Effects of aromatherapy with Rosa damascene and lavender on pain and anxiety of burn patients: A systematic review and meta-analysis.

Pain and anxiety were considered the most common complications of treatment procedures in burn patients. Non-pharmacological drugs, including aromatherapy, can decrease these issues. This systematic review and meta-analysis aim to summarise the effects of aromatherapy with Rosa damascene (RD) and lavender on the pain and anxiety of burn patients. A systematic search was performed on international electronic databases such as Scopus, PubMed, and Web of Science, as well as on Iranian electronic databases such as Iranmedex and Scientific Information Database (SID) with keywords extracted from Medical Subject Headings such as "Burns", "Pain", "Pain management", "Anxiety", and "Aromatherapy" were performed from the earliest to November 1, 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist assessed the quality of randomised control trials (RCTs) and quasi-experimental studies. STATA v.14 software was used to estimate pooled effect size. Heterogeneity was assessed with I2 value. Random effect model and inverse-variance method using sample size, mean, and standard deviation changes were applied to determine standard mean differences (SMD). The confidence interval of 95% was considered to determine the confidence level. A total of 586 burn patients participated in six studies, including three RCT studies and three quasi-experimental studies. The results based on RCT studies showed RD significantly decreased the dressing pain average when compared to the control group (SMD: -1.61, 95%CI: -2.32 to -0.99, Z = 5.09, I2 : 66.2%, P < 0.001). Aromatherapy with lavender decreased the average pain in the interventional group more than in the control group (SMD: -1.78, 95%CI: -3.62 to 0.07, Z = 1.89, I2 : 97.2%, P = 0.06). Using aromatherapy with RD and lavender significantly decreased pain average in the interventional group than the control group (SMD: -1.68, 95%CI: -2.64 to -0.72, Z = 3.42, I2 : 94.2%, P = 0.001). The results showed RD significantly decreased the anxiety average in the interventional group than the control group (SMD: -2.49, 95%CI: -2.98 to -2.0, Z = 9.94, I2 : 51.6%, P < 0.001). Overall, this study showed that aromatherapy with RD decreased pain and anxiety of dressing procedures in burn patients. Although aromatherapy with lavender decreased pain in the patients, it was not statistically significant. More RCTs studies are required to be able to better judge the effects of aromatherapy with RD and lavender on the pain and anxiety of burn patients.

Multistate Outbreak of Melioidosis Associated with Imported Aromatherapy Spray.

Melioidosis, caused by the bacterium Burkholderia pseudomallei, is an uncommon infection that is typically associated with exposure to soil and water in tropical and subtropical environments. It is rarely diagnosed in the continental United States. Patients with melioidosis in the United States commonly report travel to regions where melioidosis is endemic. We report a cluster of four non-travel-associated cases of melioidosis in Georgia, Kansas, Minnesota, and Texas. These cases were caused by the same strain of B. pseudomallei that was linked to an aromatherapy spray product imported from a melioidosis-endemic area.

Effectiveness and safety review of Chinese herbal sachets for external use in the treatment of COVID-19 pandemic: A protocol for systematic review and meta-analysis.

BACKGROUND: COVID-19 has strong transmission power, and people are generally susceptible to it. Patients with weak constitution and low immunity function are more likely to be infected. Aromatic therapy of traditional Chinese medicine has the effect of inhibiting virus and sterilization, especially the external treatment of traditional Chinese medicine has played an important role in the fight against the epidemic situation. METHODS: Nine databases will be searched under the guideline of research strategy, from their inception to March 31, 2021, for relevant randomized controlled trial (RCTs) published. These databases are Cochrane Library, PubMed, EMBASE, Web of Science, ScienceDirect, China National Knowledge Infrastructure, Wan-fang Data, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. The types on Language of literature are English and Chinese. Researchers will independently operate the literature research, screening, quality evaluation, data collection, and data analysis with same research strategy and selection criteria. Methodological quality will be evaluated under the guideline of the Cochrane Collaboration's tool. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) will be used to determine confidence in the effect estimates. Meta-analysis or subgroup analysis will be performed according to the including data type. Meta-analysis will be performed with Stata 13.0 software. RESULTS: Outcome will be displayed by effective rates, quality of life score, adverse effect. CONCLUSION: This systematic review will provide evidence whether Chinese herbal sachets are effective and safe intervention of COVID-19 Pandemic. REGISTRATION NUMBER IN PROSPERO: CRD42021238580.

