Neuropathic pain is a consequence of damage to the central nervous system (CNS), for example, cerebrovascular accident, multiple sclerosis or spinal cord injury, or peripheral nervous system (PNS), for example, painful diabetic neuropathy (PDN), postherpetic neuralgia (PHN), or surgery (1). Evidence suggests that people suffering from neuropathic pain are likely to seek alternative modes of pain relief such as herbal medicinal products due to adverse events brought about by current pharmacological agents used to treat neuropathic pain. This review examined studies in which participants were treated with herbal medicinal products (topically or ingested) who had experienced neuropathic pain for at least three months to assess their efficacy. The authors included 2 studies, testing two herbal medicinal products, namely nutmeg (applied topically as a 125 mL spray for four weeks, containing mace oil 2%, nutmeg oil 14%, methyl salicylate 6%, menthol 6%, coconut oil and alcohol) and St John's wort (taken in capsule form containing 900 μg total hypericin each, taken three times daily, giving a total concentration of 2700 mg for five weeks). The authors conclude there was insufficient evidence to determine whether nutmeg or St John's wort has any meaningful efficacy in neuropathic pain conditions. The quality of the current evidence raises serious uncertainties about the estimates of effect observed, therefore, they have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

This study observed the effects of acupuncture on the fatigue symptoms of chronic fatigue syndrome, the potential symptoms and cytokines on the base of the theory as "interaction of brain and kidney" and explored its clinical therapeutic effects and the potential mechanism (1). A total of 68 patients were randomized into an observation group and a control group, 34 cases in each one. In the control group, oryzanol and vitamin B1 were prescribed for oral administration and the patients were required to have a proper rest and physical exercise. In the observation group, on the base of the theory as "interaction of brain and kidney", acupuncture was added to Baihui (BL 20), Fengchi (GB 20), Pishu (BL 20), Shenshu (BL 23), Sanyinjiao (SP 6) and Taixi (KI 3). The treatment was given once a day, 5 treatments a week, with 2 days break. The consecutive treatment for 4 weeks was required. The results showed that after treatment, FS-14 scores, SPHERE scores and PSQI scores were all reduced as compared with the scores before treatment in the two groups. After treatment, the levels of IL-6 and INF-γ in the serum in the observation group were reduced as compared with the levels before treatment. After treatment, the scores of FS-14, SPHERE and PSQI as well as the levels of serum IL-6 and INF-γ in the observation group were all lower than the results in the control group. The authors conclude that on the base of the theory as "interaction of brain and kidney", acupuncture therapy relieves the fatigue symptoms and the potential symptoms and improves the sleep quality in the patients of chronic fatigue syndrome. The effect mechanism is probably related to the decrease of the levels of IL-6 and INF-γ in serum.

Vitamin D (VD) and its relationship in systemic lupus erythematosus (SLE) is being studied, with many studies suggesting a relationship between VD deficiency and SLE onset/disease activity. This study investigated this in a region of India receiving low solar ultraviolet-B (UV-B) index (1). 109 SLE patients were enroled along with 109 healthy controls belonging to same ethnicity and localities. Demographic and clinico-laboratory information were recorded. VD status was assessed by estimating serum 25-hydroxyvitamin D (25-OH-D) concentrations (deficient: <20 ng/mL, insufficient: 21-29 ng/mL, and sufficient/normal: ≥30 ng/mL). The SLE Disease Activity Index (SLEDAI) scoring system was used to evaluate disease activity. The results showed that hypovitaminosis D was prevalent in 90.83% SLE patients [vs. 77.98% healthy controls. SLEDAI scores and 25-OH-D values were inversely associated. SLE patients with VD deficiency were more likely to have high/very high disease activity. Conversely, patients with high SLEDAI scores (>10) also had greater risks of being VD deficient. The authors conclude that VD deficiency is widespread in SLE. The relationship appears to be bidirectional, with VD status associated both as determinant and outcome of disease activity in SLE.

This review investigated iron supplementation for anaemia ⁽¹⁾. Anaemia is a condition in which the number of red blood cells is insufficient to meet physiologic needs; it is caused by many conditions, particularly iron deficiency. Traditionally, daily iron supplementation has been a standard practice for preventing and treating anaemia. However, its long-term use has been limited, as it has been associated with adverse side effects such as nausea, constipation, and teeth staining. Intermittent iron supplementation has been suggested as an effective and safer alternative to daily iron supplementation for preventing and reducing anaemia at the population level, especially in areas where this condition is highly prevalent. The review captured and analysed randomised controlled trials (RCTs) and quasi-RCTs with either individual or cluster randomisation. Participants were menstruating women; that is, women beyond menarche and prior to menopause who were not pregnant or lactating and did not have a known condition that impeded the presence of menstrual periods. The intervention was the use of iron supplements intermittently (one, two or three times a week on non-consecutive days) compared with placebo, no intervention, or the same supplements provided on a daily basis. The authors included 25 studies involving 10,996 women. Based on the analysis of their results, the authors conclude that intermittent iron supplementation may reduce anaemia and may improve iron stores among menstruating women in populations with different anaemia and malaria backgrounds. In comparison with daily supplementation, the provision of iron supplements intermittently is probably as effective in preventing or controlling anaemia.

