Conventional Medical Treatment Research Articles

Dural venous sinus angioplasty and stenting for treatment of idiopathic intracranial hypertension: a single-center experience with 20 consecutive cases

Background: Dural venous sinus stenosis has been shown to be a potential cause or aggravating factor of idiopathic intracranial hypertension (IIH). Endovascular therapy for angioplasty of venous sinus stenosis is emerging as a potential alternative to treat IIH. Objective: This article aims to present the results of a cases series representing the experience of a single center in treating this disease. Materials and Methods: We retrospectively reviewed the angiographic and manometric data of patients undergoing angioplasty and stenting for the treatment of IIH with venous sinus stenosis on magnetic resonance angiography. All patients had failed conventional medical treatment. Data on demographic features, clinical and radiologic presentation, and outcomes were collected retrospectively. Results: 20 female patients, with persistent headache and papilledema, underwent venous sinus angioplasty and stenting. Mean age was 35.9 (SD, 10) years. Eighteen patients (90%) had clinical improvement after the procedure. Of these, all showed resolution (17 patients, 94%) or partial improvement (1 patient, 6%) of papilledema within 6 months. Two patients had persistent moderate-to-severe headache (intensity > 6 on a 10-point pain scale), with continued papilledema despite stable visual acuity on visual field testing. The mean pre-procedure lumbar puncture opening pressure was 30.1 (SD, 4) mm Hg, decreasing to 16.2 (SD, 4) mm Hg after the procedure. Only 4 patients experienced complications directly or indirectly related to the procedure, with no impact on outcome. Conclusion: Angioplasty and stenting of the stenotic segment may effectively and safely treat IIH associated with focal venous sinus stenosis, with a high technical success rate and an acceptable complication rate.

Herbal Remedies Effective on Treating Idiopathic Pulmonary Fibrosis

Idiopathic Pulmonary Fibrosis (IPF) poses a significant challenge in the realm of respiratory diseases, characterized by progressive lung scarring and compromised breathing function. While conventional medical interventions provide some relief, the exploration of complementary therapies has gained traction, and herbal remedies stand out as a promising avenue. This abstract delves into the efficacy of numerous herbal remedies in the treatment of IPF, shedding light on their potential impact on disease progression and symptom management. Turmeric, derived from Curcuma longa, emerges as a golden healer due to its anti-inflammatory and antioxidant properties, with curcumin exhibiting promise in mitigating lung inflammation and fibrosis. Boswellia serrata, or Indian frankincense, demonstrates anti-inflammatory effects through boswellic acids, suggesting its potential role in suppressing pathways leading to fibrosis. Gingko biloba, renowned for enhancing blood circulation, may contribute to improved oxygenation in individuals with IPF, offering support for compromised lung function. Licorice root, with its anti-inflammatory and expectorant qualities, presents a potential ally in soothing inflammation associated with IPF. Green tea, rich in antioxidants like catechins, shows promise in protecting lung tissues from oxidative stress and inflammation. This abstract emphasizes the importance of caution in integrating herbal remedies, particularly licorice root, and encourages consultation with healthcare professionals to ensure safety, especially in individuals with pre-existing conditions like high blood pressure. In conclusion, the integration of herbal remedies into the treatment paradigm for IPF presents a holistic approach to addressing the complexities of this debilitating condition. As ongoing research explores the mechanisms and efficacy of these herbal interventions, the potential for natural remedies to play a crucial role in managing idiopathic pulmonary fibrosis continues to offer hope for improved patient outcomes.

