Introduction: The lack of evidence that proves the benefit of traditional and complementary medicines (T&CM) in treating chronic medical conditions does not deter its usage among patients worldwide. Prevalence of usage among post-stroke patients in Malaysia especially is unknown. This study aims to determine the prevalence, practice and perception of T&CM use among stroke survivors attending an outpatient rehabilitation program in a teaching hospital. Methods: A cross-sectional study was conducted among 104 post stroke patients attending an outpatient rehabilitation program. A structured self-administered questionnaire was used to collect data on sociodemographic and clinical profile of patients, as well as types of therapy used and perception on T&CM usage. Descriptive analysis was done, and bivariate analysis was used to determine associations between categorical data. Results: Mean age of patients was 62 years (SD 12.2), 54% were Chinese and 75% of the patients had ischaemic stroke. Mean age of T&CM users was younger compared to nonT&CM users (61 years vs. 66 years, p=0.04). Two-thirds (66%) of patients admitted to concurrent T&CM usage while attending conventional post stroke rehabilitation. Acupuncture (40.4%), massage (40.4%) and traditional Chinese medicine (11.5%) were the most common T&CM used. Positive perception was recorded in terms of ability of T&CM usage to relieve post stroke symptoms (68%), and it was safe to use because it was made from ‘natural sources'. Negative perception recorded: T&CM caused significant adverse effects (57.6%) and was not safe to be used in combination with other conventional medicines (62.5%). Conclusions: Concurrent T&CM usage among post-stroke patients attending structured outpatient rehabilitation program is widely practised especially acupuncture, massage and traditional Chinese medici
Complementary Therapies, Stroke

The purpose of this study is to analyse and evaluate the characteristics of stroke patients and the causes of their spending time in arriving emergency room and the actual conditions of using alternative medicines before entering emergency room. The subject of this study four hundred seventy six patients who was hospitalized in Western Medical and Chinese Herb Medicine of D Hospital in Pusan within two weeks after attack. The collected data are analysed by the analysis method of narration statistics through SAS program and one-way analysis through ANOVA. The important results of this study are as followings: The spending time in arriving emergency room shows that under 3 hours is 19.5%, under 6 hours is 29.0%, under 24 hours is 55.1%. In the aspects of using alternative medicines before entering emergency room, the patients of 60.1% had used alternative medicines. Through the examination and analysis it can be seen that the geographical-environmental features and the clinical features for the acute stroke patients have more effect than the populational-sociological features on the spending time in arriving emergency room. For the aspects of using alternative medicines before entering emergency room, however, the charactericstics of clinical features have more effect than the populational-sociological features and the geographical-environmental features.
Asian Continental Ancestry Group ; Busan ; Complementary Therapies* ; Emergency Service, Hospital ; Humans ; Narration ; Stroke*

Hypertension is a major independent risk factor for the development of coronary artery disease, heart failure, stroke, and renal failure. Despite many experimental and clinical trials, no optimal strategy for the treatment of hypertension has been established. This editorial comment presents recent advances in the treatment of hypertension based on randomized clinical trials. This review also introduces the effects of alternative medicine and novel antihypertensives agents and covers some emerging concepts, such as vaccination, gene therapy, and individualized therapy, that will shape the approaches to treatment in the years to come.
Antihypertensive Agents ; Complementary Therapies ; Coronary Artery Disease ; Genetic Therapy ; Heart Failure ; Hypertension ; Renal Insufficiency ; Risk Factors ; Stroke ; Vaccination