There is physiological and biomechanical evidence suggesting a possible advantage of using poles in walking training programs. The purpose of this proof-of-concept study was to test the hypothesis that untrained elderly training Nordic walking for eight weeks will show higher improvements on the functional mobility, quality of life and postural balance than that training without poles ⁽¹⁾. Thirty-three untrained older people were randomly assigned into Nordic walking and free walking training groups. Improvements in the self-selected walking speed locomotor rehabilitation index, quality of life, static balance and dynamic variability were found in both groups. The authors conclude that the hypothesis was not supported, that after 8 weeks, the Nordic walking training did not result in greater improvements than free walking training for the primary outcome (self-selected walking speed) and most of the secondary outcomes (including locomotor rehabilitation index, static balance, dynamic stability, and psychological and social participation domains of quality of life).

Women often seek antidepressant alternatives for major depressive disorder (MDD) in anticipation of or during pregnancy. In this preliminary study, EnBrace HR, a prenatal supplement containing methylfolate, was investigated for depressive relapse prevention and for acute treatment of MDD in women planning pregnancy or during pregnancy ⁽¹⁾. At enrollment, Group 1 participants were well (not depressed) and planned to discontinue antidepressants for pregnancy. Group 2 participants were depressed. Primary outcome variables by group included MDD relapse and depressive symptoms, verified with the Mini-International Neuropsychiatric Interview and the Montgomery-Åsberg Depression Rating Scale (MADRS), respectively. Biomarkers of inflammation and the folate cycle were collected. The results showed that Group 1 participants experienced lower rates of depressive relapse than expected from a historical comparison group and no significant changes in MADRS scores. Group 2 participants experienced significant improvements in MADRS scores with 5 improving >50% and 1 improving 33.3%. One adverse event occurred, a hospitalization for depression. The authors conclude that EnBrace HR is a well-tolerated intervention with potential efficacy for prevention and treatment of perinatal depression.

Dyslipidemia and cholesterol concerns is one of the major risk factors for cardiovascular diseases (CVDs) ⁽¹⁾. Current strategies are not effective in the management of dyslipidemia. Thus, there is a necessity to find new preventative and therapeutic approaches. In recent years, herbal medicine has drawn great attention regarding the prevention and management of dyslipidemia. Rosmarinus officinalis, commonly known as rosemary, is an evergreen shrub containing several polyphenols. The plant grows in the Mediterranean and South American regions. Rosemary and its main components have antioxidant, anti-inflammatory, and lipid-lowering properties. This study has focused on the hypolipidemic effects of rosemary and its main constituents as well as their functional mechanisms. Studies have described lipid-scavenging activities of rosemary through its flavonoid contents. Modulating inflammation and oxidative stress have been described as possible mechanisms by which rosemary ameliorates dyslipidemia. However, the exact mechanisms are not fully understood yet. The authors conclude that experimental and clinical trial studies are recommended to confirm the safety and efficacy of rosemary in the prevention and management of dyslipidemia and other cardio-metabolic diseases.

In this study, the authors investigated the effectiveness of a workplace-based intervention to manage musculoskeletal disorders (MSDs) and their consequences in the workers of a medium-sized company ⁽¹⁾. A program consisting of Participatory Ergonomics (PE), Workplace Exercise (WE) and Acupuncture as the main resource of Physical Therapy (PT) performed at the workstations was conducted for 22 months with 126 workers of a hearing aid company. The outcomes were complaints of MSDs and absenteeism measured by the Nordic Musculoskeletal Questionnaire. The overall rate of MSDs was significantly reduced in at least one region of the body. Absenteeism was also significantly reduced. For workers with pain at baseline, at least 40% improved totally. The authors conclude that a multifaceted intervention consisting of PE, WE and Acupuncture as the main resource of PT performed at the workstations may be relevant to managing MSDs in working populations.

Existing studies suggest that dietary vitamins and carotenoids might be associated with a reduced risk of age-related cataract (ARC), although a quantitative summary of these associations is lacking. In this study, a meta-analysis of randomized controlled trials (RCTs) and cohort studies of dietary vitamin and carotenoid intake and ARC risk was completed ⁽¹⁾. The MEDLINE, EMBASE, ISI Web of Science, and Cochrane Library databases were searched from inception to June 2018. The adjusted RRs and corresponding 95% CIs for the associations of interest in each study were extracted to calculate pooled estimates. Dose-response relations were assessed with the use of generalized least-squares trend estimation. The results showed that 8 RCTs and 12 cohort studies were included in the meta-analysis. Most vitamins and carotenoids were significantly associated with reduced risk of ARC in the cohort studies. The authors conclude that higher consumption of certain vitamins and carotenoids was associated with a significant decreased risk of ARC in cohort studies, but evidence from RCTs is less clear.

