Adaptive Approaches to Physical Pain Treatment Modalities During the COVID-19 Pandemic: A Qualitative Analysis.

Background and Purpose: Despite the lack of proven efficacy, opioids historically have been used for the treatment of noncancer back pain. A variety of other effective therapeutic options for pain management are becoming more available over time. In 2016, Oregon implemented a unique and novel policy to improve evidence-based back pain care and promote safer and more effective opioid prescribing through the state's Medicaid program, the Oregon Health Plan. This article examines the ways providers adapted to providing care for patients with back pain in the context of COVID-19 and to better understand the challenges faced by and adaptations made by providers. Methods: We conducted focus groups with clinicians and physical pain treatment modality practitioners (PPTMPs). In total, 129 providers participated in one of six focus groups, including 74 clinicians (54%) and 55 PPTMPs (42%). Reflexive thematic analysis was used to construct themes or units of meaning across data. Results: Focus groups revealed concerns about PPE shortages, telemedicine challenges, communication barriers, and profession-specific responses to COVID-19, which hindered patient care and referrals. Focus groups also highlighted some advantages related to increased insight into patients' lives, which enhanced treatment. Care during COVID-19 has resulted in continued patient interest in telehealth and telemedicine. Conclusion: Optimizing use of these technologies for health conditions, such as back pain, adds to treatment options for patients and gives providers a more holistic understanding of patients' lives, the challenges they may face, and how that impacts their treatment.

Confronting Medical Diploma Mills: State Licensing Boards, Legislatures, and the Limits of Medical Authority in the 1920s.

In the standard story of the rise of professional authority in medicine in the 1920s, state medical licensing boards were partners in a coalition, led by the American Medical Association, to radically improve medical education. Boards obtained state laws that limited admission to licensing examinations to graduates of schools approved by the AMA, thus bringing about the rapid demise of low-quality schools by about 1925. The reality at the state level was quite different, however. Medical examining boards containing homeopaths, eclectics, and sometimes osteopaths could be far from reliable partners. Passing laws to benefit the medical profession was exceedingly difficult and dependent on local medical politics. Through the lens of a major medical diploma mill scandal revealed by a journalist in 1923, this paper examines reform efforts in three states greatly affected by the scandal: Missouri, where the scandal originated, Connecticut, and Massachusetts. In each of these states, graduates of low-quality schools as well as fake doctors from diploma mills were able to take a state examination and practice. This paper argues that the AMA, far from being the major player in the elimination of inadequate schools, could set standards but had to stay on the sidelines.

Analyzing Potential Interactions Between Complementary and Alternative Therapies, Over-the-Counter, and Prescription Medications in the Older Population.

BACKGROUND: The escalating use of complementary and alternative medicine (CAM) raises concerns, particularly among geriatric patients taking multiple medications. Notably, the doubled chance of major drug interactions between prescription and over-the-counter (OTC) drugs in older adults underscores the need for further research. This study aimed to evaluate clinically significant CAM and prescription medication interactions in a geriatric clinic, emphasizing the growing importance of understanding CAM implications in health care. METHODS: A 2-year cross-sectional study, approved by the Institutional Review Board, enrolled 420 participants aged 65 and older from a geriatric primary care clinic. Participants completed a survey, and pharmacy students conducted chart reviews to evaluate potential CAM products and prescription medication interactions. RESULTS: Among the 420 participants-who were predominantly White females and who were taking supplements, OTC medications, or both-15.6% experienced potential drug interactions. Ginkgo biloba, garlic, and calcium were common contributors to major, moderate, and minor interactions, respectively, among supplements. Meanwhile, ibuprofen was among the contributors to major and moderate interactions among OTC medications. Most supplements and OTC medications were disclosed to health care professionals. However, there was a lack of investigation by health care professionals regarding CAM use, emphasizing a discrepancy between patient-reported and physician-inquired CAM usage. CONCLUSION: This study highlighted the significant use of CAM and/or OTC medications, particularly among vulnerable older adults, revealing a concerning 15.6% rate of potential drug interactions. The findings emphasized the need for awareness among health care practitioners and standardized CAM surveys to enhance accuracy and patient safety.