Efficacy of inhaled Lavandula angustifolia Mill. Essential oil on sleep quality, quality of life and metabolic control in patients with diabetes mellitus type II and insomnia.

ETHNOPHARMACOLOGIC RELEVANCE: Lavandula angustifolia Mill (lavender) odor was traditionally used as sleep enhancer. Previous studies have shown interaction between insomnia, quality of life and control of diabetes mellitus (DM). Insomnia is suggested to increase the risk of depression and decrease the quality of life in diabetic patients. The aim of this study was to evaluate the efficacy of inhaled Lavandula angustifolia Mill. as a complementary therapy for insomnia in diabetic patients. METHODS: In a randomized crossover placebo-controlled clinical trial, 52 patients with type II diabetes mellitus (DM) and insomnia, defined as Pittsburgh Insomnia Rating Scale-20(PIRS-20)>5,were treated with inhaled lavender or placebo for two periods of 4 weeks duration with one week interval as washing period. Sleep quality, quality of life and mood status were assessed by PIRS-20, WHO Quality of Life-BREF(WHOQOL-BREF) Questionnaire and Beck Depression Inventory (BDI) scale respectively, at baseline and end of each period of study. Fasting blood glucose (FBS), calorie intake and physical activity were measured before and after the interventions. RESULTS: At the end of study, data of 37 patients (all received both lavender and placebo in cross-over design) were analyzed. Based on crossover analysis the first treatment was not effective on the second treatment. Inhaled lavender resulted in a significant better outcome compared to placebo according to mean PIRS-20, WHOQOL-BREF and Beck Depression Inventory scores in both crossover arms. Likewise there was a significant better outcome in PIRS-20 domains for quality and quantity of sleep after Inhaled lavender compared to placebo. No significant improvement was observed in fasting glucose in lavender compared to placebo administration period. CONCLUSION: Inhaled lavender can improve sleep quality and quantity, quality of life and mood in diabetic patients suffering from insomnia with no significant effect on metabolic status.

Scented Candles as an Unrecognized Factor that Increases the Risk of Bladder Cancer; Is There Enough Evidence to Raise a Red Flag?

The causes of bladder cancer are not yet fully uncovered, however the research has identified a number of factors that may increase the risk of developing this cancer. The chemical carcinogenesis of bladder cancer due to chronic exposure to aromatic hydrocarbons has been well-established. The identification of this correlation led to an improvement of safety measures in chemical industry and a gradual decrease of bladder cancer cases among workers. Nevertheless, in the majority of bladder cancer cases, the specific cause of the disease still can't be specified. It makes the question of unrecognized factors associated with bladder cancer development even more relevant. Taking under consideration known chemical carcinogenesis of bladder cancer, this minireview takes under investigation the possible link between using scented candles and a risk of bladder cancer development. Burning scented candles contain many of the substances that are associated with a bladder cancer. Furthermore the scented candles are not only very popular but also widely available on the market, with limited quality regulations and unspecified raw materials determining a spectrum of potentially dangerous substances emitted during burning.

Evaluation of human electroencephalogram change for sensory effects of fragrance.

BACKGROUND: The stabilizing effect of lavender and the arousal effect of peppermint essential oils are acknowledged and used widely in aromatherapy and the cosmetics industry. However, no evaluation method confirms the effects of essential oils through quantitative and objective electroencephalogram (EEG) results; instead, only a psychological and subjective method exists. Therefore, this study aims to create a new emotional cosmetic evaluation paradigm using EEG values. Moreover, it enables quantitative interpretation of the results in addition to the subjective survey outcomes. METHODS: For this study, 12 healthy female Korean participants were recruited and three fragrances were used. The EEG results were collected for 3 minutes (1 minute each before, during, and after inhalation of every fragrance). RESULTS: The quantitative EEG outcomes indicate changes in the participant's brainwaves before and after inhalation. Significant changes in the EEG were observed. Based on the results, the effects of fragrances were confirmed to be stabilizing for lavender, and arousing for peppermint and coffee aroma. Furthermore, the subjective questionnaire results indicate similar tendency as that of the quantitative EEG results. CONCLUSION: In addition to psychological and subjective assessments, our emotional evaluation method can verify the cosmetic fragrance effects through quantitative and objective results.