INTEGRATING YOGA INTO MENTAL HEALTH CARE: ENHANCING HOLISTIC WELL-BEING

Yoga is a holistic practice that originated in ancient India and has evolved over thousands of years. It encompasses physical postures (asanas), breathing exercises (pranayama), meditation, and ethical principles aimed at achieving harmony between the mind, body, and spirit. Yoga offers numerous benefits, including improved flexibility, strength, balance, stress reduction, relaxation, and mental clarity. It is practiced by people of all ages and backgrounds worldwide, with various styles and approaches catering to different needs and preferences. Beyond its physical aspects, yoga is often embraced as a lifestyle that promotes overall well-being and inner peace. Yoga in mental health care refers to the integration of yoga practices, such as physical postures (asanas), breathing techniques (pranayama), meditation, and mindfulness, into therapeutic interventions for individuals dealing with mental health challenges. It aims to promote emotional regulation, stress reduction, improved self-awareness, and overall well-being as adjunctive or complementary treatments alongside traditional mental health interventions. Yoga in integrative medicine refers to the incorporation of yoga practices into a holistic approach to healthcare that combines conventional medical treatments with complementary and alternative therapies. Integrative medicine emphasizes treating the whole person—mind, body, and spirit—to promote overall health and wellness. Yoga, with its focus on physical postures, breathing techniques, meditation, and mindfulness, can play a significant role in managing various health conditions and enhancing overall well-being when integrated into an integrative medicine approach. Yoga in integrative mental health care involves the incorporation of yoga practices, such as physical postures, breathing exercises, meditation, and mindfulness, into a comprehensive approach to mental health treatment. Integrative mental health care emphasizes treating the whole person and considers various factors contributing to mental well-being, including biological, psychological, social, and spiritual aspects. Yoga can be used as an adjunctive or complementary therapy alongside conventional mental health treatments like psychotherapy and medication. It offers a range of benefits for mental health, including stress reduction, anxiety and depression management, improved mood regulation, increased self-awareness, and enhanced emotional resilience. In integrative mental health care settings, yoga practices are often tailored to meet the specific needs and preferences of individuals with mental health concerns. Yoga sessions may be conducted in group settings or one-on-one sessions with trained instructors who can adapt the practice to accommodate different levels of ability and comfort. Research has shown promising results regarding the effectiveness of yoga in improving various mental health outcomes, making it a valuable component of integrative mental health care approaches aimed at promoting holistic well-being.

What is the state of the art on traditional medicine interventions for zoonotic diseases in the Indian subcontinent? A scoping review of the peer-reviewed evidence base

BackgroundTraditional medicine (TM) interventions are plausible therapeutic alternatives to conventional medical interventions against emerging and endemic zoonotic diseases, particularly in low-and middle-income countries that may lack resources and infrastructure. Despite the growing popularity in the usage of TM interventions, their clinical safety and effectiveness are still contested within conventional healthcare in many countries.MethodsWe conducted a scoping review of the peer-reviewed literature that synthesises and maps the evidence on TM interventions for the treatment and prevention of zoonoses on the Indian subcontinent. The region, a global hotspot of biodiversity and emerging infections, is characterised by high prevalence of TM use. Based on the scientific literature (mostly case study research, n=l06 studies), our review (1) maps the scope of the literature, (2) synthesises the evidence on the application of TM interventions for zoonoses, and (3) critically reflects on the state of TM and identifies areas for future research focus.ResultsThe evidence synthesis confirmed widespread usage of TM interventions for zoonoses on the subcontinent, with the majority of research reported from India (n=99 studies, 93.4%), followed by Pakistan (n=3 studies, 2.8%), Bangladesh (n=2 studies, 1.9%), and Sri Lanka (n=1, 0.9%). Most of the reviewed studies reported on ethno-medicinal uses of plant species, primarily for treating dengue (n=20 studies), tuberculosis (n=18 studies), Escherichia coli infection (n=16 studies), lymphatic filariasis and cholera (n=9 apiece). However, the evidence on the safety and effectiveness of these reported TM interventions is limited, indicating that these data are rarely collected and/or shared within the peer-reviewed literature.ConclusionThis review thus highlights that, whilst TMs are already being used and could offer more widely accessible interventions against emerging and endemic zoonoses and ectoparasites, there is an urgent need for rigorous clinical testing and validation of the safety and effectiveness of these interventions.

Critically Ill Patients with COVID-19 Pneumonia Requiring Continuous Renal Replacement Therapy with oXiris® Membrane in a Third-Level Hospital in Northeast Mexico

Introduction: The coronavirus disease 2019 (COVID-19) pandemic represented a global public health problem with devastating consequences that have challenged conventional medical treatments. Continuous renal replacement therapy (CRRT), based on a spectrum of modalities and dialysis membranes, can modify cytokine storms, and improve the clearance of inflammatory factors. As severe COVID-19 can lead to acute kidney injury (AKI) requiring RRT, most patients require more than one extracorporeal organ support at this point. This is due to complications that lead to organ dysfunction. The aim of our study was to assess renal recovery and survival while use of the oXiris membrane, as well as a decrease in vasopressors and hemodynamic parameters. Methods: This was a retrospective, observational study. The population included adult patients (aged >18 years) with a real-time PCR COVID-19 positive test, admitted to the intensive care unit (ICU) with AKI KDIGO 3, which required CRRT, in a hospital in northern Mexico. The primary outcomes were renal recovery and survival, and the secondary outcomes were a decrease in the vasopressor requirements and changes in the hemodynamic parameters. Results: Thirteen patients were included from January 2020 to August 2021, all of whom met the inclusion criteria. oXiris, an AN69-modified membrane, was used for blood purification and cytokine storm control in all the patients. The primary outcome, renal recovery, and survival were observed in 23% of the patients. The secondary outcome was a decrease of 12% in the use of noradrenaline in the first 24 h of CRRT initiation with oXiris, in addition to a decrease in creatinine and C-reactive protein levels in all patients. Discussion: The use of the oXiris membrane in patients with severe COVID-19 improved hemodynamic parameters, with 23% of the patients achieving renal recovery. The decrease on the requirement of vasopressors in the overall patients in the first 24 h of CRRT with oXiris was achieved. The mean decrease was of 12%, accompanied by a decrease in inflammatory markers. There is literature on the benefit of CRRT with a modified AN69 membrane in Mexico; however, studies in this regard are scarce, and our research provides valuable information on our experience in this field.