Hiccup is the sudden onset of erratic diaphragmatic and intercostal muscle contraction and immediately followed by laryngeal closure. The abrupt air rush into lungs elicits a "hic" sound. Hiccup is usually a self-limited disorder; however, when it is prolonged beyond 48 hours, it is considered persistent whereas episodes longer than 2 months are called intractable. A reflex arc involving peripheral phrenic, vagal and sympathetic pathways and central midbrain modulation is likely responsible for hiccup. Accordingly, any irritant in terms of physical/chemical factors, inflammation, neoplasia invading the arc leads to hiccups. The central causes of hiccup include stroke, space occupying lesions and injury etc, whereas peripheral causes include lesions along the arc such as tumors, myocardial ischemia, herpes infection, gastroesophageal reflux disease and applied instrumentations on human body etc. Besides, various drugs (eg, anti-parkinsonism drugs, anesthetic agents, steroids and chemotherapies etc) are the possible etiology. An effective treatment of persistent hiccup may be established upon the correct diagnosis of lesion responsible for the serious event. The pharmacotherapy of hiccup includes chlorpromazine, gabapentin, baclofen, serotonergic agonists, prokinetics and lidocaine. Non-pharmacological approaches such as nerve blockade, pacing, acupuncture and measures to hold breathing are also successful. Finally, alternative medicines and remedies are convenient to treat hiccups with uncertain effect. In conclusions, hiccup is likely to result from lesions involving the hiccup reflex arc. The lesion may need to be localized correctly for ablative treatment in patients with intractable hiccup. Apart from lesion ablation, drugs acting on reflex arc may be effective, while some other conventional measures may also be tried.
Acupuncture ; Amines ; Anesthetics ; Baclofen ; Chlorpromazine ; Complementary Therapies ; Contracts ; Cyclohexanecarboxylic Acids ; gamma-Aminobutyric Acid ; Gastroesophageal Reflux ; Hiccup ; Human Body ; Humans ; Inflammation ; Intercostal Muscles ; Lidocaine ; Lung ; Mesencephalon ; Myocardial Ischemia ; Myoclonus ; Nerve Block ; Reflex ; Respiration ; Serotonin Receptor Agonists ; Steroids ; Stroke

Menopause is very important for women causes of many health problems are related. Hormone Replacement Therapy (HRT) is so common to treat symptoms of menopause. It is important that benefits and harms of HRT based on scientific evidence should be considered when prescribing HRT. The health care workers should prepare themselves for a better dialogue with women including information about alternative treatment. Beneficial effects of HRT on vasomotor symptoms have been supported by various studies, but HRT to treat negative mood is not recommended. Estrogens and androgens have significant beneficial effects on skin collagen, but do not prevent the effect of aging on elastic tissue and have limited use in the prevention and treatment of skin changes of menopause. Short-term benefits have been shown for urogenital atrophy. Recent evidences suggest that benefits of HRT include prevention of osteoporotic fractures, and colorectal cancer while prevention of dementia is uncertain. Harms include Coronary Heart Disease (CHD), stroke, thromboembolic events, and breast cancer, with 5 or more years of use. Active living, alternative therapies and consumption of food rich in phytoestrogens are some areas, which need to be explored in more detail. Patient preferences as well as evidence are important to initiate and/or continue HRT. Treatment choice should be based on up-to-date information and targeted to individual women's needs. HRT still offers the potential for benefit to outweigh harm, providing the appropriate regimen has been instigated in terms of dose, route and combination.
Aging ; Androgens ; Atrophy ; Breast Neoplasms ; Collagen ; Colorectal Neoplasms ; Complementary Therapies ; Coronary Disease ; Delivery of Health Care ; Dementia ; Elastic Tissue ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Menopause* ; Osteoporotic Fractures ; Patient Preference ; Phytoestrogens ; Skin ; Stroke

OBJECTIVEGua Sha and Blood-letting at the acupoints were Chinese traditional therapies for heatstroke. The purpose of present study was to assess the therapeutic effect of Gua Sha on the DU Meridian and Bladder Meridian combined with Blood-letting acupoints at Shixuan (EX-UE 11) and Weizhong (BL 40) on heatstroke.

METHODSAnesthetized rats, immediately after the onset of heatstroke, were divided into four major groups: Gua Sha group, Blood-letting group, Gua Sha combined with Blood-letting group and model group. They were exposed to ambient temperature of 43 °C to induce heatstroke. Another group of rats were exposed to room temperature (26 °C) and used as normal control group. Their survival times were measured. In addition, their physiological and biochemical parameters were continuously monitored.