The Role of Alternative Medicine in Managing Type 2 Diabetes: A Comprehensive Review.

Diabetes, a chronic metabolic disorder marked by elevated blood glucose levels, is increasingly prevalent globally, significantly impacting health-related quality of life. Type 2 diabetes (T2DM), characterized by insulin resistance and inadequate insulin production, presents a substantial public health challenge, necessitating comprehensive management strategies. Conventional treatments, including lifestyle modifications and pharmacotherapy, are essential for glycemic control and preventing complications. However, adherence to these treatments is often limited, highlighting the need for alternative strategies. Complementary and alternative medicine (CAM) offers potential cost-effective and accessible approaches for managing T2DM. Key herbal remedies like cinnamon, fenugreek, and bitter melon, along with dietary supplements like chromium, magnesium, and vanadium, have shown promise in glycemic control. Mind-body therapies, including yoga, tai chi, and meditation, contribute to improved hemoglobin A1c and fasting blood glucose levels. Research supports the integration of CAM with conventional therapies, demonstrating enhanced clinical efficacy and reduced economic burden. However, challenges such as standardization, quality control, and potential risks of herbal medicines need careful consideration. Regulatory frameworks and ethical considerations are essential to ensure patient safety and informed decision-making. Patient education and effective communication between healthcare providers and patients are crucial for integrating CAM into diabetes management. Empowerment-based interventions and collaborative approaches can enhance self-management skills and clinical outcomes. Overall, integrating CAM with conventional treatments offers a holistic approach to managing T2DM, potentially improving patient outcomes and reducing healthcare costs.

Navigating ethical dilemmas in complementary and alternative medicine: a narrative review.

Complementary and alternative medicine (CAM) is a rapidly growing industry, with millions worldwide seeking these treatments for various ailments. While many CAM therapies have shown promise in improving health outcomes, there are also ethical challenges associated with them. In this article, we explore some of the most pressing ethical issues in CAM, including informed consent, justice in accessibility, and evidence-based therapies. This survey provides a comprehensive overview of the ethical issues in CAM and offers practical guidance for health-care providers navigating these complex issues. By understanding the ethical dilemmas in CAM, health-care providers can offer their patients safe and effective care while maintaining their professional and ethical obligations.

Chuna Manual Therapy or Electroacupuncture with Pregabalin for Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Pilot Study.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common side effects of chemotherapy, and effective treatments for CIPN are still lacking. For this reason, there is a growing interest in complementary and alternative medicine as a potential source of nonsurgical treatments for CIPN symptoms alongside pregabalin. One such option being explored is Chuna manual therapy (CMT), a traditional Korean manual therapy. Methods: This study compares the effectiveness and safety of using only pregabalin (PG) as a conventional method of treating breast and colorectal cancer patients with CIPN symptoms with a combination of both PG and electroacupuncture (EA) or CMT, while also assessing the feasibility of future large-scale clinical studies. Due to the COVID-19 pandemic, only 74 CIPN patients were recruited to this study. Twenty-five were assigned to the PG group, 26 to the PG + EA group, and 22 to the PG + CMT group for a five-week treatment and a four-week follow-up study. Results: For the primary outcome, we evaluated the mean differences in Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) compared to the baseline at week 5 (visit 4). Although we found that the PG + CMT group showed the biggest difference (-16.64 [95% CI: -25.16, -8.11]) compared to the PG group (-8.60 [95% CI: -14.93, -2.27]) and the PG + EA group (-6.73 [95% CI: -12.34, -1.13]), this finding lacked statistical significance (p = 0.2075). In terms of safety, two patients in the PG + CMT group reported side effects: one bruise and one headache. Conclusions: The low attrition and high adherence rates of all the groups, and the similar rates of side effects among them, support the feasibility of larger-scale follow-up studies.

