistically significant increasing trends for the number of adult chiropractic users, the number of visits, and percent utilization of chiropractic care from 2007 to 2016. Conversely, we found a statistically null trend for the total annual expenditure on chiropractic care during the same time period. Findings from this analysis imply that, while chiropractic care appears to be growing, it may still be under-utilized, and more efforts should be devoted to ensuring sustained growth and a larger role in the management of musculoskeletal health.

Predictors of Utilization Frequency of and Expenditure Amount for Chiropractic Care in U.S. Adults: A Retrospective Cohort Study.

OBJECTIVE: This study aimed to evaluate the prospective associations of baseline personal characteristics with utilization frequency and expenditure of chiropractic care in US adults (≥18 years). METHODS: Data are from the 1358 respondents to the 2014 to 2016 Medical Expenditure Panel Survey who utilized chiropractic care. Individual, familial, health-related, and behavioral factors were included as covariates in the multivariate analytic model. Poisson and multinominal logistic regressions were modeled to examine the associations between the predictors and chiropractic utilization and expenditure. RESULTS: The mean annual number of visits was 8.2 visits (95% confidence interval [CI]: 7.9, 8.5), with annual expenditure of $677.43 U.S. dollars (95% CI: $595.47-$759.39) and $84.84 (95% CI: $77.89-$91.78) per visit. Female sex was associated with a 19% higher number of visits (rate ratio [RR] = 1.19, 95% CI: 1.01, 1.41) than males. Publicly insured and uninsured were associated with a 44% higher (RR = 1.44, 95% CI: 1.14, 1.82) and 36% lower (RR = 0.64, 95% CI: 0.48, 0.86) visit frequency, respectively, than those privately insured. Rheumatoid arthritis was associated with 7.38 times the risk of high expenditure (95% CI: 2.61, 24.67) than medium expenditure, compared to no arthritis. Relative to physically active individuals, physical inactivity was associated with a 27% higher visit frequency (RR = 1.27, 95% CI: 1.09, 1.49) and an 82% higher risk (relative risk ratio = 1.82, 95% CI: 1.05, 3.14) of high expenditure than low expenditure. CONCLUSION: This analysis found distinct usage and expenditure patterns that vary according to specific baseline predictors. Female sex, being publicly insured, having rheumatoid arthritis, and physically inactive were associated with variance in expenditure. Results from this study may help identify chiropractic patients with tendencies for higher utilization or spending and may indirectly assist in predicting patients with slower response to care.

Complementary and Alternative Therapies (CATs) in Nursing Education in Spanish Universities.

BACKGROUND: The use of complementary therapies in the general population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our aim was to investigate Spanish universities that offer subjects on complementary therapies in their nursing degree programs. METHODS: This study is an observational, descriptive, cross-sectional study. For this purpose, we used a document published on the website of the Ministry of Universities as the working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches. RESULTS: Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, 27.5% (11) are public universities and 22.7% (5) are private universities, most of them being optional subjects. CONCLUSIONS: The training content on complementary care in nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization.

Effect of Lavender Oil Leg Massage on Physical, Cognitive, and Psychological Variables of Patients with Hypertension: A Randomized Controlled Trial.

Background: Hypertension (HTN) is one of the most important non-communicable risk factors that cause cardiovascular diseases. Complementary therapies including massage and aromatherapy are widely used in the management of HTN. However, studies on aromatherapy massage in HTN are limited. Thus, this study was conducted to evaluate the effect of lavender oil leg massage on physical (cardiopulmonary function), cognitive, and psychological variables of patients with HTN. Materials and methods: A parallel-group randomized controlled trial, comprising 100 HTN patients aged 44.99 ± 5.39 years who were recruited and randomly divided into the study group (SG) and control group (CG), was conducted. The SG received lavender oil leg massage, while the CG received supine rest for 20 min. Outcome variables like blood pressure (BP), pulse rate (PR), random blood sugar (RBS) level, oxygen saturation, pulmonary function, oral temperature, trail making test (TMT) A and B, and state anxiety and mindfulness were assessed before and after the intervention. Results: The within-group analysis showed a significant improvement in systolic blood pressure, diastolic blood pressure, PR, RBS, TMT-A, TMT-B, and state mindfulness both in the SG and CG. However, a significant reduction in state anxiety was observed only in the SG unlike the CG. Moreover, the between-group analysis showed a significant improvement in state mindfulness and state anxiety in the SG compared to the CG. Conclusion: The results of this study suggest that lavender oil leg massage is effective in reducing BP and RBS, and improving cognitive function in hypertensive patients. In addition, it is more effective in reducing anxiety and improving mindfulness than rest in supine position in patients with HTN.

