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Patients undergoing Still Point induction via compression of the fourth ventricle (CV4) in cranial osteopathy commonly report a distinctive quality of profound mental quiet, described as qualitatively different from ordinary relaxation. Cranial osteopathy, however, entered a prolonged crisis of scientific credibility once controlled work indicated that its founding construct, the Primary Respiratory Mechanism (PRM), could not be reliably palpated and that its proposed anatomical substrate, an inherent motility of the nervous system, palpable cranial bone motion, and a synchronised cranio-sacral rhythm, was not supported as originally formulated. In the absence of a defensible mechanism, the field has tended either toward vitalistic language or toward the untestable assertion that "something" therapeutic occurs. This paper does not defend the PRM. It proposes, instead, a modern and explicitly falsifiable theoretical framework: that CV4, treated as a standardisable manual procedure independent of the PRM construct, may transiently reconfigure a specific and measurable component of conscious experience, self-referential mental content, together with heightened interoceptive salience, through a convergent physiological cascade rather than through non-specific relaxation alone. We are explicit that "consciousness" here does not denote the global level or state of wakefulness, a brainstem-dependent arousal dimension, but a specific content dimension: the balance of self-referential versus present-moment, body-centred processing. The framework is assembled from convergent but indirect evidence drawn from autonomic, default-mode, interoceptive, and brain-state-clearance research; it therefore constitutes a chain of biological plausibility, not a demonstrated mechanism, and we say so throughout. Each proposed link is stated as a falsifiable prediction tested against a credible sham-touch comparator. We stress that the Default Mode Network (DMN) is used as a marker of one component of conscious content and is explicitly not treated as a proxy for consciousness itself. A dedicated section enumerates the non-specific alternatives, placebo and expectancy, generic effects of attentive touch, and demand characteristics, that any confirmatory study must exclude, and a further section concedes the framework's principal weakness: it lacks a firmly established grounding mechanism and, if not carefully specified and tested, risks relocating rather than resolving cranial osteopathy's long-standing problem of rational support. We set out what confirmation and what disconfirmation would each require the field to change in research, education, and integration into conventional care.

OBJECTIVE:Various pharmacological, herbal, and mechanical methods have been used to facilitate, However, evidence regarding the effects of vaginal sweet almond oil suppositories on labor outcomes remains limited. This study evaluated their effect on spontaneous labor and the duration of labor stages in nulliparous women at 40 completed weeks of gestation. MATERIALS AND METHODS:This triple-blinded, randomized, placebo-controlled clinical trial was conducted between July 2023 and January 2024 in Mashhad, Iran. Eligible nulliparous women at 40+0 weeks of gestation received one vaginal suppository daily for up to seven consecutive days. The primary outcome was spontaneous onset of labor while secondary outcomes included the duration of the first, second, and third stages of labor. Data were analyzed using SPSS version 25. Independent-sample t-test, Chi-square test, and Mann-Whitney U test were used, as appropriate. A P value <0.05 was considered statistically significant. RESULTS:The rate of spontaneous labor rate was higher in the sweet almond group than in the placebo group (66.7% vs. 40%, P=0.03). The mean duration of the second stage of labor was significantly shorter in the sweet almond group than in the placebo group (P < 0.05), whereas no significant differences were observed in the duration of the active first or third stages of labor (P > 0.05). CONCLUSION:These findings suggest that vaginal sweet almond oil suppositories may facilitate the onset of labor and shorten the second stage of labor in low-risk nulliparous women at 40+0 weeks of gestation. Larger multicenter trials are warranted to confirm these findings before routine clinical use can be recommended.

BACKGROUND:This study aimed to evaluate the effect of a reflexology-based constipation insole on constipation management, stool characteristics, and general comfort levels in patients receiving palliative care. METHODS:This randomized controlled experimental study was conducted among palliative care patients with constipation. During the first week, no intervention was applied to either group, and baseline bowel habits were assessed. From the second week onward, patients in the intervention group walked on a constipation insole for 20 min daily over a four-week period, while the control group performed walking only for the same duration. Data were collected using the Patient Identification Form and the General Comfort Questionnaire at baseline. The Constipation Assessment Scale was administered every three days, the Constipation Severity Scale was completed daily, and the Bristol Stool Form Scale was used following each defecation episode throughout the intervention period. The General Comfort Questionnaire was re-administered on day 28. RESULTS:The findings demonstrated a statistically significant reduction in constipation severity among patients using the constipation insole compared with the control group (p < 0.001). Additionally, significant improvements in stool form were observed in the intervention group (p < 0.01). General comfort levels increased significantly in the intervention group after the intervention period (p < 0.01). CONCLUSIONS:These results suggest that reflexology-based constipation insoles may serve as an effective complementary nursing intervention for constipation management in individuals receiving palliative care. The insole offers a practical, low-cost, and accessible approach that can be easily integrated into routine palliative care practice to improve symptom control and patient comfort.

