Use of complementary and alternative medicines in ENT outpatient department of tertiary care hospital in Southern Rajasthan

Background: Complementary and alternative medicine (CAM) use is highly gaining popularity along with main treatment streams these days. Physicians cannot ignore this fact and should question and counsel patients about pros and cons of CAM for cure of different ailments. Aim and Objectives: The objective of the study was to know about use of CAM among patients visiting Ear, Nose, and Throat (ENT) outpatient department (OPD) in tertiary care hospital of Southern Rajasthan. Materials and Methods: An observational cross-sectional study was conducted in ENT OPD for 2 months. Two hundred and fifty patients were considered for the study. Semi-structured questionnaire was prepared and made to be filled by the patients during their visit to ENT OPD after taking informed consent. Various questions were asked like extent of use of alternative therapies, type of CAM used by the patients, patient’s knowledge about ADRs and drug interactions, reasons for which alternative medicine might have been used. Results: Among 250 patients, CAMs were used by 36 patients. The most common CAMs were either Ayurveda or Homoeopathy medicines or both. The majority of patients obtained their information from family and friends. Maximum patients used these alternative medicines for relief of cough and hoarseness of voice. Conclusion: The study throws light on use of alternative drug therapy and streams of medicine along with routine hospital treatment among patients visiting ENT OPD. This knowledge helps to understand about patients’ alternative approach to diseases, about self-medication, patient’s belief about different types of therapies and also ignorance of possible health hazards, side effects, and complications due to use of concomitant main and alternative medicines for treatment purposes.

Panaceas, medicinas alternativas y similares: el auge y triunfo de la pseudociencia médica / Panaceas, alternative and similar medicines: the boom and triumph of medical pseudoscience

Resumen México en particular parece ser, desde hace más de un siglo, uno de los paraísos mundiales de los charlatanes. Precisamente fue en nuestro país en donde se acuñó el término "merolico", derivado del apellido del "médico" judío polaco Rafael Juan de Meraulyock. Desde entonces hasta nuestro días, hemos visto un desfile de panaceas, medicinas alternativas y similares, que en no pocas ocasiones compiten con nuestro quehacer cotidiano en la búsqueda de la salud de los pacientes mexicanos. A continuación hacemos una revisión de las principales terapias mencionadas.

Abstract Mexico in particular seems to be, for more than a century, one of the world's paradises of charlatans. It was precisely in our country where the term "merolico" was coined, derived from the surname of the Polish Jewish "doctor" Rafael Juan de Meraulyock. From then until our days, we have seen a parade of panaceas, alternative medicines and similar, that in many occasions compete with our daily work in the search for the health of Mexican patients. Below we review the main therapies mentioned.

Medicina supresora y medicina estimulante: una mirada penetrante de la práctica médica / Suppressive medicine and stimulant medicine: a penetrating view in medical practice

Resumen: La teoría de la medicina supresora (MS) y la medicina estimulante (ME) destaca dos formas radicalmente distintas de entender la enfermedad y de enfrentarla. Para la MS es un objeto extraño o ajeno al organismo que hay que disminuir o destruir (suprimir); para la ME es un trastorno de la armonía interna que requiere fortalecer o avivar el organismo para restablecerla (estimular). En la medicina moderna, el poder de la industria de la salud favorece el predominio de la MS, por su alta rentabilidad, y la marginación de las medicinas alternativas (MA), poco rentables que, al igual que la vacunación o las terapias sustitutivas y regenerativas, son formas de ME. El efecto placebo (EP) inherente a la práctica médica, revelador de fuerzas curativas endógenas susceptibles de estimulación, da sentido a la ME y credibilidad a las MA. La dirección del EP de lo macro (psicosocial) a lo micro (físico-químico) explica su alta especificidad y ausencia de efectos secundarios. El efecto farmacológico de lo micro a lo macro, opuesto a las fuerzas endógenas, conlleva indefectiblemente efectos secundarios que requieren ulteriores supresiones y dosis repetidas indefinidamente. Se analizan equívocos de la ciencia con respecto al EP y al imponer a las MA criterios metódicos propios de la MS, que las desvirtúa, descalifica y excluye como objetos de conocimiento. Se insiste en la necesidad de reconocer la ME y rescatar las MA para la indagación, a fin de explorar sinergias, complementos o reemplazos con relación a la MS en la búsqueda del bien vivir.

