Complementary Medicine Research Articles

Are Virtual Complementary and Integrative Therapies as Effective as In-Person Therapies? Examining Patient-Reported Outcomes Among Veterans with Chronic Musculoskeletal Pain.

Background: Virtual complementary and integrative health (CIH) therapy availability increased during the COVID-19 pandemic, but little is known about effectiveness. We examined the perceived effectiveness of in-person and virtual CIH therapies for patients with chronic musculoskeletal pain who recently started using CIH therapies. Methods: The sample included Veterans (n = 1,091) with chronic musculoskeletal pain, identified in the Veterans Health Administration's electronic health record based on initiation of CIH therapy use, who responded to VA's Patient Complementary and Integrative Health Therapy Experience Survey during March, 2021, to August, 2022. Using multivariable models with self-guided virtual (apps or videos) delivery as the reference, we compared patient-reported outcomes (pain, mental health, fatigue, and general well-being) associated with any yoga, Tai Chi/Qigong, or meditation use delivered: (1) only in-person, (2) only virtually with a live provider, (3) only virtually self-guided, (4) virtually self-guided + virtually provider-guided, or (5) hybrid in-person + virtual (self-or provider-guided). Results: Under 10% of Veterans reported only in-person use; 54% used only virtual formats and 36% a hybrid of in-person and virtual. Forty-one percent reported improvement in general well-being, 40.6% in mental health, 37.1% in pain, and 22.7% in fatigue. Compared with Veterans using only self-guided virtual CIH therapies, Veterans using only in-person therapies were more likely to report improvement in fatigue (odds ratio [OR]: 1.8, confidence interval [CI]: 1.1-3.1) and general well-being (OR: 1.7, CI: 1.0-2.6). Conclusions: Many patients perceived health improvements from CIH therapies, with in-person users reporting more improvement in fatigue and well-being than those using virtual sessions and similar improvements in pain and mental health for in-person and hybrid users.

Traditional and Complementary Medicine Use among Cancer Patients in Asian Countries: A Systematic Review and Meta-Analysis.

Globally, cancer patients frequently use T&CM during their treatment for various reasons. The primary concerns regarding the use of T&CM among cancer patients are the potential risks associated with interactions between pharmaceuticals and T&CM, as well as the risk of noncompliance with conventional cancer treatments. Despite the higher prevalence of T&CM use in Asia, driven by cultural, historical, and resource-related factors, no prior review has tried to estimate the prevalence and influencing factors of T&CM use and disclosure among cancer patients in this region. This study aims to examine the prevalence and disclosure rates of T&CM use among cancer patients in Asia to assess various factors influencing its use across different cancer treatment settings in Asia. Systematic research on T&CM use was conducted using four databases (PubMed, EMBASE, Web of Science, and CINAHAL) from inception to January 2023. Quality was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS). A random effects model was used to estimate the pooled prevalence of T&CM use, and data analysis was performed using Stata Version 16.0. Among the 4849 records retrieved, 41 eligible studies conducted in 14 Asian countries were included, involving a total of 14,976 participants. The pooled prevalence of T&CM use was 49.3%, ranging from 24.0% to 94.8%, and the disclosure rate of T&CM use was 38.2% (11.9% to 82.5%). The most commonly used T&CM modalities were herbal medicines and traditional medicine. Females were 22.0% more likely to use T&CM than males. A subgroup analysis revealed the highest prevalence of T&CM use was found in studies conducted in East Asia (62.4%) and those covered by both national and private insurance (55.8%). The disclosure rate of T&CM use to physicians remains low. Moreover, the factors influencing this disclosure are still insufficiently explored. Since the disclosure of T&CM use is a crucial indicator of patient safety and the quality of cancer treatment prognosis, future research should focus on identifying the determinants of non-disclosure.

How to use alternative medicine in the 21st century part II

How to use alternative medicine in the 21st century part II

Exploring the Mechanisms that Allow Incompatible Beliefs to Coexist in the Cognitive System.

