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Category Archives: Alternative Medicine

Vets And Medical Cannabis: It’s The Least We Can Do – Forbes

Posted: June 22, 2022 at 12:15 pm

Cannabis has been proven to help benefit veterans struggling with pain and insomnia, as well as ... [+] symptoms of depression, anxiety and PTSD.

Recently, the VA launched of a new grants program on suicide prevention services for military veterans that specifically states that it wont support any treatments involving the use of cannabis. We know that cannabis has been proven to help benefit veterans struggling with pain and insomnia, as well as symptoms of depression, anxiety and PTSD, but unfortunately only 50% of veterans that return from service seek help.

One thing Im always on the lookout for is ways to support veterans with cannabis medicine. When I co-founded and operated Harborside, we were one of the first dispensaries to offer a veterans discount (15%), and we hosted free support groups to educate and help veterans with their physical ailments and PTSD. We also tried to show that our community cared for veterans with free alternative health services like yoga and reiki, and our free care package program for vets with low incomes. I recently met Tim Tofaute, the Director of Security & Operations with Operational Security Solutions (OSS).

Tofaute is a US Navy SEAL veteran and no stranger to the long-term damaging effects of PTSD and chronic pain. Hes been working on these issues for some time, and owns a company that provides cash handling and banking services to the cannabis industry. Hes passionate about shining a light on medical cannabis reform for US veterans utilizing VA ressources. OSS supports dozens of financial institutions and more than 100 cannabis-related businesses; the team consists of former law enforcement, military and federal professionals to directly support the security and banking needs of the legal cannabis industry.

This is what he had to say.

Tim Tofaute, the Director of Security & Operations with Operational Security Solutions (OSS).

What does war and/or service do to the soldier and why can cannabis help?

Tim Tofaute: This is a very involved question. War-time service and peace-time service are two different things. Im not saying one is more valuable than the other, just that they're different. However, all service can make a soldier feel like they were a part of something larger than themselves and part of a meaningful cause. That can really help someone with their sense of confidence and sense of belonging. It helps the servicemember feel like their efforts are important and making a difference regardless of military occupation specialty (MOS) or job position.

War takes things to whole different magnitudes. This can be a profoundly different distinction because it's also deeply personal. The experiences of war are often very hard to speak about as most people just wouldnt get it. Also, it can take a long time to process these experiences and many vets dont want to relive it, so its just easier not to talk about it. Not to mention, the carnage often makes you develop a pretty macabre sense of humor that most civilians cant relate to. Humor in times of duress often helps everyone keep it together. War changes you, and changes your perspective on things, also how you manage stress.

You can usually tell somebody who has had to live through extremely traumatic circumstances. I have several colleagues that I work with that use cannabis as a treatment for PTSD and pain, and have had some success with that. That is not a doctor-prescribed treatment, but they used it as an alternative treatment, and they saw benefit from using cannabis. There are some war vets that swear by it and others won't touch it.

Cannabis, if administered in the right amounts can help reduce anxiety and calm the mind, and help vets process their feelings easier. In order to accurately speak to the effectiveness, we need more research to be done; and without support from the federal government that's going to be difficult, we need more research and clinical trials.

Do you feel that cannabis should be made available to active duty soldiers and vets?

TT: I think that might be an option, but only after there is through study and case studies done on the veterans side, where we can really review whether or not the treatment works or if there are any side effects, before looking at that as an option for an active duty soldier to be performing their duties possibly impaired.

What has been your personal experience as a veteran and soldier, and how has cannabis helped you?

TT: I personally haven't used cannabis with great success for pain, but I work with and I have several fellow ex-veterans that are friends that have used cannabis with great success and swear by it.

What is your vision for medical cannabis reform at the VA?

TT: Assuming that there have already been enough studies that show that cannabis would be a plausible alternative treatment, then it's really up to the caregiver and the patient to determine their treatment route. Over time, and as more research is conducted, I think the VA should support this model as well.

Tell me about your company OSS and what role it plays in the cannabis industry?

TT: OSS is a cash logistics management firm that provides secure cash-in transit, security and risk management and onsite security services to cannabis companies that are forced to operate as cash-only as the federal government continues to keep marijuana on a list of Schedule 1 controlled substances. We are acting on behalf of financial institutions that have legal banking programs.

Anything else you would like me to know?

TT: As an armed courier service supporting the cannabis industry with financial solutions, we are extremely excited to be expanding our service footprint on the East Coast in areas including Pennsylvania, New Jersey and Maryland where we have programs open right now. New Jersey's recreational program is moving forward very rapidly and the state may be announcing new details of their program very soon.

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Vets And Medical Cannabis: It's The Least We Can Do - Forbes

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Ganglion Cysts treatment Market Analysis, Growth, Statistics, By Application, Production, Revenue & Forecast to 2028 Designer Women – Designer…

Posted: at 12:15 pm

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Ganglion Cysts treatment Market Analysis, Growth, Statistics, By Application, Production, Revenue & Forecast to 2028 Designer Women - Designer...

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Photodynamic therapy for the treatment of fungal infections | IDR – Dove Medical Press

Posted: at 12:15 pm

1Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Peoples Republic of China; 2Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, Peoples Republic of China

Correspondence: Yongxuan Hu, Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, 183 West Zhongshan Road, Guangzhou, Peoples Republic of China, Tel + 86 20 62784560, Email [emailprotected]

Abstract: Cutaneous fungal infections are common in humans and are associated with significant physical and psychological distress to patients. Although conventional topical and/or oral anti-fungal medications are commonly recommended treatments, drug resistance has emerged as a significant concern in this patient population, and safer, more efficacious, and cost-effective alternatives are warranted. Recent studies have reported effectiveness of photodynamic therapy (PDT) against fungal infections without severe adverse effects. In this review, we briefly discuss the mechanisms underlying PDT, current progress, adverse effects, and limitations of this treatment in the management of superficial and deep fungal infections.

Cutaneous fungal infections are categorized as superficial and deep infections and are associated with significant physical and psychological distress to patients. Conventional therapy may be ineffective, particularly for deep fungal infections. Furthermore, antifungal agents may cause severe adverse effects, such as liver toxicity, drug interactions, and drug resistance.1 Some superficial fungal infections, such as tinea pedis and cruris are recommended treatment continued for two weeks, post clinical cure for topical agents, and recalcitrant cases usually need continued systemic therapy to eliminate pathogens,2 which is known to reduce patient compliance and remains therapeutically challenging in clinical practice.

Reportedly, photodynamic therapy (PDT) is effective against fungal infections and serves as an alternative treatment strategy. PDT was originally discovered in 1900 and was used for its anti-microbial action; however, this treatment is gradually being accepted as an anti-fungal treatment option since the 1980s.3

The rapid onset of action, mild adverse effects, combinations with other therapies, and applicability in patients with contraindications to other drugs or in those with unresponsiveness to oral antifungal agents serve as advantages of PDT. Little to no risk of development of resistance and its repeatability are other advantages of this treatment. Currently, PDT is widely used to treat many cutaneous fungal infections, such as onychomycosis, tinea capitis, pityriasis versicolor (PV), oral candidiasis, vulvovaginal candidiasis (VVC), chromoblastomycosis (CBM) and cutaneous sporotrichosis, among others, of which onychomycosis is the focus of most research. PDT is a potentially promising therapeutic alternative for treatment of cutaneous fungal infections.

In this review, we discuss the published mechanisms underlying PDT, in addition to representative research on PDT in superficial and deep skin mycoses, and summarize the reported efficacy and limitations of this therapy for the management of fungal infections.

PDT involves the use of the following three elements: a photosensitizer (PS), a light source, and molecular oxygen.1 The PS frequently used in clinical practice include 5-aminolevulinic acid (5-ALA), methylamino levulinate (MAL), and methylene blue (MB). Light sources include red, green, and blue light, and lasers, among others. The mechanism underlying PDT effects is as follows: the PS absorbs energy under the action of light, changes its energy state, and reacts with oxygen molecules to generate reactive oxygen species (ROS), which selectively injure the infected or proliferative tissue.

PS produce their effects via the following mechanisms: A Type I reaction involves an interaction between the PS and the substrate, which generates free radicals, including hydroxyl radicals, hydrogen peroxide, and a superoxide anion that reacts with oxygen molecules to generate ROS, which cause fungal apoptosis.4 A Type II reaction involves direct transfer of energy from the PS to oxygen to form singlet oxygen (1O2), a potent ROS,5 which initiates cell injury (Figure 1).6

Figure 1 Mechanisms of action of photodynamic therapy. Following light absorption, excited state 3PS* reacts with O2 to produce ROS and 1O2 (type I and II reactions). Type III PSs combine properties leading to the generation of 1O2 and reduction of native free radicals in target cells. Type IV mechanism involves a structural change from excited state 1PS* by photoisomerization to enable molecular target binding of the activated PS* to its cellular target site. (* represents the excited state).

