UNASSIGNED: Patients undergoing surgery, particularly patients undergoing surgery for oncology diagnoses, experience anxiety. Surgery remains the primary treatment for many common types of cancer. One promising potential intervention to alleviate anxiety in the preoperative and postoperative period is meditation, an integrative medicine intervention. However, there remains a gap in the literature regarding the effectiveness of meditation to alleviate anxiety during the perioperative time period.
UNASSIGNED: The scoping review was conducted using the Arksey and O\'Malley framework to synthesize the study findings and was reported with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The review included EMBASE, PubMed, Web of Science, CINAHL Plus, Scopus, and Cochrane Review databases from 2013 through 2024. All identified articles were exported to the online systematic review software, Covidence.
UNASSIGNED: A total of 538 initial citations were identified, 415 titles and abstracts were screened, and 83 full-text articles reviewed. Six studies were finally included. The data extracted from the literature included: study purpose, study design, sample size, preoperative or postoperative timeframe, instrument to evaluate anxiety, and conclusions.
UNASSIGNED: For patients undergoing oncology surgery, the perioperative period can be filled with anxiety. Guided, mindfulness, and loving-kindness meditation may be helpful in reducing anxiety, particularly in patients undergoing surgery for breast cancer during the postoperative period. However, the current literature is extremely limited. Future research should expand on the preliminary effectiveness to broader populations and carefully target the highest-risk populations for the ideal time point for interventions.

OBJECTIVE: We aimed to investigate the effects of chamomile (Matricaria chamomilla L.) on sleep in this systematic review and meta-analysis of clinical trials.
METHODS: PubMed, Scopus, Web of Science, and Cochrane Library were searched until August 2023. All clinical trials that investigated the effects of chamomile on sleep, either in healthy or diseased adults, were eligible to enter the study. The quality of studies was assessed using the Cochrane tool. Random-effects meta-analysis was used to pool weighted mean differences (WMD) and 95 % CI for the outcomes assessed by at least three studies with relatively consistent participants.
RESULTS: The systematic review included ten studies (772 participants). Meta-analysis was conducted for the Pittsburgh Sleep Quality Index (PSQI) score and sleep length. A significant reduction in PSQI score (WMD: -1.88, 95 %CI: -3.46, -0.31, I2: 88.4 %, n = 5) was found. For other outcomes, meta-analysis was not conducted. Sleep onset latency or ease of getting to sleep were improved in three of the four studies. Daytime functioning measures, including fatigue severity index or postpartum fatigue scale, did not change in all three studies. Sleep efficiency did not change in two studies and deteriorated in one. The number of awakenings after sleep or staying asleep was improved in two of the three studies. No adverse events were reported in any of the studies although passive surveillance was used to assess adverse effects except in one study. Only one study surveyed the blinding success and tested the purity and/or potency of the used products.
CONCLUSIONS: Chamomile improved sleep, especially the number of awakenings after sleep or staying asleep; however, it did not lead to an improvement in the duration of sleep, percentage of sleep efficiency, and daytime functioning measures. Future studies are suggested to assess objective measures.

Traumatic brain injury (TBI) is a complex condition associated with a range of persistent symptoms including headaches, cognitive dysfunction, mental fatigue, insomnia, and mood disorders. Conventional treatments for TBI-related symptoms can be insufficient, leading to interest in complementary and integrative medicine (CIM) approaches. This comprehensive article examines the existing literature on CIM modalities, including mind-body interventions, acupuncture/acupressure, herbal remedies, nutritional supplements, biofeedback, yoga, and tai chi in the context of managing secondary complications following TBI. The article highlights potential benefits and limitations of CIM modalities, while acknowledging the need for further research to better establish efficacy and safety in this specific population.

Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients respond well to available treatments in biomedicine alone. Additionally, there are concerns about side effects of many medications and interventions, the unsustainable cost of healthcare and the low resolution of chronic non-communicable diseases and mental disorders whose incidence has risen in the last decades. Besides, the chronic stress and burnout of many healthcare professionals impairs the therapeutic relationship. These circumstances call for a change in the current paradigm and practices of biomedicine healthcare. Most of the world population (80%) uses some form of traditional, complementary, and integrative medicine (T&CM), usually alongside biomedicine. Patients seem equally satisfied with biomedicine and T&CM, but in the field of T&CM there are also many challenges, such as unsupported claims for safety and/or efficacy, contamination of herbal medicines and problems with regulation and quality standards. As biomedicine and T&CM seem to have different strengths and weaknesses, integration of both approaches may be beneficial. Indeed, WHO has repeatedly called upon member states to work on the integration of T&CM into healthcare systems. Integrative medicine (IM) is an approach that offers a paradigm for doing so. It combines the best of both worlds (biomedicine and T&CM), based on evidence for efficacy and safety, adopting a holistic personalized approach, focused on health. In the last decades academic health centers are increasingly supportive of IM, as evidenced by the foundation of national academic consortia for integrative medicine in Brazil (2017), the Netherlands (2018), and Germany (2024) besides the pioneering American consortium (1998). However, the integration process is slow and sometimes met with criticism and even hostility. The WHO T&CM strategies (2002-2005 and 2014-2023) have provided incipient guidance on the integration process, but several challenges are yet to be addressed. This policy review proposes several possible solutions, including the establishment of a global matrix of academic consortia for IM, to update and extend the WHO T&CM strategy, that is currently under review.

