Dr Ezekiel.pptx

COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) (PCG 312) PHARM. EZEKIEL EFEOBHOKHAN  REGULATION OF CAM IN NIGERIA REGULATION OF CAM IN UNITED STATES REGULATION OF CAM IN UNITED KINGDOM OUTLIN...

COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) (PCG 312) PHARM. EZEKIEL EFEOBHOKHAN  REGULATION OF CAM IN NIGERIA REGULATION OF CAM IN UNITED STATES REGULATION OF CAM IN UNITED KINGDOM OUTLIN COMPARISON OF REGULATION IN ASIA MIND AND BODY INTERVENTION MANUAL MANIPULATION ASIAN AND CHINA HEALING METHODS E (TRADITIONAL CHINESE MEDICINE) ○ ○ UNNANI SIDDHA HYPNOSIS ACUPUNCTURE DIETARY THERAPY HOMEOPATHY HYDROTHERAPY AROMATHERAPY CONT’D… COMPLEMENTARY MEDICINE The terms “complementary medicine” or “alternative medicine” refer to a broad set of health care practices that are not part of that country’s own tradition or conventional medicine and are not fully integrated into the dominant health-care system. They are used interchangeably with traditional medicine in some countries. INTRODUCTION TRADITIONAL MEDICINE Traditional medicine has a long history. It is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. CONT’D… HERBAL MEDICINES Herbal medicines include herbs, herbal materials, herbal preparations and finished herbal products, that contain as active ingredients parts of plants, or other plant materials, or combinations. REGULATION OF CAM IN NIGERIA The traditional, Complementary and Alternative Medicines Department of the federal ministry of Health established in 2018 has been saddled with the responsibilities to :​ 1. Develop, implement, review and monitor compliance of policies and initiate legislation relating to Traditional, Complementary and Alternative Medicines as well as provide related services.​ 2. Promote the development and commercialization of indigenous Nigerian Traditional Medicine.​ 3. Integrate Traditional, Complimentary and Alternative Medicine into the National healthcare system.​  CONT’D… The department is made up of four divisions as follows:​ 1. Traditional Medicine Practice (TMP)​ 2. Complementary and Alternative Medicines Practice (CAMP)​ 3. Herbal product, Complementary and Alternative Medicines Production and Commercialization (HCAM-P & C)​ 4. Traditional, Complementary and Alternative Medicines Research and Development,​ REGULATION OF CAM IN UNITED KINGDOM Complementary and alternative therapies have become more widely used over the past two decades, but many practitioners in the United Kingdom are largely unregulated. One of the recommendations of year 2000 report on complementary and alternative medicine by the House of Lords Select Committee on Science and Technology was that “in order to protect the public, professions with more than one regulatory body make a concerted effort to bring their various bodies together and to develop a clear professional structure.”  CONT’D… Practitioners of complementary and alternative medicine in the United Kingdom are free to practice as they wish Most therapies have set up professional bodies, but the educational standards required by these bodies vary widely However, the United Kingdom is the only country in the European Union with public-sector hospitals for complementary/alternative medicine. In general, in order to become a member of a professional organization, non-allopathic practitioners must be covered by insurance and adhere to the Code of Professional Ethics Contd Although complementary/alternative medical practitioners without an allopathic medical degree are tolerated by law, only medical providers holding a university degree in allopathic medicine are officially recognized The European Directive on Homeopathic Products regulates the making and marketing of homeopathic products in the United Kingdom. The licensing of other medicines is regulated by the Medicines Act of 1968 REGULATION IN UNITED STATES OF AMERICA On behalf of the Federation of State Medical Boards and its continued commitment to assist state medical boards in protecting the public and improving the quality of healthcare in the United States, the Special Committee for the Study of Unconventional Health Care Practices (Complementary and Alternative Medicine), undertook an initiative in April 2000 to develop model guidelines for state medical boards to use in