RESULTSWhen rats underwent heatstroke, their survival time values were found to be 21-25 min. Treatment of Gua Sha combined with Bloodletting greatly improved the survival time (230±22 min) during heatstroke. All heatstoke animals displayed and activated coagulation evidenced by increased prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, and decreased platelet count, protein C. Furthermore, the animals displayed systemic inflammation evidenced by increased the serum levels of cytokines interleukin-1ß (IL-1ß), tumor necrosis factor α (TNF-α) and malondialdehyde (MDA). Biochemical markers evidenced by cellular ischemia and injury/dysfunction included increased plasma levels of blood urea nitrogen (BUN), creatinine, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and alkaline phosphatase (ALP) were all elevated during heatstroke. Core temperatures (Tco) were also increased during heatstroke. In contrast, the values of mean arterial pressure were signifificantly lower during heatstroke. These heatstroke reactions were all signifificantly suppressed by treatment of Gua Sha and Blood-letting, especially the combination therapy.

CONCLUSIONGua Sha combined with Blood-letting after heatstroke may improve survival by ameliorating systemic inflflammation, hypercoagulable state, and tissue ischemia and injury in multiple organs.

Animals ; Blood Coagulation Disorders ; drug therapy ; therapy ; Bloodletting ; Combined Modality Therapy ; Complementary Therapies ; methods ; Cytokines ; blood ; Heat Stroke ; physiopathology ; Inflammation ; drug therapy ; therapy ; Ischemia ; drug therapy ; therapy ; Male ; Malondialdehyde ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Survival Rate

BACKGROUND: The secondary prevention of stroke which is defined as the control of risk factors and continuous antithrombotic therapy if indicated plays an important role in decreasing stroke recurrence. Unlike most developed countries, the stroke mortality in Korea has yet to be on the decline. It is well known that treatment non-compliance for secondary prevention after a stroke is associated with stroke recurrence and poor functional outcome. There has been no investigation about outpatient treatment compliance of Korean stroke patients who were previously hospitalized. This study aimed to explore the behavior and preference for treatment of stroke patients after discharge and to assess the recurrence rate of stroke for those patients who were not compliant with therapy for secondary prevention and their reasons for not being compliant. METHODS: Study subjects included three hundred thirty-eight stroke patients who were admitted to the Hallym Stroke Center between Jan. 1 and Dec. 31 of 1995. Those who died during hospitalization and those who were discharged to go home on impending death were excluded. The mean age was 63.6 years and the male to female ratio was 1.2 to 1. Telephone inquiries were performed with patients or caregivers regarding the recurrence of stroke, the reasons for non-compliance with secondary preventive management and other kinds of care they received for stroke. RESULTS: Among two hundred six patients (60.9%) not given a follow up on the out-patient basis, 110 patients completed telephone interviews and 102 patients were found to be non-compliant. Nineteen patients (17.7 %) of this non-compliant group reportedly had a recurrent stroke. The age, level of education, and Rankin score were factors which influenced the compliance of patients. Non-compliant patients were currently under the care of: 1) oriental medicine and/or acupuncture (n=56); 2) alternative medicine (n=17); 3) inadvertent over-the-counter drugs (n=16); and 4) no treatment at all (n=26). The reasons for non-compliance included: 1) biased preponderance of oriental medicine (n=44); 2) ignorance about the importance of secondary prevention (n=36); 3) inconvenience of the bureaucratic procedure of hospitals (n=34); 4) economic burden (n=17); 5) dissatisfaction with medical care (n=10); and 6) other reasons (n=6). CONCLUSIONS: Secondary prevention care for Korean stroke patients seems to be inadequately achieved. The proper education of patients and their caregivers about the importance for the secondary prevention of stroke is needed to decrease stroke recurrence in Korea.
Acupuncture ; Bias (Epidemiology) ; Caregivers ; Complementary Therapies ; Compliance* ; Developed Countries ; Education ; Female ; Follow-Up Studies ; Gyeonggi-do* ; Hospitalization ; Humans ; Interviews as Topic ; Korea ; Male ; Medicine, East Asian Traditional ; Mortality ; Nonprescription Drugs ; Outpatients ; Patient Education as Topic ; Recurrence ; Risk Factors ; Secondary Prevention* ; Seoul* ; Stroke* ; Telephone