Background Chronic insomnia is a prevalent sleep disorder associated with impaired daytime functioning and reduced quality of life. Although conventional hypnotic medications may provide symptomatic relief, their long-term use is often limited by adverse effects, tolerance, dependence, and recurrence of symptoms after discontinuation. Pāshoya (herbal footbath), a traditional Unāni regimenal therapy, has historically been used for insomnia; however, published clinical evidence remains limited. Case Presentation A 36-year-old male presented with a one-year history of chronic insomnia characterized by difficulty initiating and maintaining sleep despite previous treatment with multiple hypnotic medications that provided only temporary benefit. Following a one-week washout period, the patient underwent a standardized Pāshoya consisting of Withania somnifera, Valeriana wallichii, Melissa officinalis, Matricaria chamomilla, and Lavandula stoechas. Both feet were immersed in a lukewarm herbal decoction for 20 minutes at bedtime once daily for 45 consecutive days. Intervention and Outcomes Clinical improvement was assessed using the Insomnia Severity Index (ISI). The ISI score decreased from 18 (moderate clinical insomnia) at baseline to 12 on Day 15, 8 on Day 30, and 6 on Day 45, indicating resolution of clinically significant insomnia. The patient also reported improved sleep onset, fewer nocturnal awakenings, better daytime functioning, and enhanced sleep quality. No treatment-related adverse events were observed, and the clinical improvement was sustained during a three-month follow-up without additional pharmacological therapy. Conclusion This case suggests that standardized Pāshoya may represent a safe and potentially beneficial complementary intervention for selected patients with chronic insomnia. Further well-designed controlled studies are required to establish its efficacy, safety, and underlying mechanisms.

Integrative medicine is often understood as the incorporation of therapies from different medical traditions into patient care. While this therapeutic focus has advanced important research and expanded treatment options, it may overlook another dimension of integration: the conceptual frameworks through which clinicians understand health, illness, and healing. This reflection argues that the greatest promise of integrative medicine may lie not only in combining therapies but also in cultivating conceptual pluralism-the deliberate use of multiple explanatory frameworks to inform clinical reasoning while remaining grounded in scientific evidence, patient safety, and critical reflection. Drawing on the first author's experience practicing traditional Chinese medicine before entering medical school we compare how these traditions organize clinical information, define illness, and guide decision-making. We suggest that meaningful integration begins before treatment selection by broadening the questions clinicians ask, rather than simply expanding the interventions they offer. Although Western biomedicine and traditional Chinese medicine differ substantially in their theoretical foundations and evidentiary traditions, both contribute perspectives that may illuminate different dimensions of a patient's experience. We propose that conceptual pluralism offers a framework for understanding integrative medicine as an expansion of clinical reasoning rather than merely an accumulation of therapies, with implications for clinical practice, medical education, and future research.

BACKGROUND:GV22202, a highly bioavailable extract of Curcuma longa rhizomes, was evaluated for safety and efficacy in improving knee osteoarthritis (OA) symptoms in a randomized, double-blind, placebo-and active comparator-controlled parallel-group clinical trial (CTRI/2023/04/051793). METHODS:One hundred and fifty subjects were equally randomized to: placebo, GV22202-200 mg, and active comparator-1000 mg arms and supplemented for 84 days. Primary efficacy was assessed by changes in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index scores, with secondary measures including Visual Analogue Scale (VAS) pain ratings, Lequesne's Functional Index (LFI), Six-Minute Walk Test (SMWT), Stair Climb Test (SCT), and Isometric Knee Torque. RESULTS:GV22202 demonstrated improvements across all WOMAC subdomains (pain, stiffness, and physical function) starting at day 6, with sustained benefits through day 84. By day 84, the average total WOMAC score was decreased by 23.2%, with reductions of 16.02 ± 3.90 for pain, 14.38 ± 6.09 for stiffness, and 10.68 ± 3.14 for physical function. GV22202 outperformed the active comparator by 8.9% in total WOMAC score. In addition, participants in GV22202 showed substantial (p < 0.0001) improvements in scores of VAS (25.6%), LFI (39.7%), SMWT (9.6%) and SCT (14.5%) than active comparator group. Biomarker analysis revealed superiority of GV22202 in reducing hs-CRP, TNF-α, IL-6, MMP-3, uCTX-II and increasing TAC compared to active comparator. CONCLUSION:GV22202 was well tolerated and demonstrated superior efficacy in alleviating knee osteoarthritis symptoms, improving functional mobility, and enhancing overall joint health, which may be due to its anti-inflammatory, antioxidant, and chondroprotective potential.

