Associations between perceived stress, quality of life and complementary health practices in Japanese outpatients: a multicenter observational study

In Japan and other countries, complementary health practices based on lifestyle modification such as exercise, diet, art and culture, gardening, and biofield therapy, have received increasing attention. This study was conducted to demonstrate associations between perceived stress, quality of life (QOL), and these complementary health practices. Computer-assisted data collection was conducted with Japanese outpatients in 10 clinics. Participants completed questionnaires that measured socioeconomic status (SES) and frequencies of complementary health practices. Psychological stress was measured using the 10-Item Japanese version of the Perceived Stress Scale. QOL was measured using the 10-Item Mokichi Okada Association Quality of Life Questionnaire. Data were analyzed using linear regression modeling. Baseline data of 1480 participants were available for cross-sectional analysis and data of 318 participants were available at follow-up for longitudinal analysis. Gender differences were not observed in stress and QOL, but age was positively correlated with QOL, and negatively with stress. A multiple regression model adjusted for age, gender, and SES indicated weak associations between each health practice and QOL in the cross-sectional (β=0.14-0.28) and the longitudinal analysis (β=0.17-0.27). Moreover, negative associations between each health practice and stress varied from -0.08 to -0.18, with the exception of biofield therapy in the cross-sectional analysis. In the longitudinal analysis, associations varied from -0.13 to -0.27, but diet and biofield therapy were not significantly associated with stress. These results suggest that complementary health practices had a significant effect on maintaining, or improving QOL, as well as in reducing stress of Japanese outpatients.

Antimicrobial activity of selected natural products against Gram-positive, Gram-negative and Acid-fast bacterial pathogens

Recurring epidemics of drug resistant bacterial diseases such as those caused by mycobacteria (tuberculosis and non-tuberculous infections), staphylococci (methicillin-resistant <em>Staphylococcus aureus</em> or MRSA infections) and various Gram-negative enterobacteria (enterobacterial infections) have reinforced the need to search for alternative antimicrobials. In this context, we investigated the anti-bacterial potential of nine different natural products and compared them with the antibiotic controls, using three test bacterial species, representing the Gram-negative (<em>Escherichia coli</em>), Gram-positive (<em>Staphylococcus epidermidis</em>), and Acid-fast (<em>Mycobacterium smegmatis</em>) pathogen groups. Six of the nine products showed detectable but variable zones of inhibition (mm2). The anti-bacterial activity (mm2 per 100 mg) of the extracts from the four solid natural products was in the following order for all three pathogen groups: Mint (<em>Mentha arvensis</em>) leaf extract, 264-930&gt;Mushroom (<em>Agaricus bisporus</em>) cap extract, 112-241&gt;Turmeric (<em>Curcuma longa</em>) root extract, 4-10&gt;Ginger (<em>Zingiber officinale</em>) root extract, 3-9. For the liquid products, the activity measured on 100 μL aliquots was in the following order: Eucalyptus (<em>Eucalyptus globules</em>) oil, 264-1044&gt;Mustard (<em>Brassica campestris</em> L. var. brown sarson) oil, 45-96. Taken together, these results indicated the highest activity in Mint extract and Eucalyptus oil against all three test organisms. However, the individual test strains showed the following variable order of susceptibility: Mint extract (<em>M. smegmatis</em>&gt;<em>E. coli</em>&gt;<em>S</em>. <em>epidermidis</em>); Eucalyptus oil (<em>M. smegmatis</em>&gt;<em>S. epidermidis</em>&gt;<em>E</em>. <em>coli</em>). Based on these results it can be concluded that Mint leaves and Eucalyptus oil have an unusually broad spectrum activity and may, therefore, be promising sources of new broad spectrum antimicrobials.

Antitumor potential of Citrus limetta fruit peel in Ehrlich ascites carcinoma bearing Swiss albino mice

