Treatment outcomes and cognitive function following electroconvulsive therapy in patients with severe depression

BACKGROUND Traditional treatments for major depressive disorder(MDD),including medication and therapy,often fail and have undesirable side effects.Electroconvulsive therapy(ECT)uses electrical currents to induce brief seizures in the brain,resulting in rapid and potent antidepressant effects.However,owing to misconceptions and controversies,ECT is not as widely used as it could and often faces stigmatization.AIM To evaluate the efficacy and safety of ECT compared to those of medication and/or therapy in patients with severe MDD.METHODS This prospective cohort study included 220 individuals with severe MDD who were divided into the ECT and non-ECT groups.The patients in the ECT group underwent bilateral ECT three times a wk until they either achieved remission or reached a maximum of 12 sessions.The non-ECT group received medication and/or therapy according to clinical guidelines for MDD.The primary outcome was the variation in the hamilton depression rating scale(HDRS)score from treatment/ECT initiation to week 12.In addition,patients’quality of life,cognitive abilities,and biomarkers were measured throughout the study.RESULTS Although both groups showed significant improvements in their HDRS scores over time,the improvement was more pronounced in the ECT group than in the non-ECT group.Additionally,the ECT group exhibited a more substantial improvement in the quality of life and cognitive function than those of the non-ECT group.Compared with the non-ECT group,the ECT group exhibited evidently lower variations in the brain-derived neurotrophic factor(BDNF)and cytokine interleukin-6(IL-6)levels.The side effects were generally mild and comparable between the two groups.ECT is safer and more potent than medication and/or therapy in mitigating depressive symptoms,enhancing wellbeing,and bolstering cognitive capabilities in individuals with severe MDD.ECT may also affect the levels of BDNF and IL-6,which are indicators of neuroplasticity and inflammation,respectively.CONCLUSION ECT has emerged as a potentially advantageous therapeutic approach for patients with MDD who are unresponsive to alternative treatments.

Tamanu Oil in Acne Management: Potential Anti-Inflammatory and Wound-Healing Properties for Scar Reduction

Tamanu oil, derived from the nuts of Calophyllum inophyllum, has gained increasing attention for its potential in acne management due to its purported anti-inflammatory and wound-healing properties. This analysis evaluates the efficacy of tamanu oil in acne treatment with a specific focus on its impact on inflammation and scar reduction. The novelty of this research lies in its comprehensive analysis of tamanu oil’s dual mechanism of action: reducing acne-related inflammation and promoting the healing of acne scars. Clinical trials and laboratory analyses were conducted to assess the oil’s effectiveness in diminishing erythema, swelling, and post-acne scarring compared to conventional treatments. Preliminary findings demonstrate that tamanu oil significantly reduces inflammation and accelerates wound healing, potentially offering a promising adjunct or alternative to standard acne therapies. Future research should aim to optimize formulation and application protocols, long-term effects, and comparative therapeutic efficacy with other anti-inflammatory agents. Tamanu oil offers a novel and effective approach to acne management, with potential advantages that go beyond inflammation reduction to include enhanced scar reduction, making it a subject that warrants further investigation.

Dry cupping therapy and the wellness management of health travelers

Objective:Individuals travel locally and internationally in order to find alternative treatments which are less-toxic and more beneficial to their health and wellness.Despite the popularity of the western system of medicine,cupping therapies are gaining enormous attention in Pakistan as a system of traditional and complementary medicine to ensure the quality of life and wellness notions of the people.The present study aims to examine the effectiveness of dry cupping therapy(DCT)on the health,wellness,and quality of life preferences of health-seeking travelers in a sample of Faisalabad.Methods:DCT was performed for 15-20 minutes on subjects by using 3-5 disposable cupping glasses.Study participants filled the questionnaires before and after DCT interventions.Partial least square structural equation modeling technique is used in order to statistically analyze the data.Results:A total of 187 subjects participated in two DCT interventions at Coural Wellness Center Faisalabad and provided their final responses after 30 days from 2nd DCT.Respondents’perceptions of their physical feelings were generally found in a significantly positive and direct relation with DCT and health status(HS),i.e.,body pain(β=0.019),vitality(β=0.138),and bodily movement(β=0.207).This trend was observed in the psychological feelings of respondents as well,i.e.,emotional feelings(β=0.169).DCT significantly mediated the overall phenomenon and variance account for values were found between 20%and 80%for all the study constructs.The scores of all the health and wellness items on the questionnaire were significantly improved in 79.68%of studied participants after 1st and 2nd DCT interventions except for social functioning.Conclusion:Findings of the present study suggest that DCT has an important role in determining the health perceptions and HS of health travelers without potential side-effects.It can improve the health and overall quality of life of the people by positively influencing their physical and psychological health perceptions.It additionally leads to improve travelers’emotion,behavior,and other daily matters.