Abbreviations: PS, photosensitizer; 1PS, singlet photosensitizer; 3PS, triplet photosensitizer; ROS, reactive oxygen species; 1O2, singlet oxygen; O2, oxygen.

Type III and IV reactions have also been described in the literature.7,8 These reactions are cytotoxic to intracellular structures in the absence of oxygen. Type III PSs are usually classified as antioxidant carrier sensitizers (ACS), which result in the generation of efficient 1O2 and reduce the concentration of native free radicals in target cells. A Type IV reaction involves binding of a PS to its cellular target site after the activation of light excitation. Among the aforementioned mechanisms underlying PDT effects, Type I and II are indirect reactions, whereas Type III and IV reactions lead to direct activation of the PS molecule, which produces secondary reactions independent of interactions with oxygen (Figure 1).

ROS are key participants in phototoxic reactions. Some in vitro experiments have shown the possible mechanisms contributing to the growth-inhibiting effect of PDT, including destruction of biofilm formation and fungal cell wall structure secondary to enhanced ROS production.5,9,10 PDT produces oxidative damage to cellular structures and DNA, causes structural modifications in the plasma membrane, and inhibits enzymatic systems.11 Studies have reported that PDT-mediated therapy directly destroys microorganisms and also promotes neutrophil and lymphocyte infiltration at the affected sites to augment its fungicidal effect.12,13

Onychomycosis is one of the most common superficial fungal infections encountered in clinical practice, with a relapse rate of 25%30%.14 It is caused by dermatophytes, yeasts, and non-dermatophyte molds (NDMs).15 The most common etiological pathogen is Trichophyton rubrum, one of the dermatophytes.16 Many topical and oral agents cannot penetrate the nail plate and are not absorbed owing to the insufficient blood supply to the nail plate, which is invariably thickened in a diseased state.14 Currently, PDT is a promising strategy to enhance nail penetration. A systemic review showed that PDT led to negative results on microscopy and/or culture studies in 67% of patients (N = 58) who received this treatment.17 PDT combined with other physical therapies, such as lasers results in good penetration of the nail plate. A clinical trial (n=7) in which PDT with combined with carbon dioxide (CO2) laser to treat recurrent onychomycosis reported a mycological cure rate of 100%.18 Some in vitro experiments and mouse models have shown that PDT could disrupt bacterial and fungal biofilms,1922 such as Pseudomonas aeruginosa, Staphylococcus aureus, and Candida strains biofilms, which refers to a freely suspended microbial community that provides protection against host defenses.17 Theoretically, the anti-biofilm action of PDT can prevent recurrent onychomycosis.

Various PSs are used for PDT; however, these may show different levels of antifungal effects. Reportedly, nail penetration of MB is better than that of ALA, and MB is therefore associated with higher complete cure rates.1,23,24 MB usually does not require pre-treatment except in patients with nail hyperkeratosis measuring at least 2 mm, who require nail microabrasion.25 In contrast, ALA requires pre-treatment and prolonged exposure because the ALA molecule is required to undergo enzymatic conversion into a protoporphyrin for pre-use activation.25 Furthermore, high water solubility and absorption bands in the red spectrum are important features that determine selection of PS for the treatment of onychomycosis.26

New-generation PSs wrapped in nanoemulsions are shown to have good effectiveness and a high safety profile.27 A clinical trial using aluminum-phthalocyanine chloride with nanoparticles reported photoactivation for treatment of deeper nail layers.28 Two other studies have shown that light-induced gold nanoparticles could inhibit spore germination and achieve high complete cure rates.29,30 Nanoemulsions may serve as an excellent delivery system for PS and enhance penetration of aqueous tunnels created by pre-treatment using urea solution.28 Newer PS may possess intrinsically good nail penetration capacity, which may reduce incubation time, obviate the need for pre-treatment, and also be effective under low-oxygen conditions.31

Evidence from many in vitro studies supports the role of PDT as a potential therapeutic alternative for Trichophyton rubrum infection. Rose Bengal and Citrus aurantifolia essential oil (Citrus EO) PS activated by light are shown to reduce the growth of T. rubrum.32,33 Citrus EO is activated by sunlight, and no special light source is required. Sylsens B was shown to be an effective PS to prevent T. rubrum microconidia germination.26 Although these in vitro studies have shown promising results, no clinical trials have corroborated these findings. Further in vivo studies are required to verify the fungicidal effects of these agents (Table 1).

Tinea pedis is a common fungal skin infection; topical antifungal medications remain the mainstay of treatment, and oral antifungal drugs are considered in cases of infection that remain refractory to local therapy.34 Tinea pedis is a chronic and contagious condition with reservoir effect; therefore, long-term treatment (over >4 weeks) is recommended in recalcitrant cases.2 PDT was attempted for the management of tinea pedis to overcome the limitations of long-term drug therapy. However, this approach was not more effective than conventional therapies. Two clinical studies investigated ALA-PDT for the treatment of interdigital tinea pedis, the most common type of mycotic infection of the feet.35,36 In the two studies, complete cure rates were obtained at 30% and 22% at follow-up. ALA-PDT treatment of interdigital tinea pedis showed lower response rates than conventional topical allylamines (naftifine and terbinafine) therapy with mycological cure rates of 62%100% and clinical cure rates of 66%86%.37 It may be attributable to the fact that PDT treatment administered to irregular surfaces may result in light-blind areas, which may serve as a source of re-infection (Table 1).

Tinea cruris is a fungal infection of the groin, buttocks, and perineal and perianal skin. Reportedly, cure rates range from 80% to 90% following accurate diagnosis and optimal therapy.38 However, an alarming trend of recalcitrant tinea cruris is being observed, with reduced treatment compliance in patients.39 PDT has been attempted to overcome this concern; however, long-term outcomes were not favorable.

In a clinical trial that included 10 patients with tinea cruris caused by Trichophyton, the author administered 20% 5-ALA-PDT (570670 nm wavelengths) at a light dose of 50 J/cm2 for 4 hours/ session. Direct microscopy performed after 12 sessions showed negative results in 8 patients (80%). However, only 4 patients (40%) showed sustained healing at 8-week follow-up.40 Recurrence rates were as high as 50% in this study, which suggests that PDT may not be adequately effective for the eradication of fungi. The unsatisfactory therapeutic response to PDT may be attributed to high humidity and temperature in the groin, which affect the cellular uptake of ALA (Table 1).

Tinea capitis is one of the most common fungal infections observed in pre-pubertal children.41 Oral antifungal medications are considered standard therapy for tinea capitis; however, the increasing prevalence of resistant strains and adverse events limit the use of conventional antifungal treatment. Lu et al42 reported a case of relapsed suppurative tinea capitis in a child who showed mycological and clinical cure after ALA-PDT plus itraconazole treatment administered over three sessions. Treatment included topical application of 20% 5-ALA and an occlusive dressing for 3 hours, followed by irradiation using a light-emitting diode (LED) light (630 nm, 80 J/cm2) for 20 min/session. The authors observed that PDT destroyed metabolically active cells in addition to resistant forms such as conidia. PDT may serve as a useful adjunct for the treatment of refractory tinea capitis (Table 1).

Pityriasis versicolor (PV) is a chronic recurrent fungal infection of the stratum corneum. Although guidelines recommend systemic therapy for PV, this chronic condition is characterized by refractoriness to treatment. MB and MAL are common PSs used for the treatment of PV because the hydrophilicity of MB limits it to the stratum corneum, and the lipophilicity of MAL, restrains lipophilic Malassezia.1,43 Alberdi et al43 used MB-PDT (2% MB and a red LED lamp [= 6305 nm, 37 J/cm2]) to treat 5 women with disseminated PV on the back. MB-PDT administered over six sessions with a 2-week interval between sessions led to complete cure and good cosmetic outcomes without recurrence at the 6-month follow-up. The authors also recommended MB-PDT as a potential prophylactic treatment owing to its cost-effective and highly selective features (Table 1).