Despite assumptions that people strive for consistency between their beliefs, endorsement of mutually incompatible ones is not rare - a tendency we have previously labelled doublethink, by borrowing from Orwell. In an attempt to understand the nature of doublethink and the underlying mechanism that enables incompatible beliefs to coexist, we conducted two preregistered studies (total N = 691). To do so, in Study 1, we first explored how doublethink relates to (1) thinking styles (rational/intuitive, actively open-minded thinking, and need for cognitive closure), (2) a set of irrational beliefs (magical health, conspiratorial, superstitious, and paranormal beliefs) and (3) its predictiveness for questionable health practices (non-adherence to medical recommendations and use of traditional, complementary and alternative medicine). We then additionally expanded the set of health behaviors in Study 2, and related doublethink to trust in two epistemic authorities - science and the wisdom of the common man. Finally, in both studies, we explored whether those prone to inconsistent beliefs are also more likely to simultaneously rely on conventional and alternative medicine, despite their apparent incompatibility. While doublethink was positively related to need for cognitive closure and different irrational beliefs that easily incorporate contradictions, as well as negatively to actively open-minded thinking, we did not find it to be predictive of the use of non-evidence-based medicine nor of its simultaneous use with official medicine. It seems that this novel construct can be best understood as a feature of the cognitive system that allows incompatible claims to enter it. However, once beliefs are within the system, they are compartmentalized, without any cross-referencing between them. This is further reflected in non-evidence-based beliefs persisting within the belief system, irrespective of their content.

Complementary and Alternative Therapies for Genitourinary Syndrome of Menopause : An Evidence Map.

Women seeking nonhormonal interventions for vulvovaginal, urinary, and sexual symptoms associated with genitourinary syndrome of menopause (GSM) may seek out complementary and alternative medicine or therapies (CAMs). To summarize published evidence of CAMs for GSM. Ovid MEDLINE, EMBASE, and CINAHL from inception through 11 December 2023. Randomized controlled trials (RCTs) 8 weeks or more in duration that evaluated the effectiveness or harms of CAMs for postmenopausal women with GSM and reported 1 or more outcomes of interest, with sample sizes of 20 or more participants randomly assigned per group. Data were abstracted by 1 reviewer and verified by a second. An evidence map approach was used to organize and describe trials. Studies were organized by type of intervention, with narrative summaries for population, study characteristics, interventions, and outcomes. Fifty-seven trials were identified that investigated 39 unique interventions. Studies were typically small (n < 200), and most were done in Iran (k = 24) or other parts of Asia (k = 9). Few trials evaluated similar combinations of populations, interventions, comparators, or outcomes. Most studies (k = 44) examined natural products (that is, herbal or botanical supplements and vitamins), whereas fewer reported on mind and body practices (k = 6) or educational programs (k = 7). Most studies reported 1 or 2 GSM symptoms, mainly sexual (k = 44) or vulvovaginal (k = 30). Tools used to measure outcomes varied widely. Most trials reported on adverse events (k = 33). Only English-language studies were used. Effect estimates, risk of bias, and certainty of evidence were not assessed. There is a large and heterogeneous literature of CAM interventions for GSM. Trials were small, and few were done in North America. Standardized population, intervention, comparator, and outcomes reporting in future RCTs are needed. Agency for Healthcare Research and Quality and Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42023400684).

Multi-targeted action of rooibos may protect against ischaemic stroke-induced neurological deficit and endothelial dysfunction