educating and regulating ○ (1) physicians who use CAM in their practices, and/or Contd. In the US, the Food and Drug Administration (FDA) classifies alternative medicine into four domains: biologically-based practices, energy therapies, manipulative and body-based methods, and mind-body medicine. Nowadays, acupuncture is pretty recognized in our healthcare system and it is not uncommon for conventional doctors to recommend it. In 1991, Congress established the Office of Alternative Medicine within the National Institutes of Health to encourage scientific research in the field  Contd. The Office’s objectives include the facilitation and evaluation of “alternative medical treatment modalities, including acupuncture and Oriental medicine, homeopathic medicine, and physical manipulative therapies”. The Office is mandated to set up an advisory council, establish an information clearinghouse to exchange information on traditional medicine, support research and training, and provide biennial reports on the Office’s activities to the Director of the National Institutes of Health. These reports are then included in biennial reports  Contd. In the United States, regulatory controls surrounding complementary/alternative medicine involve six related areas of law: ○ licensing, ○ scope of practice, ○ malpractice, ○ professional discipline, ○ third-party reimbursement, and ○ access to treatments. State laws dominate the first five areas. Federal laws, particularly food and drug laws, largely control the sixth.  Contd. Licensing laws in each state provide that the unlicensed practice of medicine is a crime, with medicine being broadly defined to include such matters as diagnosis and treatment of disease or any human condition. Both non-licensed providers of complementary/alternative care (such as non-allopathic physician homeopaths, herbalists, iridologists, nutritionists, and spiritualists not practising within the tenets of a specific recognized religion) and licensed complementary/alternative care providers (such as chiropractors and, in many states, acupuncturists, massage therapists, and naturopaths) who exceed their legislatively authorized scope of practice risk prosecution for unlicensed medical practice CLASSIFICATION OF CAM  NATIONAL CANCER INSTITUTE (NCI) CLASSIFICATION ❖ MIND BODY ❖ Meditation ❖ Biofeedback ❖ Hypnosis ❖ Yoga ❖ Tai chi ❖ Imagery ❖ Creative outlet ❖ MANIPULATIVE AND BODY-BASED PRACTICES a. Massage therapy b. Chiropractic c. Reflexology  NCI Contd. ❖ BIOLOGICALLY BASED PRACTICES a. Vitamins b. Dietary supplements c. Botanicals d. Special foods or diets ❖ WHOLE MEDICAL SYSTEMS a. Ayurvedic medicine b. Traditional Chinese medicine c. Naturopathic medicine JOHN HOPKINS MEDICINE CLASSIFICATION ❖ TRADITIONAL ALTERNATIVE MEDICINE a. Acupuncture b. Ayurveda c. Homeotherapy d. Naturopathy e. Chinese or Oriental medicine f. Aromatherapy ❖ MIND a. Meditation b. Hypnosis c. Biofeedback John Hopkins Contd. ❖ BODY a. Chiropractic and osteopathic medicine b. Massage c. Body movement therapies d. Tai chi e. Yoga ❖ DIET AND HERBS a. Dietary supplements b. Herbal medicine c. Nutrition/diet John Hopkins Contd. ❖ EXTERNAL ENERGY a. Electromagnetic therapy b. Reiki c. Qigong ❖ SENSES a. Art, dance music, drama etc b. Visualization and Guided Imagery ACUPUNCTURE ACUPUNCTURE ❖ Acupuncture is a technique of insertion and manipulation of fine needles in specific points on the body to achieve therapeutic purposes. ❖ It is the practice of penetrating the skin with thin, solid, metallic needles, which are then activated through gentle and specific movements of the practitioner’s hands or with electric stimulation.​ ❖ Acupuncture is based on the idea that living beings have an inner energy, known as Qi (pronounced chee), and it is the flow of this inner energy that sustains them CONT’D… ❖ According to traditional Chinese medical philosophy, balanced Qi is vital to optimal health; illness and disease are caused by the imbalance or interruption in the flow of Qi. HOW ACUPUNCTURE WORKS ❖ Acupuncture points are believed to stimulate the Central Nervous System. This in turn, releases chemicals into the muscles, spinal cord, and brain. These biochemical changes may stimulate the body’s natural healing abilities and promote physical and emotional well-being.