Ulcerative colitis, a chronic inflammatory disease of the colon, poses a great challenge for treatment because of the need for safe and effective therapies without serious side effects. Traditional Chinese medicine (TCM), with its anti-inflammatory, antioxidant, immunomodulatory and gut-protective effects, offers a promising prospect for treatment. The development of advanced delivery systems suitable for TCM could significantly improve the treatment of ulcerative colitis by increasing the targeting and efficacy of TCM while minimizing potential adverse effects. This review examines recent advances in drug delivery technologies for the treatment of ulcerative colitis, highlighting the role of these technologies in optimizing the efficacy of herbal medicines. In addition, it explores the underlying pharmacological mechanisms of Chinese herbal medicines against ulcerative colitis, laying the foundation for innovative therapeutic strategies and providing practical insights for clinical application. This review aims to support the development, application and modernization of TCM as a viable option for the treatment of ulcerative colitis.
This letter responds to the national survey by Mathur et al. on U.S. caregivers’ perceptions of integrative health (IH) for children by highlighting an underexplored determinant: moral-psychocultural caregiving communication. We argue that the observed gap between caregiver interest in provider-based IH and reported IH use may require attention not only to access, but also to cultural trust, emotional validation, and shared safety planning. Drawing on Silih Asah, Silih Asih, Silih Asuh, this letter proposes a culturally congruent hypothesis and a practical counseling mechanism for future pediatric IH research and provider training.
Medicinal plants are widely used in integrative medicine, but their safety and clinical reliability depend greatly on post-harvest storage. In many settings (particularly the developing countries), herbal materials are sold in open markets under heat, sun, humidity, dust, insect exposure, and repeated handling; such conditions can degrade bioactive compounds and promote microbial and fungal mycotoxin contamination. Studies from Africa and Asia report substantial bacterial and fungal burdens, including enteric pathogens and multiple mycotoxins, in marketed herbal products. These risks are particularly important because such products are often used by vulnerable patients. This brief report identifies poor storage as a neglected threat to therapeutic quality, calls for greater interest in standardizing the handling and storage of medicinal plants, and proposes a pragmatic minimum-storage framework for resource-limited settings, including raised drying, protective packaging, pest exclusion, and vendor training. Improving storage represents a simple, low-cost step toward safer and more reliable use of medicinal plants in integrative medicine.
Background Physical activity has many physical and mental health and wellbeing benefits across all ages, including for older people. However, older people continue to have low levels of physical activity participation. Diversity of options and choice are important considerations that may influence participation. There is a need for innovative approaches to physical activity that have research evidence demonstrating effectiveness, acceptability (including cultural acceptability) and suitability across the health spectrum for older people. The aim of this narrative review is to compare factors relating to two relatively new physical activity approaches emerging in Australia and internationally: Baduanjin (a form of traditional Chinese mind-body exercise), and outdoors Seniors Exercise Parks, that may influence physical activity participation. Methods A systematic review process evaluating outcomes associated with Baduanjin, and one evaluating outdoor exercise equipment, that included Seniors Exercise Parks were used as the basis for this narrative review. An additional search was conducted on Seniors Exercise Parks to update the 2021 outdoor exercise review publication; as well as additional searching on key parameters influencing participation in both of these forms of physical activity (such as acceptability, enjoyment and adherence). Results Twenty-six randomised trials from the Baduanjin review and nine studies (three randomised trials) from the outdoors exercise equipment review were used as the basis for this review; and a further 25 studies were identified to address the additional review aims. Both of these physical activity approaches have growing research evidence highlighting physical and mental health and wellbeing benefits for older people, although the existing research indicates Baduanjin has more often been used in older samples with health problems. Both Baduanjin and Seniors Exercise Parks have demonstrated good acceptability, enjoyment level and overall high adherence. Most Baduanjin research has been published in China, and Seniors Exercise Park research in Australia, so factors influencing their uptake in other countries warrants future research. Some feasibility factors may influence participation – for example, adverse weather may impact Seniors Exercise Park use. Conclusion Baduanjin and Seniors Exercise Parks both have supportive research to recommend greater use in practice, and warrant ongoing evaluation in Australia and other countries.