Oral candidiasis is a common opportunistic fungal infection typically observed in immunocompromised patients. Infection control is extremely important in these patients to avoid serious and often fatal outcomes. Candida albicans is the most common pathogen that causes oral candidiasis. Compared with its planktonic form, the biofilm-forming species is more pathogenic and necessitates a higher concentration of PS and a longer incubation period.4446 A study performed by Freire et al, which included biofilm growth in vitro and in a mouse model showed the efficacy of new methylene blue (NMB)-mediated PDT against C. albicans.47 Both the survival fraction analysis (log reduction of colony forming units (CFU/mL)) of C. albicans and histopathological examination showed eradication of fungi. The authors also observed that potassium iodide (KI) potentiated MB-PDT, which may be secondary to the fact that KI provides a greater number of electrons to MB to initiate a Type I photochemical reaction.

A case report and an in vivo experiment in the Galleria mellonella model have described that MB-PDT could rapidly heal oral lesions caused by drug-resistant C. albicans strains and reduce the fungal burden by 0.2 log in the animal model.48,49 However, the role of PDT in the prevention of drug resistance remains unclear.

In addition to oral lesions, C. albicans causes esophageal candidiasis (EC), particularly in immunocompromised hosts such as in patients with cancer, AIDS, diabetes, or a glucocorticoid-dependent state.50 Qiu et al51 successfully treated EC and controlled the progression of esophageal cancer using photocarcinorin-mediated PDT. Photocarcinorin (PSD-007), a mixed porphyrin preparation, is used as a PS; however, the mechanism of photo-oxidative injury remains unknown (Table 1).

Vulvovaginal candidiasis (VVC) affects approximately 75% of women of child-bearing age; C. albicans is the main pathogen associated with this infection.52 The azole family of drugs is widely used against Candida infection; however, these drugs block the activity of some essential enzymes and lead to adverse effects.53 The etiological agents implicated in VVC, including C. albicans and C. glabrata may be resistant to antifungal agents, including fluconazole.54 PDT represents a novel therapeutic adjuvant without deleterious effects.

A study performed by de Santi et al reported the use of MB- and protoporphyrin IX (PpNetNI)-mediated PDT to treat VVC in a mouse model.55 The authors observed reductions of one order of magnitude in the CFUs of C. albicans after 7-day treatment without any adverse effects on the vaginal mucosa at the ultrastructural level. In addition to its fungicidal effect, PDT reduced edema and abscess formation, which provided adequate time for the host immune system to eradicate the fungi.55

Machado-de-Sena et al observed reduction in the fungal burden and inflammation in a murine model of VVC within 24 hours of completion of MB-PDT (Table 1).56 However, fungal recolonization occurred 96 hours after PDT because this organism is a commensal that colonizes the healthy human mucosa. The authors speculated that MB-PDT may inhibit the formation of germ tubes, which contribute significantly the virulence of C. albicans. Additionally, PDT minimizes the harmful effects of toxins on the vaginal mucosa and is therefore a safe therapeutic choice.56

Chromoblastomycosis (CBM), a chronic granulomatous subcutaneous fungal infection caused by dematiaceous fungi is associated with low cure and high relapse rates.9 Fonsecaea monophora, Fonsecaea pedrosoi, and Cladophialophora carrionii are the most common fungal species associated with CBM. Notably, fibrosis is a major obstacle to successful oral antifungal management. Owing to diverse clinical manifestations and etiological agents, the optimal therapy for CBM remains uncertain. PDT has emerged as a promising physical approach to treating CBM, particularly in the early stages of the disease.57

Two in vitro experiments have shown that ALA-PDT and MB-PDT significantly decreased fungal CFUs in CBM by 24 and 4 orders of magnitude, respectively.58,59 Clinical trials have reported that muriform cells pose a therapeutic challenge; following tissue invasion, fungi are transformed into muriform cells, which aid with immune system evasion and antifungal drug resistance. PDT may directly destroy muriform cells or stimulate the host immune response. An in vivo experiment in the Galleria mellonella model confirmed the antimicrobial effect of ALA-PDT via immunomodulation of innate immunity secondary to increased hemocyte density, cell morphological transformation, and pathogen sensitivity.60

Combination therapy including PDT and systemic antifungal drugs is preferred in clinical practice, because most patients present for evaluation with moderate or severe disease. There are some successful clinical practices for PDT in patients with complex CBM using ALA-PDT associated with itraconazole or terbinafine.9,58,61 A sequential PDT protocol after failed drug therapy showed fungicidal effects similar to those observed with combination therapy.62 In patients with CBM post PDT treatments, most lesions showed clear improvement, and mycological examination results were negative after the last therapy session, with a few pigmentary changes but no new lesions on long-term follow-up.9

In addition to the combination of two methods, comprehensive treatment using several methods may be beneficial. Lan et al63 reported that PDT combined with oral antifungal agents, isotretinoin, and CO2 laser showed antifungal activity against clinical CBM (Table 1). The CO2 laser slightly injures the skin surface and thereby promotes penetration of the PS; such comprehensive management produces synergistic inhibitory effects.

Moreover, in vitro susceptibility tests may not accurately predict clinical response. A study has reported that several isolates of pathogenic strains from patients were sensitive to oral antifungal drugs but showed resistance in vivo.9 The overall patient status, phenotypic changes, differential gene regulation, and biofilm formation by dermatophytes may affect treatment efficacy.64 Therefore, clinical trials that determine the response rate of specific fungi to PDT are urgently needed.

Sporotrichosis, a fungal infection caused by the Sporothrix schenckii complex, a thermally dimorphic species, is often restricted to cutaneous, subcutaneous tissue, and lymphatic vessels.65 Oral itraconazole is commonly used for treatment of sporotrichosis; however, drug-induced hepatotoxicity remains a serious concern. PDT is an effective alternative for localized fungal infections without severe adverse effects.

Gilaberte et al66 reported complete microbiological and clinical cures in a patient with recalcitrant cutaneous sporotrichosis, who received intralesional 1% MB-PDT combined with intermittent low-dose itraconazole. The authors also performed an in vitro photoinactivation test on the fungus isolated from the patient and observed that three phenothiazinium PSs (MB, NMB, and 1.9-dimethyl methylene blue) produced a 6 log10 fungicidal effect, whereas MAL did not inhibit fungal growth, even at high concentrations (6 M). This result was consistent with the clinical outcomes observed in the patient (Table 1). Reportedly, the S. schenckii complex produces melanoid pigments that absorb light and scavenge ROS to limit the efficacy of PDT.67 The fungicidal efficacy of MB-PDT specifically against S. schenckii complex may be attributed to the method of administration, low optical interference, and high ROS production.66

Phaeohyphomycosis is a fungal infection that includes a wide spectrum of infections of the epidermis and subcutaneous tissues in addition to systemic involvement. It is caused by melanized fungi, and no standard antifungal therapy is currently available for this infection. Liu et al68 reported the use of ALA-PDT as adjuvant therapy combined with oral itraconazole and terbinafine to treat an elderly immunocompromised woman with phaeohyphomycosis caused by Exophiala spinifera. The authors used 20% 5-ALA red light (633 nm) at an intensity of 120 mW/cm2 administered over three sessions. Mycological evaluation showed negative results with significantly improved lesions and no notable adverse effects (Table 1).

Majocchis granuloma (MG) is a deep suppurative granulomatous perifolliculitis primarily caused by T. rubrum. Shi et al12 reported a case of refractory MG that was successfully treated after three-cycles of ALA-PDT. The lesions were treated using a plum-blossom needle before incubation with 10% ALA, followed by irradiation using red LED light (635 nm) at a power density of 100 mW/cm2 for 120 J/cm2. The authors simultaneously used the clinical strain isolated of the patient for in vitro and in vivo experiments in a guinea pig model. Both in vitro and in vivo experiments demonstrated that ALA-PDT directly destroys the structural framework of the fungal cells and thereby inhibits T. tonsurans and also recruits CD4+ T lymphocytes (Table 1).

Mucormycosis, most commonly caused by Rhizopus oryzae is an aggressive and invariably fatal opportunistic fungal infection that originates in the nasal tissues and spreads into the paranasal sinuses and deep organs with a rapid angioinvasive course. Mucorales are resistant to most triazoles, and surgical debridement is associated with specific limitations.11 Liu et al11 observed that MB-PDT inhibited the growth of R. oryzae and enhanced its susceptibility to azoles and amphotericin B in vitro, which explains the synergistic effects of antifungal agents combined with PDT, which was observed in the clinic to some extent (Table 1).