Long-Term Follow-Up Data of Tumor-Induced Osteomalacia Managed with Surgery and/or Radiofrequency Ablation from a Single Center.

Data on radiofrequency ablation (RFA) in tumor-induced osteomalacia (TIO) are restricted to case reports (~ 11 patients) and long-term follow-up data are further scarce. We describe our experience on managing TIO from a tertiary care center in India. Retrospective study of patients with localized TIO was performed and clinical, biochemical, treatment and follow-up details were retrieved. Normalization of serum phosphorus in absence of phosphate supplementation was defined as remission. Of 33 patients (23 males), 24 patients underwent surgery as first-line treatment, and early remission, delayed remission (> 1month for phosphorus normalization) and persistence were observed 12, 3, and 9 patients at a median follow-up of 5 (4-9) years. The gender, age, tumor size, location of tumors and FGF23 levels were not statistically different in patients who were in remission after surgery versus those with persistent disease. Second/third line treatment included conventional medical treatment and/or repeat surgery (n = 3), radiotherapy (n = 3), peptide receptor radionuclide therapy (n = 1), RFA (n = 1). Two patients had transient worsening (weeks) of weakness post-surgery. 10 patients underwent RFA (first-line n = 9); at the last follow-up 5 (4-10) years, 7 are in remission. Two of three persistent disease patients had large tumors (5.6 and 3.6cm). There were no RFA-related complications except local ulcer in one. Although persistent disease was present in a few patients in both arms, there was no recurrence in either RFA or surgical cohort. RFA provide durable response similar to surgery, persistence requires multi-modality treatment.

Comparison of ozone therapy and routine medical treatment effect on disease severity and serum level changes of IL-33 in patients with remitting-relapsing multiple sclerosis: A parallelled randomised clinical trial

IntroductionIL-33 is an inflammatory cytokine involved in the pathogenesis of Multiple sclerosis (MS) as an autoimmune inflammatory disease. Ozone therapy has been shown to improve the symptoms of the disease in previous studies. Given the limitations of previous studies, we investigated the effect of adding ozone therapy to conventional medical treatment in remitting-relapsing multiple sclerosis (RR-MS) patients from the points of disease severity and blood levels of IL-33. MethodsThis clinical trial was performed on 66 RR-MS patients, among whom 55 finished the study. The patients were divided randomly into two groups; one group (intervention) received ozone therapy in addition to the routine medical treatment, and the other group (control) received only routine medical treatment. The level of IL-33 was measured by ELISA, and the severity of the disease was measured by an expanded disability status scale (EDSS) in all patients before and after the treatment. Finally, the relationship between the serum levels of IL-33 and EDSS score with the type of treatment was evaluated. The research project was registered at the International Center for the Registration of Clinical Trials in Iran (IRCT20171105037262N3). ResultsOur findings showed that the serum levels of IL-33 in the ozone plus medical-treated group significantly decreased compared to the medical-treated group (P<0.001). The EDSS score also decreased significantly in the ozone plus medical-treated group compared to the medical-treated group (P=0.019). ConclusionOzone therapy reduces the severity of RR-MS. Such an effect may be influenced by modifying IL-33 levels.