Hyperglycemia induced by clozapine and its alternativetherapy:a case report

Clozapine has been recognized as the best drug for the treatment of refractory schizophrenia,but its clinical use is very cautious.Clozapine has many side effects,among which agranulocytosis is fatal.And it often causes glucose intolerance,leading to type 2 di-abetes.The treatment plan for elevated blood glucose in clozapine patients is still unclear.This paper will report one case of glucose intolerance caused by clozapine and its alternative treatment,and discuss the treatment plan.

A scoping review on traditional medicine for bruxism

Objective:To investigate the current evidence on traditional medicine in managing bruxism and its clinical efficacy.Methods:A search was conducted in nine databases to identify potential eligible articles published from the date of inception until August 3,2022.All clinical studies that used traditional medicine of any type in treating bruxism were eligible for inclusion.Two authors performed data extraction and quality as-sessments independently.Retrieved data were tabulated and discussed narratively.Results:A total of 16 clinical studies were included in this scoping review.Of the 16 studies,three studies were randomized controlled trials,one was a caseecontrol study,10 were case series,and two were case reports.Our review identified studies of interventions based on herbal medicine and acupuncture-related therapies.Most studies reported positive results,but the overall quality of the included studies was typically fair to poor.Conclusions:This study is the first scoping review on traditional medicine for bruxism despite the limited evidence.More research on traditional medicine in bruxism management should be conducted for better clarification and application in daily practice.

Randomized controlled trial on the efficacy and safety of autologous serum eye drops in dry eye syndrome

BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in relieving the distressing symptoms of DES.This study aimed to evaluate the safety and effectiveness of ASEDs compared to traditional treatments,which often prove inadequate or result in unwanted side effects,particularly in individuals with moderate-to-severe DES.AIM To evaluate whether ASEDs are safer and more effective than conventional artificial tears in the treatment of moderate-to-severe DES.METHODS This multi-centered randomized controlled trial included 240 patients with moderate-to-severe DES from three ophthalmology clinics in China.They were randomly assigned to receive either ASEDs or artificial tears for 12 wk.The primary outcome was the change in the ocular surface disease index(OSDI)score,with secondary outcomes including tear break-up time(TBUT),Schirmer I test,corneal fluorescein staining(CFS),and conjunctival impression cytology(CIC).Statistics analysis was performed using an analysis of covariance with adjustments made for baseline values.RESULTS Our findings revealed that both ASEDs and artificial tears significantly improved the OSDI score,TBUT,Schirmer I test,CFS,and CIC from baseline to week 12.The ASEDs group showed significantly greater improvement in all these measures than the artificial tears group(all P values<0.05).The average difference in the OSDI score between the two cohorts was-10.3(95%confidence interval:-13.6 to-7.0),indicating a substantial improvement in the ASEDs group.The occurrence of adverse events was comparable between cohorts,with no reports of severe adverse events.CONCLUSION ASEDs are more effective and safer than artificial tears for mitigating symptoms of moderate-to-severe DES.ASEDs could be an alternative/supplementary therapy for patients with DES less responsive to traditional treatments.