​ ❖ Anatomically, acupuncture points have been reported to correspond to cutaneous areas of high electrical conductivity and distinct histologic differences compared with adjacent tissue ❖ There are many theories that may explain how  CONT’D… Recent research has found that traditional Chinese medicine acupuncture therapy has a direct effect in the up-regulation of m-opioid receptor binding availability in the central nervous system compared with placebo (sham) acupuncture. This finding may help explain some of the analgesic effects seen with acupuncture therapy. ❖ NEUROTRANSMITTER MODEL Research in animals has found that acupuncture can modulate serotonin, norepinephrine, and neurons that transmit or secrete g-aminobutyric acid. It is postulated that through the neurotransmitter model, acupuncture can be efficacious for  THEORIES ON MOA OF ACUPUNCTURE ❖ GATE CONTROL THEORY OF PAIN This theory postulates that specific nerve fibers transmit a pain signal to the brain via the spinal cord, and input of other nerve fibers can inhibit the pain signal transmission. Acupuncture is thought to stimulate inhibitory nerve fibers for a short period, thus reducing transmission of the pain signal to the brain. ❖ ENDORPHIN MODEL Clinical studies reported that inserting acupuncture needles into specific acupuncture points triggered the production of endorphins in cerebrospinal fluid after patients underwent acupuncture treatments. CONT’D OTHER THEORIES ❖ postulate that acupuncture indirectly influences the autonomic system. ❖ Research indicates the increased electrical conductivity of tissues along acupuncture meridians. This result suggests that manipulation of the acupuncture meridians with needles may modulate the transmission of certain signals within the body. EVIDENCE-BASED INDICATIONS FOR ACUPUNCTURE ❖ NEUROLOGIC; migraine and tension headache ❖ MUSCULOSKELETAL; osteoarthritis, fibromyalgia, back pain, neck pain, postoperative pain ❖ GASTROINTESTINAL; nausea and vomiting, constipation, postoperative ileus, IBS ❖ PSYCHIATRIC/MOOD; stress. Anxiety, depression ❖ GYNECOLOGICAL/REPRODUCTIVE; hot flashes, infertility, PMS ❖ ADDICTION; nicotine dependence, alcohol dependence CONT’D ❖ ENDOCRINE; obesity ❖ ENT; allergic rhinitis, sinusitis ❖ RESPIRATORY; asthma, COPD ❖ CVS; HTN, angina ❖ SLEEP; insomnia, enuresis CLASSICAL ACUPUNCTURE TECHNIQUES 1. Needling. 2. Moxibustion. 3. Cupping. OTHER ACUPUNCTURE TECHNIQUES ❖ Auricular acupuncture ❖ Electroacupuncture ❖ Trigger point acupuncture ❖ Laser acupuncture ❖ Acupuncture point injection ❖ Microwave acupuncture ❖ Acupressure ❖ Moxibustion ❖ cupping CONT’D… Needle insertion: needles are inserted to various depths at strategic points on the body. The needles are very thin, so insertion usually causes little discomfort. Most times it isn’t felt at all. A typical treatment uses 5-20 needles. One may feel a mild aching sensation when needle reaches the correct depth.​ Needle manipulation: gently move or twirl the needles after they are placed. or apply heat or mild electrical impulses to the needles.​ Needle removal: in most cases, the needle remain in place for 10-15 minutes while the client is still and relaxed. There is usually no discomfort when the needles are removed.​ No plant is used in this procedure.​  ACUPUNCTURE-MOXIBUSTION ❖ In acupuncture-moxibustion treatment, it is important to establish the pattern of the patient’s complaint, to understand the patient’s predisposition and clinical condition, and to prescribe and locate the points (selection of meridians and meridian points), based on main indication of meridians and meridian points. ❖ The task of acupuncture-moxibustion treatment is to select a few meridian points, insert a needle, and give appropriate stimulus at the appropriate depth to obtain the maximum effect  CONT’D ❖ The number of needle insertions is not directly proportional to the therapeutic effect. ❖ It is important to understand the symptoms and signs, locate the point correctly, and give appropriate stimulus. ❖ The number of needle insertions during treatment differs according to the patient’s clinical condition and the type of asthenia or fullness. ❖ The number of needle insertions should be adjusted considering the patient’s age, body build/predisposition, habituation to treatment, and clinical conditions. CONT’D CRITERIA FOR ACUPUNCTURE 1. 