Open Access Study Protocol

Medical Acupuncture in Raynaud's Disease: Protocol Development for Conducting Systematic Review and Meta-analysis

Naseem Akhtar Qureshi, Nasreen Khawer Salahuddin

Journal of Complementary and Alternative Medical Research, Page 1-18
DOI: 10.9734/jocamr/2019/v8i130113

Background: Idiopathic Raynaud’s disease is twice common in women than their counterparts, and secondary Raynaud’s disease co-occurs with a variety of medicosurgical conditions. Both diseases are managed by several medications which are invariably associated with various adverse effects.

Objective: This study aimed to describe several standardized SPIRIT and PRISMA steps and items that help in the development of research protocol directed towards systematic review and meta-analysis conduction concerning Raynaud’s phenomenon managed by clinical acupuncture. Methods and Results: Statements, guidelines, list of items and processes related to SPIRIT and PRISMA and their extensions and updated versions are ideal methodological tools in framing Raynaud’s disease and acupuncture research protocols for scientifically conducting not only randomized controlled trials but also systematic review and meta-analysis. By extension, these methodological tools could also be applied to develop research protocols for other diseases and nontraditional treatment interventions with some modifications. A total of 53 studies were included in this study protocol.

Discussion: In line with Traditional Chinese Medicine, the pattern of Raynaud’s disease and pros and cons of medical acupuncture should make an important component of discussion, besides the details of included randomized clinical interventions in systematic review and meta-analysis, which are but not limited to treatment effects, their strengths and limitations, quality, heterogeneity and endpoints.

Conclusion: The development of research protocol for conducting systematic review and meta-analysis is an art and while framing the draft researchers must take into account various SPIRIT and PRISMA statements and guidelines and their latest versions applicable to various diseases including Raynaud’s phenomenon managed by traditional and modern medications across the world.

Open Access Original Research Article

Randomised Controlled Trial of Salt Solution (Sodium Chloride) Mouth Wash vs Thymol Glycerine Usage in Sore Throat with Non Bacterial Pharyngitis

Mohd Azreen Ezairy Bin Mohmad Sallih, Mohd Zukiflee Bin Abu Bakar

Journal of Complementary and Alternative Medical Research, Page 1-5
DOI: 10.9734/jocamr/2019/v7i430110

Backgrounds: Sore throat is one of the most common reasons for visits to the hospital. While most patients with sore throat have an infectious cause (pharyngitis), either bacterial or viral infection, fewer than 20 per cent have a clear indication for antibiotic therapy.

Objective: The aim of this study is to investigate the patient’s clinical outcome after using a salt solution (sodium chloride) and thymol glycerine mouth wash in the evaluation of sore throat patient with non bacterial pharyngitis.

Methods: This was a randomized clinical trial, in which 100 patients who had non-bacterial pharyngitis were divided into two groups: those who gargled a salt solution (sodium chloride 3%) and those who gargled a thymol solution. A sore throat questionnaire was filled out 1 week later.

Results: Demographically, the results showed that there were significant differences between the two groups with regard to gender. However, there was no significant difference in age of the patients. A significant difference was observed between the two groups in term of sore throat pain scale, difficulty swallowing scale and swollen throat scale. All p-value are <0.001.

Conclusion: Gargling a salt solution, a natural, and harmless substance, can reduce the pain and other symptom of sore throat in patients with non-bacterial pharyngitis.

Open Access Original Research Article

Antimicrobial Potency and Bioactive Ingredients of Different Extracts of Prosopis africana against Some Selected Human Pathogenic Microbes: An In-vitro Approach

A. R. Abdulmumin, Z. J. Kassim, I. L. Muhammad, S. B. Mohammed, Y. Ya’aba

Journal of Complementary and Alternative Medical Research, Page 1-9
DOI: 10.9734/jocamr/2019/v8i130112

Background: The resistance to conventional drugs by microbes is at alarming rate and poses extra challenges in the field of medical and pharmaceutical industries. This study was aimed to determine the active ingredients and assess the antimicrobial potency of Prosopis africana leave extract using system of different solvents as aqueous, ethylacetate and n-hexane.

Methodology: The plant specimen was collected, identified, prepared and cold macerated using aqueous, ethylacetate and n-hexane as solvent.  The resulted crude extracts were further assayed for anti-infective potency; adopting agar well diffusion protocol against some selected human pathogenic isolates viz Streptococcus pyogenes, Klebsiella pneumoniae, Salmonella typhi, Methicillin-Resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Candida albicans. The Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Minimum Fungicidal Concentration (MFC) were ascertained using the standard protocol of microdilution assay.

Results: The antimicrobial screening of the crude extracts showcased that P. africana leave is susceptible against all the tested microbial stains by exhibiting significant degrees of inhibition zone of diameter (0 to 25 mm). The positive controls likewise were observed to be vulnerable to the tested isolates while P. aeruginosa was resistant. The MIC was observed at 50.0 to 12.5 mg/mL and MBC at 50.0 mg/mL against some bacteria strains. P. aeruginosa and C. albicans has no bactericidal and fungicidal properties. The phytochemical analysis led to the isolation of anthraquinones, carbohydrates, saponins, terpenes, steroids and cardiac glycosides as the active constituents of the plant part.