Efficacy and safety of mild-warm moxibustion in treating diarrhea-predominant irritable bowel syndrome(spleen deficiency and dampness excess syndrome):a study protocol for a randomized controlled trial

1Background:Irritable bowel syndrome(IBS)is a disorder of bowel function,and diarrhea-predominant irritable bowel syndrome(IBS-D)is the most common.The current treatment for IBS-D is focused on improving patients’gastrointestinal-related symptoms,but there are limitations such as unstable effects and adverse drug reactions.Acupuncture and moxibustion exerts advantages in treating IBS-D.They include several forms,of which moxibustion is one of the most commonly used.And moxibustion is a common way used in treating IBS-D,but there is a lack of relevant evidence-based medical research data.This protocol aims to compare the efficacy of moxibustion(mild-warm moxibustion)in treating IBS-D(spleen deficiency and dampness excess syndrome)with the first-line treatment.Methods:In this prospective,parallel,randomized controlled trial(RCT)protocol,patients will be randomly allocated for 4-week treatment or control therapies and then 4-week follow-up in both groups.We will use Irritable Bowel Syndrome-Symptom Severity Scale(IBS-SSS)score,Irritable Bowel Syndrome-Quality of Life(IBS-QOL)score,serum brain-gut peptide levels,and traditional Chinese medicine(TCM)syndrome scale score to produce more evidence on IBS-D treatment with moxibustion.Finally,we will use SPSS 22.0 software to statistically analyze the data.Discussion:Mild-warm moxibustion is a complementary alternative therapy that fits with the pathogenesis of IBS-D.We hope to see more clinical evidence for mild-warm moxibustion against IBS-D that this RCT supported.

Perspectives of traditional Chinese medicine in pancreas protection for acute pancreatitis

Acute pancreatitis(AP)is one of the most common diseases.AP is associated with significant morbidity and mortality,but it lacks specific and effective therapies.Traditional Chinese medicine(TCM)is one of the most popular complementary and alternative medicine modalities worldwide for the treatment of AP.The current evidence from basic research and clinical studies has shown that TCM has good therapeutic effects on AP.This review summarizes the widely used formulas,single herbs and monomers that are used to treat AP and the potential underlying mechanisms of TCM.Because of the abundance,low cost,and safety of TCM as well as its ability to target various aspects of the pathogenesis,TCM provides potential clinical benefits and a new avenue with tremendous potential for the future treatment of AP.

Frontiers in antibiotic alternatives for Clostridioides difficile infection

Clostridioides difficile(C.difficile)is a gram-positive,anaerobic spore-forming bacterium and a major cause of antibiotic-associated diarrhea.Humans are naturally resistant to C.difficile infection(CDI)owing to the protection provided by healthy gut microbiota.When the gut microbiota is disturbed,C.difficile can colonize,produce toxins,and manifest clinical symptoms,ranging from asymptomatic diarrhea and colitis to death.Despite the steady-if not risingprevalence of CDI,it will certainly become more problematic in a world of antibiotic overuse and the post-antibiotic era.C.difficile is naturally resistant to most of the currently used antibiotics as it uses multiple resistance mechanisms.Therefore,current CDI treatment regimens are extremely limited to only a few antibiotics,which include vancomycin,fidaxomicin,and metronidazole.Therefore,one of the main challenges experienced by the scientific community is the development of alternative approaches to control and treat CDI.In this Frontier article,we collectively summarize recent advances in alternative treatment approaches for CDI.Over the past few years,several studies have reported on natural product-derived compounds,drug repurposing,highthroughput library screening,phage therapy,and fecal microbiota transplantation.We also include an update on vaccine development,pre-and probiotics for CDI,and toxin antidote approaches.These measures tackle CDI at every stage of disease pathology via multiple mechanisms.We also discuss the gaps and concerns in these developments.The next epidemic of CDI is not a matter of if but a matter of when.Therefore,being well-equipped with a collection of alternative therapeutics is necessary and should be prioritized.