Assessment of Knowledge and Communication Regarding Complementary and Alternative Medicine Among Physicians in Madinah City.

INTRODUCTION: Despite the recognition of the importance of physician knowledge and physician-patient communication about the use of complementary and alternative medicine (CAM), few studies have explored this issue. Therefore, this study aims to assess physicians' knowledge and physician-patient communication regarding CAM. METHODS: A cross-sectional study was conducted among physicians working at governmental hospitals and primary healthcare centers in Madinah, Saudi Arabia. The data collection tool was a validated English language questionnaire distributed using social media platforms. The questionnaire included sections to assess physician knowledge and communication about CAM. RESULTS: Of the 373 completed questionnaires, around 151 (40.5%) of the respondents stated that they have a poor level of knowledge about CAM, and 272 (72.9%) need to gain additional knowledge to properly counsel patients on CAM. Medical journals were the main source of knowledge about CAM. There were 121 (32.4%) physicians who believed that <20% of their patients use some form of CAM, and 180 (48.3%) believed that <20% of their patients spontaneously reported their CAM use without prompting or direct questioning. Around 180 (48.3%) of physicians believed that they asked <20% of their patients about using CAM. Regarding barriers that limit communication with the patient about CAM, the highest percentage was insufficient knowledge about CAM (137, 36.7%). CONCLUSION: The study showed that a significant number of physicians lack the appropriate knowledge about CAM and most of them agreed to gain additional knowledge to properly counsel their patients. Further research is needed to evaluate physicians' knowledge about CAM using a more objective method.

From the kitchen to the medicine cabinet: Examples of functional herbs and spices.

In many cultures, "food as medicine" has existed for centuries as the foundation of health. It is a practice built on the knowledge that food and diet play important roles in disease prevention and management. Foods possessing therapeutic properties are often referred to as functional foods. Many herbs and spices contain numerous nutritional and non-nutritional components that can interact with pharmacologically relevant receptors, either directly or indirectly via their metabolites, to regulate cellular biochemical processes. Although opinions are changing, the concept of food as a therapeutic intervention goes against conventional Western medicine. To provide guidance to clinicians interested in using these products, members of the Food as Medicine working group of the Nutrition Committee for the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition, as part of a two-part review series, have identified frequently used foods, supplements, herbs, and spices that are utilized for therapeutic intent and have created summaries of commonly used indications, doses, and caveats. In this review, the focus is the use of select herbs and spices for medicinal purposes. Gaps in our knowledge in how to effectively use these agents in pediatric patients are discussed. Evidence supporting their use for management of gastrointestinal conditions, especially in the pediatric population, is provided when available. Circumstances in clinical settings and patient indications may require actions different from those recommended in this review and professional judgment should prevail.

Ethical requirements of instructions for authors of complementary and alternative medicine journals: a cross-sectional study.

BACKGROUND: Medical research in complementary and alternative medicine (CAM) has increased recently, raising ethical concerns about the moral status of CAM. Medical academic journals are responsible for conducting ethical review (ER) of manuscripts to protect the interests of human subjects and to make ethical results available before deciding to publish. However, there has been no systematic analysis of the ER in CAM journals. This study is aim to evaluate the current status of ethical requirements and compliance in CAM journals. METHODS: This is a cross-sectional study. We reviewed instructions for authors (IFAs) of CAM journals included in the Journal Citation Reports (2021) ( https://jcr.clarivate.com ) for general information and requirements for ER. We also browsed the manuscripts regarding randomized controlled trials published by CAM journals in Q1 and Q2 section from January to June, 2023, to check the actual situation of ethical requirement. Descriptive statistics and Fisher's exact test were used for statistical analysis. RESULTS: 27 journals and 68 manuscripts were ultimately included. 92.6% (25/27) IFAs included keywords of ER, indicating the presence of ethical considerations. However, no specific ER was required for CAM (n = 0). We categorized journals by Geographic origin, JCR section, Year of electronic JCR, Types of studies, % of OA Gold to explore the factors that could influence CAM journals to have certain ethical review policies. The results showed there was no statistical significance in certain ethical review policy in any classification of journals (p > 0.05). All RCT manuscripts included in the study generally met the requirements of the published journals for ethical review. CONCLUSIONS: All IFAs discussed ER, but the content was scattered, unfocused, and there were no specific ER requirements regarding CAM. Although the manuscripts basically met the requirements of the journal, it was not possible to get closer to the process of ER in the manuscript. To ensure full implementation of these policies in the future, CAM journals should require authors to provide more details, or to form a list of items necessary for CAM ethical review.