18 years and above 2. Able to understand and follow instructions 3. Clinically stable STANDARD OPERATING PROCEDURE 4. Diagnosis 5. Comorbidities 6. Medication history 7. Other relevant ACUPUNCTURE TREATMENT REGIMENS TREATMENT SEVERI MINIMU FREQUE ASSES MAXIM TY M NCY SMENT UM FOR SESSIO SESSIO NS N POST STROKE MILD 10 Once in 3 10th 20 days session MODERA 10 Once in 2 10th 30 TE days session SEVERE 20 Once in 2 10th 40 days session CONT’D… CHRONIC PAIN; minimum of 5 sessions and maximum of 10 sessions with frequency of alternate days. Assessment should be at 5th session  ADVERSE EFFECTS Serious adverse effects of acupuncture are rare. ❖ Reported accidents and infections appear to be related to violations of sterile procedure, negligence of the practitioner, or both MINOR ADVERSE EFFECTS INCLUDES; ❖ Pain at needling sites ❖ Hematoma ❖ Tiredness ❖ Lightheadedness ❖ Drowsiness ❖ Localization skin irritation CONTRAINDICATIONS ❖ Neutropenia, thrombocytopenia, or history of endocarditis ❖ Pregnancy ❖ Pacemakers ❖ Medical and surgical emergencies; uncontrolled DM, cardiac arrhythmias ❖ Severe uncontrollable neurological conditions; uncontrollable epilepsy, athetoid patients or movements ❖ Diagnosed skin infections; undiagnosed (himp, warts, moles), infected skin, allergic to metal  GOOD PRACTICES IN ACUPUNCTURE HAND WASHING Based on WHO 5 Moments in Hand Hygiene, healthcare providers should always wash their hands 1. Before touching a patient; 2. Before clean or aseptic procedure; 3. After body fluid exposure risk; 4. After touching a patient; and 5. After touching patient surroundings. Gloves should not be regarded as a substitute for hand hygiene. An alcohol rub or hand wash should be performed after removing gloves and before sterile gloves are worn. CONT’D… PREPARATION OF THE ACUPUNCTURE SITE The needling site should be clean, free from cuts, wounds or infections. The needling site should be swabbed with 70- 75% ethyl or isopropyl alcohol from the centre to the surrounding area using a rotary scrubbing motion and allowed to dry.  CONT’D… DISPOSAL OF ACUPUNCTURE NEEDLES The following are important measures during the handling of acupuncture needles: 1. Sharps shall not be passed from hand to hand; 2. Handling of sharps should be kept to a minimum; 3. Needles shall not be broken or bent before usage or disposal; 4. Needles should not be resheathed by hand; 5. Healthcare personnel should take personal responsibility for any sharps used and should dispose them in a designated container at the point of use (You Use, You Throw); 6. Sharps container should not be more than three quarters full and stored in an area away from the public and children; 7. Sharps container must be adequately and strategically placed. It should be consistent with work process and placed close to the point of use; 8. Safety devices should be considered whenever possible; 9. Healthcare personnel should be aware of the sharps injury policy at the facility. CONT’D… ASEPTIC NEEDLE TECHNIQUE ❖ The needle shaft must be maintained in a sterile state prior to insertion. ❖ Needles should be manipulated in such a way that the practitioner‟s fingers do not touch the shaft. ❖ If it is difficult to insert a long needle, for example the use of GB 30 (Huan Tiao) or BL 54 (Zhi Bian), the shaft can be held in place with a sterile cotton wool ball or swab. ❖ Upon withdrawing a needle, a sterile cotton wool ball can be used to press the skin at the insertion site. ❖ All compresses or cotton wool balls which are contaminated with blood or body fluids must be discarded in a special container for infectious waste HYDROTHERAPY (AQUATIC THERAPY) INTRODUCTION ❖ Hydrotherapy is considered the oldest therapeutic method, being used as a remedy for various common ailments since ancient Greek culture, Japanese, indians, Romanian ❖ Numerous research studies have highlighted the role it has hydrotherapy on muscle relaxation in treating musculoskeletal and neurological disorders, sore throat, backache, arthritis, head injury, spasticity, etc. vascular accidents. CONT’D ❖ Hydrotherapy is a therapeutic method that uses water at different temperatures and in different states of aggregation (liquid, solid or gaseous) to treat certain