<em>Citrus limetta </em>Risso (Rutaceae), commonly known as sweet lime in English and <em>Mousambi</em> in India, has been traditionally used for several medicinal purposes. This study explored the relationship between <em>Citrus limetta </em>fruit peel and its antitumor activity against Ehrlich ascites carcinoma (EAC) bearing mice. The antitumor activity of methanol extract of peel of <em>Citrus limetta</em> fruits (MECL) was evaluated against EAC cell line in Swiss albino mice. Twenty-four hours after intraperitoneal inoculation of tumor EAC cells in mice, MECL was administered at 200 and 400 mg/kg body weight i.p. daily for nine consecutive days. On the 10th day, half of the mice were sacrificed for the estimation of tumor growth (tumor volume, viable and non-viable tumor cell counts), and hematologic parameters (red blood cells, white blood cells and hemoglobin). The rest were kept alive for assessment of survival parameters, <em>i.e. </em>median survival time and percentage increase in life span of EAC bearing mice. Intraperitoneal administration of MECL at the doses of 200 and 400 mg/kg for nine days to the carcinoma induced mice demonstrated a significant (P&lt;0.001) decrease in tumor volume, viable tumor cell count, tumor weight and a significant (P&lt;0.001) improvement in hematological parameters and life span as compared to the EAC control mice. The present study establishes marked and dose dependant anti-tumor effect of <em>C. limetta </em>fruit peel against Ehrlich ascites carcinoma bearing Swiss mice.

Physico-chemical characterization and antimicrobial activity of Ceiba pentandra (Kapok) seed oil

Oil extracted from <em>Ceiba pentandra</em> seed was studied to explore its suitability for ethnomedical uses with a special emphasis on its physiochemical characterization, antimicrobial behavior and spectrophotometric parameters. Some of the physiochemical properties were examined and compared with those of standard oils and, in particular, any common characteristics with cotton seed oil were evaluated. Spectrophotometric analysis of oil was carried out to obtain information regarding the types, numbers and position of chromophores and auxochrome, and saturated and unsaturated compounds. Crude <em>Ceiba pentandra</em> oil was found to show good to moderate activity against bacteria, and in particular Gram +ve (<em>B. cereus, B. subtilis </em>and <em>S. aureus</em>) and Gram -Ve (<em>E. coli</em> and <em>P. aeurignosa</em>) and fungal stains, more specifically <em>Aspergillus flavans</em>, <em>Aspergillus niger</em>, <em>Candida albicans</em> and <em>Saccharomyces cerevisiae</em>. Maximum activity was observed on bacterial strains compared with fungal strains. Among bacteria, <em>Bacillus subtilis</em> was highly sensitive; fungi were less susceptible to oil and <em>Saccharomyces cerivisiae </em>were the most susceptible. Minimum inhibitory concentrations and minimum bactericidal and fungicidal concentrations of the seed oil varied between 3 to 10 mg/50 μL against all bacterial and fungal strains used in this study. In conclusion, <em>Ceiba pentandra</em> oil is a natural antimicrobial agent and could have therapeutic potential.

Examining the relationship between traditional Chinese medicine and conventional medicine in breast cancer patients medicated with estrogen antagonists

Breast cancer is the most common type of cancer among women, with a 10.4% incidence rate worldwide. It is the fifth most common cause of death. Treatment includes surgery, radiation and drugs. Conventional treatment of estrogen receptor positive types of tumors involves the use of hormone therapy. The side-effects of these drugs, <em>i.e.</em> menopausal type symptoms, are an extra burden to women with breast cancer. Further use of drugs to treat such side-effects often provokes adverse symptoms, prompting a search for alternative types of treatment. This paper aims to review research into the use of traditional Chinese medical acupuncture to combat side-effects in breast cancer patients medicated with estrogen antagonists, and examine its complementary role.

Responsiveness and minimally important difference of a generic quality of life measure for complementary health practices

Shorter and easier methods of conducting community health surveys would be useful. We conducted a study to demonstrate the responsiveness of the 10-item Mokichi Okada Association quality of life questionnaire (MQL-10) in a follow-up survey and to determine the minimally important difference (MID) for this measure. In 2007, Japanese adults participated in a survey on health prac- tices. We analyzed the MQL-10 scores (n=6365) together with the following factors: gender, age group, disease, reason for participation, and complementary health practices, such as food and eating. The mean baseline MQL-10 score was 26.4±5.83 [standard deviation (SD)] and the mean follow-up score was 27.6±5.45 SD with a mean change of 1.20±4.41 SD. The effect size for change was 0.21 and the standardized response mean was 0.27. The MQL-10 scores in the baseline condition were associated with gender, age group, disease, reason for participation and complementary health practices. Furthermore, the changes in the MQL-10 during the 12 weeks of study were associated with age group, disease, reason for participa- tion and complementary health practices. The increase in frequency of health practices was significantly associated with improvements in the participants’ quality of life (QOL). These results suggest that the MQL-10 is use- ful for assessing the effects of complementary health practices on QOL. The estimate of 3 points for the range of this measure (0-40) was higher than half of the SD of scores; therefore, it was considered reasonable for the MID.

