Self-Protection of Medical Workers in Traditional Hospitals and Clinics Against SARS-CoV-2 Infection

Coronavirus Disease 2019 (COVID-19) is the most prevalent infectious human disease spreading in several parts of the world caused by SARS Coronavirus 2 (SARS-CoV-2). COVID-19 transmission is mainly spreading via the respiratory tract, personal contact, digestive tract and hospital-acquired infections. Health care workers particularly working in clinics practicing traditional medicine need to be in close contact with patients, so they have a higher risk of SARS-CoV-2 infection. In this paper, therefore, the personal-protective measures need to be followed by healthcare workers in traditional medicine clinics during COVID-19 pandemic are emphasized, to enlighten them about self-protection and to improve the safety of such a special group of traditional healers.Copyright © 2021 Bentham Science Publishers.

Chilblain: a brief history of cold comfort remedies

Chilblain, also known as pernio, has gained publicity in recent years as a result of its association with 'COVID toes' during the COVID-19 pandemic. Long before this, chilblain had left its mark throughout history and literature. The word 'chilblain' has Anglo-Saxon roots. 'Chil' comes from Old English ciele meaning 'chill' or 'frost', while 'blain' comes from the Old English blegen meaning 'inflammatory swelling' or 'sore'. The two words were brought together in the 1540s. The choice of words somehow acknowledges that cold is the aetiological factor that brings on this painful swelling. The Victorian novel Jane Erye, written by Charlotte Bronte in 1847, described the physical hardships that children had to struggle with through the winter at Lowood, the charity school for poor and orphaned girls. Her work masterfully sculptured the essence of chilblain and its effects on the children. Multiple notable figures proposed various remedies to treat the bothersome symptoms of chilblains. Pedanius Dioscorides was a Greek physician and botanist whose monumental work De Materia Medica in the first century AD compiled a list of topical remedies for chilblains, including quince oil, fenugreek oil, frankincense gum, burnt figs in wax, a mixture of gentian, crab ashes and honey, burnt ass hooves, bear grease and decoction of turnip as a warm pack. To cure chilblains, Nicholas Culpeper, an English herbalist, advised grating horseradish and applying it as a mustard plaster. We now know grated horseradish root produces a powerful mustard oil that acts as a rubefacient, which irritates the skin and increases its blood flow. Dr Lewis Johns was a recognized medical officer in the field of medical electricity in charge of the Electrical Department of St Bartholomew's Hospital. He noted a reduced incidence of chilblains in children with poliomyelitis who were treated with a warm electric footbath in 1899. The beneficial effects most likely originated from the warm bath rather than the electricity itself. Sir Thomas Lewis, a British cardiologist, investigated skin responses to injury and vascular reactions of the skin to cold exposure. His careful observations and descriptions of chilblains published in the British Medical Journal in 1941 remain true to this day. Practices such as praying to the statue of St Benignus of Dijon with chilblains, wearing electric patent socks (invented in 1882) and using an electrical vacuum tube in 1922 had also made their way into the lives of sufferers as a potential cure. Despite the epidemiological study of chilblain in over 3000 servicewomen, carried out by the Auxiliary Territorial Service in the winter of 1942, no specific remedy was found. When it comes to chilblain, prevention is better than cure by keeping the hands and feet warm and dry and staying active, and chilblains usually resolve spontaneously within a few weeks.

An Ethnobotanical Survey of COVID-19 Therapeutic Plants

After the emergence of COVID-19, the global usage of herbal medicine has expanded considerably. Exploring the scientific and clinical potential of medicinal plants, the World Health Organization (WHO) promotes projects to create COVID-19 medicines via traditional medicine. The purpose of our research was to compile a list of plants used in the outpatient treatment of COVID-19 by herbalists, including the plants, the sections utilized, and the method of preparation and administration. an ethnobotanical survey was done in order to determine the plants prescribed by herbalists to their COVID-19 patients/clients. In our investigation, we discovered 14 plant species, with Eucalyptus globulus, Lavandula angustifolia, Artemisia herbacea alba, Syzygium aromaticum, and Thymus vulgaris being the most often suggested.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

COVID-19 on the Navajo Nation: Experiences of Dine Families of Children with Asthma