diseases. ❖ The water used may be fresh, mineral or marine, pure or mixed with other substances or herbs and medicinal: infusions or decoctions (chamomile, marshmallow, walnut leaf, etc..) ❖ And various mixtures of herbs, also salt, iodine, sulfur, mud, gas, etc PRINCIPLE OF HYDROTHERAPY ❖ Principle of this method of therapy is based on fluid properties: mechanical (thermo conductivity of water is 30 times greater than air, heat capacity, 8 times greater than air), heat and chemicals. ❖ The pressure of gravity on the bones in water, can be reduced by 90%. ❖ Physiological fluid factor is exercised through the skin, the skin is the first organ to which the contact, the structure characteristic of the vast network of vascular and nerve receptors can be obtained many and varied responses, local and general reactions. CONT’D ❖ Local and general action occurs in the metabolism and systems: muscular, cardiovascular, neros, respiratory etc.  EFFECTS OF HYDROTHERAPY ON VARIOUS SYSTEMS CARDIOVASCULAR Rich vascular network skin reaction to cold or of warmer can be exciting vasoconstriction or vasodilation. Vasoconstriction is the initial phase, which is longer under the influence of "cold" and very short, sometimes almost macroscopically unnoticed, under the action of warmer exciting. Active vasodilation is the phase in which there is a redness (flushing) of the skin (pink-red), under the action of hot or cold exciting,. Is of longer duration and is the most important of stages. Cont’d… Passive or paralytic vasodilatation usually follows the previous one, if the action exciting factor is prolonged or if it is too brutal. Skin becomes red-violet or marble. The reaction you want and not have to avoid in hydrotherapy, being an indication that the procedure should be discontinued. Cold" soothes and eases the heart work (heart rate accelerates, etc.), hot and tired heart procedures. CONT’D blood composition was deviated to acidosis through procedures cold and to alkalosis through hot procedures (due to hyperventilation that lowers CO2). Increases in blood clotting procedures warm and back again in the cold. RESPIRATORY; the cold, deep inspiration and after a short pause, respiratory rate increases. Hot procedures triggers from the beginning, a frequent and shallow breathing. CONT’D NERVOUS SYSTEM; Application of cold decreases nerve sensitivity and has an anesthetic effect. Cold was one of the first means of anesthetics used in surgery. Heat has a stimulating effect in analgesic processes is acute and chronic inflammatory processes HYDROTHERAPY PROCEDURES The procedures used in hydrotherapy are divided into general, most demanding, which is usually prescribed in the morning and local or partial. The common procedures are; CONT’D METABOLISM; cold procedures cause an increase in metabolism, with higher consumption of oxygen. Increases metabolic procedures produce lighter warm by consuming carbohydrates and lipids. Indifferent procedures do not alter metabolism. CONT’D… 1. compresses- hot and cold or alternating 2. packing- lower / upper / in 3 quarters / full trunk 3. friction-partial or complete 4. băi terapeutice- reci (sub 20 ºC), racoaroase (20-30 ºC), intermediare (34-37 ºC), calde (38-39 ºC), fierbinti (40 ºC).  COMPRESSES The simplest procedures and is of several types depending on water temperature and area of application. 1. COLD COMPRESS: analgesic effect, vasoconstriction, antihemoragic Is used in any acute inflammatory process Is a local application of cloth wrung from cold water Change every 3-5 mins Towels and ordinary cotton cloths may be used Temperature of -45 to 60 F INDICATIONS; abscesses, flegmoane, acute appendicitis, digestive, brain bleeding, etc.  CONT’D… 2. WARM COMPRESS; acting analgesic, relaxing, sedation, anti-ing, vasodilators, for which is indicated in all chronic inflammatory processes (hepatic, renal colic etc.). A heating compress consists of an application of heat to the body by means of ¾ thickness of cotton cloth It should be covered with dry cloth to prevent circulation of air On removal of compress, the part should be rubbed with cold water and dried with towel Duration is 3 to 5 min Temperature of 100 to 102 F BENEFITS OF COMPRESSED Helps in detoxification of areas which are swollen, blocked or sensitive. Excellent for tight sore muscles, edema. Stimulates the blood stream. Gives soothing, refreshing, calming and decongesting qualities.  