Complementary And Alternative Medicine Therapies Research Articles

Understanding the Role and Uses of Alternative Therapies for the Management of Rheumatoid Arthritis.

With the growing popularity of complementary and alternative medicine (CAM) among individuals with chronic pain and muscular problems, a number of patients with rheumatoid arthritis (RA) show their interest in CAM interventions for disease improvement. Various reports published on CAM are based on an animal model of RA; however, there is often a lack of high-quality clinical investigations for explaining the success stories of CAM therapies in patients with RA. CAMs having the potential to be used for therapy in patients with RA have been identified, however lack of awareness and skepticism of their efficacy has made the patients reluctant to choose these drug-less therapies. In this review, we have summarized the existing evidence which suggests promising efficacy of different alternative therapies in managing RA and providing both physical and mental well-being to RA patients.

Complementary and alternative medicine practice and perceptions of Saudi subjects in Western region of Saudi Arabia

Background: Complementary and alternative medicine (CAM) offers a different approach to conventional medicine. CAM is very popular in many countries. Objectives: To study the magnitude of use, and determinants and awareness of CAM therapy use among the population in Western region of Saudi Arabia. Method: This was a cross sectional study; a non-probability convenient sampling method was used to select 1073 subjects through online Google survey. Data were collected using interview questionnaire, which provided information on the sociodemographic characteristics of the subjects, as well as questions on the practices and awareness of CAM therapies. The GAD-7 test to assess anxiety state was also used. Results: Almost half of the study population used CAM (51.6%), particularly those who live in the villages of Makkah city. CAM therapies were used by almost half of all patients with chronic diseases particularly those with gastrointestinal disorders and anxiety. Most common CAM method were Honey, Herbs, Ruqayyah and black seeds; while Acupuncture was the least method used. CAM methods were mainly used if needed, and main source of information about its use, was from the family. Almost half of the users were satisfied with the results of using it; however, their attitude about CAM in general was neutral. Conclusion: Use of CAM is a common health practice among the Saudi population. The majority of the participants had equivocal awareness about its effects. More health education programs by specialized health care authorities on the use and benefits of CAM are needed. Doctor-patient communication regarding CAM use is important. Increasing awareness of Saudi population about instructions and restrictions when using CAM is greatly needed. Keywords: CAM, Saudi Arabia, anxiety, Jeddah city, Gastro intestinal disorders.

Complementary and Alternative Medicine for Premature Ovarian Insufficiency: A Review of Utilization and Mechanisms.

Premature ovarian insufficiency (POI) is defined as a decline in ovarian function before the age of 40 and is one of the leading causes of infertility in women. The etiology is complex, and the pathogenesis is not clear. The main treatment is hormone replacement therapy, but a growing body of data confirms that such treatment can increase the risk of endometrial disease and cardiovascular disease. Complementary and alternative medicine (CAM) has been widely used in patients with POI due to its limited adverse reactions and high efficiency. According to literature reports, CAM therapy for POI mainly includes traditional Chinese medicine, acupuncture, psychotherapy, dietary supplements, and exercise therapy. This article reviews the application of CAM in the treatment of POI and attempts to determine the therapeutic effects and the mechanisms behind these effects based on existing clinical and experimental studies in order to provide theoretical support for the treatment of POI.

The prevalence of using complementary and alternative medicine products among patients with pressure ulcer

BackgroundThe use of complementary and alternative medicine (CAM) therapies has increased in recent years throughout the world and in Iran. Nonetheless, there are limited data about the prevalence of their use. This study aimed to assess the prevalence of using CAM therapies among patients with pressure ulcer (PU).MethodsThis cross-sectional study was conducted in 2019–2020. Participants were 299 patients with PU conveniently selected from wound clinics and healthcare settings in Shiraz, Iran. A demographic questionnaire and the International Questionnaire to Measure Use of CAM were used for data collection. The data were analyzed using the SPSS software (v. 22.0).ResultsAll 299 participants completed the study. Their mean age was 59.56 ± 18.76 years. The most common CAM therapies used for PU management were herbal products (100%), vitamin supplementation therapy (45.2%), spiritual therapies (21.7%), wet cupping therapy (16.4%), leech therapy (9.4%), acupuncture (1.7%), dry cupping therapy (1.3%), and massage therapy (1.3%). The most common herbal product used for PU management was Pistacia atlantica gum either alone or in combination with other herbal products (15.5%). The use of CAM therapies had significant relationship with participants’ age, underlying conditions, and PU stage (P < 0.05) and the most significant predictor of using herbal products for PU was educational level (P < 0.05, OR = 5.098).ConclusionsThe use of CAM therapies, particularly herbal products, for PU management is high in Iran. Quality public education and close professional supervision are needed for the safe use of these products.