BACKGROUND: Approximately 173,000 persons live on the Navajo Nation (NN) and 14.7% live in multi-generational households. One-third of the Nation's residents are children and 44% live in poverty. The median household income is $27,389 with 1/3 having incomes < $15,000/year. The first confirmed case of COVID-19 on the NN was identified March 17, 2020. The Navajo government took swift action to combat COVID-19 by declaring a public health state of emergency which established the Navajo Department of Health Command Operations Center, closed the government offices except for essential employees, ceased inperson classroom instruction for all schools located within the borders of the NN and issued travel restriction for governmental employees. Even with strong public health efforts, Navajo Nation saw the highest per capita infection rate in the US during May of 2020 with 2450/100,000 versus New York 2119/100,000. METHODS: The Community Asthma Program is an NHLBI funded program working to improve health outcomes for children with asthma on the NN. We sought to determine the impact of COVID- 19 on the families of children with asthma who were participating in our study. RESULTS: Sixty-six of 193 families (34%) were interviewed about their pandemic experience. The average age of the child with asthma was 13.5 (SD=3.9) and 33% were female. On average, 5.2 people lived in each house (SD=2.1). Results of the interviews are shown in the table. Our data indicate that most Diné children with asthma in our study did not contract COVID-19. However, the pandemic had a significant impact on them and their families. Many family members contracted COVID-19, some children lost family members, and half of interviewed parents reported a decline in their child's mental health. Responses suggest that Navajo families may have been less able to work remotely than the US population at large, perhaps increasing stress for families. Despite the trauma from COVID-19, families adopted strategies to cope with the pandemic. Most diligently followed health guidelines including washing hands, wearing masks, and social distancing. One in four families sought the help of a traditional healer. Many accessed medical care through telehealth and most were able to obtain asthma medications when needed. More recently, as the pandemic subsides, parents indicate that their outlook and mental health have significantly improved. CONCLUSION. Despite significant challenges, our research indicated resilience among Navajo families and we heard stories of positive community structures and relationships that are particular to the Diné culture. (Figure Presented).

Streptococcus pluranimalium associated with invasive wound infection post-visit to traditional healer: case report

This case study involves an unusual clinical case of a 46-year-old female of African descent, presenting to a tertiary hospital from her rural clinic with a one-day history of difficulty in breathing after a visit to her traditional healer. COVID-19 PCR was negative and retro viral disease (RVD) status unknown. No wound was noted, but likely present at time of presentation. After an emergency tracheostomy because of sudden deterioration due to airway obstruction, an acute progressive wound was noted with discolouration and epidermolysis of the overlying skin. The patient was admitted to ICU and demised on day three after presentation due to multiple organ failure secondary to overt sepsis due to multiple organisms, including the newly described pathogen Streptococcus pluranimalium, which was grown on blood cultures tests collected on admission and released post-mortem. This organism was possibly introduced through a small superficial wound induced by her traditional healer.

Appropriating spiritual help for traditional healing: why ancestors are needed

This study investigates the use of traditional medicine by traditional healers in a South African context in the fight against Covid-19. Appropriating spiritual help in fighting the symptoms of the virus would be part of the treatment prescribed by traditional healers. This is not an evaluative study to judge whether traditional healing methods are valid or not. This is a descriptive exercise to show how traditional healers appropriate the help of the spiritual realm in the process of healing. Two different worldviews are discussed to indicate under which conditions the help of the spiritual realm is required in the healing process. The discussion of the porous and buffered worldviews provides insight into how people perceive their reality, and the influence of the spiritual realm in it. By describing how healing functions in an African (porous) worldview by adopting help from the spiritual realm, the importance of rituals as mediating actions, are emphasised. A porous worldview is not only found among African communities;several examples illustrate this. The conclusion drawn is that all illnesses and healing systems are culturally influenced, and one cannot be judged as being better or more efficacious than the other. © 2021, Pharos Journal of Theology. All rights reserved.

Using the socioecological model to explore barriers to healthcare provision in rural communities in the Philippines

Background: Basic healthcare in the Philippines is provided via rural healthcare clinics (RHC) located in barangays and supervised by provincial health centers. These RHC are the cornerstone of the country's public health system and were designed to promote and prevent disease through basic healthcare services and education. However, RHC became nonfunctional during the COVID pandemic leaving the community without the resources necessary to address the acute problems associated with COVID and chronic conditions. Given the crucial role of RHC in disease prevention and control, identifying barriers to providing its services and programs is warranted. Aims: The purpose of this qualitative study was to explore multilevel barriers to the provision of healthcare services and education in RHC. Methods: We used a qualitative approach and the socioecological model as a framework to investigate the multilevel barriers affecting resource access at RHC. Four public health nurses and fifteen community healthcare workers (CHW) from five RHC across the country participated in individual interviews and group discussions. Traditional content analysis was used to examine the data. Results: Findings revealed barriers at the individual (insufficient motivation, incorrect beliefs), interpersonal (insufficient ability of CHW to provide services, and lack of training, unrealistic expectations, and lack of supervision and monitoring of CHW), organizational (excessive workload for CHW, lack of resources, inadequacy of evaluation and monitoring of CHW), community (lack of trust in CHW by people, lack of motivation to seek healthcare, continued belief in traditional healers), and policy (lack of financial support for RHC, lack of an organized system to meet community needs) levels. Conclusion: Examining individual, interpersonal, community, and policy level determinants that affect RHC can inform community-based health promotion interventions for the country's rural communities. Given the multidimensional barriers identified, it is recommended that a comprehensive program be developed and implemented in collaboration with licensed healthcare providers, CHW, district and regional healthcare department representatives, and healthcare policymakers.