Ethnopharmacological relevanceIndigenous use communities in the Western Cape (South Africa) where Aspalathus linearis (Brum.f) R.Dahlgren - or rooibos - grows naturally, has a long history of using rooibos for medicinal purposes. Apart from its well-known antioxidant effect, the Cederberg community in particular has been using rooibos as a treatment for high blood pressure. Given the detrimental effects of high blood pressure on endothelial cells, rooibos may either directly or indirectly affect vascular health. This, together with more recent reports of neuroprotective effects, may position rooibos as complementary medicine in related vascular conditions such as ischaemic stroke. Aims of the studyThe study aimed to evaluate the potential benefit of acute administration of unfermented rooibos, on vascular health in a larval zebrafish model of stroke. Materials and methodsStroke was induced via 24-h ponatinib exposure, in the presence or absence of an aqueous solution of an ethanolic extract of unfermented Rooibos (GreenOxithin™). The magnitude of stroke was assessed by monitoring larval locomotion and thrombus formation. In terms of specific mechanisms probed, changes in redox status (MDA and TEAC), neurological markers (TH and NeuroD1) and endothelial health (tight/adhesion junction protein expression) were assessed. ResultsRooibos treatment limited thrombus formation and prevented stroke-induced deficits on larval motility. In terms of redox status, rooibos treatment prevented lipid peroxidation 3 days after initial stroke induction, reducing the need for significant upregulation of endogenous antioxidant mechanisms. Stroke-induced changes in neuronal (NeuroD1 and TH) protein expression were normalized in the presence of rooibos, suggesting a neuroprotective role. In terms of tight junction proteins, stroke-related decreases in ZO-1 expression were again prevented by rooibos treatment. In addition, rooibos treatment may beneficially modulate levels of claudin-5 and VE-cadherin, to indirectly limit stroke-associated vascular dysfunction. ConclusionsTaken together, activity data and physiological assessments suggest that unfermented rooibos may indeed have benefit in the context of stroke, via action at multiple targets. Thus, current data further our understanding of the mechanisms of actions of rooibos and warrant future research to confirm sufficient bioavailability of rooibos in target tissues, in mammalian systems.

Investigation of The Effect of Metal-based Medicine Arsenicum album on Humoral Immune Response in SRBC-immunized Mice.

In complementary and alternative medicinal systems, the Arsenicum album in ultra-high dilution was used in various therapeutic conditions, considering its effects on the body's immune system, including the COVID-19 pandemic. However, scientific evidence regarding its immunomodulatory effects is insufficient. The current study aimed to investigate the immunomodulatory effects of Arsenicum album in an experimental mouse model. Immunomodulatory activity of potentized dilutions of Arsenicum album i.e., 6C, 30C, 200C in BALB/c mice was evaluated by humoral antibody titer and delayedtype hypersensitivity assays wherein a fixed concentration (0.5 ml of 1× 109 cells/ml) of freshly prepared sheep RBC was administered as a foreign antigen to generate primary and secondary antibodies. Arsenicum album showed significant immunomodulatory activity by increasing primary antibody titer evaluated on day 21 of the treatment in all the dilutions as compared to SRBC and vehicle control group in humoral immune response assay without showing any effect on delayed-type hypersensitivity. The results of this preliminary study indicate that oral administration of Arsenicum album has the potential to augment primary humoral response at all dilutions. Hence, the possibility of using the Arsenicum album could be explored to treat immunological conditions, infections, etc., as an alternative therapy alongwith modern medicines.

Economic Burden of Huntington's Disease: Analysis from a Brazilian Tertiary Care Perspective.

Huntington's disease (HD) exerts significant impacts on individuals and families worldwide. Nevertheless, data on its economic burden in Brazil are scarce, revealing a critical gap in understanding the associated healthcare costs. This study was conducted at a tertiary neurology outpatient clinic in Brazil with the aim of assessing annual healthcare service utilization and associated costs for HD patients. We conducted a cross-sectional observational study involving 34 HD patients. A structured questionnaire was applied to collect data on direct medical costs (outpatient services, medications), non-medical direct costs (complementary therapies, mobility aids, home adaptations), and indirect costs (lost productivity, caregiver costs, government benefits) over one year. Significant economic impacts were observed, with average annual direct medical costs of $4686.82 per HD patient. Non-medical direct and indirect costs increased the financial burden, highlighting extensive resource utilization beyond healthcare services. Thirty-three out of 34 HD patients were unemployed or retired, and 16 relied on government benefits, reflecting broader socioeconomic implications. Despite the dataset's limitations, it provides crucial insights into the economic impact of HD on patients and the Brazilian public health system. The findings underscore the urgent need for a more comprehensive evaluation of the costs to inform governmental policies related to HD. Future research is needed to expand the data pool and develop a nuanced understanding of the economic burdens of HD to help formulate effective healthcare strategies for patients.