Prevalence and 20-year trends in meditation, yoga, guided imagery and progressive relaxation use among US adults from 2002 to 2022.

Meditation, yoga, guided imagery, and progressive relaxation are promoted as complementary approaches for health and wellbeing in the United States, but their uptake by different sociodemographic groups is unclear. This study assessed the prevalence and 20 year trends in the use of these practices in US adults between 2002-2022. We examined practice use and associations with sociodemographic and health factors in a population-weighted analysis of n = 134,959 participants across 5 cycles of the National Health Interview Survey. The overall use of meditation (18.3%, 60.53 million), yoga (16.8%, 55.78 million) and guided imagery/progressive relaxation (6.7%, 22.22 million) increased significantly from 2002 to 2022. Growth was consistent across most sociodemographic and health strata, however users of 'Other' race (comprising 54% Indigenous Americans, Odds Ratios; ORs = 1.28-1.70) and users with moderate (ORs = 1.19-1.29) psychological distress were overrepresented across all practices, and those with severe psychological distress were overrepresented in meditation (OR = 1.33) and guided imagery/progressive relaxation (OR = 1.42). Meditation use has accelerated over time for 65 + year olds (OR = 4.22), people not accessing mental health care (OR = 1.39), and less educated (OR = 4.02) groups, potentially reflecting unmet health needs. Health professionals should consider the extensive use of complementary practices in service and treatment planning and consider their risks and benefits.

Complementary and Alternative Medicine for Autism - A Systematic Review.

Complementary and Alternative Medicine (CAM) is a therapeutic option currently used by autistic people with continued interest and uptake. There remains limited evidence regarding the efficacy of CAM use in autism. The aim of this systematic review is to comprehensively review published clinical trials to explore the efficacy of CAM in autism. A systematic literature review of available research published from June 2013 to March 2023 was conducted. Our literature search identified 1826 eligible citations, and duplications removed (n = 694) with 102 articles eligible for title/abstract screening. After full text review, 39 studies were included. The results of this systematic review identified that for autistic people, vitamin and mineral supplements may only be of benefit if there is a deficiency. The results also found that the main interventions used were dietary interventions and nutraceuticals, including targeted supplements, vitamins and minerals, omega 3 s and prebiotics, probiotics and digestive enzymes. The evidence does not support some of the most frequently utilised dietary interventions, such as a Gluten Free Casein Free (GFCF) diet, and the use of targeted nutraceutical supplements may be of benefit, but more conclusive research is still required to direct safe and effective treatment.

Alternative Treatments for Emotional Experiencing and Processing in People with Migraine or Tension-Type Headache: A Scoping Review.

This narrative review aims to summarize the use of alternative treatments (e.g., relaxation training, meditation, written intervention) for emotional expression, processing, control, or management in patients with migraine and tension-type headaches, which the previous literature has shown to be related to migraine pain perception and headache symptoms. Online databases including PubMed, Scopus, Web of Science, PsycINFO, and Medline were searched to identify studies published between 2000 and 2023. A descriptive synthesis of the included studies was conducted. We included seven articles after screening 1.173 records. A total of 610 patients with a diagnosis of migraine or tension-type headache, and an average age of 19-45.5 years (68-90.4% females) were recruited in the selected studies. Overall, the results show that alternative approaches to headache treatment contribute to the management, reduction, or control of negative emotions and at the same time have a positive impact on pain perception and headache symptoms. However, in some cases, the effects are more promising than others, depending on the peculiarities or limitations of each approach considered. This review provides useful insights from a methodological point of view for future studies on the management or control of negative emotions in patients with migraine and tension-type headache.