Usually, most adverse effects of PDT, including local erythema, edema, pain, burning and stinging sensations, and itching, which occur within the first PDT session are mild and tolerable.69,70 Slight blistering and minimal exudation may occur in a few patients. Hyper- or hypopigmentation or scars may persist over a long period of time, particularly in patients with deep fungal infections using ALA-PDT.71 However, most adverse effects are temporary and usually disappear within 2 weeks after PDT.72

Although significant research has focused on the role of PDT against fungal infections in recent years, most studies have provided proof-of-concept evidence in case reports in contrast to clinical data obtained through large-scale randomized controlled trials to confirm the long-term efficacy and safety of PDT, to optimize PDT protocols, and definitively establish PS for optimal benefit in specific fungal infections.

Comparison between articles is difficult owing to heterogeneity across studies, which results in a lack of high-quality meta-analyses. Notably, with regard to PDT, the type and concentration of PS, incubation time, light source, wavelengths used, energy, density, duration of exposure to irradiation, frequency of treatment, and growth of microorganisms, among such variables differed across studies, and in view of the diverse treatment settings, results too tend to vary widely, which may interfere with the accuracy of results, with regard to the efficacy of PDT.

Most studies have focused on only a few fungal diseases such as onychomycosis, oral candidiasis, and CBM that are commonly observed in clinical practice or are refractory to standard therapy.15,31,48,57,63 Further studies are needed to gain deeper insight into the exact mechanisms underlying cell death and enhanced susceptibility of fungi to antifungal medications.9,11,60

Few clinical studies in the literature have investigated the specific fungal response to PDT. Some studies have reported inconsistent and even contradictory results between in vitro and in vivo experiments.9 Therefore, in vitro experiments may not accurately predict the clinical response to PDT, and systematic clinical evaluation of specific fungal susceptibility to PDT is essential.

PDT may serve as a potential therapeutic alternative to address increasing drug-resistance encountered in patients with cutaneous fungal infections. PDT is effective against onychomycosis, tinea capitis, PV, oral candidiasis, and VVC in patients with superficial fungal infections. However, PDT did not offer any advantages over conazoles for the treatment of tinea pedis and tinea cruris.73 With regard to deep fungal infections, PDT combined with antifungal drugs was shown to improve treatment efficacy in patients with CBM, sporotrichosis, phaeohyphomycosis, MG, and mucormycosis.

To summarize, PDT is safe and effective and is occasionally useful as a prophylactic and cosmetic tool. Most adverse effects of PDT are limited, temporary, and tolerable. PDT monotherapy or PDT combined with oral antifungal medications may be a promising therapeutic strategy for the management of recurrent or severe cutaneous fungal infections.

This work was supported by grants from the Scientific Research Project of the Traditional Chinese Medicine Bureau of Guangdong Province (Grant no-20212147).

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

The authors report no conflicts of interest in this work.

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19. Collins TL, Markus EA, Hassett DJ, et al. The effect of a cationic porphyrin on Pseudomonas aeruginosa biofilms. Curr Microbiol. 2010;61(5):411416. doi:10.1007/s00284-010-9629-y

20. Park JH, Moon YH, Bang IS, et al. Antimicrobial effect of photodynamic therapy using a highly pure chlorin e6. Lasers Med Sci. 2010;25(5):705710. doi:10.1007/s10103-010-0781-1

21. Bapat P, Singh G, Nobile CJ. Visible lights combined with photosensitizing compounds are effective against candida albicans biofilms. Microorganisms. 2021;9(3):500. doi:10.3390/microorganisms9030500

22. Wiench R, Skaba D, Stefanik N, et al. Assessment of sensitivity of selected Candida strains on antimicrobial photodynamic therapy using diode laser 635 nm and toluidine blue - In vitro research. Photodiagnosis Photodyn Ther. 2019;27:241247. doi:10.1016/j.pdpdt.2019.06.007

23. Harris F, Pierpoint L. Photodynamic therapy based on 5-aminolevulinic acid and its use as an antimicrobial agent. Med Res Rev. 2012;32(6):12921327. doi:10.1002/med.20251

24. Sotiriou E, Koussidou-Eremonti T, Chaidemenos G, et al. Photodynamic therapy for distal and lateral subungual toenail onychomycosis caused by Trichophyton rubrum: preliminary results of a single-centre open trial. Acta Derm Venereol. 2010;90(2):216217. doi:10.2340/00015555-0811

25. Gilaberte Y, Robres MP, Fras MP, et al. Methyl aminolevulinate photodynamic therapy for onychomycosis: a multicentre, randomized, controlled clinical trial. J Eur Acad Dermatol Venereol. 2017;31(2):347354. doi:10.1111/jdv.13842

26. Smijs TG, van der Haas RN, Lugtenburg J, et al. Photodynamic treatment of the dermatophyte trichophyton rubrum and its microconidia with porphyrin photosensitizers. Photochem Photobiol. 2004;80(2):197202. doi:10.1562/2004-04-22-RA-146.1

27. Senge MO. mTHPCa drug on its way from second to third generation photosensitizer? Photodiagnosis Photodyn Ther. 2012;9(2):170179. doi:10.1016/j.pdpdt.2011.10.001

28. Morgado LF, Trvolo A, Muehlmann LA, et al. Photodynamic Therapy treatment of onychomycosis with aluminium-phthalocyanine chloride nanoemulsions: a proof of concept clinical trial. J Photochem Photobiol B. 2017;173:266270. doi:10.1016/j.jphotobiol.2017.06.010

29. Tawfik AA, Noaman I, El-Elsayyad H, et al. A study of the treatment of cutaneous fungal infection in animal model using photoactivated composite of methylene blue and gold nanoparticle. Photodiagnosis Photodyn Ther. 2016;15:5969. doi:10.1016/j.pdpdt.2016.05.010

30. Mohsen Hanafy AM. Epidemiology of cutaneous mycosis in the Medina region of Saudi Arabia correlated with studying the effect of light-induced gold nanoparticles on the growth of dermatophytes in vitro. Afr J Microbiol Res. 2012;6(37):37. doi:10.5897/AJMR12.1101

31. Simmons BJ, Griffith RD, Falto-Aizpurua LA, et al. An update on photodynamic therapies in the treatment of onychomycosis. J Eur Acad Dermatol Venereol. 2015;29(7):12751279. doi:10.1111/jdv.12950

32. Cronin L, Moffitt M, Mawad D, et al. An in vitro study of the photodynamic effect of rose bengal on trichophyton rubrum. J Biophotonics. 2014;7(6):410417. doi:10.1002/jbio.201200168

33. Fekrazad R, Poorsattar BMA, Ghasemi BV, et al. Eradication of C. albicans and T. rubrum with photoactivated indocyanine green, Citrus aurantifolia essential oil and fluconazole. Photodiagnosis Photodyn Ther. 2015;12(2):289297. doi:10.1016/j.pdpdt.2014.12.009

34. Nigam PK, Saleh D. Tinea Pedis; 2022.

35. Sotiriou E, Koussidou T, Patsatsi A, et al. 5-Aminolevulinic acid-photodynamic treatment for dermatophytic tinea pedis of interdigital type: a small clinical study. J Eur Acad Dermatol Venereol. 2009;23(2):203204. doi:10.1111/j.1468-3083.2008.02783.x

36. Calzavara-Pinton PG, Venturini M, Capezzera R, et al. Photodynamic therapy of interdigital mycoses of the feet with topical application of 5-aminolevulinic acid. Photodermatol Photoimmunol Photomed. 2004;20(3):144147. doi:10.1111/j.1600-0781.2004.00095.x

37. Korting HC, Rychlik R, Pfeil B. Behandlung der Tinea pedis vom interdigitalen Typ. Systematischer Review [Treatment of interdigital tinea pedis]. Dtsch Med Wochenschr. 2003;128(36):18191824. German. doi: 10.1055/s-2003-41969.