Evaluation of the quality of online patient information at the intersection of complementary and alternative medicine and hypertension

BackgroundHypertension impacts 1.1 billion people globally; many patients seek complementary and alternative medicine (CAM), as a result of adverse side effects from antihypertensive medications or because they believe natural options are safer. The internet is increasingly playing a role in patient health information-seeking behavior, however, the variability of information quality across websites is unclear. Thus, the purpose of this study was to assess the quality of websites providing consumer health information at the intersection of hypertension and CAM.MethodsFour unique terms were searched on Google, across Australia, Canada, the US, and the UK. The first 20 webpages resulting from each search were screened for eligibility, and were included if they contained consumer health information relating to CAM therapies for the treatment/management of hypertension. To assess the quality of health information on eligible websites, we used the DISCERN instrument, a standardized quality index of consumer health information.ResultsOf 90 unique webpages, 40 websites were deemed eligible and quality assessed. The 40 eligible websites were classified into seven categories: professional (n = 15), news (n = 11), non-profit (n = 5), health portal (n = 3), commercial (n = 2), government (n = 1), and other (n = 3). The mean summed DISCERN score was 52.34 (standard deviation [SD] = 10.69) out of 75 and the mean overall score was 3.49 (SD = 0.08) out of 5. A total of 10 websites had a total DISCERN score of 60.00 and above with an average rating of 4.33. Among these, Medicine Net (69.00) and WebMD (69.00) were determined to have the highest quality information. Websites generally scored well with respect to providing their aims, identifying treatment benefits and options, and discussing shared-decision making; websites generally lacked references and provided inadequate information surrounding treatment risks and impact on quality of life.ConclusionsWhile some websites provided high-quality consumer health information, many others provided information of suboptimal quality. A need exists to better educate patients about identifying misinformation online. Healthcare providers should also inquire about their patients’ health information-seeking behavior, and provide them with the guidance necessary to identify high-quality resources which they can use to inform shared-decision making.

Corrigendum to “CAM recommendations in type 2 diabetes clinical practice guidelines: A systematic review” [Eur. J. Integr. Med. 48C (2021)

It has been reported that up to 70% of patients with type 2 diabetes mellitus (T2DM) use complementary and alternative medicine (CAM) each year. Healthcare providers refer to clinical practice guidelines (CPGs) in order to assist patients in making evidence-based decisions, however, no resource currently systematically summarizes CAM-related recommendations across CPGs for the treatment and/or management of T2DM. The purpose of this study was to identify all CPGs that make CAM-related recommendations and summarize them in a single review. We conducted a systematic search of MEDLINE, EMBASE, and CINAHL databases, as well as the Guidelines International Network and National Center for Complementary and Integrative Health websites, to identify CPGs for the treatment and/or management of T2DM published between 2009 and 2020, inclusive. Two independent reviewers conducted a data extraction of types of CAM mentioned and how they were recommended across all eligible CPGs. Of 2607 unique search results, 27 CPGs were eligible, and 7 included CAM therapy recommendations. Recommendations relating to CAM made in these 7 CPGs included (number of recommendations in total; for/against/uncertain): cardioprotective diet (1;1/0/0), cognitive behavioural therapy (1;1/0/0), diet emphasizing dietary pulses (1;1/0/0), diet emphasising fruits and vegetables (1;1/0/0), diet emphasizing nuts (1;1/0/0), Dietary Approaches to Stop Hypertension (DASH) diet (2;2/0/0), folic acid (1;1/0/0), goal setting skills (1;1/0/0), herbs (1;0/0/1), Mediterranean diet (3;3/0/0), motivational interviewing (1;1/0/0), omega-3 (2;0/1/1), plant-based preparations (1;1/0/0), potassium (1;1/0/0), selenium (1;0/0/1), vegan/vegetarian diet (1;1/0/0), vitamin A (1;0/0/1), vitamin C (1;0/0/1), vitamin D3 (1;1/0/0), vitamin E (2;0/1/1), vitamin/micronutrient supplementation (1;0/1/0), and yoga (1;1/0/0). CAM therapies for T2DM are only represented in approximately one-quarter of CPGs. Given that a high proportion of T2DM patients use CAM, current T2DM CPGs’ neglect of CAM treatment and/or management highlights a major gap in guidance for clinicians and patients.