Surgical treatment of refractory low back pain using implanted BurstDR spinal cord stimulation (SCS) in a cohort of patients without options for corrective surgery: Findings and results from the DISTINCT study, a prospective randomized multi-center-controlled trial

Background: Low back pain (LBP) is a highly prevalent, disabling condition affecting millions of people. Patients with an identifiable anatomic pain generator and resulting neuropathic lower extremity symptoms often undergo spine surgery, but many patients lack identifiable and/or surgically corrective pathology. Nonoperative treatment options often fail to provide sustained relief. Spinal cord stimulation (SCS) is sometimes used to treat these patients, but the lack of level 1 evidence limits its widespread use and insurance coverage. The DISTINCT RCT study evaluates the efficacy of passive recharge burst SCS compared to conventional medical treatment (CMM) in alleviating chronic, refractory axial low back pain. MethodsThis prospective, multicenter, randomized, study with an optional 6-month crossover involved patients who were not candidates for lumbar spine surgery. The primary and secondary endpoints evaluated improvements in low back pain intensity (NRS), back pain-related disability (ODI), pain catastrophizing (PCS), and healthcare utilization. Patients were randomized to SCS therapy or CMM at 30 US study sites. ResultsThe SCS arm reported a 85.3% NRS responder rate (≥ 50% reduction) compared to 6.2% (5/81) in the CMM arm. After the 6M primary endpoint, SCS patients elected to remain on assigned therapy and 66.2% (49/74) of CMM patients chose to trial SCS (crossover). At the 12M follow-up, SCS and crossover patients reported 78.6% and 71.4% NRS responder rates. Secondary outcomes indicated significant improvements in ODI, PCS, and reduced healthcare utilization. Six serious adverse events were reported and resolved without sequelae. ConclusionDISTINCT chronic low back pain patients with no indication for corrective surgery experienced a significant and sustained response to burst SCS therapy for up to 12 months. CMM patients who crossed over to the SCS arm reported profound improvements after 6 months. This data advocates for a timely consideration of SCS therapy in patients unresponsive to conservative therapy.

Ligand-based analysis of the antifungal potential of phytosterols and triterpenes isolated from Cryptostegia grandiflora against Candida auris FKBP12

Candida auris, a pathogenic fungus, has posed significant challenges to conventional medical treatments due to its increasing resistance to antifungal agents. Consequently, due to their promising pharmacological properties, there is a compelling interest in exploring novel bioactive compounds, such as phytosterols and triterpenes. This study aimed to conduct virtual screening utilizing computational methods, including ADMET, molecular docking, and molecular dynamics, to assess the activity and feasibility of phytosterols extracted from Cryptostegia grandiflora as potential therapeutic agents. Computational predictions suggest that compounds bearing structural similarities to Fsp3-rich molecules hold promise for inhibiting enzymes and G protein-coupled receptor (GPCR) modulators, with particular emphasis on ursolic acid, which, in its conjugated form, exhibits high oral bioavailability and metabolic stability, rendering it a compelling drug candidate. Molecular docking calculations identified ursolic acid and stigmasterol as promising ligands. While stigmasterol displayed superior affinity during molecular dynamics simulations, it exhibited instability, contrasting with ursolic acid’s slightly lower affinity yet sustained stability throughout the dynamic assessments. This suggests that ursolic acid is a robust candidate for inhibiting the FKBP12 isomerase in C. auris. Moreover, further investigations could focus on experimentally validating the molecular docking predictions and evaluating the efficacy of ursolic acid as an FKBP12 isomerase inhibitor in models of C. auris infection.

The Effect of Acupuncture on Brain Iron Deposition and Body Iron Metabolism in Vascular Cognitive Impairment: Protocol for a Randomized Controlled Trial.

Vascular cognitive impairment (VCI) persistently impairs cognition and the ability to perform activities of daily living, seriously compromising patients' quality of life. Previous studies have reported that disorders of serum iron metabolism and iron deposition in the brain can lead to inflammation, abnormal protein aggregation and degeneration, and massive neuronal apoptosis in the central nervous system, which in turn leads to a progressive decline in cognitive processes. Our previous clinical studies have found acupuncture to be a safe and effective intervention for treating VCI, but the specific mechanisms require further exploration. The objective of the trial is to evaluate the clinical efficacy of Tongdu Xingshen acupuncture and to investigate whether it can improve VCI by regulating brain iron deposition and body iron metabolism. In total, 42 patients with VCI and 21 healthy individuals will participate in this clinical trial. The 42 patients with VCI will be randomized into acupuncture and control groups, while the 21 healthy individuals will be in the healthy control group. Both the control and acupuncture groups will receive conventional medical treatment and cognitive rehabilitation training. In addition, the acupuncture group will receive electroacupuncture treatment with Tongdu Xingshen for 30 minutes each time, 6 times a week for 4 weeks. Meanwhile, the healthy control group will not receive any intervention. All 3 groups will undergo baseline assessments of brain iron deposition, serum iron metabolism, and neuropsychological tests after enrollment. The acupuncture and control groups will be evaluated again at the end of 4 weeks of treatment, as described earlier. By comparing neuropsychological test scores between groups, we will examine the efficacy of Tongdu Xingshen acupuncture in treating VCI. Additionally, we will test the correlations between neuropsychological test scores, brain iron deposition, and body iron metabolism indexes to explore the possible mechanisms of Tongdu Xingshen acupuncture in treating VCI. Participants are currently being recruited. The first participant was enrolled in June 2023, which marked the official start of the experiment. As of the submission of the paper, there were 23 participants. The recruitment process is expected to continue until June 2025, at which point the processing and analysis of data will begin. As of May 15, 2024, up to 30 people have been enrolled in this clinical trial. This study will provide data on the effects of Tongdu Xingshen acupuncture on cerebral iron deposition as well as somatic iron metabolism in patients with VCI. These results will help to prove whether Tongdu Xingshen acupuncture can improve VCI by regulating brain iron deposition and body iron metabolism, which will provide the clinical and theoretical basis for the wide application of acupuncture therapy in VCI rehabilitation. China Clinical Registration Agency ChiCTR2300072188; https://tinyurl.com/5fcydtkv. PRR1-10.2196/56484.