Pathological complete response of locally advanced triple-negative breast cancer: case report

Background. Triple-negative breast cancer is the most aggressive molecular subtype among breast malignancies. Due to the high proliferative activity of tumor cells and the lack of targets for targeted therapy, neoadjuvant chemotherapy plays the main role in complex treatment of this subtype. The optimal time to start neoadjuvant chemotherapy is defined as less than 8 weeks. Delays in time to treatment initiation may adversely affect treatment outcomes, as well as cause local or systemic disease progression. Achieving complete pathological response after neoadjuvant chemotherapy reduces the relative risk of relapse by more than 70 %, which, in turn, leads to a significant improvement in long-term survival of these patients. Description of the clinical case. A 32-year-old woman came to the clinic 15 months after being diagnosed with triple-negative breast cancer. The patient was treated with alternative medicine methods for 15 months, and upon admission to the hospital, the patient had pronounced local tumor growth with massive decay, tumor lysis syndrome and nutritional disorders. We decided to perform neoadjuvant chemotherapy: 12 cycles of weekly paclitaxel + carboplatin, followed by 4 cycles of dose-dense doxorubicin + cyclophosphamide. Chemotherapy resulted in a significant reduction in tumor size and improvement of health status of the patient. There were no clinically significant side effects requiring hospitalization or dose reduction. Upon completion of neoadjuvant treatment, the patient underwent mastectomy. The histological examination revealed a complete pathological response of the primary tumor and regional lymph nodes. The patient underwent adjuvant external beam radiation therapy. The patient is alive 3 years after diagnosis and 1.5 years after treatment completion. She plans delayed breast reconstruction with contralateral breast augmentation. Conclusion. This is a rare case of locally advanced triple-negative breast cancer with pathological complete response to neoadjuvant chemotherapy 15 months after diagnosis.

When assisted reproductive technology (ART) opens the door for inclusivity in a highly charged cultural milieu: an exploration of news articles on the establishment of ART clinics in Zimbabwe

The study focuses on how infertility and assisted reproductive technology (ART) have been portrayed in the Zimbabwean print news media, specifically looking at articles related to the country’s two private fertility clinics established in 2016 and 2017 respectively. Through thematic analysis of 35 news articles, seven prominent themes were developed: infertility as an undesirable and stigmatised condition; stress and the feminisation of infertility; the impact of societal and familial pressure to have children; ART as a ray of hope for infertile couples; growing acceptance of ART; availability, accessibility and affordability of ART; and the use of alternative medicines to cure infertility. The research highlights the coexistence of traditional medicine and ART in Zimbabwe, as well as the impact of stigma, pressure, and gender dynamics on infertile couples. Study findings signal how costly ART treatments may drive individuals towards potentially harmful traditional remedies. They also underscore the need for increased awareness of infertility, efforts to reduce stigma, and addressing barriers to ART access, particularly for men. Overall, findings shed light on the complexities surrounding infertility in Zimbabwe and the importance of addressing these issues in pursuit of better reproductive healthcare outcomes.

Hypertensive patients' experience of care: a qualitative study

Hypertension is an incurable disease, requiring patients to comply with treatment in order to reduce the risk of complications, including death. Therefore, this study aimed to explore the experience of individuals with hypertension in relation to compliance with treatment.The study adopted a qualitative descriptive design using semi-structured questions, and a total of 20 patients with hypertension participated.The result of this study found 5 themes, namely, not taking the medication regularly, adhering to a diet, using complementary medicine, stable blood pressure, and dizziness as the primary complaint.There were significant and exciting results from this study, namely, patients who do not take medication regularly and do not adhere to their diet.