38. Hay R. Therapy of skin, hair and nail fungal infections. J Fungi. 2018;4(3):99. doi:10.3390/jof4030099

39. Bhargava P, Nijhawan S, Singdia H, et al. Skin barrier function defect - a marker of recalcitrant tinea infections. Indian Dermatol Online J. 2020;11(4):566569. doi:10.4103/idoj.IDOJ_434_19

40. Sotiriou E, Panagiotidou D, Ioannides D. 5-Aminolevulininic acid photodynamic therapy treatment for tinea cruris caused by Trichophyton rubrum: report of 10 cases. J Eur Acad Dermatol Venereol. 2009;23(3):341342. doi:10.1111/j.1468-3083.2008.02880.x

41. Ely JW, Rosenfeld S, Seabury SM. Diagnosis and management of tinea infections. Am Fam Physician. 2014;90(10):702710.

42. Lu J, Li W, Zheng W, et al. Successful treatment of kerion with itraconazole and ALA-PDT: a case report. Photodiagnosis Photodyn Ther. 2019;27:385387. doi:10.1016/j.pdpdt.2019.07.007

43. Alberdi E, Gmez C. Successful treatment of Pityriasis Versicolor by photodynamic therapy mediated by methylene blue. Photodermatol Photoimmunol Photomed. 2020;36(4):308312. doi:10.1111/phpp.12555

44. Seddiki SM, Boucherit-Otmani Z, Boucherit K, et al. Infectivits fongiques des cathters implants dues Candida sp. Formation des biofilms et rsistance [Fungal infectivities of implanted catheters due to Candida sp. Biofilms formation and resistance]. J Mycol Med. 2015;25(2):130135. French. doi:10.1016/j.mycmed.2015.03.003

45. Pierce CG, Lopez-Ribot JL. Candidiasis drug discovery and development: new approaches targeting virulence for discovering and identifying new drugs. Expert Opin Drug Discov. 2013;8(9):11171126. doi:10.1517/17460441.2013.807245

46. Gursoy H, Ozcakir-Tomruk C, Tanalp J, et al. Photodynamic therapy in dentistry: a literature review. Clin Oral Investig. 2013;17(4):11131125. doi:10.1007/s00784-012-0845-7

47. Freire F, Ferraresi C, Jorge AO, et al. Photodynamic therapy of oral Candida infection in a mouse model. J Photochem Photobiol B. 2016;159:161168. doi:10.1016/j.jphotobiol.2016.03.049

48. Campos L, Rezende SB, Palma LF, et al. Antimicrobial photodynamic therapy to oral candidiasis not responsive to micafungin in a patient undergoing hematopoietic cell transplantation. Photodiagnosis Photodyn Ther. 2021;34:102296. doi:10.1016/j.pdpdt.2021.102296

49. Chibebe JJ, Sabino CP, Tan X, et al. Selective photoinactivation of Candida albicans in the non-vertebrate host infection model Galleria mellonella. BMC Microbiol. 2013;13:217. doi:10.1186/1471-2180-13-217

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51. Qiu H, Mao Y, Gu Y, et al. The potential of photodynamic therapy to treat esophageal candidiasis coexisting with esophageal cancer. J Photochem Photobiol B. 2014;130:305309. doi:10.1016/j.jphotobiol.2013.11.028

52. Chew SY, Than LT. Vulvovaginal candidosis: contemporary challenges and the future of prophylactic and therapeutic approaches. Mycoses. 2016;59(5):262273. doi:10.1111/myc.12455

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QC Kinetix (Grand Junction) is Improving the Quality of Life for Patients Suffering Pain and Injuries Through Regenerative Medicine – Digital Journal

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Grand Junction, CO QC Kinetix (Grand Junction) offers regenerative medicine treatments to patients suffering from different types of pain and injuries. Their Grand Junction regenerative medicine is natural and works by stimulating the bodys natural healing capacities to repair damaged tissues resulting in reduced discomfort, minimized inflammation, and restored mobility. The clinic has non-invasive therapies which do not require surgery or prescription drugs. They treat a variety of conditions, including pain in the knee, elbow, wrist, back, and other body parts. They offer Grand Junction joint pain treatment for patients with joint pains from degenerative diseases like arthritis and sports injuries.

QC Kinetix (Grand Junction) has customized plans that are tailored to meet the unique health needs of each patient. They have a thorough pre-screening process to determine patients eligibility for regenerative medicine by looking at their medical history and may require additional tests. Their treatments offer long-lasting results and strengthen the damaged tissues to avoid re-injury. Their Grand Junction sports medicine combines regenerative treatments with rest, bracing and physical therapy. The minimally invasive treatments improve the quality of life and function.

QC Kinetix (Grand Junction) has a team of board-certified physicians with considerable experience in regenerative medicine. The clinic uses advanced technologies and equipment for diagnosis and treatment. They have a patient-centered approach that prioritizes patient needs and wellbeing. Their staff creates a friendly environment for patients that helps them understand patient needs and values. The clinic continually adopts new, well-researched methods that are at par with industry trends.

The clinic representative had this to say about their services,

When pain affects your daily routine and limits you from doing simple activities, it is time to take action to heal your body. At our QC Kinetix clinic in Grand Junction, CO, we focus on regenerative medical solutions so that our patients regain their strength and return to their daily activities and hobbies as soon as possible. Through various alternative treatments, we stimulate your bodys natural healing system to lessen joint degeneration, repair broken ligaments and tendons, and improve the overall quality of life.

The clinics treatments have minimal disruption of patients lives as they barely have any downtime once the healing begins. The experienced staff and technologies improve accuracy in diagnosis and treatment, resulting in better patient outcomes. The therapies offer an alternative to patients who do not want to experience the high costs and long recovery periods commonly associated with invasive providers like surgery.

QC Kinetix (Grand Junction) offers other services like free consultations. During the first visit, the patients treatment eligibility is determined, and the staff recommends the best treatments for their pain or injury.

For consultation and booking, contact their staff by calling (970) 747-5868. The clinic is located at 2646 Patterson Rd, Suite B Grand Junction, CO, 81506, US. Visit the company website for more information on their Grand Junction office and their natural regenerative medicine treatments.

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Company NameQC Kinetix (Grand Junction)Contact NameScott HootsPhone(970) 747-5868Address2646 Patterson Rd, Suite BCityGrand JunctionStateCOPostal Code81506CountryUnited StatesWebsitehttps://qckinetix.com/grand-junction/

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QC Kinetix (Ashwaubenon) Reveals How Its Green Bay Regenerative Medicine Treatments Have Improved Patients’ Lives – Digital Journal

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Green Bay, WI QC Kinetix (Ashwaubenon) has recorded many patient testimonials from Green Bay residents who have chosen to explore alternative treatments to combat joint pain and related problems. The pain control clinic leverages its regenerative medicine treatment approach to address common pain complaints affecting the joints while improving patients quality of life.

Describing their treatment program, the Pain control clinics spokesperson noted that they use natural treatment therapies in conjunction with regenerative medicine to address common symptoms complained by patients suffering from joint pain. According to the clinics spokesperson, their treatment approach is free from the use of heavy medications or other conventional treatment approaches, instead, they focus on encouraging the bodys natural healing abilities using natural and minimally invasive treatment strategies.

Green Bay residents who have been told to seek surgical intervention can also prevent the risks and complications associated with such invasive procedures by scheduling an appointment with QC Kinetix (Ashwaubenon).

Describing their surgery alternative, one of the treatment providers at the clinic said: Many residents in Ashwaubenon have received a surgery recommendation as the only option to relieve their chronic pain. However, regenerative medicine offers countless alternatives to surgery that could help you heal. Why not seek a second opinion from the orthopedic treatment providers at QC Kinetix or schedule a free initial consultation at our Ashwaubenon regenerative clinic to learn more? Our team offers an extensive range of regenerative medical solutions. These treatments offer natural, non-surgical alternatives to treating the chronic pain and inflammation associated with various conditions, including degenerative diseases, inherited diseases, sports injuries, and trauma injuries.

Encouraging Green Bay residents to explore their Green Bay regenerative medicine services, another treatment provider at the clinic noted that their treatment approach not only addresses the symptoms but also goes deeper to address underlying conditions and problems. Patients at the clinic will enjoy many benefits, including the repair and restoration of damaged and injured tissues, strengthened existing healthy tissue, reduced pain and inflammation, and increased response to repairs in the body.

QC Kinetix (Ashwaubenon) offers personalized services to each patient. The treatment providers will learn more about their patients during the consultation, perform a comprehensive examination and physical assessment, and then provide tailored treatment plans to address diagnosed problems. The pain control clinic welcomes interested people to visit their website to check testimonials of patients who have experienced improvements after four treatment sessions.

QC Kinetix (Ashwaubenon) is open to victims of all kinds of joint-related problems, including knee pain, shoulder pain, elbow and wrist pain, finger, toe, and ankle pain, etc. The treatment providers can be reached at their clinic located at 1525 Park Place, Suite 200, Green Bay, WI, 54304, United States. Call (920) 944-8811 to schedule an appointment or visit their website to fill out a web form.

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Company NameQC Kinetix (Ashwaubenon)Contact NameScott HootsPhone(920) 944-8811Address1525 Park Place, Suite 200CityGreen BayStateWIPostal Code54304CountryUnited StatesWebsitehttps://qckinetix.com/green-bay/ashwaubenon/

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Khairy: Medicine shortage will be resolved within next month | Malay Mail – Malay Mail

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Health minister Khairy Jamaluddin speaks during a press conference in Petaling Jaya June 21, 2022. Picture by Firdaus Latif

By Shahrin Aizat Noorshahrizam

Tuesday, 21 Jun 2022 1:46 PM MYT

KUALA LUMPUR, June 21 The Ministry of Health is currently monitoring the medicine shortage issue in the country and has conducted random surveys in local health facilities to ascertain the situation.