Background Ashwagandha (Withania somnifera) is a traditional herbal remedy known for its adaptogenic properties. Shoden®, a novel extract of Ashwagandha standardised with withanolide glycosides, is gaining attention for its potential health benefits. Objectives This study aims to assess the safety and tolerability of Ashwagandha extract enriched with 35% withanolide glycosides (Shoden®) in healthy participants. Materials and methods An open-label study was conducted with 62 healthy participants, administered 480 mg/day of the test Ashwagandha extract for 90 days. Hematology, lipids profile, liver and renal function tests, urine analysis and vitals were evaluated on Day 30, 60 and 90 against baseline. Participants were also monitored for adverse effects. Results Safety parameters remained stable with no clinically significant deviations from baseline. No significant variability was noted in body weight or vital parameters. The extract did not show significant variability in the blood sugar, ESR, serum cholesterol, and renal function indicators among the participants across the trial period. No significant variability of liver enzyme activity was observed following Ashwagandha administration. Conclusion Daily intake of 480 mg of test Ashwagandha extract standardised with 35% withanolide glycosides for 90 days was found to be safe and well-tolerated, supporting its use for general well-being.
Background Chronic musculoskeletal pain (CMP) is a leading global health burden and one that is often associated with pain sensitization. Mindfulness-based interventions (MBIs) are increasingly used for pain management; however, their effects on pain sensitization in CMP have not been systematically reviewed. Purpose This study aimed to synthesize the evidence on the effects of MBIs on pain sensitization in individuals with CMP. Methods Six electronic databases were searched from their respective inceptions to April 2025 for randomized controlled trials (RCTs) and quasi-RCTs evaluating MBIs for CMP with quantitative sensory testing (QST) outcomes. Meta-analysis was performed to synthesize standardized mean differences (SMDs) in QST outcomes, and narrative synthesis was used when meta-analysis was not feasible. Risk of bias was assessed using ROB 2 and ROBINS-I, and the certainty of evidence was assessed using the GRADE approach. Results Ten studies were included, with seven RCTs (139 participants in the MBIs group, 114 in the control groups) incorporated into the meta-analysis. The meta-analysis revealed a statistically significant increase in the pressure pain threshold (PPT) at local sites following MBIs compared to the controls (SMD = 0.64, 95% CI = 0.14–1.14, I2 = 65.7%, P＜0.01). Narrative synthesis showed that other mechanical and thermal thresholds in most QST outcomes (including sensation threshold, pain detection threshold, pain tolerance threshold, pain intensity, and unpleasantness) did not demonstrate significant between-group improvements. The overall certainty of evidence ranged from very low to moderate, with risk of bias and imprecision being the main reasons for downgrading. Conclusion There is low-quality evidence showing that MBIs may improve the local PPT in individuals with CMP, suggesting the potential effects of MBIs in modulating pain sensitization. However, effects on other QST outcomes remain unclear. The current evidence is limited by a high risk of bias, small sample size, moderate heterogeneity, and variability in QST outcomes. Registration This review was registered in PROSPERO (CRD420251030751) on 15 April 2025.
Purpose a critical narrative review of scientific literature regarding the efficacy of Piper methysticum (kava) for anxiety and Generalised Anxiety Disorder (GAD) Background 17% of Australian adults experience anxiety which includes GAD. Pharmaceutical treatments have side effects. Recent research has explored Piper methysticum (Kava) for GAD. Methods PubMed, EBSCO Host and the Cochrane library databases were searched focusing on RCTs, systematic reviews, and meta-analyses of peer-reviewed, full-text articles in English. 115 records were screened for which 98 were excluded; 17 full text articles were retrieved; ten were rejected and seven articles consisting of two systematic reviews and 5 RCTs were selected for critical analysis Results Kava, in commercial nutraceutical or ethanol form, is not effective for GAD. Of the two Systematic Reviews, one did not support Kava for GAD, while the other found that Kava is suitable for acute anxiety but not for long term symptoms of GAD. Three RCT studies had statistically significant results for anxiety but did not specifically address GAD. One RCT had moderate, non-significant results for GAD compared to a larger RCT showing Kava is only effective for short-term anxiety relief. Conclusion Kava, in commercial form, may help with short-term anxiety, but it is not proven effective for GAD. Further research on higher dosages and longer durations is needed to assess its efficacy and safety as a first-line treatment for GAD. Further research is needed in aqueous forms of extracts used as psychopharmacology in traditional cultural contexts.