Hypertension, a prevalent chronic condition characterized by elevated blood pressure, is a significant global health burden, contributing to approximately 7.5 million premature deaths annually. While existing literature predominantly focuses on conventional treatment modalities, this paper offers unique insights into dependable approaches to hypertension management. Drawing upon epidemiological data, it highlights the increasing prevalence of hypertension across diverse populations, emphasizing demographic disparities and regional variations. This article underscores the need for tailored interventions considering individual risk profiles and socioeconomic determinants. Beyond conventional lifestyle modifications and pharmacological therapies, it explores emerging trends such as mindfulness-based interventions and integrative medicine in hypertension management. Additionally, it discusses the role of digital health technologies and telemedicine in enhancing patient engagement and remote monitoring, optimizing treatment outcomes. Furthermore, the paper addresses the evolving landscape of personalized medicine and genomic advancements in predicting individual responses to antihypertensive therapies, advocating for precision medicine approaches. This paper advocates for a holistic and patient-centered approach to hypertension management by offering a comprehensive overview of established and emerging strategies. It underscores the importance of interdisciplinary collaboration, continuous education, and innovative research endeavors to address the multifaceted challenges posed by hypertension and improve global cardiovascular health outcomes.

The number of traffic accidents (TAs) is rising each year, and the severity of injuries can vary. Many people experience limitations in activities of daily living following TAs, affecting their quality of life. In pregnant women, even simple injuries caused by a TA could lead to unfavorable obstetric outcomes. Thus, we conducted a retrospective chart review and follow-up questionnaire survey to assess the safety and effectiveness of integrative Korean medicine (KM) treatment for pregnant women injured in TAs. To assess integrative KM effectiveness, the numeric rating scale (NRS) for TA-related symptoms, neck disability index (NDI) score, Oswestry disability index (ODI) score, shoulder pain and disability index score, Western Ontario and McMaster Universities Arthritis Index score, EuroQol 5-dimension 5-level (EQ-5D-5L) score, and patient global impression of change score were investigated for pregnant women injured in TAs. Additionally, for safety evaluation, obstetric and neonatal outcomes, as well as symptoms related to pregnancy, were assessed. At the end of treatment and follow-up, there were significant reductions in NDI and ODI scores, as well as NRS for neck pain, lower back pain, and headache, compared to scores at baseline. EQ-5D-5L scores significantly increased. A follow-up of 50 patients showed no major differences in obstetric and neonatal outcomes compared to the typical outcomes that occur in pregnant women and neonates. Major improvements were observed in the symptoms of patients who underwent integrative KM treatment after being injured in TAs. The symptoms occurred at a rate similar to those in typical pregnant women, while causality with integrative KM treatment was assessed to be unlikely or unclear. Therefore, integrative KM treatment may be considered an alternative treatment option for pregnant women who currently have limited treatment options.

UNASSIGNED: Chronic fatigue is a predominant symptom of post COVID-19 condition, or long COVID. We aimed to evaluate the efficacy and safety of Traditional, Complementary and Integrative Medicine (TCIM) for fatigue post COVID-19 infection.
UNASSIGNED: Ten English and Chinese language databases and grey literature were searched up to 12 April 2023 for randomized controlled trials (RCTs). Cochrane \"Risk of bias\" (RoB) tool was applied. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Effect estimates were presented as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI).
UNASSIGNED: Thirteen RCTs with 1632 participants were included. One RCT showed that Bufei Huoxue herbal capsules reduced fatigue (n=129, MD -14.90, 95%CI -24.53 to -5.27), one RCT reported that Ludangshen herbal liquid lowered fatigue (n=184, MD -1.90, 95%CI -2.38 to -1.42), and the other one RCT shown that fatigue disappearance rate was higher with Ludangshen herbal liquid (n=184, RR 4.19, 95%CI 2.06 to 8.53). Compared to traditional Chinese medicine rehabilitation (TCM-rahab) alone, one RCT showed that fatigue symptoms were lower following Qingjin Yiqi granules plus TCM-rehab (n=388, MD -0.48, 95%CI -0.50 to -0.46). Due to concerns with RoB and/or imprecision, the certainty in this evidence was low to very low. No serious adverse events was reported.
UNASSIGNED: Limited evidence suggests that various TCIM interventions might reduce post COVID-19 fatigue. Larger, high quality RCTs of longer duration are required to confirm these preliminary findings.
UNASSIGNED: The protocol of this review has been registered at PROSPERO: CRD42022384136.