Conclusion: This finding provides a logical justification to the traditional healers for the utilization of the plant in the management of different ailments caused by the tested microbes.

Open Access Original Research Article

A Cross Sectional Clinical Analysis of Hemiplegia (Pakkavatham) Related to Diabetes Mellitus (Mathumeham) and Hypertension (Erathakothippu)

K. Sujeethasai, A. Manoharan, A. Rajarajeshwari

Journal of Complementary and Alternative Medical Research, Page 1-8
DOI: 10.9734/jocamr/2019/v8i130114

Background: Stroke (Pakkavatham) is the second leading mortality cause in global and death occurrence rates, rising in middle to older aged people. This condition is increased due to the dietary pattern and lifestyle modifications.

Aim: To determine about the interrelationship of Type II Diabetes Mellitus DM) and Systemic Hypertension (SHT) associated with hemiplegia.

Study Design: Cross Sectional Descriptive Observational Study.

Place and Duration of Study: This study work was carried out in 50 patients in Government Siddha Medical College and Hospital, Palayamkottai, Tirunelveli, Tamil Nadu from April 2019 to September 2019.

Materials and Methods: This study was carried in 50 subjects (30 subjects in Out Patient Department (OPD) and 20 subjects in In Patient Department (IPD) were randomly selected and the data were collected by interviewing with a structured questionnaire. The ethical clearance was attained from the Institutional Ethical Committee.

Results: The highest incidence was male patients (38%) than female patients, the affected age group was 51-60 years. The prevalence was seen in male alcoholic consumers (46%), chronic smokers (44%) respectively. The incidence was mostly seen in hypertensive (70%) and non-diabetic (46%) male patients. Among the 50 patients, 14 patients (28%) had both SHT and DM. The most prevalence was seen in hypertensive patients than DM or SHT combined with DM patients. The moderate improvement was seen in the patients (32%) of control blood pressure and serum glucose level.

Conclusion: The SHT may influence in the prevalence of Pakkavatham and control blood pressure and serum glucose level may be improved the good prognosis in Pakkavatham patients.

Open Access Original Research Article

Anti-bacterial Activity of Crude Flavonoid Fraction from Bidens pilosa Leaves against Selected Chronic Wound Bacterial Pathogens

Maria Kayondo Nakibuule, Ibrahim Ntulume, Daniel Chans Mwandah, Julius Tibyangye, Alkali Bashir, Martin Odoki, Deogratius Okoche, Josephat N. Maniga, Eliu Emmanue, Eliah Kwizera, Bwanika Richard, Adamu Almustapha Aliero

Journal of Complementary and Alternative Medical Research, Page 1-13
DOI: 10.9734/jocamr/2019/v8i130115

Aims: Bidens pilosa is an extraordinary source of phytochemicals particularly flavonoids especially in leaves which have been attributed in various studies due to its antibacterial properties. The present study aimed at addressing bio-burden of chronic wound through proving a possible source of new antimicrobial product for wound healing.

Methodology: Solvent-solvent extraction method was used to isolate crude flavonoid fraction from leaves of B.  pilosa using ether, chloroform, ethylacetate and methanol (1:1:1). Thin-layer chromatography was used to identify crude flavonoid fraction using methanol/n-hexane (1:2: v/v) as mobile phase solvents. Agar well diffusion method was used to determine anti-bacterial activity of crude flavonoid against bacterial pathogens: Susceptible Pseudomonas aeruginosa ATCC®27853™, resistant Pseudomonas aeruginosa susceptible Staphylococcus aureus ATCC®25923™, methicillin resistant Staphylococcus aureus, Streptococcus pneumoniae and methicillin resistant Staphylococcus epidermidis. Minimum inhibitory concentration (MIC) and Minimum bactericidal contrition (MBC) were also determined using broth dilution and culture methods.

Results: Thin-layer chromatographic profiling revealed an identity of three different spots with flavonoids from B. pilosa leaves showing three bands with Rf values 0.51, 0.60 and 0.63. The mean and standard deviation zone of inhibition of crude flavonoids ranged from 11.50±0.50 mm to 17.50±1.50 mm. The mean and standard deviation of positive controls (Ciproflaxacin, Co-Amoxiclay and Voncomycin) ranged from 0.00±0.00 to 22.50±0.50 mm. MIC and MBC of crude flavonoids ranged from 12.5-25.0 mg/mL and 50 to 200 mg/mL respectively. The flavonoid fraction was more effective against gram positive bacteria than on gram negative bacteria and it exhibited bactericidal effect on Methicillin resistant Staphylococcus aureus, resistant P. aureginosa, sensitive P.aureginosa and S. pneumonia.

Conclusion: B. pilosa leaves could be a potential source for future drug development from flavonoid to address the issue of need for new antibiotics due to alarming burden of antimicrobial resistance in last resort antibiotics.