Complementary and alternative therapies in multiple sclerosis: a systematic literature classification and analysis.

Multiple Sclerosis (MS) is a disease determined by inflammatory demyelination and neurodegeneration in the Central Nervous System (CNS). Despite the extensive utilization of Complementary and Alternative Medicine (CAM) in MS, there is a need to have comprehensive evidence regarding their application in the management of MS symptoms. This manuscript is a Systematic Literature Review and classification (SLR) of CAM therapies for the management of MS symptoms based on the International Classification of Functioning Disability and Health (ICF) model. Studies published between 1990 and 2020 IN PubMed, Science Direct, Scopus, Pro-Quest, and Google Scholar using CAM therapies for the management of MS symptoms were analyzed. Thirty-one papers on the subject were analyzed and classified. The findings of this review clearly show that mindfulness, yoga, and reflexology were frequently used for managing MS symptoms. Moreover, most of the papers used mindfulness and yoga as a CAM therapy for the management of MS symptoms, which mostly devoted to mental functions such as fatigue, depression, cognition, neuromuscular functions such as gait, muscle strength, and spasticity, and sensory function such as balance, in addition to, reflexology is vastly used to management of mental functions of MS patients. Evidence suggested that CAM therapies in patients with MS have the potential to target and enhancement numerous elements outlined in the ICF model. Although the use of CAM therapies in MS symptom management is promising, there is a need for strict clinical trials. Future research direction should concentrate on methodologically powerful studies to find out the potential efficacy of CAM intervention.

Self-Medication with Modern and Complementary Alternative Medicines in Patients with Chronic Pain.

Objective:The study aimed to assess the prevalence, pattern, and determinants of the self-medication practices with modern and/or complementary and alternative medicine (CAM) therapies in patients with chronic pain.Methods:The descriptive cross-sectional study was conducted between August 2021 and January 2022 and assessed a representative sample of chronic pain patients visiting outpatient departments in India by administering a semi-structured questionnaire. The survey questionnaire consisted of forty multiple response items, including ten questions that assessed the subjects’ sociodemographic profile, for example, age, sex, education, marital status, employment status, residence, and distance of home from any health care facility. The next part of the questionnaire evaluated the practice and determinants of self-medication for chronic pain with modern or CAM therapies. It included thirty questions assessing the reasons, duration, sources of information, procurement methods, preference for a particular system of medicine, knowledge about risks or drug interactions, rationality, perception of the subject, and communication with the physician, among other aspects of self-medication for pain.Findings:Out of the 325 respondents with chronic pain, those who practiced self-medication (237) were significantly more in number than those who did not (P < 0.05). Among those who self-medicated, the practice was significantly higher in urban participants living closer to healthcare facilities, with better economic backgrounds and higher education (P < 0.05). Modern medicine was the predominant choice of self-treatment for chronic pain compared to various CAM therapies (P < 0.05). Among the alternatives, homeopathic and ayurvedic systems of medicines were preferred. The main reasons for self-medicating were urgency, ease, previous prescriptions, and presumed mildness of the underlying disease. More than one-third of the respondents opined in favor of continuing self-medication in the future.Conclusion:The prevalent practice of self-medication for chronic pain may not be hazardous, but it can turn into a serious problem if not based on correct information. The inherent risks need to be minimized by increasing awareness, health education, and pharmacy regulations.