PACKAGE PROCEDURES The procedure is a wet and dry procedure Wet sheets are used as blanket covering the patient directly or after a particular technique, There are packs with different substances (paraffin, mud). Used in all chronic inflammatory processes: arthritis, osteoarthritis, neuralgia, stiff etc.. After these procedures warm mandatory bath should follow washing.  FRICTIONS Procedures which acts both by thermal factor, and by the mechanic. They are always cold, using wet cloth over that run friction, long strokes, sliding palms until they are heated (active vasodilation). After that, rubbed region wipe and cover. Friction can be partial (hands, legs, chest etc.) or total (complete). It can perform bedside immobilized (fractures, rheumatism).  BATHS 1. Are the most requested procedures in hydrotherapy. 2. There are several types a. Simple (regular water) b. Drug c. With different substances (iodine, salt, sulfur etc) d. Complete or partial (hands, legs, seat) e. Indifference to temperature (35-37 C) f. Warm (38-40 C) g. Cold (below 22 C) CONT’D… There are three (3) factors of Baths actin 1. Thermal 2. Chemical 3. Mechanical (hydrostatic pressure upwards pressure, movement of water in the bathroom)  BENEFITS Relieves localized pain and inflammations Relieves congestive headaches Relieves the spasms of the bronchioles and facilitates easy breathing as in asthma and bronchitis Excellent for relieving the numbness and tingling in the extremities as in diabetes mellitus It is one of the hydrotherapeutic techniques where the body locally or wholly is immersed in water of different temperatures. Helps improve the circulation to the part immersed and also the peripheral circulation CONT’D Steam inhalation helps decongest the respiratory tract. Herbal steam helps rejuvenate the body Helps open up the skin pores Helps remove the toxins of the skin through sweating Helps the skin maintain its natural moisture and softness.  CONTRAINDICATIONS OF HYDROTHERAPY Severe organic deficiency; Severe brain impairment; Senile deterioration; Diabetes; People with multiple sclerosis; 􀂃 to persons suffering from cardiovascular diseases (hypertension, cardiac arrhythmia, cardiac ischemia, stroke, thrombosis, etc..) to avoid certain procedures, especially those using hot water Pregnant women should avoid hot baths and saunas. AROMATHERAPY INTRODUCTION ❖ Aromatherapy is the practice of using essential oils for therapeutic benefit. ❖ Aromatherapy has been used for centuries. ❖ Essential oils are plant extracts made by steaming or pressing various parts of a plant (flowers, bark, leaves or fruit) to capture the compounds that produce fragrance. ❖ It can take several pounds of a plant to produce a single bottle of essential oil CONT’D… ❖ Essential oils can also be absorbed by the skin. ❖ Massage therapist add a drop or two of wintergreen to oil to help relax tight muscles during a rubdown. ❖ Skincare company may add lavender to bath salts to create a soothing soak. ❖ Aromatherapy is an alternative medicine or integrative therapy that works with conventional medicine treatment. SOURCES OF ESSENTIAL OILS SEEDS ❖ Cardamon (Ellettaria cardamomum); the essential oil is from the plant family Zingiberaceae Uses; antibacterial, antifungal, antispasmodic, aphrodisiac, digestive stimulant, expectorant, parasympathetic nervous system stimulant and stimulant, toni.  Cont’d… ❖ Black Pepper (Piper nigrum); essential oil is from the plant family Piperaceae Uses; analgesic, antiseptic, antispasmodic, antitoxic, aphrodisiac, digestive, and circulatory tonic; reducing fever reducing pain; as a rubefacient; and for stimulating. ❖ Sweet fennel (Foeniculum vulgare var. dulce); is from the plant family Apiaceae. Uses; anti-inflammatory, antibacterial, antifungal, antispasmodic, detoxifier, and digestive and for relieving gas  STEMS, LEAVES AND NEEDLES ❖ Cistus (Cistus ladanifer); is from the plant family Cistaceae. The essential oil comes from stems, twigs, dried leaves, and dried flowers. Uses; as a cictrisant or for cell regeneration; as an antibacterial, anti-infectious, antimicrobial, astringent, and antiviral agent; as an immunity booster and regulator; as a tonic and support for parasympathetic and central nervous systems; and for wound healing.  