Efficacy of traditional Thai massage as adjunctive therapy in patients with major depressive disorder.

Background: Major depressive disorder (MDD) is the most common mental ailment. Moreover, it is one of the most incapacitating medical conditions. Although antidepressant medication has traditionally been the mainstay of treatment, adjunctive therapy may provide therapeutic advantages that reduce the severity of depression. Methods: An experiment using randomization and control groups was undertaken. A total of forty-eight individuals diagnosed with severe depressive illness and undergoing antidepressant medication were selected and randomly assigned to either get traditional Thai massage (TTM) treatment, consisting of 90-minute sessions twice a week for eight weeks, or to be part of the control group, which continued with their regular daily activities. The main assessment tools used were the Hamilton Depression Rating Scale (HAM-D), the Clinical Global Impression-Severity (CGI-S), and the Khon Kaen University Depression Inventory 14 (KKU-DI-14). Secondary outcomes, such as blood pressure (BP) and quality of life measured by The EuroQol-5D-5L (EQ-5D-5L), were assessed both before and after the first therapy, as well as at the last session at the 8th week. Results: The TTM group showed a statistically significant decrease in the HAM-D score within the eighth week of therapy compared to the control group (5.14 points, 95% confidence interval=2.92 to 7.37 points, P<0.001). Conclusion: These findings suggest that combining TTM with antidepressant medication may effectively reduce depression scores and improve quality of life scores.

Varieties of silence - a mixed-methods study exploring reasons and justifications for nondisclosure of the use of complementary therapies to physicians in Finland.

BACKGROUND: In health care, two in three users of complementary therapies (CT) stay silent about their CT use. Disclosure of CT use to physicians is important for patient safety, participation, and shared decision-making. Common reasons for CT nondisclosure include patients´ expectations of physicians' unaccepting response to disclosure, physicians not asking, and patients believing it is unnecessary. This study aimed to increase understanding of patient silence. We investigated how the reasons for nondisclosure of CT use reported by CT users were associated with the frequency of CT disclosure and how these associations and reported justifications to keep silent reflect patient silence among the study participants. METHODS: This mixed-methods study used existing data from the non-probability-based online survey (n = 6802) targeted to CT users among the general population in Finland. A qualitative structured tabular thematic analysis was conducted for the selected 342 brief texts describing the reasons and justification for not telling physicians about CT use. The associations between the frequency of CT disclosure and the reasons for CT nondisclosure were analysed by crosstabulations and binary logistic regression analysis with SPSS (v28). RESULTS: Three types of patient silence were revealed. Avoidant silence illustrates the respondents coping with the fear of unwanted response from a physician and avoiding the expected negative consequences of CT disclosure. Precautionary silence exemplifies respondents striving to prevent the reoccurrence of previously experienced frustration of wishes to be seen and heard as CT users. Conditional silence portrays the self-confidence of respondents who assessed their need to disclose CT use to physicians on a case-by-case basis. CONCLUSIONS: Silence, for some patients, may serve as a way of warding off past and possible future fears and frustrations related to CT disclosure. It is important to recognise different types of patient silence related to CT disclosure to enhance patient participation and shared decision-making in health care. Efforts are needed to provide health policy decision-makers with information about CT users' lived experiences with CT communication in health care.