Akciğer Kanseri Tanılı Hastaların ve Ailesinin Tamamlayıcı ve Alternatif Tedavi Yöntemlerine Olan Tutumları ve Kullanım Sıklığı: Tanımlayıcı Araştırma

Objective: Complementary and alternative medicine (CAM) therapies do not have scientifically proven benefits, are preferred instead of medical therapies, or are used together with them. We investigated the prevalence of CAM use in a serious disorder with a short life expectancy, lung cancer (LC). Material and Methods: This study was planned as a cross-sectional study, and patients diagnosed with LC who applied to our clinic between 2017 and 2018 were invited to the study. 101 patients who accepted the invitation to study and whose consents were obtained were included in the study. Results: The mean age of the patients was 64.25±8.17 (42-82) years, majority of them were male patients (90%), and the prevalence of CAM therapy use was 62.2% (n=56/90). Herbal products were most frequently preferred. It was determined that the patients who were recommended a diet by their doctor used alternative therapies at a lower rate than the patients who have any recommendation (p=0.040). Conclusion: It is important to give a special nutrition program to the patient with LC and to ask the patients whether they use CAM therapies.

Attitudes Towards Complementary and Alternative Medicine Among Pediatricians in Saudi Arabia.

BackgroundComplementary and Alternative Medicine (CAM) refers to a variety of healthcare practices outside the domain of conventional medicine, which may be integrated with conventional medicine by many physicians.ObjectivesThis study aims to assess the attitudes and beliefs of pediatricians toward the use of CAM on children and to evaluate their knowledge and experience regarding CAM therapies and their desire for additional CAM training courses.MethodsThis is a cross-sectional study that was conducted in Saudi Arabia. A self-administered electronic questionnaire consisting of 27 questions was distributed among pediatricians to assess the demographics, beliefs, experiences, and attitudes of pediatricians related to the use of CAM for children. Non-probability convenience sampling was used in selecting the sample of pediatricians. Data analysis was performed using SPSS version 21 (IBM Corp., Armonk, NY).ResultsIn this study, 140 participants completed the questionnaires. Most of the participants were of the male gender (83, 59.3%) and Saudi nationals (127, 90.7%). With regards to questions related to the experiences and opinions of participants regarding the use of CAM, 101 (72.1%) subjects reported the use of CAM among family members. Pediatricians cited affirmative encounters of use of CAM in 94 (67.1%) by parents. Pediatricians were not in favor of the use of CAM for end-stage (114, 81.4%) and chronic disease (108, 77.1%). The overall median self-reported CAM knowledge score was statistically higher for males in comparison with females [3 (IQR 1-5)] versus 2 (IQR 2-4), P = 0.030]. Also for nationality, median scores were significantly greater for the Riyadh region in contrast to other regions [[3 (IQR 2-5)] versus 2 (IQR 1-4), P = 0.041]. There was a significant difference in median scores for qualification of participants (P = 0.002). A multiple pairwise comparison revealed a statistically significant (P = 0.012) difference between participants with the qualification of residents and specialization. No differences in median CAM scores were found for responses related to the experiences, opinions, and attitudes of pediatricians towards the use of CAM therapies.ConclusionMost of the pediatricians in Saudi Arabia don’t recommend the use of CAM treatment in their practice, but they acknowledge that learning more about CAM and imparting appropriate knowledge regarding it may incorporate its use in their routine clinical practices in a safe way.