Current strategies for the management of psoriasis with potential pharmacological pathways using herbals and immuno-biologicals.

Psoriasis is an acute to chronic multifunctional inflammatory skin disorder mediated through T-cell activation, dendritic cell intervention, local vascular variations, atypical keratinocyte proliferation, and neutrophil activation, leading to a skin disorder with no permanent cure. This review aims to find a potent, secure, and dependable medication, with a more scientific examination of herbal resources and recent targeted immunobiological therapies. Reports evaluating the effectiveness of biologics & herbal remedies for the topical therapy of psoriasis against control therapies were taken into consideration (placebo or active therapy). The work examined cellular circuits involved in inflammation with its immunogenetic mechanism behind various options available for treating psoriasis in addition to the role of agents inducing psoriasis. The extent of psoriasis can range from small, localized spots to total body coverage, and it can happen at any stage of life. Several theories exist for clarification however, the exact cause of psoriasis is not entirely understood. Researchers have discovered genetic loci linkages, environmental changes, drug induction, lifestyle conditions, some infections, etc. resulting in this disorder. There are numerous known conventional medical treatments for psoriasis, ranging from topical and systemic medicines to phototherapy or combinations of both with recent immunobiological treatment. However, the majority of these treatments are ineffective and have a variety of side effects that limit their long-term usage, such as cutaneous atrophy, tissue toxicity, mutagenicity, and immunosuppression. Herbal extracts or isolated compounds can be considered as a substitute for conventional psoriasis treatment. Unfortunately, many investigations often provide a small amount of facts about the safety and effectiveness of topically applied herbal remedies for the treatment of psoriasis. Thus, further factual evidences and validations are needed to promote herbal options, which must be supported by rigorous animal studies or clinical trials using standardised materials and compositions.

만성 편두통에 대한 기능의학적 이해 및 치료적 접목

Chronic migraine, affecting approximately 2% of the global population, markedly diminishes quality of life and imposes significant societal costs, surpassing the impacts of episodic migraine. Conventional medical treatments leave about 30% of patients with persistent chronic migraine, some of whom fluctuate between episodic and chronic migraine states. A holistic, functional medicine approach may provide supplementary benefits for these individuals. Clinical imbalances often identified in chronic migraine patients—such as mitochondrial dysfunction, oxidative stress, gut microbiota dysbiosis, leaky gut syndrome, food intolerance, histamine syndrome, vitamin D deficiency, and autonomic nervous system imbalances—can be detected through specific functional medical assessments, including urine organic acid profiles, hair tissue mineral analysis, hydrogen breath tests, comprehensive blood tests, and heart rate variability tests. Integrative functional medical interventions, encompassing lifestyle modifications, oral and intravenous nutrition therapies, and the comprehensive 5R program (remove, replace, reinoculate, repair, rebalance) for gut health, could offer therapeutic benefits. This review delves into the functional medicine paradigm and its potential role in managing chronic migraine.