Acute moderate to severe ulcerative colitis treated by traditional Chinese medicine:A case report

BACKGROUND Ulcerative colitis(UC),also known as chronic nonspecific UC,is an inflammatory bowel disease characterized by diffuse colonic mucosal inflammation.The incidence and prevalence of UC have risen markedly,and the disease seriously affects the quality of life of patients and imposes a great burden on the world health care infrastructure and economy.CASE SUMMARY Case I describes a 34-year-old female who came to see a doctor because of repeated abdominal pain,diarrhoea and purulent blood for 2 mo.This patient had UC with an initial onset,an active stage and a wide range of lesions.After the poor effect of sulfasalazine and mesalazine,the patient’s condition gradually deteriorated,her abdominal pain and bloody stools continued,and anemia occurred.She began treatment with the Chinese medicine Guizhi Dahuang decoction,which was taken orally twice a day,200 mL each time.After 6 mo of treatment,abdominal pain,diarrhoea,bloody stool and other symptoms disappeared.No abnormality was found by repeat electronic enteroscopye,and the anemia was corrected.The patient’s condition did not recur after nearly 4 years of follow-up.CONCLUSION A series of symptoms in this UC patient significantly improved with the administration of traditional Chinese medicine.

Acupuncture:a new method to treat tic disorders in children

Tic disorder is a common pediatric neurological disorder that severely affects children’s quality of life.But in fact,there is still a lack of a very effective treatment for tic disorder.Acupuncture as a flexible treatment time,treatment cycle control,easy to operate treatment method,widely used in the field of neurological disorder,widely praised by clinicians and patients.At the same time,tic disorder belongs to the category of chronic inflammatory convulsion in traditional Chinese medicine,and acupuncture has a good effect of relieving spasticity and fewer adverse reactions,which makes acupuncture have a good application prospect.Now,more and more studies about acupuncture treatment of tic disorder in children have been published.The main methods of treating tic disorder are acupuncture,electroacupuncture,scalp acupuncture and ear acupuncture.The efficacy of acupuncture alone or in combination with other drugs such as tiapride hydrochloride and haloperidol has been shown to be good.The safety of acupuncture is also commendable,and clinical trials showing that the combination of acupuncture and medication can reduce the incidence and severity of adverse drug reactions.According to the existing studies,acupuncture can promote the development and repair of the nervous system,regulate the secretion of neurotransmitters,and reduce the occurrence of local discomfort,which may be the main mechanism of acupuncture treatment of tic disorders.

Acupuncture as a potential approach to improve the health of women with obesity

In addition to higher risks of various obstetric and gynaecological illnesses among women with obesity or who are overweight, maternal adiposity threatens the lifetime health of their offspring. Diverse treatments are provided, including complementary and alternative medicine such as Chinese medical practices. Acupuncture, a traditional Chinese medicinal method, is increasingly being applied to this health problem. This literature review analyses 25 clinical studies, involving 2407 participants aged 13-65 in Africa, Asia, the Middle East and North America. This illustrates the use of acupuncture alone or with other approaches to control body weight, obesity-induced diseases, and gynaecological health. Although positive indicators are presented, this study offers recommendations for enhancing reliability and validity in further research. It therefore suggests the use of acupuncture in dealing with obesity due to its efficacy, and economic and safety benefits.

Traditional Herbal Medicine and Its Clinical Relevance: A Need to Preserve the Past for the Future

Herbal medicines have been gaining popularity worldwide. They are an integral component of alternative medical care and provide a rich source for innovative drug discovery. However, the rapid increase in the demand for herbal medicines and products has led to the rapid depletion of herbal plants. In addition, rapid population growth, industrialization, and global climate change have endangered these medicinal plants. Given the imminent threat associated with the loss of medicinal plant diversity, this review highlights the need to protect these threatened plant species and avoid the loss of their therapeutic value. The aim of the study was to conserve resources and link them with current research activities and projects to develop novel and more effective drugs in the future.