Assessment of acupuncture's effectiveness in mitigating fatigue among patients afflicted with multiple sclerosis: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: Fatigue is a pervasive and debilitating symptom of multiple sclerosis (MS) that severely impairs quality of life and daily functioning. This emphasizes the essential need for complementary therapies that go beyond conventional therapies. Although acupuncture is gaining popularity in MS management, there is a critical lack of rigorous research on its effectiveness in alleviating symptoms. METHODS: A comprehensive literature search was conducted across multiple databases, focusing on studies evaluating acupuncture's effectiveness in alleviating fatigue in MS patients. Key outcomes measured in the analysis included fatigue, quality of life, and disability. RESULTS: Six studies were included in the analysis, consisting of two observational studies and four randomized controlled trials. The analysis focused on evaluating acupuncture's efficacy in alleviating fatigue induced by MS. Despite variations in acupuncture protocols, outcome metrics, and control conditions, our meta-analysis revealed that acupuncture significantly reduces fatigue (MD: -0.92, 95 % CI: -1.36 to -0.47, p < 0.0001) and enhances quality of life (SMD: 0.91, 95 % CI: 0.07-1.74, p = 0.03), underscoring its potential as a therapeutic intervention in the management of MS. CONCLUSION: The meta-analysis suggests a notable improvement in MS-related fatigue following acupuncture, both compared to controls and pre-treatment levels, positioning it as a potential adjunct therapy. However, the prevalent risk of bias in these studies necessitates further high-quality research, along with studies involving larger patient cohorts, to definitively ascertain acupuncture's efficacy and safety in this context.

Interprofessional education in traditional and complementary medicine: a scoping review.

Interprofessional education (IPE) is a teaching method that improves collaboration and communication across health professions. There are consistent reports of poor interprofessional collaboration and communication between conventional health professionals and traditional and complementary medicine (TCM) professions. The application of IPE within courses that provide training in TCM requires close examination. This research aimed to identify the state of the art in IPE in TCM teaching. A scoping review was conducted. Thirteen databases were searched to identify citations up to March 2021. Thirty articles were selected after filtering for relevance against the inclusion criteria. The included articles were categorized into four a priori categories: Knowledge and Attitudes of students and professionals about TCM and IPE; Competencies of IPE in TCM; Teaching about TCM using IPE and Challenges and Opportunities for IPE in TCM. Nineteen of the included articles reported empirical research and primarily presented the evaluation of IPE activities within TCM courses or workshops; six studies consisted of texts with propositions and theoretical analyses; and five were case/experiential reports of IPE and TCM interventions, with or without evaluation of results. The studies report all health science students (undergraduate and graduate) exposed to IPE demonstrate a decrease in prejudice and an increase in knowledge about TCM. A sense of partnership developed through the collaborative competencies common to IPE and TCM and integrated care of patients. IPE in the context of TCM has been used for fostering integrative health care through the collaborative work of professional teams. Implementing IPE in TCM teaching requires inclusion in the curriculum, primarily undergraduate and research training.

The potential of arts therapies in Parkinson's disease rehabilitation: A comprehensive review.

Background and purpose: Parkinson's disease (PD) causes a decline in motor function, cognitive decline, and impacts the mental health of patients. Due to the high cost and side effects of conventional treatments, the medical community has begun to explore safer and more cost-effective alternative therapies. In this context, arts therapies have gained increasing attention as innovative treatments. This review plans to explore the role and potential of various arts therapies in the rehabilitation of PD patients by analyzing existing literature and case studies. Methods: This review comprehensively searched the literature in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure, to assess the effectiveness of different arts therapies in the rehabilitation of patients with PD. Results: From 3440 articles screened, 16 met the inclusion criteria. These studies included a variety of therapies, including music, meditation, yoga, art, dance, theatre, video games and play therapy. These different types of arts therapies had a positive impact on the motor, psychological and cognitive rehabilitation of PD patients, respectively. Conclusion: The existing literature highlights the great potential of arts therapies in the rehabilitation of people with PD, further confirming the efficacy of arts therapies in enhancing the motor, psychological and cognitive rehabilitation process of people with PD. In addition, this review identifies research gaps in the use of color therapy in PD rehabilitation and highlights the need for further exploration of various arts therapies modalities.