Improvement in Balance and Walking in a Patient with Guillain-Barré Syndrome Treated with Acupuncture and Electroacupuncture: A Case Report

Introduction: Gullain-Barré syndrome (GBS) is a rapid, symmetric muscle weakness that often follows respiratory or gastrointestinal infections. Standard treatments include plasmapheresis and intravenous immunoglobulin, but outcomes can vary among patients. The integration of Korean medicine, notably unexplored in quantitative assessments of balance and walking, provides a novel approach to treatment.Case presentation: A 53-year-old male diagnosed with GBS presented to the hospital 8 days post-onset. He received treatments consisting of acupuncture, electroacupuncture, and rehabilitation over a period of approximately 4 weeks. Upon admission, the patient exhibited symptoms of both limb weakness and paresthesia, requiring the use of a wheelchair. Post-treatment, muscle strength and balance were significantly improved, leading to the restoration of independent ambulation, including running.Conclusions: This case illustrates the potential of integrated Korean and conventional medical treatments to accelerate recovery in GBS patients, overcoming typical prognosis timelines. The improvements in gait and balance were substantiated by quantitative assessments, suggesting a promising area for further research into the effects of combined therapeutic approaches to GBS recovery.

Effect of Neutral Pulmonary Douche on Pulmonary Functions among Bronchial Asthma Patients

Introduction: Bronchial Asthma is the second-most significant contributing factor to mortality rates for chronic respiratory diseases. It is characterized by hyperreactivity of the airways and reversible episodes of bronchoconstriction. Douche is a general application in hydrotherapy, which is a stream of water directed against the body generally or locally. The neutral pulmonary douche (NPD) is employed to improve pulmonary functions, but there is no scientific report validating its effect. Materials and Method: A randomized control trial study of a total of 60 subjects belonging to the age group of 18–44 years participated in the study. The study participants were randomized into intervention and control groups (1:1). The intervention group (30) underwent NPD for 30 minutes. No intervention was given to the control group (30) and was followed up. The assessments were taken at baseline and after 10 days of the study. Result: The collected data was subjected to statistical analysis, employing interferential statistical tests. These analyses showed a significant difference in all parameters (FEV1, FVC, the FEV1FVC ratio, and PEFR) within (t-tests, the Wilcoxon rank test) and between (ANCOVA) groups. Conclusion: The implementation of hydrotherapy-facilitated NPD has demonstrated notable enhancement of pulmonary functionality in Bronchial asthma (BA) sufferers, in conjunction with conventional medical interventions. This discovery contributes to the progressively accumulating substantiation endorsing the efficacy of hydrotherapy within the domain of naturopathy.

Comparison of the Outcomes of Anterior Cervical Discectomy and Fusion and Cervical Disc Replacement for Cervical Disc Disease.

To compare the radiological outcome and development of heterotopic ossification (HO) following single-segment anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (CDR) for cervical disc herniation and evaluate their impact on surgical success. Descriptive comparative study. Place and Duration of the Study: Neurosurgery Department at Bozyaka Education and Research Hospital, Izmir, Turkiye, between January 2020 and June 2022. Patients aged 18-70 years with radicular neck pain unresponsive to conventional medical treatment and an MRI-confirmed diagnosis were included. Patients with osteoporosis (OP) were excluded. Patients were randomised into two treatment groups (ACDF and CDR) and stratified by age and symptom severity. Radiographic assessments and HO classification according to McAfee were performed. Among the included patients, 56 underwent ACDF and 45 underwent CDR. The mean patient age was 48.29 ± 9.530 and 41.84 ± 7.239 years in the ACDF and CDR groups, respectively (p <0.001). The postoperative disc height increased in both groups. The T1 slope was significantly higher preoperatively and in the early postoperative period in the CDR group than in the ACDF group (p = 0.001). HO was graded as 1, 2, 3, and 4 in 28 (27.7%), 6 (5.9%), 7 (6.9%), and 4 (3%) patients, respectively. ACDF and CDR provided similar improvements in radiological measurements and pain relief. Although both procedures significantly enhanced the patient's quality of life and disability scores, HO was more prevalent following CDR during long-term follow-up. Cervical disc replacement, Anterior cervical discectomy and fusion, Spinal surgery techniques, Heterotopic ossification.

Promoting Comprehensive Health Services: Harnessing the Synergy of Traditional and Modern Healing Approaches