Health Minister Khairy Jamaluddin said through the survey that was conducted in seven hospitals and 10 private clinics, it was found that at least one medicine that is usually used to treat common ailments like cough and cold fever is facing a shortage.

Since June 16, 1,231 products have been sent to product registration holders to get active ingredient feedback ... we have received 50 percent of the feedback. There is a shortage of alternative products that have been reported by the medical association of hospitals and so on so that they can get alternative medicine.

Last week, the MoH agreed to lend medicines to private medical facilities that have enough of their medicines. We expect this situation to be stabilized within the next month or so, he said during a press conference today.

On June 9, Khairy said that the medicine shortage issue was not due to panic buying by members of the public.

He clarified that the shortage was due to the high demand for certain medications following the spread of the Omicron variant of Covid-19 and the rising cases of the hand, foot and mouth disease (HFMD) at the moment.

However, Khairy said the situation is not reported nationwide and only involved several locations. Earlier this month, Bandar Kuching MP Dr Kelvin Yii raised the issue and urged the government to come up with a clear policy to address the current shortage of medicines in the country.

He said this is on top of devising a "longer-term national medicine security strategy" to prevent future drug shortages in Malaysia, given the countrys current vulnerable position as a net importer of pharmaceutical products.

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Anthony Hardnett, DC, BCIM, DMBBP, DAAMLP, a Chiropractor with Effective Chiropractic Health Wellness Center – Pro News Report

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Get to know Chiropractor Dr. Anthony Hardnett, who serves patients throughout the State of Maryland.

(ProNewsReport Editorial):- New York City, New York Jun 21, 2022 (Issuewire.com)An established chiropractor, Dr. Hardnett places his emphasis on treating the patient as a whole and finding the cause of the problem, not just the symptoms. He owns and operates the premier state-of-the-art Effective Chiropractic Health & Wellness Center in Maryland, and has an overwhelmingly high success rate in helping patients with their health concerns. He feels that offering the latest treatment options, efficient care plans and patient education are all keys to the patients ultimate success. In 11 short years, he has made his practice the premier state-of-the-art chiropractic health and wellness facility in Maryland.

Effective Chiropractic Health & Wellness Center has grown from a small, 2-person office to a staff of 16 with expanded services and providers to meet their patients needs. It provides a variety of services that make them a one-stop-shop for healthcare. And in an effort to further expand services, the doctor has now added a Medical Doctor and Nurse Practitioner establishing Effective Integrative Healthcare, LLC to provide more integrative services for the community. He also added another office in Prince Georges County to further expand the practices ability to reach and help more patients.

In regards to his educational background, Dr. Hardnett graduated with his Doctor of Chiropractic degree from Life University in 2007. He is board-certified in Integrative Medicine (BCIM), which is the practice of using multiple treatment options within traditional medicine and alternative medicine to help patients. He also has extensive post-doctorate education relating to MRI interpretation and treatment of disc-related injuries.

With an unwavering commitment to his specialty, the doctor has been recognized as a Diplomate of the College of Manipulative and Body-Based Practices (DMBBP), which enhances his knowledge of how manipulation of the spine can assist the body to heal, as well as a Diplomate of the American Academy of Medical Legal Professionals (DAAMLP).

Chiropractic is a form of alternative medicine that mainly deals with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine. A chiropractor uses spinal adjustments, manipulation, and other techniques to manage patients health concerns, including neck pain, back pain, headaches, vertigo, and a long list of other ailments and conditions. They aim to improve patients functionality and quality of life by properly aligning the bodys musculoskeletal structure and enabling the body to heal itself naturally, without the use of medication or surgery.

Learn More about Dr. Anthony Hardnett:Through his findatopdoc profile, https://www.findatopdoc.com/doctor/2610078-Anthony-Hardnett-Chiropractor, or through Effective Chiropractic Health & Wellness Center, https://www.eihmd.com/about-us/

About FindaTopDoc.comFindaTopDoc is a digital health information company that helps connect patients with local physicians and specialists who accept your insurance. Our goal is to help guide you on your journey towards optimal health by providing you with the know-how to make informed decisions for you and your family.

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Yoga’s still postures give you happy hormones, manage chronic stress – The Indian Express

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The Yoga Sutras of Patanjali, considered to be a collective authoritative text on the practice and philosophy of yoga, were compiled by the sage Patanjali at least 1,700 years ago. They outline the eight limbs of yoga, which teach us the ways in which one can live a yogic life. They also describe the result of a regular and dedicated practice and how one can achieve that goal.

Sutra means thread, and collectively, the Yoga Sutras weave together the wisdom, philosophy and practice of yoga like the threads of a beautiful tapestry. These learnings evolved and were passed on over thousands of years via the oral tradition of chanting and were organised and explained in written form by Patanjali.

Yoga is recognized as a form of mind-body medicine that integrates an individuals physical, mental and spiritual components to improve aspects of health, particularly stress related-illnesses. Evidence shows that stress contributes to the aetiology of heart disease, cancer and stroke as well as other chronic conditions and diseases. The scientific study of yoga has increased substantially in recent years and many clinical trials have been designed to assess its therapeutic effects and benefits.

Yoga started as a mix of various ideas, beliefs and techniques. Patanjalis Yoga Sutra first gave yoga an order. The Raja yoga, often referred to as classical yoga, consists of an eight-limbed path listing a series of steps and stages that lead towards samaadhi or enlightenment. Tantra yoga was later developed as a series of practices to rejuvenate the body and to prolong life. It comprises radical techniques to cleanse the body and mind.

Yoga is now regarded in the Western world as a holistic approach to a healthy lifestyle and is even classified by the National Institute of Health as a form of Complementary and Alternative Medicine (CAM). The word yoga comes from a Sanskrit root yuj which means union, or yoke, to join, and to direct and concentrate ones attention.

Yoga has four principles: conserve your breath, preserve your body, be established in the flow, and synchronise your unit rhythm with the universal rhythm your circadian rhythm, with that of the cosmos. For you to become superhuman, you need to have insight, foresight and multi-sensory perceptions.

Yoga, as we see, experience and have heard about, involves asanas, breathing and meditation. What we miss out on is its role in reorganising our systems, functions and organs. In the last few years, when the world was going through a devastating pandemic, this 5,000-year-old mental, physical and spiritual practice came to our rescue.

Yoga has the potential of aligning and balancing our elements or Panchamahabhuta (air, water, fire, earth, space). The imbalance of Panchamahabhuta creates tridoshas. The three doshas, meaning basic components, are Vaata, Pitta and Kafa Prakruti. These doshas together determine our Prakruti (body organisation). Every human body is a well-adjusted mixture of the Vaata (constituted by space and air), Pitta (constituted by fire and water) and Kafa (constituted by water and Earth).

These doshas in an ideal balanced state give healthy status to the individual. But when there is an imbalance, it results in disease. Our attitude and behaviour play a pivotal point in upholding health or conversely, bring in an array of diseases. Thus, the balanced sattvic diet or food intake, regular yoga exercise and timely medication (which changes according to the dominant dosha), are advocated to avoid health problems.

Most also havent known and understood how the power of stillness in postures can stimulate growth hormones and regulate glandular hormonal functions. Many also dont realize how yoga helps cellular regeneration in real time simultaneously. Just as one cell dies, the other is created. This itself is anti-ageing, supports longevity and prevents diseases.

Yoga is designed to bring about increased physical, mental and emotional wellbeing, says M. Mala Cunningham, Ph.D., counselling psychologist and founder of Cardiac Yoga. Hand in hand with leading a heart-healthy lifestyle, it really is possible for a yoga-based model to help prevent or reverse heart disease. It may not completely reverse it, but you will definitely see benefits. As stress has an adverse reaction on blood pressure and heart disease, yoga has a tremendous benefit to manage it. Many individuals also experience calmness after doing yoga.

A 2016 report from the American Academy of Paediatrics concluded that yoga appears to be promising as a stress management tool for children and adolescents, with very low reports of adverse effects. It also said that yoga may have positive effects on psychological functioning in children coping with emotional, mental, and behavioural health problems. The report noted, however, that studies of yoga for children have had limitations, such as small sample sizes and high dropout rates.

