Seventeen Cree anti-diabetic medicinal plant were investigated for their capacity to cause adverse effects when used as alternative or complementary medicine. Two aspects of safety were studied using their extracts: the ability to affect the contraction rate of neonatal rat cardiomyocytes in vitro to determine if the plants can influence the human heart rate, and the ability to interfere with drug metabolism by inhibiting the cytochrome P450 enzymes in vitro. The results suggest that several Cree plants may cause a harmful effect through different mechanisms. The extracts ofW2, W4, W5, and W9 did not affect the contraction rate of cardiomyocytes; however W9 extract was cardiotoxic at 10 mug/mL. Extracts of AD01, AD07, W2, and W4 had moderate or strong inhibitory potency towards the CYP isoforms involved in metabolizing common anti-diabetic drugs. Furthermore, AD02 extract was identified as a possible CYP3A4 mechanism-based inhibitor. Overall, the results suggest that several of the plant species can cause adverse events when used by diabetic patients.

University of Macau / Institute of Chinese Medical Sciences

Magister Pharmaceuticae - MPharm / The World Health Organization estimates that 4 billion people use herbal medicine for some aspect of primary health care. These herbal products are however mostly used without the necessary clinical trial done to prove their pharmacological activities and, therefore, their quality, efficacy and safety. It was the objective of this study to review the current international guidelines for the evaluation of herbal medicine; to gain a perspective on the number, type and quality of clinical trials that have been done on herbal medicine and to adopt a set of guidelines that could be used to conduct trial on a traditional herbal medicine used in South Africa. To verify these guidelines, a protocol for a clinical trial was drafted and submitted for approval to the regulatory and ethical authorities in South Africa. / South Africa

Subjective tinnitus is the perception of sound despite the absence of an external stimulus. This challenging sensory event affects millions of people per year. There currently is no cure for tinnitus, but there have been many different options researched to help patients manage its effects, albeit with varying efficacy. In a viral internet video, the Beating the Heavenly Drum maneuver, found in the Eastern practice of Qigong, was said to eliminate the perception of tinnitus for the participants. In this current study, the Beating the Heavenly Drum maneuver was compared to a sham maneuver and evaluated for effectiveness in relieving tinnitus. To be included in this study, participants had experienced tinnitus for at least 6 months and were not currently receiving other tinnitus care. Exclusionary criteria included a diagnosis of Post-Traumatic Stress Disorder, Traumatic Brain Injury, any neurological condition, whiplash, neck injury, or severe anxiety or depression, as determined by the Hospital Anxiety and Depression Scale. Participants completed a tinnitus case history form, Tinnitus Functional Index (TFI), Tinnitus Handicap Index (THI), and Visual Analog Scale (VAS) ranking the annoyance of their tinnitus. Participants were assigned to groups in an alternating fashion, with odd identifiers in Group 1 and even identifiers in Group 2. In Group 2, participants received the experimental maneuver (Beating the Heavenly Drum) during the first session and the sham maneuver (circles rubbed at the base of the skull) during the second. In Group 1, participants received a sham maneuver during the first session and the experimental maneuver during the second session. Within 48 hours after each session, participants completed the TFI, THI, and rated the annoyance of their tinnitus on a scale of 0 to 10 (keeping the same parameters from the VAS) via phone call. Of the twelve participants, two reported that the experimental maneuver, Qigong, was effective for tinnitus relief; while five reported the sham condition relieved their tinnitus. The remaining five participants stated that neither maneuver altered their tinnitus sensation. Across all participants, there were no significant difference scores on the THI, and only one significant difference score on the TFI. While participants reported some change in their tinnitus with either maneuver, none of the questionnaire measures corroborated their subjective report. Additionally, the sham maneuver was perceived as more effective than the experimental maneuver. The Qigong maneuver was not effective for tinnitus relief in this study. It should be noted that a limitation to this study is the small sample size. While this Qigong maneuver did not relieve tinnitus, there are other Internet tinnitus “cures” that should be investigated for their effectiveness in tinnitus relief. With the rise of the Internet and more patients searching for “quick fixes” to tinnitus, it is vital that clinicians provide appropriate education and research to best help patients manage their tinnitus.

Background: To assess physicians' attitudes regarding the legitimacy of complementary and alternative medicine (CAM) in medical practice, as well as factors that affect referral or prescription of a complementary therapy.Methods: Questionnaires were mailed to 380 physicians on staff at a local hospital in a mid-sized southeastern city in the United States; 138 were completed, for a 38% response rate.Results: Physicians in practice for less than 10 years were significantly more likely to accept most CAM therapies as legitimate than those in practice greater than 10 years. Nearly two-thirds of the physicians surveyed (65%, n = 88) had prescribed or referred for at least one complementary therapy. More than one-third of the physicians (34.8%, n = 48) had personally utilized at least one of these therapies, and personal experience resulted in a higher level of acceptance of CAM as legitimate medical therapy.Conclusions: It is likely that more positive attitudes regarding complementary therapies among more recently trained physicians is related to increased exposure during training and an increased awareness within the medical community of patient utilization of CAM. Despite a relatively positive attitude toward some CAM therapies, patients continue to use alternative medicine without notifying their primary care physicians. Unsupervised use of these therapies is potentially harmful and reflects a deficiency in the doctor-patient relationship. Open communication between physicians and their patients will continue to be hindered until physicians become knowledgeable in this area.