Promoting comprehensive health services entails leveraging the synergy between traditional and modern healing approaches. This article utilizes a qualitative literature review method to explore the integration of traditional and modern healing methods in the delivery of healthcare services. By examining a wide array of scholarly articles, books, and research papers, this study elucidates the potential benefits and challenges associated with combining traditional and modern approaches to health and wellness. The analysis reveals that incorporating traditional healing practices alongside modern medical interventions can lead to more holistic and culturally sensitive healthcare delivery. Traditional healing methods, rooted in indigenous knowledge and cultural traditions, often provide unique perspectives on health and healing that complement conventional medical treatments. Additionally, traditional healers often serve as trusted community members who play a vital role in promoting health-seeking behaviors and addressing psychosocial needs. Furthermore, synergies between traditional and modern healing approaches can enhance access to healthcare services, particularly in underserved and marginalized communities where cultural beliefs may influence health-seeking behaviors. By acknowledging and integrating traditional healing practices into mainstream healthcare systems, healthcare providers can foster greater trust and collaboration with local communities, ultimately improving health outcomes. However, challenges such as differing belief systems, lack of standardization, and limited research on the efficacy of traditional healing practices pose barriers to effective integration. Overcoming these challenges requires collaborative efforts between traditional healers, healthcare providers, policymakers, and researchers to develop culturally competent and evidence-based healthcare interventions. In conclusion, this article underscores the importance of harnessing the synergy between traditional and modern healing approaches to promote comprehensive health services. By embracing diversity and inclusivity in healthcare delivery, stakeholders can enhance the accessibility, acceptability, and effectiveness of healthcare services for all individuals and communities. Further research is needed to explore best practices for integrating traditional healing into mainstream healthcare systems and to evaluate the impact on health outcomes.

Phytochemicals, Herbal Extracts, and Dietary Supplements for Metabolic Disease Management.

Comprehensive and effective care techniques have become essential due to the global epidemic dimensions of metabolic disorders, including diabetes, obesity, and cardiovascular ailments. Recent research highlights the potential of dietary supplements, herbal extracts, and phytochemicals in treating metabolic diseases. This abstract conveys the current state of the science in this field by highlighting these findings' underlying mechanisms and potential therapeutic applications. Plant-based diets contain naturally occurring bioactive molecules termed phytochemicals, which have shown promise in treating various metabolic illnesses. Examples include curcumin, flavonoids, and polyphenols' insulin-sensitizing, antioxidant, and antiinflammatory properties. Herbal extracts, derived from ancient medicinal herbs, have been used by people for years to treat a wide range of ailments. Recent studies have shown the efficacy of these strategies in improving lipid profiles, glucose metabolism, and overall cardiovascular health. Omega-3 fatty acids, vitamins, and minerals are just a few of the numerous nutritional supplements that are critical to metabolic health. These vitamins improve insulin sensitivity, regulate blood sugar, and decrease inflammation. Probiotics and prebiotics also affect the gut flora, which significantly affects metabolic function. These natural medicines' ability to treat metabolic diseases either by themselves or in combination with conventional medical interventions. However, when using it therapeutically, one must consider the differences in doses, individual responses, and bioavailability. The article concludes that phytochemicals, plant extracts, and food supplements offer a promising avenue for the management of metabolic illnesses. Comprehensive research, including clinical studies, is needed to ascertain their safety and efficacy characteristics. When added to treatment strategies, these natural therapies could be helpful supplements that improve overall health and the quality of life among individuals with metabolic diseases. Naringenin, a citrus flavonoid, can potentially prevent kidney injury in hyperuricemia by reducing uric acid, inflammation, apoptosis, DNA damage, and activating antioxidants. Further research and professional consultation are essential. Factors contributing to metabolic diseases, current approaches to management nutritional approaches for managing obesityassociated metabolic impairments in the liver and small intestine, and nutritional approaches for managing obesity-associated metabolic dysregulation are also explained briefly.

Holistic approaches to living well with endometriosis

Endometriosis is a common chronic condition for which there is currently no cure. Those suffering from endometriosis-related pelvic pain (ERPP) may struggle with side effects and/or risks presented by conventional medical and surgical treatment strategies, or not get pain relief. Increasing numbers of endometriosis patients wish to explore holistic management with fewer side effects, however it is important that medical professionals maintain an evidence-based practice for recommended treatments. We present up-to-date evidence of holistic strategies used for managing ERPP including nutritional strategies, body and mind therapies, acupuncture, traditional Chinese medicine (TCM) and the use of adjunct devices such as phallus length reducers and transcutaneous electrical nerve stimulation (TENS). Recent findings Nutrition: Gluten-free, low-nickel and high intake of omega-3 polyunsaturated fatty acids diets improve ERPP. Low FODMAP (fermentable oligo-, di-, monosaccharides and polyols) is helpful in those with concurrent irritable bowel syndrome. Body and mind: Cognitive behaviour therapy (CBT) is particularly beneficial in postoperative pain reduction, whilst mindfulness has been shown to reduce pain scores and dyschezia. Progressive muscle relaxation therapy and regular yoga sessions improve ERPP and Quality of life. Acupuncture: 15 randomised control trials assessing acupuncture and moxibustion show improved pain scores when compared to those receiving conventional therapies alone. Adjunct devices: TENS improves deep dyspareunia and lessens the number of days pain is experienced. Conclusions Holistic management strategies for ERPP should be incorporated into routine counselling when discussing conservative, medical and or surgical treatments for endometriosis. The growing evidence presented for the use of holistic management strategies gives hope to those patients who cannot have, or don’t respond to conventional approaches and as an adjunct alongside standard treatments.