Cont’d… ❖ Eucalyptus; is a tree from the plant family Myrtaceae. It also is referred to by many names, such eucalyptus oil, blue gum oil, blue mallee oil, and gully gum oil. Uses; The leaves and twigs are used for burns, wounds, nasal congestion, lowering blood glucose, nasal congestion, and asthma and as a tick repellent. It also is used in medications and supplements.  Cont’d… ❖ Laurel (Laurus nobilis); is from the plant family Lauraceae. This aromatic evergreen scrub is known for its aromatic dark green, glossy leaves. Uses Dried and fresh leaves oil is used as an analgesic, antibacterial, antimicrobial, antiseptic, antispasmodic, and antiviral; for boosting the immune system and calming the nervous system; and as an expectorant and fungicide. Cont’d… ❖ Patchouli (Pogostemon cablin); comes from the plant family Lamiaceae that is commonly called the mint or dead needle busy herb. Uses; Oil from leaves are used as an antidepressant, anti- inflammatory, antimicrobial, antiviral, aphrodisiac, astringent, deodorant, and digestive; for relieving gas soothing the nervous system; and as a stimulant and tonic. Cont’d… ❖ Peppermint (Mentha x piperita L); comes from the plant family Lamiacae in the mint family. Peppermint essential oil is a common flavoring agent in pharmaceuticals, soaps, cosmetics, food, and beverages. Uses; This essential is used as an analgesic, antibacterial, anti- inflammatory, antispasmodic, antimicrobial, decongestive, digestive, and expectorant and relieves coughs.  Cont’d… Pine (Pinus sylvestris)—pinus edulis; is from the plant family Lamiaceae and from the mint family. Pine essential oil is derived from the needles on the pine tree. The scent is known for the uplifting and positive impact on the mood. It is known for treatment of post surgery nausea and vomiting. Uses; as an analgesic, antibacterial, antibiotic, anti-infectious, anti- inflammatory, antifungal, and antimicrobial agent; assisting in opening lungs and air pathways; as an expectorant; and for soothing nerves.  Cont’d… ❖ Rosemary (Rosmarinus officinalis); is from the plant family Lamiaceae. ❖ This aromatic evergreen shrub essential oil is derived from leaves, flowers, and stems. ❖ This essential oil is known for folk medicine, flavoring food, and herbal tea. ❖ Rosemary has been known as a sacred oil. Uses; as an analgesic, anti-inflammatory, anti-infectious, antiseptic, and antispasmodic agent; for breaking up mucus; as a cognitive stimulant, decongestant, expectorant, muscle relaxant (cineole), stimulant, and tonic; and for wound healing (verbenone)  PETAL AND FLOWERS ❖ Clary sage (Salivia sclarea); is an herbaceous perennial in the plant family Lamiaceae with a history of petal and flowers used as an herb. The essential oil of clary sage is used in perfumes and muscatel flavoring in wines and liqueur. Uses as an antidepressant, antifungal, anti-inflammatory, antispasmodic, and aphrodisiac and for calming the nervous system, relaxing the uterus, and stimulating the blood flow.  Cont’d… ❖ Chamomile (Matricaria chamomilla [Anthemis nobilis]); is in the plant family Asteraceae and is a common name for several daisy-like flowers. Chamomile essential oil from flowers is used in herbal tea and is a popular night herbal tea due to the sedative effect. Use for support for the nervous system, inflammation, insomnia, menstrual issues, headaches, and skin concerns.  CONT’D… ❖ Jasmine (Jasminum sambac; Jasminum grandiflorum); —this essential oil is from the plant family Oleaceae. Jasmine is a genus of shrubs and vines in the olive family. Flowers of this bushy strong-scented perennial plant are used for scent and in tea as a base for green and white teas. Uses as an essential oil, jasmine is used as an antidepressant and aphrodisiac, for calming the nervous system, and as a sexual tonic and stimulant.  Cont’d… ❖ Lavender (Lavandula angustifolia); —this essential oil is in the plant family of Lamiaceae and is a bushy strong-scented perennial plant. Lavender is a popular house décor and frequently used with dried flowers as a complement in weddings. The popular scent is used in balms, salves, and cosmetics. Uses; As an essential oil, lavender is used as analgesic, anti- inflammatory, antifungal, and antispasmodic; for calming the nervous system, lowering blood pressure, and reducing anxiety and sensations of pain; as a sedative; and for wound healing.  