Aim Analgesic and patient tolerability of wet cupping (Hijama bi’l Shart) versus aceclofenac (100 mg BD) in individuals with knee osteoarthritis. Methods This randomized, single-blind, controlled trial compared wet cupping therapy with oral aceclofenac (100 mg twice daily) in patients with symptomatic knee osteoarthritis over six weeks. Participants were randomly assigned in equal groups, with interventions delivered under a structured protocol at baseline, week 2, week 4, and week 6. Primary outcomes were pain (VAS), stiffness, and function (WOMAC). Secondary measures included joint mobility (goniometry), radiographic changes, and treatment tolerability. Analyses followed the intention-to-treat principle, using independent t-tests or chi-square tests for between-group comparisons and repeated measures ANOVA with Bonferroni correction for longitudinal data. Results A total of 117 participants completed the study (wet cupping: n = 60; aceclofenac: n = 57). Both interventions produced significant improvements in pain, stiffness, and functional outcomes. Pain scores declined in parallel across the groups, with aceclofenac showing relatively faster early relief, reflected in greater reductions in VAS (4.23 ± 0.7 vs 2.13 ± 0.6) and WOMAC scores (27.76 ± 6.8 vs 16.53 ± 3.1) at weeks 2–4. Wet cupping demonstrated progressive and sustained benefits, particularly in flexion contracture (166.70 ± 6.8 vs 133.66 ± 5.9), indicating superior gains in joint mobility by week 6. A two-sided p < 0.05 was considered statistically significant. Radiographic changes remained minimal in both groups. Tolerability profiles favoured wet cupping, which caused only mild local reactions. Conclusion Both aceclofenac and wet cupping effectively improve symptoms in knee OA, but with distinct temporal patterns. Aceclofenac offers rapid analgesia, while wet cupping provides gradual, sustained functional gains with a superior safety profile. Wet cupping therapy represents a viable, well-tolerated adjunct or alternative to NSAIDs, contributing to improved quality of life and joint function.
Background Dietary supplements (DS) and adapted physical activity (PA) are recognized as complementary strategies in oncology; however, guidelines for DS use during cancer treatment are lacking. Many patients self-prescribe DS and their adherence to PA guidelines remains low. Combined integrative approaches, such as supplementation and exercise, can induce synergistic effects rather than each intervention alone. This study investigated patterns of DS behavior across cancer phases. Understanding the potential link between motivations for DS and interest in PA may provide insights into the design of multidisciplinary approaches for oncology patients, with the goal of enhancing their quality of life. Methods A cross-sectional study was conducted among 114 cancer patients using DS (106 women, 8 men), 27–79 years. Clinical data, DS behavior, and PA interest and levels (according to international guidelines) were collected by self-administered questionnaire. Descriptive statistics and chi-square tests were used. An exploratory binary logistic regression examined the association between DS behaviors and interest in PA. Results Vitamin D and magnesium were the most used DS across all treatment phases, while olive oil and vitamin C were frequently reported during active treatment. Although oncologists were the preferred counselling source (59.6%), the main recommendations came from naturopaths, general practitioners, and personal networks. 38.6% of participants self-prescribed DS. Self-prescription was significantly associated with reasons for not informing general practitioners about DS use (χ²=10.371, p=0.016). Interest in structured PA programs was higher among patients using DS for general strengthening, dietary support, and sleep (p<0.05), but not among those using DS for fatigue, stress, or anxiety. Conclusion Among DS users, self-prescription was common despite a clear preference for oncologist guidance. Many patients rely on non-medical sources. The observed association between motivations for DS use and interest in PA highlights the need to further investigate the impact of integrated supportive care strategies in oncology.