Effects and long-term outcomes of endurance versus resistance training as an adjunct to standard medication in patients with stable COPD: a multicenter randomized trial

BackgroundComparisons between endurance training (ET) and resistance training (RT) have produced equivocal findings in chronic obstructive pulmonary disease (COPD) patients. The purpose of our study is to investigate the effectiveness and long-term outcomes of adding ET and RT to conventional medical treatment in patients with COPD. A secondary objective is to investigate the clinical improvements resulting from exercise training in patients with different disease severities.MethodsThe study was a multicenter, prospective trial in people with stable COPD. The cohort was randomized to three groups: individualized medical treatment group (MT), MT + endurance training group (MT + ET) and MT + resistance training group (MT + RT). Exercise was performed 3 times weekly over a 12-week period. The endpoints of exercise capacity, health-related quality of life, COPD symptoms, lung function, and anxiety and depression questionnaires were re-evaluated at baseline, at the completion of the intervention and at 6 and 12-month follow-up. According to the COPD assessment tool offered by GOLD guidelines, patients were stratified into GOLD A and B groups and GOLD C and D groups for further subgroup analysis.ResultsThe intention-to-treat (ITT) population included 366 patients, 328 of them completed the study protocol over 12 months (the PP-population). There were no significant differences in the primary outcome, quality of life, between patients who underwent medical treatment (MT) alone, MT + endurance training (MT + ET), or MT + resistance training (MT + RT) at the completion of the intervention, 6-, or 12-month follow-up. Additionally, no significant differences were observed between MT, MT + RT, or MT + ET groups concerning the primary outcome, exercise capacity (3MWD), after initial 3 months of intervention. However, a small statistically significant difference was noted in favor of MT + ET compared to MT + RT at 12 months (ITT: Δ3MWD in ET vs RT = 5.53 m, 95% confidence interval: 0.87 to 13.84 m, P = 0.03) (PP: Δ3MWD in ET vs RT = 7.67 m, 95% confidence interval: 0.93 to 16.27 m, P = 0.04). For patients in the GOLD C and D groups, improvement in quality of life following ET or RT was significantly superior to medical intervention alone. Furthermore, upon completion of the exercise regimen, RT exhibited a greater improvement in anxiety compared to ET in these patients (ITT: ΔHAD-A at 3-month: RT = -1.63 ± 0.31 vs ET = -0.61 ± 0.33, p < 0.01) (PP: ΔHAD-A at 3-month: RT = -1.80 ± 0.36 vs ET = -0.75 ± 0.37, p < 0.01).ConclusionsOur study presents evidence of the beneficial effects of ET and RT in combination with standard medical treatment, as well as the long-term effects over time after the intervention. While the statistically significant effect favoring ET over RT in terms of exercise capacity was observed, it should be interpreted cautiously. Patients in severe stages of COPD may derive greater benefits from either ET or RT and should be encouraged accordingly. These findings have implications for exercise prescription in patients with COPD.Trial registrationChiCTR-INR-16009892 (17, Nov, 2016).

Media Edukasi Komplementer Mengatasi Anemia Pada Ibu Hamil Di Puskesmas Kotabaru

The mother's condition during pregnancy, childbirth, the postpartum period, and the baby being born are greatly influenced by the mother's health. The consequences of anemia in pregnant women include the risk of abortion, premature birth, fetal growth restrictions, increased risk of infection, low birth weight babies, as well as other complications such as difficulties during delivery, congenital abnormalities, and the risk of shock during the birth process. Complementary therapies refer to various systems of medicine and health care that are not included in conventional medicine. This therapy aims to complement conventional medical treatment and must be in accordance with applicable health values and laws. The aim of the activity is to create complementary educational media to overcome anemia in pregnant women at the Kotabaru Community Health Center. Activities will be carried out in January 2024 involving pregnant women and the community in the Kotabaru Community Health Center working area. The result is that activities have been carried out by providing education using poster media. Complementary implementation can be continued to inform the public so that pregnant women can be independent in maintaining their pregnancy and also have support from health workers and the community.