Vitamin D insufficiency is common in older people and may lead to increased bone resorption, bone loss, and increased falls and fractures. This study examined the effect of Vitamin D supplementation on bone mineral density at the hip. A total of 379 adults aged ≥70 y (48% women; mean age: 75 y) from the northeast of England were randomly allocated to 1 of 3 doses of vitamin D3 [12,000 international units (IU), 24,000 IU, or 48,000 IU] given once a month. The primary outcome was change in BMD (ΔBMD) at the hip. Secondary endpoints comprised the dose effects on femoral neck BMD, falls, circulating calciotropic hormones, bone turnover markers, and adverse events. The authors conclude that there was no difference in change in BMD over 12 mo between the 3 doses of vitamin D, suggesting no effect of the intervention or a similar attenuation of the anticipated decrease in BMD over 12 mo. The treatment was safe and effective in increasing plasma 25(OH)D concentrations, with no dose-related adverse events.

Vitamin D (VD) deficiency has been associated with increased incidence and severity of atopic dermatitis (AD), but the mechanisms through which VD may ameliorate AD are unclear. In this study, the authors compared the phenotypic characteristics of circulating myeloid and plasmacytoid dendritic cells of children with AD vs. healthy controls (HC), and evaluated if VD can modulate the allergic phenotype of circulating DCs in AD patients ⁽¹⁾. There was no difference in frequency of circulating DCs between groups, among children with AD. The authors conclude that, in summary, VD decreases the allergic phenotype of circulating DCs in children with AD, a potential mechanism for how VD supplementation may improve AD severity.

A randomized controlled study compared the treatment efficacies of superficial acupuncture and traditional acupuncture on trigger points of the upper trapezius muscle ⁽¹⁾. Forty people were recruited and randomly allocated to the traditional and superficial acupuncture groups. Each subject received two treatments per week in a four-week period. Outcomes were measured by visual analogue scale (VAS), the Northwick Park neck pain questionnaire scores (NPQ), and pressure pain threshold (PPT) assessments of trigger points. Data collected before the interventions were considered as baseline. Assessments were performed after the first treatment and at the end of the second and fourth weeks of treatment. Patients reported significant and immediate improvements in VAS and PPT for both superficial acupuncture and traditional acupuncture after the first treatment and after two and four weeks. Significant improvements in NPQ were attained after two weeks of treatments in both groups. Because superficial acupuncture is associated with less pain while producing immediate pain relief, the authors conclude it is useful in treating myofascial pain syndrome in the upper trapezius muscle.

A study examined the relationship between the use of complementary medicine (CM) and women’s choices of contraceptive methods ⁽¹⁾. A secondary analysis of a cross-sectional survey of Australian Women aged 34-39 years from the Australian Longitudinal Study on Women's Health (ALSWH) was conducted. Associations between use of CM and contraception were analysed using Chi-squared tests and multivariate logistic regression. Based on the responses from the included women, women who consulted a naturopath/herbalist were less likely to use implant contraceptives. Those consulting a chiropractor or an osteopath were more likely to use natural contraception. The authors conclude there may be a link between women's choice of contraceptive method and their use of CM, in particular, with CM practitioner consultations.

This meta-analysis investigated 9 randomized trials with regards to whole grain consumption and the concentration of inflammatory markers ⁽¹⁾. The results showed that totally 9 randomized trials included 838 participants were identified. In a pooled analysis of all studies, consumption of whole grains had an inverse association with inflammatory markers, including C-reactive protein (CRP), Interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β). Specific analyses for CRP and IL-6 yielded that whole grain diet was related with a significant decrease in the concentration of CRP and IL-6. The authors conclude that citizens could benefit from increased whole grain intake for reducing systemic inflammation.

Vitamin D (VitD) deficiency is prevalent in patient with inflammatory bowel disease (IBD). Recent studies have found that VitD can induce and maintain IBD remission through antibiosis, anti-inflammatory, and repair of intestinal mucosal barriers, thus improving the patient's disease activity and quality-of-life. This meta-analysis evaluated the therapeutic effect and safety of VitD in the treatment of IBD ⁽¹⁾. The results showed that eighteen RCTs involved 908 patients were included. The authors conclude that the treatment of VitD in patients with IBD can improve the level of 25(OH)D3 and control the relapse rate of the disease, whose clinical curative effect is more accurate. Thus VitD should be recommended for the treatment of IBD, at least as an adjunctive treatment.