The most beautiful part about yoga is its subtlety and its capacity to regenerate our faculties our ability to see, hear, touch, taste, smell, patience, tolerance, insights, foresights, intuitions and clarity of mind. It makes us evolve, brings leadership to form.

Weve heard about yoga balancing the mind, calming the mind, but many wouldnt know how yoga, meditation, postures and balance can heal your heart, heal your pain and give you sympathy, empathy, compassion, inner strength, grace for forgiving, forgetting and blessing.

Yoga has the power to heal diseases. The disorder turns into order, disease will turn into ease of living and decay will turn into regenerative processes. Yoga is invincible. It brings faith, conviction and most importantly, optimism.

A 2020 review of 12 recent studies (672 total participants) on a variety of types of yoga for stress management in healthy adults found beneficial effects in all of them. Of the 17 older studies (1,070 total participants) of yoga for stress management included in a 2014 review, 12 studies showed improvements in physical or psychological measures related to stress.

In a recent review of 14 studies (involving 1,084 total participants) that assessed the effects of yoga on positive aspects of mental health, most found evidence of benefits, such as improvements in resilience or general mental well-being.

Yoga has been shown to be helpful for sleep in several studies of cancer patients, women with sleep problems and older adults.

In conclusion, yoga has various benefits for our bodies as well as our minds. A constant and healthy boost of happy hormones can significantly influence your energy levels and overall productivity. Yatha pinde tatha brahmande (As is the atom, so is the universe).

(Dr Mehta is the FIT India Movement Champion by the Sports Authority of India and is a holistic health guru)

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CLL alternative therapies and complementary treatments – Medical News Today

Posted: June 20, 2022 at 2:59 pm

Chronic lymphocytic leukemia (CLL) occurs when the bone marrow makes atypical white blood cells. These cells crowd out the healthy cells, impairing a persons immune system. Treatment involves killing the cancerous cells to stop them from spreading.

So far, the only scientifically recommended treatments that can achieve this are:

Alternative therapies for CLL involve replacing medical treatments with other forms of medication or lifestyle changes. However, there is not much evidence suggesting they are effective for treating CLL in comparison with standard treatments.

However, for many people, complementary therapies can help ease symptoms and treatment side effects and improve quality of life. Complementary therapies are methods a person uses alongside regular medical treatment.

Because people often integrate these alternative therapies with their regular medical treatments, individuals often refer to this treatment plan as integrative medicine.

In this article, we will discuss whether it is possible to treat CLL naturally, complementary therapies for CLL, and their benefits.

Currently, there is no strong evidence that natural therapies can treat or cure CLL. This includes:

However, CLL does not always need treatment right away. It can develop slowly and may show no signs or symptoms for a few years.

Therefore, in some cases, doctors may decide to monitor a persons condition without giving them any treatments to see if their signs and symptoms change. This is known as watchful waiting or observation.

If a person needs treatment, doctors may recommend one or more of the following:

Doctors do not recommend relying solely on alternative treatments as a replacement for medical intervention. That said, some alternative therapies show promise as complementary treatments, which may help a person cope with having CLL mentally or physically.

Additionally, if someone is considering alternative treatments, they should discuss this with a healthcare professional first to determine if there will be any risks.

Below are some complementary therapies for CLL.

Dietary changes may help a person with CLL:

However, the exact diet a person follows can depend on their symptoms and needs. For example, for those experiencing appetite loss or weight loss, the Leukemia and Lymphoma Society of Canada recommends:

Learn more about diets for CLL.

Curcumin is an anti-inflammatory compound present in turmeric. It also has antioxidant and anticancer properties. A 2017 review argues that this makes curcumin beneficial to take during cancer treatment, particularly in the early stages.

And while curcumin alone is not a cure for CLL, numerous laboratory and human studies have found it improves outcomes alongside conventional cancer treatment.

However, more long-term, large scale human trials are necessary to fully understand the effects of curcumin. This is because people with CLL may need to take it for long periods for it to have an effect.

According to the National Cancer Institute, some clinical trials report that acupuncture can reduce nausea and vomiting for those undergoing chemotherapy.

A 2020 literature review also found that acupuncture may be helpful in managing cancer-related fatigue among cancer survivors, helping improve their quality of life.

Furthermore, a 2021 systematic review of previous research concluded that acupuncture may be an effective and safe way to reduce pain for CLL patients in palliative care.

Receiving a diagnosis of CLL, experiencing symptoms, and undergoing cancer treatment can all be highly distressing. Some people find that complementary therapies, such as mind-body therapies, help them cope with this.

Mind-body therapies aim to promote mental and physical well-being simultaneously. They often involve mindfulness or relaxation, which in turn, may affect symptoms. People may find it helpful to try:

The National Cancer Institute says there is a lack of conclusive evidence to prove aromatherapy is an effective form of treatment to manage the symptoms of cancer. Some studies suggest it may help some people with their mood, anxiety, nausea, or pain. However, other studies have shown no change in symptoms.

If a person finds aromatherapy helpful, they may feel benefits from aromatherapy massages or diffusers.

Learn more about aromatherapy.

Cannabidiol (CBD) is a chemical compound that occurs naturally in the cannabis plant. It is not addictive, and some report that it helps with relieving the symptoms or complications of cancer, including nausea, vomiting, and depression.

However, research on CBD is still in its early stages. Therefore, more studies are necessary to confirm it works reliably for people with CLL.

Learn more about using CBD for cancer.

Before trying any alternative or complementary therapy, it is important to speak with a doctor. Some therapies, such as herbal medicine, aromatherapy, or diet changes, may affect a persons treatment. Some can also interact with medications.

People with CLL can also speak with their doctor about safely incorporating complementary therapies into their treatment plan.

Other things to consider include what someone wants to achieve with the therapy, whether they need to go to a specific location to get it, and how much it costs.

Some health insurance companies may cover certain complementary therapies for those with leukemia. It is worth contacting insurers to check this before paying.

The Leukemia and Lymphoma Society recommends that people interested in complementary therapies for CLL ask their doctor some questions, such as:

Some people turn to alternative therapies for CLL instead of doctor-recommended treatments. However, there is not much evidence to support their effectiveness compared with chemotherapy, radiation, and other conventional treatments.

However, many doctors support using complementary therapies alongside medical treatment. Acupuncture, dietary changes, and mind-body approaches may help with managing symptoms and treatment side effects.

Preliminary evidence also suggests some supplements, such as curcumin, may help enhance chemotherapy. However, more research on which therapies are most helpful is necessary.

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CLL alternative therapies and complementary treatments - Medical News Today

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Complementary and Integrative Medicine for Migraine – Medscape

Posted: at 2:59 pm

This transcript has been edited for clarity.

Anna Pace, MD: Hi, everyone, and welcome. My name is Dr Anna Pace. I'm an assistant professor of neurology at the Icahn School of Medicine at Mount Sinai, and I direct the Headache Medicine Fellowship at Mount Sinai Hospital. Today, I'm lucky enough to be joined by my illustrious colleague, Dr Zhang.

Dr Zhang, would you like to introduce yourself?

Niushen Zhang, MD: Hi, Dr Pace. It's great to be here. I'm Dr Niushen Zhang. I'm a clinical assistant professor of neurology. I'm also the chief of headache medicine at Stanford University. Great to be here.

Pace: Today, we're going to be talking about complementary and integrative medicine for migraine. I think this is a topic that has sparked a lot of interest, especially on the patient side over the last couple of years. Dr Zhang, can you tell me a little bit about what exactly complementary and integrative medicine is?

Zhang: There are actually many definitions of it. What we generally think about are nonpharmaceutical treatment approaches or healthcare practices that may not be part of conventional medicine. The American Board of Integrative Medicine gives a very well-rounded definition of this, in which they say that it's a practice of medicine that focuses on the whole person, and it should be informed by evidence and make use of all of the appropriate treatment approaches that can help our patients achieve optimal health.

The name that we use to describe this field of medicine has changed over time. Initially, it was alternative medicine, then it was called complementary and alternative medicine, or CAM. The most recent term that we use is complementary and integrative medicine.

Pace: Or CIM, for short. I think CIM, based on what you're describing, sounds like it would fit well with headache medicine, in general, when we're thinking about all of the different factors that can potentially contribute to or affect a person's headache frequency. Some of the things that we always think about are lifestyle factors that can affect headaches.

Do you have any data or anything you'd like to talk about in terms of some of the different lifestyle factors that patients can work on when they are looking to try to reduce their headache frequency?