Antenatal education incorporating complementary medicine techniques for labour and birth to reduce the rates of epidural in primiparous women: A randomised control trial.

PROBLEM: Globally medical management of labour and birth has significantly increased, with epidurals attributed to the cascade of interventions. BACKGROUND: There are few randomised control trials that evaluate the effectiveness of antenatal education programs. A previous trial at two Australian hospitals found an antenatal program of integrative complementary therapies significantly reduced rates of interventions for low-risk primiparous women. AIM: To reduce rates of intervention in labour and birth, with a primary outcome of decreased epidural use during labour. METHODS: Low to moderate risk primiparous women were randomised at 24-36 weeks' gestation to the intervention group and standard care, or standard care alone. Clinical and psychological measures were analysed by intention-to-treat. Trial registration ACTRN12618001353280 FINDINGS: In total, 178 women participated (n = 88 intervention, n = 90 Standard care), demographic characteristics were similar between groups, almost half (49 %) reported a pre-existing medical condition, and wellbeing scores fell within the average range. Epidural use was lower in the intervention group (47.7% vs 56.7 %) with higher rates of vaginal birth (52.3% vs 42.2 %), however, no statistical differences for birth outcomes were found between groups. Attitude to childbirth scores were statistically higher for women who attended the intervention (59.1 vs 54.3 p00.001). DISCUSSION: Higher psychometric scores demonstrated women in the intervention group felt an increased sense of coping and control. Antenatal education that includes complementary therapies can reduce fear and improve attitudes about childbirth. CONCLUSIONS: Replicating study protocols enabled the generalisability of findings to a more diverse group of women, and data will contribute to a larger meta-analysis design to detect smaller treatment effects for operative birth.

Correlates and patterns of using complementary health approaches among individuals with recent and longer-term cancer diagnoses: a US national cross-sectional study.

PURPOSE: To (1) describe and compare the prevalence of using of complementary health approaches, focusing on mind and body practices, and reasons for use among cancer survivors, and (2) examine characteristics associated with use among those with a recent and non-recent diagnosis of cancer compared to those without a previous cancer diagnosis. METHODS: Using data from the 2022 US National Health Interview Survey, prevalence estimates were derived for using any complementary health approach, by category (manipulative body-based [chiropractor, acupuncture, massage], creative [music therapy, art therapy], and mind-body [meditation, guided imagery, yoga]), and reasons for use. Regression models identified correlates of use among all participants and within cancer diagnosis subgroups. RESULTS: Among 26,523 adult participants, overall prevalence of using any complementary approach was similar amongst individuals with recent cancer (40.17%), non-recent cancer (37.75%), and no cancer diagnosis (37.93%). However, odds of use were higher amongst recent (OR = 1.37) and relatively long term (OR = 1.14) cancer survivors compared to those without a history of cancer in adjusted models (both p < 0.05). In cancer survivors, mind-body approaches were mostly used for general health purposes, whereas manipulative approaches were used for general health and pain management. Female sex, younger age, higher education and income were among the prominent variables associated with using complementary approaches. CONCLUSION: We present an important snapshot of the landscape of using complementary approaches, specifically mind and body practices, in adult cancer survivors in the US. Inequalities in access to these therapies may exist, as use remains highest amongst those with higher socioeconomic conditions. IMPLICATIONS FOR CANCER SURVIVORS: Given the prevalence and potential benefits of complementary approaches among cancer survivors, there is a need to better understand their effectiveness, optimal use, and integration into cancer care. Further research is needed to understand and address access barriers that might exist amongst some cancer survivors.

Humanising childbirth - Maternity acupressure training for healthcare providers at the Fernandez Foundation Hospitals, Hyderabad, India. Evaluation of program delivery in one region of India.