Nonpharmacologic Treatment Options in Pediatric Tension-Type Headache Patients: A Systematic Review.

Objective: This systematic review aims to examine effects of nonpharmacologic treatment options for pediatric tension-type headache patients as well as evaluate current results from these treatment options. Background: Headache is a worldwide problem among both adults and children, with tension-type headache among the most common. Methods: Eighteen relevant studies were found using PubMed and evaluated in this review. These include therapy programs, biofeedback, alternative medicine, strength exercise, physical therapy, mindfulness therapy, and psychotherapy. Results: Several nonpharmacologic treatment methods showed improvement in pediatric headache patients, with few reported adverse effects. This suggests that nonpharmacologic treatment is safe for use and might have an effect in most cases. Conclusion: No single intervention has been proven superior to another, and some studies would need replication with a control group to confirm the findings. This study illustrates the variety of nonpharmacologic treatment options and the importance of future research on this topic.

A Medico-Sociological Study on Postpartum Depression: Wedum Gei Sanniya

Postpartum depression is a medical condition faced by some mothers during pregnancy, influenced by cultural values and norms in the Asian Sri Lankan context. This research aimed to investigate the medical and sociological aspects of the healthcare system and treatment conditions for postpartum depression. A sample of 25 respondents, including 20 people from rural and urban areas, was selected for the study. Data analysis was conducted using 20 in-depth interviews and 5 semi-structured interviews. The study found a clear difference between traditional treatment methods in the western medical system and traditional methods in Sri Lankan rural society. About 40% of the sample resorted to treatment in the rural knowledge system, while the remaining 60% relied solely on western medicine. In rural Sri Lankan society, postpartum depression is analyzed through supernatural forces and interpersonal relationships, with chemical methods being used for remedies. However, postpartum depression in urban society tends to shift away from indigenous wisdom-based cultural healing systems and towards Western medical treatments. The research findings suggest that while Western medicine is used in environments affected by modernization and urbanization, alternative medicine is still used in rural areas. The power of the Western medicine system in Sri Lanka should be examined, as it may continue to be based on modernity and urbanization.

Antilipidemic Effect of Ethanolic Extract of Aloe barbadensis Gel, Cymbopogon citratus Leaves and Its Combination on Alloxan Induced Diabetic Rats

This research sought to investigate the antilipidemic effect of ethanolic extract of Aloe barbadensis, Cymbopogon citratus leaves and its equal combination on induced-alloxan diabetic rat. Plants like Aloe barbadensis and Cymbopogon citratus are commonly used as home remedies for some diseases such as diabetes thereby making them alternative medicines. Ethanolic extract of both plants was extracted using 70% ethanol. The effect of glibenclamide, ethanolic extract of A. barbadensis gel, C. citratus leaves and its combination after 21 days experimental study showed a significantly increased (P&lt;0.05) high density lipoprotein (HDL) in the induced rats when in comparison with the normal control and diabetic untreated rats. The low density lipoprotein (LDL) significantly showed a (P&lt;0.05) decrease in the rats treated with A. barbadensis gel, C. citratus leaves and its combined extract compared with those treated with standard drug. The serum total cholesterol (TCHOL), triglyceride (TG) and very low density lipoprotein (VLDL) significantly showed a (P&lt;0.05) decrease in the rats treated with A. barbadensis gel, C. citratus leaves and its combined extract compared with diabetic untreated rats. This research revealed that ethanolic extract of A. barbadensis, C. citratus and its combination has antilipidemic effects and holds potential as an alternative therapy for its management.