Evaluation of central nervous system depressant activity of Cleome rutidosperma

The central nervous system (CNS) depressant activity of the ethanol extract (200 and 400 mg/kg) and its fractions (200 mg/kg each) of the aerial parts of Cleome rutidosperma was investigated in various models. The tested extract and its fractions showed significant (P&lt;0.01) anxiolytic, anticonvulsant activity (in treating petit mal epilepsy) without any unwanted sedation effect. These findings justify the traditional use of this plant in CNS disorders.

Complementary use of topical bitter melon for atopic dermatitis

<em>Momordica charantia</em> (bitter melon) is popular in systems of traditional medicine to treat a variety of diseases including atopic dermatitis, which is an inflammatory, chronically relapsing skin disorder characterized by dry, scaly, pruritic skin. While there is growing community interest in adopting bitter melon as a complementary medicine, there are no clinical studies looking at its use for atopic dermatitis. Here we report a case of a 6-yearold female with severe refractory atopic dermatitis that responded to treatment with topical bitter melon in an open half-side comparison trial.

A review of medicinal plants that modulate nitric oxide activity

Modulation of nitric oxide (NO) may offer novel approaches in the treatment of a variety of diseases, such as Alzheimer’s, cardiovascular disease, and diabetes. A strategy in the modulation of NO expression may be through the use of herbal medicines. We surveyed medicinal plant research that utilized multicomponent extracts similar to what is used in clinical phytotherapy or in commerce, for demonstrated effects on NO activity. SciFinder Scholar, Pubmed, Web of Science, and BIOSIS were searched to identify human, animal, <em>in vivo</em>, <em>ex vivo </em>or <em>in vitro</em> research on botanical medicines, in whole or standardized form, that act on nitric oxide activity. iNOS was the most frequently investigated enzyme system and this system was up-regulated by many plant extracts, including, <em>Chicorium intybus, Cocos nucifera, Echinacea purpurea, Euonymus alatus, Ixeris dentate, Oldenlandia diffusa, Rhinacanthus nasutus, and Sida cordifolia. Many plant extracts down-regulated iNOS, including Centella asiatica, Dichroa Febrifuga, Echinacea purpurea, Evolvulus alsinoides, Fagonia cretica, Ginkgo biloba, Mollugo verticillata, Lactuca indica, Lithospermum erythrorhizon, Pueraria thunbergiana, and Taraxacum officinale</em>. The eNOS system was stimulated by <em>Eucommia ulmoides, Sida cordifolia</em>, and <em>Thymus pulegioides while Fagonia cretica, Rubia cordifolia</em> and <em>Tinospora cordifolia </em>down-regulated nNOS. Given the activity demonstrated by many of these herbal medicines, the increasing awareness of the effects of nitric oxide on a wide variety of disease processes and the growing incidence of these conditions in the population, further study of medicinal plants on nitric oxide signaling may lead to novel therapies and further insight into human physiology.

Yoga for persons with severe visual impairment: a feasibility study

This exploratory study aims to establish the feasibility of an Ashtanga-based Yoga Therapy (AYT) program for improving sleep disturbances, balance, and negative psychosocial states, which are prevalent issues for visually impaired (VI) individuals. Ten legally blind adult participants were randomized to an 8-week AYT program. Four subjects in the 1st cohort and three in the 2nd cohort successfully completed the AYT program. They convened for one session per week with an instructor and performed two home-based sessions per week using an audio CD. The Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were administered at baseline and post-intervention. A Timed One-Leg balance measure, respiratory rate (RR), and the Philadelphia Mindfulness Scale (PHLMS) were assessed in the 2nd cohort. Both groups completed a qualitative exit survey. Positive exit survey responses (all subjects were extremely or mostly satisfied, and wanted to continue AYT) and good participation rates (7 subjects attended at least 7 of the 8 weekly sessions) support the feasibility of the AYT. PSQI, PSS, BAI and BDI scores changed in the direction of reduced negative symptoms after AYT for the 1st cohort. Changes in PSQI and PSS for the 2nd cohort were varied. Balance, RR and PHLMS awareness trended toward improvement for each individual. This preliminary study provides proof of concept for potential benefits of AYT that may be observed in VI subjects. Larger studies and an active control group are needed to determine efficacy.