Can a six-week Swedish massage reduce mood disorders and enhance the quality of life in individuals with Multiple Sclerosis? A randomized control clinical trial.

INTRODUCTION: There is a limited amount of research specifically focusing on the effects of Swedish massage on mood disorders and the quality of life (QOL) among individuals with MS, emphasizing the need for further investigation. Therefore, this study aimed to assess the effects of a 6-week Swedish massage on the quality of life, stress, anxiety, depression, pain, fatigue, spasticity, and sleep quality in MS patients. METHODS: This randomized controlled trial involved 70 MS patients who were divided into two groups. The massage group underwent two 50-minute sessions of whole-body Swedish massage per week for six weeks, while the usual treatment group maintained their regular medical care routine. Outcomes were Short Form-36 (SF-36) and the Depression, Anxiety, and Stress Scale (DASS), Visual Analog Scale (VAS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI-P), and Modified Ashworth Scale (MAS). These measurements were taken before and after the massage intervention. RESULTS: The massage group demonstrated significant improvements in QOL and its components compared to the usual treatment group (Hedge's g = 0.53 for QOL, ranging from 0.31 to 0.58 for QOL components; p < 0.001). Participants in the massage group also reported significantly lower levels of stress (Hedge's g = 0. 80), anxiety (Hedge's g = 0.47), and depression (Hedge's g = 0.70) than those in the usual treatment group (p < 0.001). Additionally, the massage group had lower levels of pain, fatigue, and spasticity, and better sleep quality compared to the usual treatment group (p < 0.05). CONCLUSION: Swedish massage can be considered a valuable complementary and alternative treatment alongside conventional medicine for individuals with MS.

Battlefield Acupuncture for the Treatment of Chronic Migraines.

A 70-year-old man presented with worsening migraines and was referred to a neurologist by their primary care doctor for further workup. Imaging and lab work were benign. The patient then underwent several trials of various first and second-line medications and anti-migraine devices to no avail. It was not until one session of battlefield acupuncture, where five needles were placed in the patient's ear for a few days, that the patient had a resolution of his symptoms.

Wellness or medicine? Use and perception of Ayurveda in Germany: data from an online-representative cross-sectional study.

Introduction: Ayurveda, South Asia's largest and most relevant system of Traditional Medicine, holds a legal status akin to conventional Western medicine in India and elsewhere. There is an almost complete lack of data on the use of Ayurveda in Germany. The aim of this study was to investigate Ayurveda's utilization patterns, entry points, and factors influencing its use and the perception of Ayurveda among the German population. Methods: Basis of this manuscript was an online-representative survey which involved 4,065 participants aged 18-75 about the use and acceptance of Traditional, Complementary and Integrative Medicine (TCIM) in Germany. The survey was conducted online using Computer Assisted Web Interview (CAWI) in 2022. The dataset was analyzed descriptively and inferentially. Results: Altogether 9.3% (n = 377) of all survey participants (n = 4,065) had already used Ayurveda somehow, either more often (1.7%) or at least once in a lifetime (7.6%). Responders associated Ayurveda primarily with Indian Medicine (27.7%) and wellness (18%). Commonly used Ayurvedic services included non-medical treatments at wellness resorts/spas (48.3%), in outpatient practices (27.1%), and hotels (23.6%). 30.2% of the participants believe in Ayurveda's therapeutic potential. 76.7% of Ayurveda users find healthy nutrition important or very important. Nine predictors were found to classify Ayurveda users vs. non-users with spirituality and belief in Ayurveda's therapeutic efficacy as the most relevant ones. Ayurveda seems to be primarily used by well-educated and female individuals, often from higher-income groups and with a rather modern social milieu-orientation. Conclusion: Study results suggest that about every tenth German citizen has used Ayurveda in the past and about one third believes in its therapeutic potential. Because Ayurvedic therapies are often not evidence-based, there is an urgent need to perform high quality randomized controlled trials to investigate potential effects and safety of Ayurveda and how evidence-based Ayurveda treatments can be integrated into the German healthcare system.