Characteristics of persons with hand osteoarthritis visiting complementary and alternative medicine providers

ObjectiveTo examine the frequency of Complementary and Alternative Medicine (CAM) in a hand osteoarthritis (OA) population, and to compare demographic and clinical characteristics between persons with hand OA visiting vs. not visiting CAM providers. Methods300 persons with hand OA from the Nor-Hand study responded to questionnaires concerning demographic information, medical assessments and their use of CAM and other therapies. In addition, they answered questions about health-related quality of life, comorbidities, psychological health and joint symptoms. The characteristics of persons visiting vs. not visiting CAM providers were compared using chi-square tests and t-tests or Mann-Whitney tests, as appropriate. ResultsIn total 227 (75.7%) persons with hand OA had used CAM for their joint symptoms and 68 (22.7%) had visited CAM providers. Persons visiting CAM providers reported more severe joint pain when taking all joints into account (mean 4.5 vs. 3.9 on a 0–10 Numerical Rating Scale, p ​= ​0.05) and more frequent use of non-pharmacological interventions, conventional analgesics, opioids, and previous surgery on ligaments and joints compared with persons not visiting CAM providers. Persons visiting CAM providers also reported more comorbidities and anxiety symptoms and they were characterized by having a more approach-seeking behaviour. ConclusionPersons with hand OA in secondary care were frequently visiting CAM providers. Persons visiting CAM providers were characterized by more severe joint symptoms despite the use of non-pharmacological and pharmacological interventions compared with persons not visiting CAM providers.

Use of Complementary and Alternative Medicine for Prostate Cancer among African Americans, African Immigrants and Caribbean Immigrants.

Black men have the highest rate of prostate cancer (PCa) morbidity and mortality in the US, and often receive delayed and/or poorer-quality treatment. This inequity has led many to turn to complementary and alternative medicine/therapies (CAM). However, little is known about the use of these therapies within the Black community. The purpose of this study was to describe types of CAM therapies used, and the reasons behind their use for overall health and PCa treatment and prevention among three groups of Black males, namely African Americans, Caribbean Immigrants and African Immigrants. This study used a mixed-methods design with a quantitative phase (n = 575) followed by a qualitative phase (n = 61) with participants recruited from various parts of the country. Results revealed differences among subgroups in CAM use for overall health and PCa, as well as differences in the types of CAM therapies used and differences in the reasons behind their use. The findings of this study reveal a prevalence of CAM use for overall health and PCa within three different groups of Black men and identifies the specific CAM used. There were significant differences in the types of CAM used by each subgroup for both overall health and PCa. This study also shows that there is value in looking at Black subgroups distinctively, for their rates of CAM use and reasons for use, are distinctly different.

The Role of Complementary and Alternative Medicine in Facial Plastic Surgery.

Complementary and alternative medicine (CAM) has become increasingly popular among facial plastic surgery patients. Over the last few decades, there has been a surge in the use of CAM. Despite the increasing prevalence of CAM, patients may feel uncomfortable discussing these therapies with their physicians, and physicians feel under-equipped to engage in meaningful discussions regarding these nontraditional therapies. This article reviews recent literature on the use of CAM for skin treatment in an attempt to provide additional resource. To date, the evidence to support statistically significant symptom improvement with use of non-traditional therapies remains limited. While preliminary data supports essential oil therapy in some cases, the results of the studies investigating other CAM therapies (traditional Chinese medicine, Ayurveda, and homeopathy) have been mixed and inconclusive.

Complementary and Alternative Medicine for Substance Use Disorders: A Scientometric Analysis and Visualization of Its Use Between 2001 and 2020.

Background: This study aimed to identify frontiers for further studies via brief understanding in complementary and alternative medicine (CAM) for substance use disorders (SUDs).Materials and Methods: Publications on the use of CAM for treating SUDs were retrieved from the Web of Science Core Collection from 2001 to 2020 on July 12, 2020, and visualized by CiteSpace V.Results: A total of 3,807 publications were obtained. The USA, China, and England were the leading research centers. However, India and Pakistan have recently focused on assessing CAM for the treatment of SUDs. Frederick L Altice was found to be the most productive author. Addiction ranked first among the frequently cited journals, which exceeded 1,000. The most common CAM therapies were acupuncture and CAM psychotherapies, such as mindfulness meditation.Conclusion: CAM is gaining attention globally for treating SUDs. CAM psychotherapy and acupuncture are hotspots and deserve further study. Researchers should strengthen peer cooperation in this field.