Knowledge and attitude of the Jordanian community towards the use of medicinal herbs during COVID-19 pandemic: Females vs males perspective point of view

This paper examines the knowledge and attitudes towards complementary and alternative herbal medicine among the Jordanian population by gender during the COVID-19 outbreak. A cross-sectional self-reported survey conducted over two months included 419 participants in Jordan. Data were gathered and analyzed using SPSS V22. The results show that 65.4 % of participants used herbal medicine for COVID-19 symptoms, with higher usage among females (70.7 %) compared to males (51.3 %). For prevention, 44.4 % of participants used herbal medicine, with 78.5 % being females. Commonly used remedies included Anise, Chamomile, Ginger, Mint, Green Tea, and Thyme, with females using them more frequently. The average knowledge level was 72.08 %, with males (77.4 %) scoring higher than females (70.1 %). The knowledge level did not significantly vary across sociodemographic characteristics. Participants aged 19–25 showed less confidence in herbs for prevention, likely due to better health and fewer chronic conditions. A wide range of remedies was cited, and the primary sources of herbs were herbalists and affordable options. Family and friends were the main sources of information, with less reliance on the internet or professionals. The most common preparation methods were boiling or infusion. The study highlights the need for more education from professionals and enhancing the credibility of web-based health information.

Global trends in acupuncture research: A scientometric analysis from 1980 to 2023.

The objective of this study was to examine articles on acupuncture from past to present, revealing prevalent research trends, showcasing global productivity, identifying international collaborations, and highlighting influential publications and journals in the field. We acquired a comprehensive dataset comprising 9340 articles pertaining to acupuncture that were published within the time frame spanning from 1980 to 2023. These articles were sourced from the Web of Science and underwent rigorous analysis through a diverse set of bibliometric techniques. Our analytical approaches encompassed trend keyword analysis, thematic evolution analysis, conceptual structure analysis, factor analysis, citation and co-citation analyses, as well as an exploration of international collaboration patterns. The 3 most productive countries were China (n = 3357), the USA (n = 1351), and South Korea (n = 814). The 3 most productive journals were Acupuncture in Medicine (n = 440), Evidence Based Complementary and Alternative Medicine (n = 415), and Medical Acupuncture (n = 400). The 3 journals with the highest h-index on acupuncture were the Journal of Alternative and Complementary Medicine (h = 45), Pain (h = 41), and the American Journal of Chinese Medicine (h = 35). The most active author was Park Hi-Joon (n = 128). According to the findings of the factor analysis, acupuncture literature was grouped around 3 main subfactors. The primary factor encompassed topics related to the effectiveness/applicability of the treatment method for various medical conditions and general principles of acupuncture methods and points. The second factor covered topics related to mental health and quality of life. The third subfactor addressed the qualitative and quantitative analysis direction of acupuncture, such as meta-analysis and systematic reviews, and randomized controlled trials. From the past to the present, the most extensively researched main topics in acupuncture literature have covered a wide range of subjects. Prominent themes among these topics included acupuncture methods and applications, pain management, the nervous system and acupuncture, mental health and acupuncture, quality of life, and general health. In recent years, emerging trends in acupuncture research have focused on neurological health issues, oncology and cancer treatment, women's health and hormonal issues, sleep problems, digestive issues, and studies related to the quantitative and qualitative evaluation of acupuncture research.

Complementary and Alternative Therapies (CATs) in Nursing Education in Spanish Universities.

The use of complementary therapies in the general population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our aim was to investigate Spanish universities that offer subjects on complementary therapies in their nursing degree programs. This study is an observational, descriptive, cross-sectional study. For this purpose, we used a document published on the website of the Ministry of Universities as the working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches. Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, 27.5% (11) are public universities and 22.7% (5) are private universities, most of them being optional subjects. The training content on complementary care in nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization.

Phytochemical profiles, bioactivities, and molecular docking and molecular dynamics approaches of endemic Campanula baskilensis Behçet (campanulaceae)