Effect of Bacrobial@ Skin Cleanser on the Prevention of Muscle Cramps

Anecdotal evidence supports the use of Bacrobial skin cleanser for preventing muscle cramps; however, empirical evidence is lacking. OBJECTIVE： To examine whether Bacrobial prevents muscle cramping in the triceps surae. DESIGN： Randomized, double-blind, placebo-controlled, crossover study. SETTINGS/LOCATION： Laboratory. SUBJECTS： Seventeen cramp-prone participants （11 male, 6 female; age 21 -4- 2 yrs; 79.72 - 19.75 kg; 175.86 - 11.76 cm） volunteered. INTERVENTION： Participants completed two trials, at least one week apart. On the ftrst trial, Bacrobial was liberally applied to the skin over the triceps surae musculature of one leg, while placebo was applied to the other leg. At 1, 5, 10, and 20 min after application, participants were instructed to induce a cramp in the triceps surae via maximal voluntary contraction. For the second trial, treatments were applied to the opposite leg as in trial one and the cramping procedure was repeated. OUTCOME MEASURES： Incidence of cramping was the main outcome measure and event-odds tables, risk reduction and NNT （numbers needed to treat） or NNH （numbers needed to harm） were calculated at the time intervals of 1, 5, 10 and 20 minutes. RESULTS： No significant differences between treatments were found in cramping incidences at all time intervals. Bacrobial decreased the risk of cramping by 12.5% at one minute （NNT = 8）, while causing a 5.3% increased risk at five minutes （NNH = 5.3）. CONCLUSIONS： Our findings indicate Bacrobial skin cleanser is not an overall effective treatment for muscle cramp prevention. However, the observed results at one minute may be useful to clinicians who treat cramp-prone patients.

A Review for Existing Complementary and Alternative Medical Therapies for Autism Spectrum Disorder

Autism Spectrum Disorder(ASD)has always been a frustrating disability for families and no official effective medical interventions has been found to cure this disorder yet.With more attention from the general public both nationally and internationally,more and more families and therapists showed preference to implement complementary and alternative medical(CAM)therapies.This review aims to provide more information about potential CAM that has been applied and their effectiveness.

Current complementary and alternative therapy for gastroesophageal reflux disease

Gastroesophageal reflux disease(GERD)is a widely prevalent gastrointestinal disorder,affecting13.3%of the global population.There are shortages and limitations of current GERD treatment modalities,and complementary and alternative therapy(CAT)is a promising option to fill in the gap.Dietary and lifestyle modifications might play an important and complementary role in alleviating GERD symptoms.Traditional Chinese medicine and brain–gut behavior therapy,particularly transcutaneous electrical acustimulation and diaphragmatic breathing therapy were shown to be useful adjuncts or alternatives in treating GERD.CAT may help to relieve GERD symptoms,minimize medication dosage,and slow the demand for surgery.The aim of this review was to summarize the existing evidence of some common CATs in treating symptomatic GERD,including dietary modification,lifestyle change,traditional Chinese medicine,and brain–gut behavior therapy.

Efficacy of acupuncture on treating obesity and adipose-incurred illnesses

Being overweight and obese impacts health due to adiposity itself and illnesses it incurs,which produces individual and societal financial burdens.This urges effective interventions,including adjunct therapies.Acupuncture,a traditional Chinese medical practice,indicates positive signs for tackling these problems.Investigating 101 empirical human-based projects,this narrative review analyses their outcomes and then provides an overview of the effects of acupuncture in body weight reduction and obesity-induced diseases,either performed alone or with other approaches.It involves 15941 participants from 9-80 years old in China's Mainland,Taiwan,Turkey,Brazil,Egypt,Iran,Greece,Korea,Sudan,Thailand,and the USA.It also reveals practical implications and future research directions,benefiting the development of acupuncture in the modern medical arena for both patients and practitioners.