Background Sinusitis is a common inflammatory condition associated with substantial symptom burden and impaired quality of life. Increasing interest has emerged regarding the potential role of yoga therapy as a supportive intervention for sinusitis management. However, the available evidence has not been comprehensively synthesized. Objective To comprehensively map the available evidence on yoga-based interventions for sinusitis, including intervention characteristics, outcome measures, and reported findings. Methods A scoping review was conducted in accordance with the PRISMA-ScR. Electronic databases including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Ovid were systematically searched along with grey literature sources and citation searching. Studies investigating yoga-based interventions for sinusitis or related sinonasal disorders were included irrespective of study design. Data were extracted using a standardized charting form and synthesized narratively. Results A total of 12 studies were included. The evidence consisted of randomized controlled trials, comparative interventional studies, controlled intervention studies, case reports, case series, and single-group intervention studies. Yoga-based interventions included cleansing techniques (Jala Neti, Kapalabhati, Sutraneti, Vamana), pranayama, asanas, relaxation techniques, and integrated yoga protocols. Symptom severity was the most frequently assessed outcome domain, commonly measured using SNOT-20 and SNOT-22. Improvements were reported in sinonasal symptoms, sleep quality, stress, headache severity, pulmonary function, inflammatory markers, and selected physiological parameters following yoga-based interventions. Conclusions The available evidence suggests that yoga therapy may represent a promising supportive approach for sinusitis management, particularly for symptom reduction and quality-of-life improvement. However, the current evidence base remains limited by methodological heterogeneity, small sample sizes, inconsistent reporting, and limited objective outcome assessment. Future research should prioritize adequately powered randomized controlled trials employing standardized and clinically validated yoga modules with systematic safety evaluation.

PURPOSE:To evaluate the effectiveness of auricular point acupressure (APA) in reducing perioperative anxiety and pain in patients undergoing cataract surgery under topical anesthesia. METHODS:In this single-center prospective randomized controlled clinical study, 120 patients scheduled for phacoemulsification with intraocular lens implantation were randomly assigned to an APA group (n = 60) or a standard-care control group (n = 60). Anxiety was assessed using the Hamilton Anxiety Rating Scale at baseline, 30 min preoperatively, and one day postoperatively. Pain intensity was measured using the Numerical Rating Scale intraoperatively and one day after surgery. Intraoperative cooperation and the need for supplemental topical anesthesia were recorded. RESULTS:Baseline anxiety scores were comparable between the control and the APA groups (17.33 ± 3.16 vs. 17.60 ± 2.65, P > 0.05). Thirty minutes before surgery, anxiety scores increased significantly in the control group but decreased markedly in the APA group (20.82 ± 3.57 vs. 10.63 ± 3.57, P < 0.01). Intraoperative pain scores were significantly lower in the APA group (0.15 ± 0.40 vs 2.78 ± 1.12, P < 0.01), and this difference persisted at one day postoperatively (0.03 ± 0.18 vs 1.50 ± 0.73, P < 0.01). Patients receiving APA demonstrated better intraoperative cooperation and required less supplemental anesthesia (P < 0.01). CONCLUSION:APA appears to be an effective non-pharmacological adjunct for reducing perioperative anxiety and pain during cataract surgery.

Background Trigeminal neuralgia, known in Unani medicine as ʻIṣāba”, is a recurrent, excruciating pain affecting the areas innervated by one or more branches of the fifth cranial nerve. In Unani medicine, the principle of management of such headache disorders is expulsion of morbid humors and neuromodulation with drugs. Case presentation Herein we describe a case of a 32-year-old female who reported to our hospital with severe paroxysmal pain on the right side of face. She had previously taken allopathic treatment, which gave temporary relief, and caused somnolence. She had been advised surgery, which she was skeptic of; hence, sought Unani treatment. At the time of presentation, the patient was in severe pain (indicated as 10 on NRS scale by her). Vital signs, local and systemic examination, laboratory and radiological imaging revealed no abnormality. Intervention and outcomes The patient was prescribed Unani formulations containing ingredients such as Terminalia chebula Retz., Prunus amygdalus Batsch., Santalum album L., and Borago officinalis L., which exert many actions including neuroprotective, anxiolytic, general tonic, and pro-cognitive. Besides, she was advised wet-cupping therapy on the nape of neck and supra-scapular region. There was significant relief after the first session of wet-cupping and negligible symptoms after the 4th session. All medicines were discontinued after 4-months, and the patient is symptom-free till date. Conclusion The exceptional improvement in this case reiterates that Unani neuromodulator (Musakkin-e-Aʻṣāb) drugs and wet-cupping may be a potentially effective and safe treatment option for Trigeminal Neuralgia. Larger studies are warranted to substantiate the observations.