Essentials of essential oils.

PURPOSE: Information to guide clinicians in educating and advising patients using or intending to use essential oils for self-administered aromatherapy or other medicinal purposes is presented. SUMMARY: The term essential oils refers to highly concentrated, aromatic oils extracted from plants by steam distillation, hydrodiffusion, or pressure. Market reports indicate strong growth in the use of essential oils in the United States in recent decades. Therapeutic claims made in the marketing of essential oils have led the Food and Drug Administration to caution a number of suppliers. Along with rapid growth in sales of essential oils to consumers there has been an increase in the amount of published evidence regarding aromatherapy and essential oils; the annual number of relevant articles indexed using Medical Subject Headings terminology has doubled since 2004. In order to help ensure proper application and safe use of essential oils as a self-care modality, healthcare professionals can benefit from a general knowledge of the terminology and foundational concepts of medicinal use of essential oils, as well as resources to facilitate evaluations of appropriateness of use. CONCLUSION: Because of the increasing popularity of essential oils and the prevalence of essential oil-based self-care practices targeting a wide variety of ailments in the United States, healthcare professionals must be prepared to address concerns about the agents' safety and efficacy. Proper literature evaluation requires the ability to discern the quality of an oil, the safety of administration, and the validity of its use.

Randomized trial of aromatherapy versus conventional care for breast cancer patients during perioperative periods.

PURPOSE: Several studies focused on the effect of aromatherapy on mood, quality of life (QOL), and physical symptoms in patients with cancer. We compared the effects on QOL, vital signs, and sleep quality between aromatherapy and conventional therapy during perioperative periods of the breast cancer patients in this study. METHODS: Patients were randomly assigned in a 2:1 ratio to receive aromatherapy or usual care. The primary endpoint was QOL, which was assessed using the quality of life questionnaire QLQ-C30, Version 3.0 of the European Organization for Research and Treatment of Cancer (EORTC) Study Group on quality of life. Secondary endpoints included the necessity of hypnotics, vital signs including blood pressure and heart rate and adverse events. In addition, we also summarized the patients' perception of the experience from a free description-type questionnaire. RESULTS: A total of 249 patients had breast cancer surgery and 162 patients gave physician consent and were recruited; 110 were randomly assigned to aromatherapy group (eight patients showed incomplete EORTC QLQ-C30) and 52 to control group (one patient showed incomplete EORTC QLQ-C30). There were no statistically significant differences between the aromatherapy group and control group in the EORTC QLQ-C30 at the surgery day. As for the results of the post-operation day 1, trends for differentiations of physical functioning and role functioning were detected between aromatherapy group and control group, but the differences did not reach statistical significance (p = 0.08 and 0.09). There were no significant differences of systolic and diastolic blood pressures between aromatherapy group and control group (p = 0.82 and 0.68). There was no statistically significant difference in heart rates between aromatherapy group (70.6 ± 11.0 bpm) and control group (71.2 ± 9.8 bpm) (p = 0.73). Likewise, the rate of hypnotic use was not statistically significant (p = 0.10). No adverse events were reported after aromatherapy and all impressions from aromatherapy group were positive with descriptors such as relaxed, comfortable, and enjoyable being common. CONCLUSION: The results showed no effects of aromatherapy on QOL, sleep quality, and vital sign. However, there was not any harm or adverse event for using aromatherapy. All impressions from self-reporting were positive such as relaxed, comfortable, and enjoyable by the aromatherapy group. Therefore, we can use aromatherapy during perioperative periods in order to meet the expectations of the patients.

Nosocomial outbreak of extensively drug-resistant Pseudomonas aeruginosa associated with aromatherapy.