Treatment strategy for metastatic prostate cancer with extremely high PSA level： reconsidering the value of vintage therapy

The prognostic significance of initial prostate-specific antigen （PSA） level for metastatic prostate cancer remains uncertain. We investigated the differences in prognosis and response to hormonal therapies of metastatic prostate cancer patients according to initial PSA levels. We analyzed 184 patients diagnosed with metastatic prostate cancer and divided them into three PSA level groups as follows： low （〈100 ng ml-1）, intermediate （100–999 ng ml-1）, and high （≥1000 ng ml-1）. All patients received androgen deprivation therapy （ADT） immediately. We investigated PSA progression-free survival （PFS） for first-line ADT and overall survival （OS） within each of the three groups. Furthermore, we analyzed response to antiandrogen withdrawal （AW） and alternative antiandrogen （AA） therapies after development of castration-resistant prostate cancer （CRPC）. No significant differences in OS were observed among the three groups （P = 0.654）. Patients with high PSA levels had significantly short PFS for first-line ADT （P = 0.037）. Conversely, patients in the high PSA level group had significantly longer PFS when treated with AW than those in the low PSA level group （P = 0.047）. Furthermore, patients with high PSA levels had significantly longer PFS when provided with AA therapy （P = 0.049）. PSA responders to AW and AA therapies had significantly longer survival after CRPC development than nonresponders （P = 0.011 and P 〈 0.001, respectively）. Thus, extremely high PSA level predicted favorable response to vintage sequential ADT and AW. The current data suggest a novel aspect of extremely high PSA value as a favorable prognostic marker after development of CRPC.

Effects of Baduanjin(八段锦) Exercise on Knee Osteoarthritis:A One-Year Study

Objectives： Knee osteoarthritis （OA） is a major cause of pain and functional limitation. Short-term Baduanjin （八段锦） exercise had been testified to be beneficial to the disease. This study conducted an initial assessment of the one-year Baduanjin exercise on knee OA. Methods： The recruited patients practiced Baduanjin at the community recreational center. Sessions were held for 30 min five times a week for one year. Knee pain, stiffness, physical disability, general health, knee extensors and flexors strength, and aerobic ability were measured using the Westem Ontario and McMaster Universities Osteoarthritis Index （WOMAC）, the Medical Outcomes Study Short Form-36 （SF-36）, the 6-Minute Walk Test （6-MWT）, and the Isoldnetic Strength of the Knee Extensors and Flexors （ISKEF）. Body mass index （BMI） was also calculated before and after the study period for comparison. Results： Twenty-eight patients signed the informed consent. Six patients withdrew from the trial. Twenty-two patients （29 knees） completed the one-year study. After one-year Baduanjin exercise, WOMAC pain （132.0 ± 69.6 vs. 56.2±67.6, P=0.000）, stiffness （64.7±54.8 vs. 22.3±34.6, P=0.000）, and physical function subscales （386.1± 275.8 vs. 182.0 ±235.7, P=0.003）; SF-36 body pain （45.7 ±20.0 vs. 57.4 ±17.9, P=0.005）, general health （50.5± 20.0 vs. 62.1 ±16.1, P=0.004）, role emotional （64.4±26.1 vs. 73.5±21.3, P=0.047）, and health transition （3.3± 1.0 vs. 2.6±1.0, P=0.008）; BMI （25.0±2.9 vs. 24.4±2.9, P=0.032）; 6-MWT （565.7±94.6 vs. 610.5±66.7, P=0.036）; and ISKEF Peak Torque （the Knee Extensors： 60.5 ±25.5 vs. 76.8 ±31, P=0.000; the Knee Flexors： 29.3±15.9 vs. 37.1 ±15.8, P=0.001） were significantly improved. No adverse effects resulted from the exercise. Conclusions： It suggested that the long-term Baduanjin could be a feasible and safe exercise option for knee OA.

Complementary and Alternative Medicine in Rheumatoid Arthritis

There are studies that have evidence for and are against to suggest that some of the complementary and alternative medicines （CAM） are effective against rheumatoid arthritis （RA）. However, there are no adequate studies that have evaluated the role that can be played by CAM in the management of RA. A focused approach in defining the role and limitation as well as the possible adverse events and safety should help in integrating both CAM and mainstream treatment of RA. This review discussed the limitations in the available literature and the direction for future research, which can accelerate the defining role of CAM in RA.