Zhang: First, we always want to think about which patients are a best fit for this type of treatment. We think about patients who may not have had adequate responses to their pharmaceutical treatments, who have poor tolerance to these treatments, or maybe some medical contraindication to medications. We also think about people who may be pregnant or lactating or planning pregnancy. These treatments can also be helpful for people who have medication overuse headache or exhibit significant stress and may not have adequate stress coping skills.

Really, the foundation is the lifestyle modifications. The way that I explain it to patients is basically your migraine brain is hypersensitive, especially to change. What it likes is a very regular and predictable schedule for eating, sleeping, and exercise.

Specifically, what we see for exercise is that about 20 minutes a day of aerobic exercise can actually decrease headache frequency and severity. This could be anything from devoted time to walking, hiking, biking, or swimming. Those can all be very helpful.

For sleep, poor sleep quality, including things like insomnia, can affect about 30% of patients with migraine. In our clinic, we always screen for any potential underlying sleep disorders, like sleep apnea. We want to make sure our patients receive appropriate evaluations and treatment for those conditions. What we find most helpful with sleep is just keeping the same bedtime and wake-up time every day, Monday through Sunday.

Of course, we get many questions about food and nutrition. The truth is the evidence is just not strong in this area at this time, for any specific dietary interventions. We always counsel our patients to keep a very regular and consistent meal schedule throughout the day and to avoid skipping meals. Patients also love to ask about food triggers, but the evidence is not strong for what foods must be avoided.

In practice, we find that food triggers are very individual for people. If someone finds that a certain food consistently triggers their migraines, then it would make sense to avoid that food, but in general, we don't encourage people to restrict their diet.

Pace: Exercise and sleep come up often in my clinic as well. Particularly for patients who find that exercise may trigger their attacks or they're hesitant to do any exercise because their attacks are so frequent, I often recommend gentler, low-impact exercises, like yoga, tai chi, or swimming, for example, which I think people find a little bit easier to warm up to or incorporate into their routine.

And really focusing on good sleep hygiene, and even things like trying to wind down before bed and having some type of routine, is really helpful. I have had a number of patients come to me and ask, "Is there anything, like vitamins or herbal supplements, that I can take to try to help prevent my attacks?" There is quite a number of them that have good evidence. What do you usually recommend for your patients?

Zhang: I'm glad you brought that up. There are, I would say, four that are evidence-based and very helpful for our patients. One of them is magnesium. That one has a level B recommendation from the American Academy of Neurology (AAN)/American Headache Society (AHS). We think it helps with calming down neuronal hyperexcitability and preventing cortical spreading depression. Some of the formulations we like are magnesium glycinate, magnesium oxide, and citrate. We do want to watch for any loose stool or diarrhea, because those are some of the common side effects that can potentially happen. The daily dosing is about 200-600 mg/d.

Other than magnesium, we also have vitamin B2 or riboflavin. That also has a level B recommendation, and it's well-tolerated. Some people do get very bright orange or yellow urine when they take it, and the dosing is around 400 mg. There's also coenzyme Q10, which has level C recommendation from AAN/AHS. It plays a role in the electron transport chain and may play an important role in sustaining mitochondrial energy stores. It's also very well-tolerated, and the daily dosing is about 300 mg.

The last one we have is something called feverfew, which is a type of chrysanthemum. This also has a level B recommendation. We think this may have some anti-inflammatory properties. Some people do get gastrointestinal (GI) side effects with that, so you do have to watch out. We don't recommend this one during pregnancy because it can cause early contractions and potentially miscarriage. The daily dosing for that is 50-300 mg.

Pace: It's great that there are so many different nutraceutical options for migraine prevention. I personally find the combination of magnesium and riboflavin to be a good one that I tend to start with. I think nutraceuticals come up quite often. I have many patients who ask me about them. Are there any patients, in particular, whom you think would benefit most from nutraceuticals?

Zhang: Similar to what we talked about before, many of our patients just don't tolerate some of the pharmaceutical treatments that we have, so this would be a good option to start with. One thing I always ask my patients to keep in mind is that the improvement can be gradual with these supplements. Really, like any preventive treatment, you want to give it up to 3 months before someone may see maximum benefit.

Pace: Agreed. I think it's hard sometimes to wait that long, but when they do, it really can help. Another type of CIM treatment that has really great evidence in migraine prevention includes the behavioral therapies, which brings to mind things like cognitive-behavioral therapy. I'm curious what your thoughts are about those and whether or not you recommend patients to utilize them?

Zhang: I think those are terrific options. Honestly, I think one of the challenges for providers is how to broach this topic without making your patients feel like you're dismissing their experience as psychiatric or psychological. I think one way to approach this is to help your patients understand that the contributors to their headaches are usually partial and additive, and that things like stress, anxiety, and mood disorders can have a significant impact on their headaches.

That's why it's really important that we find effective ways to address those. What's great is that now we have the highest level of evidence showing that specific biobehavioral treatments, such as cognitive-behavioral therapy, biofeedback, and relaxation training, are all effective preventive treatments for migraine.

Pace: As far as I understand, it sounds like patients who have migraine and who may also have anxiety and depression may benefit from these. Do you ever see patients who don't have a history of anxiety or depression utilize any of these therapies and find them helpful just for migraine?

Zhang: Absolutely. I would say relaxation training and also biofeedback. These are great because you can not only use them as a preventive treatment things that you practice on a daily basis for prevention but also reach for them as acute treatment tools when you feel that migraine escalating or the onset of migraine.

Pace: I think that sounds great, and I agree. I find that sometimes broaching this topic with patients can be a bit challenging because on the one hand, you want to be able to validate their experience, but at the same time help to target some of the potential mood components of their presentation or the anxiety that comes with having a migraine attack with aura, which I see very commonly and I'm sure you probably do as well. Using things like relaxation therapy in the moment during an aura, I think, can be incredibly useful.

One of the other things that I always get asked about is acupuncture and whether or not there is evidence for that in terms of its efficacy in helping with migraine prevention. I seem to get that question from many of my pregnant patients. Do you have any experience recommending acupuncture to patients? What do you think about the data for that?

Zhang: We are very data-driven and we want to provide evidence-based treatments for our patients. Acupuncture has pretty good evidence for its use as a preventive treatment in episodic migraine. There's still sparse evidence for using it to treat chronic migraine or to use it as an acute treatment.

When it comes to treating episodic migraine with acupuncture, there's an excellent 2016 Cochrane review that nicely summarizes the evidence for acupuncture for this treatment. They looked at 22 trials with almost 5000 patients and found that acupuncture is slightly more effective than sham in reducing frequency of headaches and at least similarly effective as some of our standard prophylactic medications.

Pace: That's great. As far as I know about the data, it seems like it would be a good option in addition to, perhaps, the traditional therapies that we are using, like oral medications. Similarly, yoga also comes up in the same conversation whether yoga can be useful. Again, many of my pregnant patients ask this question. Do you ever recommend yoga to patients?

Zhang: With yoga, I think there's still much we have to learn about in terms of how it helps our patients with migraine. At this time, we just don't have that much robust evidence for that.

There was a randomized clinical trial published in Neurology in 2020 that looked at the effect of yoga as an add-on therapy for episodic migraine. They had two groups. One was a medical therapy group, and the other underwent medical therapy for migraine treatment, as well as yoga. They had the yoga group practice a predesigned yoga intervention 3 days per week for 1 month with an instructor at a center. This was followed by, I think, 5 days per week for 2 months at home. They looked at over 100 patients for this study.

In the end, when they compared the medical therapy group with the yoga group, the yoga group showed a significant decrease in headache frequency, intensity, and some of the migraine disability scores. The conclusion was that yoga, as an add-on therapy for episodic migraine, may be superior to medical therapy alone. I think this is a very promising beginning in terms of the research, and I really hope that we get more studies like this done in the future.

Pace: Yes. I think it illustrates an important concept that I think many of us ascribe to, in that it's really important to think about the patient, what their lifestyle is like, and what they feel comfortable with in terms of a treatment regimen and how important it is to really create an individualized plan for them.

I personally use, often, a combination of pharmacologic treatment and nonpharmacologic treatments, so the fact that that study showed that yoga was great in addition to traditional migraine therapy hammers that point home for me, in terms of using even some of the other therapies that we've talked about in addition to our traditional oral or injectable therapies for migraine. Would you agree?

Zhang: I totally agree, Dr Pace. I think some of the most helpful treatment plans that we develop for our patients are those that integrate both pharmacologic tools and the nonpharmacologic tools that we have. Part of why I love headache medicine is that we actually get to personalize these treatments for our patients.

Pace: I completely agree. I think that's a good place for us to end. We thank you all very much for joining us.

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