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No description available.

Siu Yuen-man. / Thesis submitted in: September 2003. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 249-251). / Abstracts in English and Chinese. / Abstract --- p.i / Acknowledgments --- p.iii / Note on the Transliteration --- p.vii / Chapter 1. --- Introduction --- p.1 / Chapter 2. --- The General Public View on Health Consciousness and Qigong --- p.49 / Chapter 3. --- The Life Stories of the Informants --- p.64 / Chapter 4. --- The Perception of the Informants on Diseases --- p.96 / Chapter 5. --- "The Attitudes of the Informants towards Biomedicine, Traditional Chinese Medicine, and Qigong" --- p.123 / Chapter 6. --- The Motivations of the Qigong Followers for Practicing Qigong --- p.165 / Chapter 7. --- Conclusion --- p.212 / Appendix1 --- p.238 / Appendix2 --- p.240 / Appendix3 --- p.242 / Appendix4 --- p.246 / Bibliography --- p.249

The thesis argues that processes of contemporary social change, broadly defined as postmodernisation, are undermining the authority and practices of the medical profession. It focuses on the increasing use of alternative medicine, by orthodox medical practitioners, as a site of radical social change. The thesis employs the middle-range theory of Mary Douglas and Aaron Wildavsky to explore changes in primary health at the institutional level. Data from interviews of health providers (n=50) and primary educational sources are used to provide empirical evidence of a significant challenge to the modernist medical hierarchy and its biomedical knowledge base. The evidence broadly supports the predictions of Douglas and Wildavsky, and those of the other macro-theorists associated with the study of globalisation and postmodernisation. Namely, contemporary society is characterised by a simultaneous shift of Centre to Periphery and vice versa. In the medical context, this has resulted in the increasing hybridisation and destabilisation of established forms of culture, knowledge and authority.

Philosophiae Doctor - PhD / The present healthcare system in South Africa suffers from a number of serious deficiencies. Whilst orthodox bio-medicine is well established in most first world countries, its total introduction and implementation into all communities within South Africa faces many obstacles. The cost of diagnostic techniques, investigative procedures and pharmaceutical products, the availability of competent medical staff in the non-urban areas, and the lack of acceptance of the philosophy and practice of orthodox bio-medicine in rural regions are but some of the factors which conspire against the general application of this orthodox medical paradigm. Another problem confronting healthcare and medical practice in South Africa, particularly at this stage of our historical development, is the absolute focus on orthodox bio-medicine, often to the detriment of other medical paradigms that also have advantages to offer. Can the integration of another medical paradigm, such as Unani-Tibb, enhance the practice of orthodox bio-medicine in this country?The aim of the thesis was to investigate the possibility of integrating Unani-Tibb with orthodox biomedicine (also termed conventional, Western or allopathic medicine) and assess its potential for improving delivery of an effective, affordable and appropriate healthcare system in South Africa.The research questions which the thesis seeks to answer is whether this integration is possible and whether the delivery of healthcare to the South African population can be enhanced. Changes in the provision of medical education are necessary, and occupy a pivotal role in allowing for this integration. Unani-Tibb is a traditional medical system practiced extensively on the Indian sub-continent and in other parts of the world. At present, however, it is minimally practiced in South Africa. Its primary principle is the energetic promotion of health maintenance behaviour and the prevention of disease, through effective application of dietotherapy, pharmacotherapy and other interventions, as well as the empowerment of the patient towards adopting behavioural changes and lifestyle adaptations. One positive aspect of Unani-Tibb is that it has many features in common with both orthodox biomedicine and African Traditional medicine. These commonalities should allow for greater acceptance by orthodox healthcare professionals, as well as the general population. The first part of the study involved the research and conceptualisation required for the production of a series of customized training modules which introduced the theory and practice of Unani-Tibb. A twelve month part-time training programme based on these modules was subsequently conducted with a number of healthcare professionals presently in active practice and with a background of orthodox medical or nursing healthcare. This outcomes-based training programme included a number of specifically designed training activities, such as case studies, practical exercises and assignments. Appropriate evaluations and assessments were pursued in order to measure performance outcomes and attitudes. Questionnaires for assessing the motivation and satisfaction of the participants were also completed. The second part of the study was in the form of a pilot participant research project, in which the participants applied the information from the integrative programme to a number of chronically ill patients who had previously been treated with standard orthodox bio-medical procedures. The parameters derived for clinical efficacy, cost-benefit and improvement in Quality of Life from Unani-Tibb treatment were then compared to equivalent results obtained by orthodox bio-medicine. In all parameters inspected, the integrative training programme compared favourably to orthodox bio-medical practice. Not only was there an improved clinical efficacy, but the cost-benefit was shown to be superior in most indices measured. The Quality of Life comparison, which assessed the patient and total health status, subjective behaviour and attitude, generally favoured the integrative training programme. The thesis serves to suggest that the integration of Unani-Tibb into orthodox bio-medical training in South Africa is a distinct possibility, and could ultimately allow for treatment which is clinically acceptable, cost-effective and which provides an improved Quality of Life for the population as a whole. I suggest that this pilot study be repeated more extensively, thereby allowing for a more confident and objective assessment. / South Africa