Abstract: The theory of suppressive (SuM) and stimulant (StM) medicine highlights two radically different ways of understanding and coping with diseases. For SuM it is a strange or foreign object to the organism that must be diminished or destroyed (suppressed); for StM it is a disorder of internal harmony that requires strengthening or enlivening the body to re-establish it (stimulate). In modern medicine, the power in the health industry favors the predominance of SuM, because of its high profitability, and the marginalization of low-cost alternative medicines (AM) that, like vaccination or substitutive and regenerative therapies, are forms of StM. The placebo effect (PE) inherent to medical practice, revealing of endogenous curative forces susceptible to stimulation, gives meaning to StM and credibility to AM. The direction of the PE from the macro (psychosocial) to the micro (physical-chemical) explains its high specificity and absence of side effects. The pharmacological effect of the micro to the macro, opposed to the endogenous forces, inevitably entails side effects that require further suppression and indefinite repetition of doses. Scientific assertions that misunderstand PE, and impose on the AM methodical criteria of the SuM that detract, disqualify and exclude them as objects of knowledge, are analyzed. The emphasis is on the need to recognize the StM and rescue the AM for inquiry in order to explore synergies, complements or replacements in relation to the SuM, in the quest for to live well.

A Brief Review On Current Scenario Of Antihypertensive Ayurvedic Drugs

Now a day’s hypertension is most prevailing lifestyle disorder. It is also known as silent killer. Hypertension has been globally acknowledged as most prevalent risk factor for life threatening cardiovascular diseases. Ayurveda is a science of life and oldest medical science known to the mankind practised in India. Since ages Indian population have been benefited by the healing touch of this science. Due to life style of hurry, worry and curry, many lifestyle disorders become household diseases in developing countries and hypertension is one among them. Hypertension is one of such disorders which can be caused by many factors, including increase in the volume of body fluid, resistance of the blood vessels, and other factors that elevate blood pressure. Modern treatment modalities although reduce the blood pressure very effectively but their long term efficacy i.e. target organ damage reduction is not enough. Despite various new drugs the overall percentage of population suffering from hypertension is increasing day by day. The use of herbal medicine is finding more relevance with the recognition that we are facing more challenges in the treatment of some medical conditions such as hypertension. This review is regarding current on medicinal approach to deal with hypertension as well as antihypertensive actions of some herbal medicines and formulations, their therapeutic values in clinical situation and recent approaches to validate and document their antihypertensive efficacies. The central idea behind this review is that if we can demonstrate the value of our science and art of healing even in current lifestyle disorders like hypertension with proper evidence based documentation then it will not only increase faith for Ayurveda among young researchers but also enhance global acceptability of our science as a contemporary science of medicine.

Medicina complementar e alternativa na rede básica de serviços de saúde: uma aproximação qualitativa / Alternative and complementary medicine in the basic health system network in Brazil: a qualitative approach

O artigo focaliza as representações sociais de profissionais da área da saúde sobre a introdução de práticas médicas complementares e alternativas na rede básica do município de Campinas (SP). A partir de uma perspectiva metodológica essencialmente qualitativa, o artigo analisa as condições, os problemas e os obstáculos na implementação dessas práticas nos serviços de saúde. O sucesso desta inclusão foi encontrado em quatro razões fundamentais: a disposição da clientela, que apoia e solicita este tipo de serviço; a visão de saúde dos médicos sanitaristas, que mostram uma abertura para este tipo de projeto; o amplo apoio proveniente de profissionais de saúde não médicos, que pretendem valorizar e ampliar a sua prática; e, finalmente, a própria perspectiva das medicinas alternativas e complementares, que se encontra em plena sintonia com a ênfase na saúde proposta pelo Sistema Único de Saúde (SUS). Apesar do sucesso na implantação dessas práticas na rede básica, dois aspectos negativos foram detectados: o planejamento insuficiente e uma visão simplificadora que converte as racionalidades alternativas em meras técnicas que seguem os mesmos princípios mecanicistas da medicina alopática e o mesmo entendimento reificado de doença.

This article focuses on the social representations of health professionals about the introduction of complementary and alternative medical practices in the public health service network in Campinas city (SP, Brazil). Based in an essentially qualitative methodological perspective, the article analyses the general conditions, the problems and the obstacles related to the implementation of such practices. The success of this inclusion was found in four main reasons: the clientele disposition which gives support and demands this kind of service; the health vision of the sanitarian doctors, which is open to such project; the wide support given by the non-medical health professions, which intend to add value and amplify their practice and, finally, the own perspective of the alternative and complementary medicines, which agree with the Unified Health System (SUS) proposals. Despite the success in the implementation of such practices in the health basic system, two negative aspects were detected: the insufficient planning and the simplified vision which converts such rationalities in mere techniques, which follow the same mechanistic principles of the allophatic medicine and the same reified understanding of disease.