BACKGROUND: Internationally, traditional medicine approaches are used to support humanised childbirth practices. Labour support issues in low- and middle-income countries (LMICs), include limited resources, staffing, and escalating pharmaceutical interventions. There is a strong interest in evidence-based acupressure programs, however, training and experience to implement them is limited. Maternity professionals at the Fernandez Foundation (FF) including associated hospitals in the Hyderabad region, India, sought training in acupressure to support humanised childbirth. AIMS: To evaluate the implementation of the 'Acupressure for childbirth training program' at FF hospitals, up to 6-months post-training, including barriers and facilitators, as well as determining pregnancy and labour conditions for which the techniques are most useful. METHODS: Pre- and post-training, and 6-month surveys, were distributed to participants. RESULTS: Participants included a diverse group of 88 midwives, doulas, physiotherapists, educators and obstetricians. There were significant improvements in participant skills and knowledge, which persisted up to 6-months post-training (p<0.01). Participants indicated they were 'highly satisfied' with the training, and found it valuable, easy to implement, and reported extremely positive responses from women and support people. Facilitators to implementation included 'strategies and ideas', 'effectiveness of pain relief', and 'aiding labour progress'. Barriers included 'other staff and institutional challenges', 'needing more training', 'women's attitudes'. CONCLUSION: Acupressure training as part of a humanised approach to childbirth, demonstrates significant skill and knowledge gain, usefulness of training and skills, ease of implementation, and a highly positive reception within the clinical environment. Implementation of these practices should be widespread and supported by policy makers and clinicians.

An Integrative Approach for Endometriosis-Related Pain.

BACKGROUND: Pain is a common, severe symptom related to endometriosis. Despite this prominent feature, there is limited literature regarding its description and use of integrative treatment methods. OBJECTIVE: We aimed to describe endometriosis-related pain characteristics, severity, and association with an integrative approach encompassing pharmacological and non-pharmacological methods. METHODS: A cross-sectional descriptive correlational study was conducted using convenience sampling of adult women with endometriosis-related pain. Three questionnaires were utilized: a demographic and general health questionnaire, a visual analog pain scale (VAS), and the short-form McGill pain questionnaire (SF-MPQ). RESULTS: Participants included 93 women with a mean general pain level of 6.2/10 (SD = 2.7) on the VAS. The total mean pain score on the SF-MPQ was 26.25/45 (SD = 10.1). Sixty-four women (68.8%) reported experiencing pain at the time of completion of the questionnaire (mean: 1.6/4, SD = 1.3). All participants utilized analgesia; those who used opioids reported a higher overall mean pain score of 2.3 (SD = 1.3) than patients who did not use opioids reported a mean of 1.4 (SD = 1.2; z = 9.59; P < .001). Present pain intensity was significantly higher for women using opioids than those not using opioids. In all, 77 women (82.8%) used integrative methods to alleviate the pain symptoms. Women who utilized nutritional therapy as part of the non-pharmacological method experienced lower mean (SD) overall pain (4.4 [2.5]) compared with patients who did not utilize nutritional therapy (6.75 [2.5]; P < .01). CONCLUSIONS: More studies are needed to find evidence-based treatment options for women for integrative pain relief for endometriosis-related pain.

Complementary and Alternative Medicine for People with Epilepsy: Opinions of Physicians in Oman.

Objectives: Several studies have explored the opinions of healthcare workers on the use of complementary and alternative medicine (CAM) in epilepsy treatment. We sought to survey the views of non-neurologist and non-psychiatrist physicians in Oman on the use of CAM for epilepsy. Methods: We used convenience sampling to recruit physicians (except neurologists and psychiatrists) from all 11 governorates of Oman. The online questionnaire was open to physicians from 5 January 2022 to 15 February 2023. This study collected anonymous data on their demographics, discipline, work settings, geographical area, and years of practice. Additionally, participants were asked to answer questions about their perception of CAM use and its effectiveness in treating epilepsy. Results: A total of 190 physicians participated, of whom 69.5% were men. Respondents were mostly 36 to 45 years old (51.1%). The majority (52.1%) were general practitioners, 21.1% were internists, 17.9% were pediatricians, and 8.9% were family physicians. Most participants (n = 144; 75.8%) believed that CAM may help treat patients with epilepsy (PWE). The most common therapies that participants considered helpful were meditation (46.0%), prayers (44.7%), yoga (32.6%), and exercise (31.1%). Conclusions: While the evidence supporting the use of CAM for the treatment of epilepsy is scarce, this survey showed that most physicians (non-neurologists and non-psychiatrists), who manage PWE in Oman, believed that some CAM modalities would help treat epilepsy. Well-designed controlled trials are needed to provide reliable evidence on the usefulness of CAM options in PWE.