An increase of extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) in various clinical specimens among intensive care unit patients (n = 7) initiated an outbreak investigation consisting of patient data analyses, control of adherence to infection control guidelines, microbiologic surveys, and molecular-based studies. XDR-PA was detected in a jointly used aroma-oil nursing bottle for aromatherapy. We implemented the restriction of oil sharing among patients. Hence, the outbreak was controlled successfully.

Qualitative and quantitative composition of essential oils: A literature-based database on contact allergens used for safety assessment.

The risks related to the use of essential oils are difficult to ascertain at present, due in part to the large number of different oils available on the market, making it difficult for the risk assessor. Essential oils may contain skin allergens in significant amounts, and could thus pose a risk to the consumer. The aim of our study was to collect as much qualitative and quantitative data as possible on allergens present in essential oils. 11 types of essential oils, with 25 respective subspecies, were taken into account based on a previous survey. Based on the literature, 517 dosages were recorded from 112 publications, providing precious information for probabilistic exposure assessment purposes. 22 substances recognized as established allergens were found in the essential oils we included. Of these, 11 are also found in cosmetics as fragrance components. These results are of major importance regarding co-exposure to fragrance allergens. Moreover, this could lead to regulatory measures for essential oils in the future, as it is the case for cosmetic products, in order to better protect consumers against skin allergy.

Usage patterns of aromatherapy among the French general population: A descriptive study focusing on dermal exposure.

Although likely benefits of aromatherapy are well documented, little is known about essential oils consumption and exposure to molecules present in the oils. The aim of our study was to determine usage patterns of 12 types of essential oils among a quite large panel, sorted per sex and quintile of age from birth to 70. A survey was conducted in September 2014 among 1507 French individuals, selected to build a representative panel of the general population. The key point of our study, apart from the fact that it has never been done among general population, was the focus on dermal exposure. Information about types of essential oils used, skin areas exposed, frequencies and quantities were collected. Our work revealed that some sub-populations could be significantly exposed to molecules of toxicological concern, especially in terms of skin sensitization. This work is the first step to assess human exposure to these molecules, and will help safety authorities and risk managers to protect the population.

The effects of aromatherapy on sleep improvement: a systematic literature review and meta-analysis.

OBJECTIVES: To evaluate the existing data on aromatherapy interventions for improvement of sleep quality. DESIGN: Systematic literature review and meta-analysis on the effects of aromatherapy. Study Sources: Electronic databases, including the Korea Education and Research Information Service (KERIS), Korean studies Information Service System (KISS), National Assembly Library, and eight academies within the Korean Society of Nursing Science, were searched to identify studies published between 2000 and August 2013. STUDY SELECTION: Randomized controlled and quasi-experimental trials that included aromatherapy for the improvement of sleep quality. Of the 245 publications identified, 13 studies met the inclusion and exclusion criteria, and 12 studies were used in the meta-analysis. RESULTS: Meta-analysis of the 12 studies using a random-effects model revealed that the use of aromatherapy was effective in improving sleep quality (95% confidence interval [CI], 0.540-1.745; Z=3.716). Subgroup analysis revealed that inhalation aromatherapy (95% CI, 0.792-1.541; Z=6.107) was more effective than massage therapy (95% CI, 0.128-2.166; Z=2.205) in unhealthy (95% CI, 0.248-1.100; Z=3.100) and healthy (95% CI, 0.393-5.104; Z=2.287) participants, respectively. CONCLUSION: Readily available aromatherapy treatments appear to be effective and promote sleep. Thus, it is essential to develop specific guidelines for the efficient use of aromatherapy.

Poikilodermatous changes on the forearms of a woman practicing aroma-therapy: extracervical poikiloderma of Civatte?

We report the case of a 48-year-old, Caucasian female who presented with slowly progressing asymptomatic poikilodermatous changes of the extensor aspects of the forearms. She also had typical Poikiloderma of Civatte on the V of the neck and erythemato-telangiectatic rosacea of the central face. The patient had been practicing aroma-therapy for many years. Histologic examination revealed findings consistent with PC. Patch-testing revealed positive reactions to Fragrance mix and Nickel sulphate. Based on clinical and histological findings, a diagnosis of extracervical PC was suggested. PC with extra-cervical or extra-facial involvement is rare. In addition, this case supports the theory that contact sensitization to fragrances may contribute to the development of PC.