Campanula species have phenolic derivatives with a broad biological potential. This study aimed to investigate the chemical contents, bioactivities, and prediction of the biological effect mechanism using the molecular docking study for C. baskilensis (CB) leaf (L), root (R), and stem (S) extracts.CBL gave the highest phenolic contents as hesperidin at 7.56 mg/g extract. Total phenolic and flavonoid contents of CBS were determined as 3.12 ± 0.05 mg GAE/g and 1.11 ± 0.11 mg QE/g, respectively. CBS and CBL exhibited high DPPH• scavenging, H2O2 scavenging, AChE, BChE, carbonic anhydrase, lipase, and tyrosinase inhibition effects and demonstrated potent antimicrobial activity. The strong phenolic components of CBS and CBL extracts contributed to their biological activities. According to the molecular docking results, a high inhibition effect was observed on the inhibition activities due to the presence of hesperidin, which is the highest main component of the extracts. Additionally, docking studies were performed on hesperidin for the first time. Dynamics study showed that the interaction between the hesperidin and BChE increased stability, producing a stable complex form within 100 ns. In conclusion, C. baskilensis extracts, especially hesperidin, may be promising potential sources for neurological diseases and complementary medicine.

IMPROVING KNOWLEDGE AND EMPOWERMENT OF PITASIDIA HEALTH CADRES ABOUT MEDICINAL PLANTS IN PATIENTS WITH DIABETES MELLITUS AND HYPERTENSION IN SINGOTRUNAN VILLAGE, BANYUWANGI SUB-DISTRICT, BANYUWANGI DISTRICT

Hypertension (HT) and Diabetes Mellitus type 2 (DM2) are the two most common non-communicable diseases in East Java, Indonesia. Therefore, there is a need for outreach about these two diseases and the use of herbal plants as complementary therapy. educational and learning practices are needed to be able to understand these two diseases and be able to make good herbal preparations such as Centella asiatica and Hibiscus sabdariffa so that the chemical compounds are not damaged. To provide education about HT and DM, herbal plant processing practices, and understanding the importance of regular health checks. The activity was conducted in Singotrunan Village, Banyuwangi Sub-district, Banyuwangi Regency, East Java Province. The stages of community service consist of preparation, implementation, and evaluation. The evaluation results showed that there was a 90% increase in the level of understanding after providing education on DM prevention, HT, and medicinal plants. Routine health checks found that most of the correspondents had random blood glucose levels and normal blood pressure. There was an increase in respondents' knowledge about hypertension and diabetes mellitus and the use of medicinal plants in helping the treatment of these diseases.

Recent Advances in Allergic Rhinitis: A Narrative Review.

Allergic rhinitis (AR) is a prevalent chronic respiratory condition characterized by nasal inflammation, sneezing, congestion, and itching, significantly impacting quality of life. Over recent years, considerable advancements have been made in understanding the pathophysiology, diagnosis, and management of AR. This narrative review aims to synthesize these recent developments, providing a comprehensive overview of key areas. Emerging insights into AR pathophysiology have elucidated the complex interplay between genetic predisposition, environmental factors, and immune system dysregulation. Notably, the role of the epithelial barrier and the microbiome in AR pathogenesis has garnered increasing attention, offering potential targets for novel therapies. Advances in diagnostic technologies, such as component-resolved diagnostics and molecular allergology, have enhanced the precision of allergy identification, enabling more personalized treatment approaches. In terms of management, significant progress has been made in pharmacological and non-pharmacological treatments. Novel biologics targeting specific pathways involved in AR, including monoclonal antibodies against immunoglobulin (Ig)E and interleukin (IL)-4/13, have shown promise in reducing symptoms in refractory cases. Additionally, there has been a resurgence in interest in non-pharmacological strategies, including allergen avoidance, immunotherapy, and complementary therapies, which offer holistic options for patient care. The integration of digital health tools and mobile applications in AR management has further empowered patients, allowing for real-time symptom tracking and personalized treatment adjustments. Recent guidelines emphasize a multidisciplinary approach to AR management, promoting integrated care models that involve collaboration between allergists, primary care providers, and other specialists. These guidelines also highlight the importance of patient-centered care, advocating for shared decision-making and tailored treatment plans based on individual patient profiles. In conclusion, the landscape of allergic rhinitis management is rapidly evolving, with ongoing research and innovation paving the way for improved outcomes. This review underscores the importance of staying abreast of these advances to optimize the care and quality of life for individuals affected by allergic rhinitis.