OBJECTIVE: Children and adolescents with cancer, along with their parents and other informal caregivers, often report using complementary and alternative medicine (CAM) during active oncology and hemato-oncology treatment. Some adopt an \"alternative\" approach to conventional medical care, which often entails the use of these practices without the knowledge of the treating pediatrician. In contrast, many others search for consultation provided by a pediatric integrative oncology (IO) practitioner working with the conventional medical team. IO seeks to provide evidence-based complementary medicine therapies, many of which have been shown to augment conventional supportive and palliative care, while ensuring the patient\'s safety. The present narrative review examines the current state of and future direction for the IO setting of care.
RESULTS: A large body of published clinical research supports the effectiveness of leading Pediatric IO modalities, while addressing potential safety-related concerns. Despite the growing amount of clinical research supporting the beneficial effects and implementation of Pediatric IO models of care, there is still a need for further studies in order to establish clinical guidelines in the treatment of children and adolescents with cancer. Such IO-directed guidelines will need to address both the effectiveness and the safety of the CAM modalities being used in pediatric oncology and hemato-oncology settings, promoting a better understanding among pediatric healthcare professionals and helping them understand the indications for referral to the IO treatment service.

Whole-person care and holistic care approach has been proposed for complementary and integrative health care for type 2 diabetes mellitus. However, some doubts still exist on the feasibility of replicating processes followed in clinical trials and observational studies in real-world settings. This narrative literature review summarized and assessed existing clinical evidence (clinical trials, observational studies, and case reports) describing holistic and integrated care approach in adult and adolescent individuals with type 2 diabetes mellitus in clinical practice. The goal was to highlight existing evidence for implementation and outcomes of whole-medical systems and holistic integrated care approach for type 2 diabetes mellitus. A nonsystematic literature search was performed on Google Scholar, PubMed, Web of Science, ProQuest and ScienceDirect to identify clinical evidence from different parts of the world, evaluating the use of whole-medical systems and/or holistic care interventions in clinical practice for management of type 2 diabetes mellitus. Relevant keywords were used in the search. Data were analyzed using content analysis and simple descriptive statistics (percentages). Most of the studies (64%) were mainly conducted in Eastern countries (India, China and Israel) while 36% of the studies were conducted in the Western countries (USA, Netherlands, Canada and Mexico). Lifestyle medicine and integrated naturopathy were shown to be the commonly used whole-medical systems for type 2 diabetes mellitus management. Significant improvements in type 2 diabetes parameters, medication use, other symptoms, and overall feeling of wellness were observed in all studies. This review study revealed limited utilization and/or documentation of whole-medical systems or holistic care treatments for type 2 diabetes mellitus in regions of the world other than eastern countries. Lifestyle medicine, naturopathy, yoga, Ayurveda and traditional Chinese medicine were shown to be effective for type 2 diabetes mellitus, either as an alternative or as a complementary therapy. Please cite this article as: Makoni L, Manduna IT, Mbiriri AL. A review of whole-medical systems and holistic care approach for type 2 diabetes and associated metabolic syndrome. J Integr Med. 2024; 22(3): 199-209.

Herbal medicines are used by patients with IBD despite limited evidence. We present a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating treatment with herbal medicines in active ulcerative colitis (UC). A search query designed by a library informationist was used to identify potential articles for inclusion. Articles were screened and data were extracted by at least two investigators. Outcomes of interest included clinical response, clinical remission, endoscopic response, endoscopic remission, and safety. We identified 28 RCTs for 18 herbs. In pooled analyses, when compared with placebo, clinical response rates were significantly higher for Indigo naturalis (IN) (RR 3.70, 95% CI 1.97-6.95), but not for Curcuma longa (CL) (RR 1.60, 95% CI 0.99-2.58) or Andrographis paniculata (AP) (RR 0.95, 95% CI 0.71-1.26). There was a significantly higher rate of clinical remission for CL (RR 2.58, 95% CI 1.18-5.63), but not for AP (RR 1.31, 95% CI 0.86-2.01). Higher rates of endoscopic response (RR 1.56, 95% CI 1.08-2.26) and remission (RR 19.37, 95% CI 2.71-138.42) were significant for CL. CL has evidence supporting its use as an adjuvant therapy in active UC. Research with larger scale and well-designed RCTs, manufacturing regulations, and education are needed.