The efficacy and safety of Gukang Capsule for primary osteoporosis: a systematic review and meta-analysis of randomized clinical trial.

Background: Gukang Capsule has been used as a complementary and alternative medicine (CAM) for the treatment of primary osteoporosis (POP) in China. The primary aim of this study was to assess the clinical effectiveness and safety of Gukang Capsule in POP patients. Methods: A systematic search was conducted across multiple academic databases including PubMed, Web of science, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP Information, and Wanfang database to identify randomized controlled trials investigating the Gukang Capsule in the treatment of POP. The screening process, data extraction, and assessment of methodological quality were conducted independently by two reviewers. Statistical analysis was performed using the Rev Man 5.3 software. Subgroup analysis was carried out through the combination of OPF. Subgroup analysis was performed according to whether OPF were combined. Stata 12.0 was used for sensitivity and bias analysis. Results: Nineteen studies were assessed that included 1804 participants. It was found that compared with the control group, the total effective rate (RR = 1.26, 95% CI, 1.20, 1.33), the Medical Outcomes Study Short-form 36 [RR = 1.26, 95% CI(1.20, 1.33)], the bone mineral density (BMD) of lumbar vertebra (SMD = 0.77, 95% CI, 0.48, 1.07), the BMD of femoral neck [SMD = 0.84, 95% CI(0.53, 1.14)], and the BMD of Ward's triangle (SMD = 0.64, 95% CI, 0.44, 0.85) of the Gukang Capsule experimental group were higher. Compared with the control group, the fracture healing time (SMD = -2.14, 95% CI, -2.45, -1.84), the bone specific alkaline phosphatase (BALP) levels in serum (SMD = -2.00, 95% CI, -2.83, -1.17), the tartrate resistant acid phosphatase 5b (TRACP-5b) levels in serum (SMD = -2.58, 95% CI, -3.87, -1.29) of the Gukang Capsule experimental group were lower. The bone glaprotein (BGP) levels in serum (SMD = -0.22, 95% CI, -1.86, 1.43) and the adverse events (RR = 0.80, 95% CI, 0.40, 1.63) of the experimental group and the control group have no difference. Conclusion: Gukang Capsule, as a CAM for the management of POP, exhibits the potential to enhance BMD and quality of life, expedite the healing time of OPF, diminish levels of BALP and TRACP-5b, and improve the total effective rate without increasing the adverse events. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023477774, PROSPERO CRD42023477774.

Is complementary medicine and diagnosis associated among spinal patients in the secondary sector: a cross-sectional study.

PURPOSE: The services defined as complementary and alternative medicine/healthcare (CAM) are used to varying degrees according to the nature of the health problem, and musculoskeletal disorders, in particular, often lead to the use of CAM. Chronic pain is often cited as a reason for using CAM, and it is also the cardinal symptom of patients with back pain referred for specialist care. However, previous studies do not consider the heterogeneity of back pain when examining the use of CAM. Thus, this study aimed to explore the associations between CAM use and clinical findings incl. ICD-10 diagnostic codes in such a context. METHODS: In a cross-sectional study, a logistic regression analysis examined associations between CAM use and clinical findings at a public outpatient spine department. Chi-squared test examined the association between self-reported reasons for CAM use and the diagnostic groups. RESULTS: Of the 432 patients in the study population, 23.8% reported using CAM within 12 months prior to clinical assessment. CAM use was associated with being female and of younger age. Seeking CAM was not associated with clinical findings nor diagnosis, and no statistically significant association between the reasons for seeking CAM and the diagnostic groups was described. CONCLUSIONS: Among patients referred to specialist care for back pain, this study provides no evidence that the spinal condition should be expected to lead to the use of CAM. Only the individual demographic findings, specifically age and gender, were associated with CAM use.