LIPOID PNEUMONIA DUE TO PHARYNGOESOPHAGEAL DYSPHAGIA CAUSING PARAFFIN BRONCHOASPIRATION

TYPE: Case Report TOPIC: Occupational and Environmental Lung Diseases INTRODUCTION: We present a case of exogenous lipoid pneumonia caused by paraffin broncoaspiration due to pharyngoesophageal motor dysphagia. CASE PRESENTATION: A 57 year old female consulted for diarrhea. She had a previous history of ischemic stroke related to hypercoagulability syndrome, causing oropharyngeal dysphagia due to pharyngo-esophageal motor incoordination. Owing to possible neurogenic dysfunction she also presented megadolichocolon with chronic diarrhea-constipation syndrome. Due to the epidemiological situation caused by SARS-COV2, a chest X-ray was performed showing increased density of the right middle lobe. The control X-ray exhibited a persistence of this alteration, therefore a thoracic tomographic study was performed (findings included in image), as well as a bronchoalveolar lavage. The bronchoalveolar lavage fluid was initially turbid white which, posterior to resting, revealed a superficial layer of fat, supporting the diagnosis of lipoid pneumonia. The patient was subsequently interrogated. She associated the consumption of oily materials from herbalists and paraffin in order to palliate her constipation symptoms, which in relation to her esophageal motor-pharyngeal incoordination produced bronchoaspiration of the referred oily material. DISCUSSION: Oily substance ingestion was suspended. Subsequently she underwent a corticosteroid treatment and is currently under clinical control. CONCLUSIONS: The ground glass pattern is a finding that causes a wide differential diagnosis in the radiological study, therefore it is of great importance to take an adequate clinical history and to take into account the motor dysfunctions related to swallowing, due to the high consumption of herbalist products that contain oily materials that can cause exogenous lipoid pneumonia. DISCLOSURE: Nothing to declare. KEYWORD: Exogenous_Lipoid_Pneumonia

COVID-19 and herbal medicine: A practitioner survey

Introduction: COVID-19 has had a large impact upon UK society and healthcare, however little is currently known about its impact upon UK herbal medicine practice. This survey aimed to identify: changes to herbal medicine practice since the start of the pandemic, common herbs used to support people with COVID-19 symptoms and types of advice patients are seeking from herbal practitioners. Methods: We developed a mixed-methods e-survey for herbal practitioners, disseminated in June 2020 through practitioner professional bodies and social media. Quantitative results were analysed descriptively and qualitative results were analysed using basic content analysis. Results: Findings from 59 complete responses indicated that most practitioners have moved to phone or video consultations only, whilst 37% had observed a decline in patients with other conditions. 56% respondents reported seeing patients with COVID-19 symptoms and 27% seeing patients with a COVID-19 diagnosis. Herbal practitioners reported that patients most commonly asked for information about herbs to support the immune system (46/59, 78%) and herbs to support them during COVID-19 symptoms (36/59, 61%), although the percentage of patients asking for COVID-19 advice varied. Practitioners described using a range of herbs to support people with COVID-19 symptoms, most commonly Glycyrrhiza glabra L. (15/31, 48%), Echinacea spp. (13/31, 42%) and Andrographis paniculata (Burm.f.) Nees (8/31, 26%). Practitioners also recommended vitamin D (14/29, 48%) and C (8/29, 28%). Herbal practitioners’ main sources of information about COVID-19 were webinars from other herbalists (56%), research databases (58%) and NHS guidance (49%). Conclusions: The COVID-19 pandemic has had a substantial impact upon herbal medicine practice. Herbal practitioners are a source of information and support for patients with COVID-19 symptoms. However, herbal medicines used varied widely. Future research needs to evaluate these herbal medicines and to develop a comprehensive database on herbal substances used and their potential benefits and risks. Keywords: Herbal medicine, COVID-19, survey;herbal practitioners;practice delivery