Atenção farmacêutica e práticas integrativas e complementares no SUS: conhecimento e aceitação por parte da população sãojoanense / Pharmaceutical care and complementary and alternative medicine in the SUS: knowledge and acceptance on the part of the population from the city of São João da Mata, Minas Gerais state, Brazil

Em 2006, o Ministério da Saúde criou a Política Nacional de Terapias Integrativas e Complementares no SUS. O objetivo do estudo foi investigar o conhecimento e a aceitação das terapias integrativas e complementares e atenção farmacêutica por parte dos usuários do SUS. O estudo foi realizado na farmácia da Unidade Básica de Saúde da cidade de São João da Mata, Minas Gerais, Brasil. Um estudo transversal descritivo qualitativo e quantitativo foi realizado com três médicos e 35 usuários do serviço. Destes, 100 por cento não conheciam as terapias integrativas e complementares. Após explicação clara e simples pelo pesquisador, 31,42 por cento disseram que aceitariam o uso de fitoterapia, 51,42 por cento aceitariam a acupuntura, 37,14 por cento aceitariam a homeopatia e nenhum utilizaria a crenoterapia. Quando questionados sobre a atenção farmacêutica, 45,71 por cento disseram já ter ouvido falar neste assunto, 22,85 por cento sabem do que se trata e 31,42 por cento nunca tinham ouvido falar em atenção farmacêutica. Quando os três médicos que atendem na unidade de saúde foram questionados, observou-se indiferença, não-aceitação e aceitação, respectivamente. Em conclusão, este estudo demonstrou que a grande maioria dos pesquisados aceitaria as terapias integrativas e complementares se estas fossem oferecidas pela unidade de saúde. Além disso, os usuários acham importante uma maior atuação do farmacêutico. É necessária a implantação de programas de divulgação para os pacientes e principalmente para os médicos prescritores de práticas integrativas e complementares.

In 2006, the Ministry of Health created the National Policy on Integrative and Complementary Therapies in the Unified Health System. This study aimed to investigate the knowledge and acceptance of complementary and integrative therapies and pharmaceutical care by SUS users. The study was conducted in the pharmacy of a primary healthcare unit in São João da Mata city , Minas Gerais state, Brazil. A cross sectional study was performed qualitatively and quantitatively with three doctors and 35 service users. Of these, 100 percent did not know the complementary and integrative therapies. After clear and simple explanation by the researcher, 31.42 percent said they would accept the use of herbal medicine, 51.42 percent accepted acupuncture, 37.14 percent would use homeopathy and none would use crenotherapy. When asked about the pharmaceutical care, 45.71 percent said they had heard of this matter, 22.85 percent know what it is and 31.42 percent had never heard of it. When the three doctors who at the clinic were questioned, there was indifference, non-acceptance and acceptance, respectively. In conclusion, this study showed that the vast majority of respondents would accept the complementary and integrative therapies if they were offered by the health unit. In addition, users find important a greater role of the pharmacist. One need to implement outreach programs for patients and especially for prescribers of complementary and integrative practices.

Herbs and herbal constituents active against snake bite.

Snake bite, a major socio-medical problem of south east asian countries is still depending on the usage of antisera as the one and only source of treatment, which has its own limitations.  In India, mostly in rural areas, health centres are inadequate and the snake bite victims mostly depend on traditional healers and herbal antidotes, as an alternative treatment. The present review has been focussed on the varied folk and traditional herbs and their antisnake venom compounds, which might be a stepping stone in establishing the future therapy against snake bite treatment and management.

Use of alternative medicines among medical patients at Siriraj Hospital.

Alternative medicine is widely used throughout the world. The objective of this study was to determine the prevalence, patterns and cost of alternative medicine among patients attending the Department of Medicine, Siriraj Hospital. One hundred patients admitted to Department of Medicine and one hundred outpatients in the Department of Medicine in January 2000 were interviewed. Information concerning underlying medical conditions and details of use of alternative medicine including their cost and patient satisfaction were collected. The results revealed 1) 52.5% of the patients used at least one modality of alternative medicine 2) the most common modalities of alternative medicine were folk remedies or herbal medicine (72%) and massage (31%) 3) older patients and those living outside Bangkok, with underlying disease or who had received conventional medicine had a higher rate of use of alternative medicine 4) the main problems leading patients to use alternative medicine were musculoskeletal problem (41%), fever (16%) and fatigue (14%) 5) most of the patients (60%) were satisfied with the alternative medicine they received and 6) the cost of alternative medicine for each patient was 1,434 Baht per month for ex-user and 379 Baht per month for current-user. Based on the information obtained from this study, alternative medicine is commonly used by Thai patients and it is estimated that at least 155 million Baht has been spent on alternative medicine for all patients attending the Department of Medicine, Siriraj Hospital annually, and at least 6 billion Baht has been spent on alternative medicine for all patients in Thailand each year.