Background Gastroparesis is a chronic gastric motility disorder associated with significant symptom burden and limited effectiveness of conventional treatments. As a result, many individuals explore complementary approaches, including chiropractic care, yet little is known about how patients experience and interpret these therapies. Methods A qualitative study using inductive thematic analysis was conducted. Adults with a self-reported diagnosis of gastroparesis and prior experience receiving chiropractic care were recruited through purposive sampling in the United States. Semi-structured interviews were conducted and transcribed verbatim. Data were analyzed using the six-phase approach described by Braun and Clarke. Results Nine participants contributed to the study. Four themes were identified: (1) descriptions of chiropractic techniques, (2) temporal relief and challenges of sustained symptom management, (3) multimodal approaches to symptom management, and (4) patient empowerment through interpersonal support. Participants described chiropractic care as a structured and consistent experience often associated with perceived short-term changes in symptoms. These experiences were typically not sustained and were interpreted within the broader context of living with a fluctuating chronic condition. Chiropractic care was commonly integrated alongside other therapies as part of individualized management strategies. Interpersonal aspects of care, including communication and attentiveness, influenced how participants experienced and engaged with treatment. Conclusions Participants perceived chiropractic care as one component within a multifaceted approach to managing gastroparesis rather than a standalone or curative intervention. These findings highlight how chiropractic treatments are experienced and interpreted within symptom-management practices and emphasize the importance of patient perspectives in understanding care for complex chronic conditions.
Background Post-stroke Gastrointestinal Dysfunction (PSGD) can impede patient recovery and diminish quality of life. Acupoint catgut embedding therapy (ACET) with PGLA threads may be beneficial, but its safety as an invasive treatment needs further investigation. Objective To evaluate the safety of ACET with PGLA threads in patients with PSGD. Methods This study assessed safety using adverse events (AEs) and laboratory tests. Forty patients with PSGD were randomly assigned to a treatment group(PGLA thread embedding at the acupoints CV12, ST25, and ST36) or a control group(sham embedding procedure at the same acupoints without thread implantation). The intervention was conducted once weekly for four weeks. Adverse events were recorded after each session, and blood and stool tests were performed before and after the intervention. Results All patients completed the trial, and no severe AEs were reported. Minor bleeding was observed in a few cases and was easily controlled by brief local pressure. Transient pain or numbness reported by several patients resolved spontaneously within one hour. All laboratory values stayed within normal limits. Conclusion PGLA threads acupoint embedding therapy is relatively safe for treating PSGD. No serious adverse events occurred, and all laboratory parameters remained stable.
Objectives Anxiety is the most common psychiatric disorder and is associated with dysregulation in the hypothalamic-pituitary axis causing elevated cortisol levels. Increased cortisol release impacts the function of brain regions and increases autonomic symptoms. Medical students are disproportionately affected by high levels of anxiety, which may increase burnout, reduce empathy, and compromise patient care. Nature-based therapies, such as gardening, offer a nonpharmacological and cost-effective approach to anxiety management. This study aimed to evaluate the potential effects of gardening as a nature-based intervention for reducing anxiety in first- and second-year osteopathic medical students. Study design and setting Participants (n = 32) were adult medical students at Lake Erie College of Osteopathic Medicine in Elmira, NY. The intervention consisted of approximately 2 h of gardening per week over an 8-week period. Anxiety levels were assessed pre- and post-intervention using the Hamilton Anxiety Rating Scale (HAM-A) and the Severity Measure for Generalized Anxiety Disorder–Adults (SM-GAD-A). Results All participants had a certain level of anxiety with 75% reported mild, 22% moderate, and 3% severe in the HAM-A pre-intervention survey. Furthermore, 53.1% of participants reported mild, 37.5% moderate, and 9.38% severe levels of anxiety in the SM-GAD-A pre-intervention survey. Analysis of the SM-GAD-A domain scores indicated that none of the domains demonstrated a statistically significant change from pre-intervention to post-intervention. However, HAM-A domain analysis revealed a significant (p < 0.05) reduction in autonomic symptom scores. Conclusion These findings suggest that gardening may be associated with improvements in self-reported autonomic symptoms of anxiety and may serve as a supportive nonpharmacologic strategy for medical students. However, the absence of a control group and paired analyses limit causal interpretation, and further comprehensive studies are needed to evaluate broader effects on anxiety severity.