Are There Biological Correlates of Response to Yoga-Based Interventions in Depression? A Critical Scoping Review.

Depression is the most common mental disorder worldwide. Both antidepressants and psychotherapy are effective in treating depression, but the response to these treatments is often incomplete. Yoga-based interventions (YBIs) have been advocated by some researchers as a promising form of alternative treatment for depression. Recent research has attempted to identify the biological mechanisms associated with the antidepressant actions of YBIs. In this scoping review, conducted according to the PRISMA-ScR guidelines, the PubMed and Scopus databases were searched to retrieve research on biomarkers of response to YBIs in patients with depression. These studies were also critically reviewed to evaluate their methodological quality and any sources of bias. Nineteen studies were included in the review. Based on these studies, there is preliminary evidence that YBIs may be associated with increased serum brain-derived neurotrophic factor (BDNF) and reduced serum cortisol and interleukin-6 (IL-6) in patients with depression. However, many of these changes were also observed in the control arms, and the overall quality of the research was low. At present, it cannot be concluded that there are reliable biomarkers of response to YBIs in depression, though there are some potential biological correlates. Further advances in this field will depend critically on improvements in study design, particularly the minimization of sources of bias and the selection of more specific and sensitive biomarkers based on existing evidence from other treatment modalities.

The Use of Traditional and Complementary Medicine Among Patients With Multiple Sclerosis in Morocco.

BACKGROUND: Multiple sclerosis (MS) is an acquired chronic, autoimmune, and neurodegenerative disease of the central nervous system. In addition to conventional MS therapy, patients are interested in traditional and complementary medicine (T&CM). Our study aims to describe the use of T&CM in a cohort of Moroccan patients with MS. METHODS: A quantitative descriptive study was adopted to study this subject. For data collection, we opted for an anonymous questionnaire for 98 patients with MS. We gathered data via an electronic survey, using multivariable analysis to examine the effect of specific factors on T&CM use. Data collection took place from March 2022 to June 2022. RESULTS: The results show that 52% of patients use T&CM. Of those, 29.6% use cupping, 23.5% recite the Holy Quran, 15.3% use phytotherapy, 13.2% use apitherapy, and 10.2% use acupuncture. In addition, 66.3% of the surveyed respondents stated that alternative medicine positively affects their health. Finally, 49.1% of surveyed patients who use alternative medicine are between 30 and 40 years old. The results also show that the rate of T&CM use is higher in patients with progressive MS (OR = 2.540) and patients without financial access to disease-modifying therapy (OR = 2.100). CONCLUSIONS: This study invites us to consider societal, cultural, and economic factors when studying the use of T&CM among people with MS. Further research is needed to understand the motivations for using T&CM.

Exploring the Potential Use of Natural Products Together with Alkalization in Cancer Therapy.

Cancer treatment is a significant focus in medicine, owing to the increasing global incidence of cancers. Patients with advanced cancers that do not respond to conventional therapies have limited options and an unfavorable prognosis. Consequently, researchers are investigating complementary approaches to conventional treatments. One such approach is alkalization therapy, which aims to neutralize the acidic tumor microenvironment (TME) by increasing its pH level. The acidic TME promotes inflammation, tumor progression, and drug resistance. Alkalization therapy has been demonstrated to be effective for various cancers. In addition, natural products, such as triterpenoids, parthenolides, fulvic acid, Taxus yunnanensis, and apple pectin have the potential to alleviate symptoms, maintain physical fitness, and improve treatment outcomes of cancer patients through their anti-inflammatory, antioxidant, and anticancer properties. In this review, we focus on the effects of alkalization therapy and natural products on cancer. Furthermore, we present a case series of advanced cancer patients who received alkalization therapy and natural products alongside standard treatments, resulting in long-term survival. We posit that alkalization therapy together with supplementation with natural products may confer benefits to cancer patients, by mitigating the side effects of chemotherapy and complementing standard treatments. However, further research is warranted to validate these clinical findings.