Therapy-dependent inconsistencies in self-reported use of complementary and alternative medicine in the general population: findings from a longitudinal study

ObjectiveInformation on the use of complementary and alternative medicine (CAM) in the general population is often collected by means of surveys, causing the reliability of data to rely on the...

Medical students use, attitudes towards, and knowledge of complementary and alternative medicine: A scoping review

Introduction: Use of complementary and alternative medicine (CAM) is popular in the general population and medical practitioners may not be fully equipped in their knowledge of CAM to advise patients appropriately. The aim of this paper was to perform a scoping review of current literature describing undergraduate medical student use, attitudes, and knowledge of CAM as a means of better understanding the educational needs of these students. Methods: A systematic search of Medline, PubMed and the Education Resources Information Center (ERIC) databases with keywords related to “complementary and alternative medicine” and “undergraduate medical students” for relevant articles published until August 2020. Results: Of 131 papers identified, 38 underwent full review. It was found 13-80% of medical students use CAM, and overall have a positive attitude towards CAM therapies. Female medical students and those with religiosity had more positive attitudes towards CAM than their male colleagues and those without a religion. Knowledge of CAM is lacking with approximately only half of students feeling they were knowledgeable about CAM therapies. Popular information resources are the Internet and social media, but students expressed they want more teaching of CAM in the undergraduate medical curriculum. Conclusion: Evidence suggests high usage of CAM amongst undergraduate medical students, and positive attitudes towards CAM therapies; however, knowledge of CAM is poor, and students want more CAM teaching to upskill them in counselling patients interested in CAM therapies. Further areas for research include a better understanding of resources medical students use for their knowledge and how gender and religiosity influence attitudes towards CAM.

Headache and migraine clinical practice guidelines: a systematic review and assessment of complementary and alternative medicine recommendations

BackgroundGlobally, 3 billion people suffer from either migraine or tension-type headache disorder over their lifetime. Approximately 50% of American adults suffering from headache or migraine have used complementary and alternative medicine (CAM), however, the quality and quantity of recommendations associated with such therapies across clinical practice guidelines (CPGs) for the treatment and/or management of these conditions are unknown. The purpose of this study was to identify the quantity and assess the quality of such CAM recommendations.MethodsMEDLINE, EMBASE and CINAHL were systematically searched from 2009 to April 2020; the Guidelines International Network and the National Center for Complementary and Integrative Health websites were also searched for eligible CPGs. CPGs were included if they provided any therapy recommendations. Eligible CPGs included those written for adult patients with headache and migraine; CPGs containing CAM recommendations were assessed twice for quality using the AGREE II instrument, once for the overall CPG and once for the CAM sections.ResultsOf 486 unique search results, 21 CPGs were eligible and quality assessed; fifteen CPGs mentioned CAM, of which 13 CPGs made CAM recommendations. The overall CPG assessment yielded higher scaled domain percentages than the CAM section across all domains. The results from highest to lowest were as follows (overall, CAM): clarity of presentation (66.7% vs. 50.0%), scope and purpose (63.9% vs. 61.1%), stakeholder involvement (22.2% vs. 13.9%), rigour of development (13.5% vs. 9.4%), applicability (6.3% vs. 0.0%), and editorial independence (0.0% vs. 0.0%).ConclusionsOf the eligible CPGs, the CAM sections were of lower quality compared to the overall recommendations across all domains of the AGREE II instrument. CPGs that scored well could serve as a framework for discussion between patients and healthcare professionals regarding use of CAM therapies in the context of headache and migraine.