Integrative Oncology for High-Grade Glioma: A Case Report on the Combined Effects of Oncothermia and Complementary Therapies.

High-grade gliomas are aggressive brain tumors with a poor prognosis despite conventional treatments such as surgery, radiation, and chemotherapy. Integrative oncology, combining conventional and complementary therapies, may offer additional benefits in managing these complex cases. We present a 68-year-old male farmer diagnosed with high-grade glioma in the left medial temporal lobe. The patient presented with severe headache, disturbed sleep, and anxiety, and experienced an episode of fever and seizure. He refused conventional radiation therapy due to concerns about side effects and opted for an integrative medicine protocol. This protocol included oncothermia, high-dose vitamin C therapy, hydrogen inhalation, ozone therapy, magnet therapy, fasting, acupuncture, pulsed electromagnetic field therapy, yoga therapy, hydrotherapy, biologicals, and dietary modifications. The patient underwent 12 sessions of oncothermia over 24 days, combined with other integrative therapies. MRI scans before and after treatment showed a reduction in tumor size from 3.6 x 2.9 x 2.5 cm to 3.4 x 2.7 x 2.5 cm, corresponding to a 12% decrease in volume. Hematological parameters (complete blood count, liver function test, kidney function test, C-reactive protein), cancer markers (carcinoembryonic antigen, lactate dehydrogenase), and mental health indices (quality of life, survival rate) also showed significant improvement. The patient experienced no adverse events and reported enhanced quality of life. This case report suggests that an integrative oncology approach, combining oncothermia and various complementary therapies, may be an effective treatment option for high-grade gliomas, particularly for patients intolerant to conventional therapies. Further research, including randomized controlled trials, is necessary to validate these findings and determine the specific contributions of each therapy.

Grade 3 cytolysis in a patient with metastatic colorectal cancer consuming a mushroom powder-based alternative therapy.

INTRODUCTION: The use of Complementary Alternative Medicine (CAM) in patients with cancer is increasing. CAM is associated with potential toxicity and drug interactions, particularly with chemotherapy. Here, we report a case of cytolysis and hepatic cholestasis in a patient who was self-medicated with a mushroom powder-based alternative therapy containing Agaricus blazei Murril (ABM) during cancer treatment. CASE REPORT: A 43-year-old woman with metastatic colorectal cancer and hepatic metastases was admitted to our hospital for intravenous chemotherapy. Markers of hepatic grade 3 cytolysis and cholestasis were identified during the pretreatment consultation. The baseline results were within normal limits. MANAGEMENT AND OUTCOME: The chemotherapy was immediately canceled, and further tests were performed. After the investigation, the patient reported taking three mushroom powder-based capsules per day since November 2023. The dietary supplement contained ABM and Hericium erinaceus (HE) powder. After Pharmaceutical analysis, treatment with the supplement was discontinued, and the patient has not resumed. The changes in liver function were also favorable. DISCUSSION: In our case, given the improvement in liver function after CAM discontinuation, hepatic cytolysis appeared to be linked to ABM consumption despite the patient's liver metastases. Pharmaceutical analysis of CAM is essential to ensure the safety and optimization of cancer treatments. Patients should also communicate their CAMs to healthcare professionals and be aware of the consequences of consuming these dietary supplements. Finally, collaboration between pharmaceutical teams and oncologists is essential for optimal management of cancer patients.