Opinions of Turkish parents of children with autism spectrum disorder on use of complementary and alternative medicine methods

BackgroundThe use of CAMs is increasing in the pediatric population with chronic diseases. Culture may affect parents' choice of CAM. This study was conducted to determine the prevalence of using complementary and alternative medicines (CAMs) in children with Autism Spectrum Disorder (ASD) in Turkey and to evaluate their parents’ these practices and opinions on them. MethodThis exploratory and descriptive study was conducted between January and May 2019 with parents of 109 ASD children living in a province in Turkey. The data were collected using a “Socio-demographic information form” and a “Self-report form about CAM usage.” Numbers, percentages, and chi-square analysis were used to analyze the data. ResultsIt was found that 67.0 % of 109 children with autism used CAMs. It was determined that a total of 12 CAMs were used, and the most popular CAM therapy was spiritual relaxation techniques (prayers) (69.8 %), followed by probiotic supplements (49.3 %), vitamin supplements (38.4 %), equine-assisted therapy (34.2 %), music therapy (31.5 %), gluten-free diets(27.4 %). It was reported that CAM therapies had positive effects on children’s communication, behavior, learning, and health. ConclusionsThe study found that more than half of the Turkish parents with children with autism used CAM therapies. Healthcare providers should be aware of the high prevalence of using CAMs in children with ASD and inform parents about CAMs through regular and continuous training programs based on evidence-based practices.

The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease.

Uremic toxins (UTs) are mainly produced by protein metabolized by the intestinal microbiota and converted in the liver or by mitochondria or other enzymes. The accumulation of UTs can damage the intestinal barrier integrity and cause vascular damage and progressive kidney damage. Together, these factors lead to metabolic imbalances, which in turn increase oxidative stress and inflammation and then produce uremia that affects many organs and causes diseases including renal fibrosis, vascular disease, and renal osteodystrophy. This article is based on the theory of the intestinal–renal axis, from bench to bedside, and it discusses nonextracorporeal therapies for UTs, which are classified into three categories: medication, diet and supplement therapy, and complementary and alternative medicine (CAM) and other therapies. The effects of medications such as AST-120 and meclofenamate are described. Diet and supplement therapies include plant-based diet, very low-protein diet, probiotics, prebiotics, synbiotics, and nutraceuticals. The research status of Chinese herbal medicine is discussed for CAM and other therapies. This review can provide some treatment recommendations for the reduction of UTs in patients with chronic kidney disease.

Complementary and Alternative Medicine Use in a Pregnant Population, Northwest Ethiopia.

Background Complementary and alternative medicine (CAM) appears to be the source of healthcare particularly in the majority of pregnant communities of Africa due to its intrinsic qualities as well as its accessibility and affordability. Despite acknowledged benefits of CAM use in pregnancy, majority of users are unaware of its safety and effects on fetal development. The present study was aimed at examining CAM use among pregnant women in Northwest Ethiopia to provide an opportunity for future investigations on the effectiveness of CAM modalities in the management of pregnancy-related complications across the country. Methods This was an institution-based cross-sectional study which was conducted at Poly Clinic Health Center in the Northwest part of Ethiopia between March and May 2018. Two hundred and eighty two Ethiopian women were conveniently recruited to take part in the study. Structured questioners were used for the survey. Descriptive statistics of sociodemographic and CAM use characteristics were expressed in frequencies and proportions. Chi-square test was performed to determine the difference between CAM user and nonuser. Besides, binary logistic regression analyses were performed to examine predictors of CAM use in the study population. The result was considered statistically significant if P value ≤ 0.05. Results The prevalence rate of CAM use in pregnant women was 89.36% with the commonest practice of spiritual healing (65.2%) and herbal supplement (51.8%) CAM therapies. Use of CAM positively associated with marital status and previous number of children. The odds of using CAM among single/not married women were 3.22 times higher (COR: 3.22, CI: 1.07-9.64) as compared to married women. Pregnant women with no children were 3.30 times more likely (COR: 3.30, CI: 0.92-11.84) to use CAM than those women having ≥3 children. Lower odds of using CAM significantly associated with educational level (COR: 0.20, CI: 0.046-0.93) and antenatal care (COR: 0.45, CI: 0.18-1.13) in a binary logistic regression model. Conclusions A considerable number of pregnant women were utilizing CAM including herbal products as part of their maternity care. This finding provides a reference on the use of CAM for policy-makers, health professionals, and parents. Further studies are needed to investigate the effectiveness and safety of specific CAM modalities with particular focus on herbal medicinal products.