Cont’d… ❖ Neroli (Citrus aurantium var. amara);—this essential oil is in the plant family Rutaceae and is from the bitter orange tree. This essential oil from flowers has a rich floral scent and is known as orange blossom oil. Neroli is used in scented products, such as perfumes and lotions. Uses; as an antidepressant, antifungal, anti-inflammatory, antimicrobial, antioxidant, antiparasitic, antiseptic, and aphrodisiac; for calming; and as a digestive, nervous system stimulant, sedative, and tonic.  Cont’d… ❖ Rose (Rosa damascena; R damascena var. alba);—this essential is from the plant family Lamiaceae and is a flowering shrub known as a rosebush. Rose oil is a powerful rich sweet smell. It is used commonly in perfumery. Uses; as an antibacterial, antidepressant, anti-infectious, anti- inflammatory, antiseptic, antiviral, aphrodisiac, and astringent agent; for calming the nervous system and reducing anxiety; as a sedative; as a sexual, general, and uterine tonic; and for wound healing.  Cont’d… ❖ Ylang-ylang (Cananga odorata)—this essential oil is from the plant family Annonaceae, or custard apple family. This tropical flower is a yellow-shaped flower that grows on the cananga tree. Oil from ylang-ylang is used in cologne, lotion, food flavoring, and soap. This essential oil elevates the mood. Uses; as an antidepressant, anti-inflammatory, antiparasitic, antispasmodic, and aphrodisiac; for calming the nervous system and lowering blood pressure; and as a sexual tonic  RINDS AND FRUITS ❖ Bergamot (Citrus bergamia); is from the plant family Rutaceae. This yellow or green fruit is a hybrid of lemon and bitter orange and has a bitter taste that is more than grapefruit but less than a lemon. The essential oil from the peel or zest of the fruit can cause photosensitivity, with sun exposure causing damage to sun-exposed skin. The essential oil has a citrus fruit smell, with uses in oil perfumes, cosmetics, and scenting food. uses; as an air purifier, antibacterial, antidepressant, antifungal, anti- inflammatory, and antiviral; for calming; as a deodorant; for digestive regulating (undereating or overeating); for reducing  CONT’D… ❖ Lemon (citrus limonum);—this essential oil is fruit from a small evergreen tree. This oil is from the Rutaceae plant family, with the peel of the fruit and pulp used in culinary and noncultural from lemon essential oil, lemon pie for culinary to cleaning products. The distinct sour taste of lemon is a popular essential oil. Uses as an antibacterial, anticoagulant, antidepressant, anti- infectious, anti-inflammatory, antiseptic, antiviral, astringent, antioxidant, and antimicrobial agent; as a digestive stimulant, immunity booster, and lymphatic; and for reducing anxiety.  Cont’d… ❖ Mandarin (Citrus reticulata); —this essential oil is from the Rutaceae plant family. This small citrus tree grows mandarin oranges that are smaller than oranges. A hybrid of the mandarin orange is the tangerine. The mandarin essential oil from peel and rind is sweeter and can be dried for seasoning and used in various food. Used as an analgesic, antidepressant, antiseptic, central nervous system tonic, deodorant, digestive tonic, and immunity booster; for reducing reduces anxiety and fevers; and as a sedative.  Cont’d… ❖ Sweet orange (citrus sinensis);—this essential oil is from the plant family Rutaceae. This sweet citrusy greenish orange fruit oil is from the peel and zest. This oil is used in top perfumes. The leaves are photosensitive but not the fruit. Uses; as an analgesic, antidepressant, antibacterial antifungal, antiseptic, antiviral, deodorant, and digestive tonic; for reducing anxiety; as a sedative; for soothing the nervous system; and as a stimulant.  Cont’d… ❖ Juniper berry (Juniperus communis);—this purple- black berry is a female evergreen cone. This essential oil is from the plant family Cupressaceae, derived from conifers, and often is used as a spice. Uses; as an analgesic, antiseptic, antiseborrheic, anti- inflammatory, antifungal, antiviral, decongestant, and detoxifier and for increasing circulation and reducing fever. WOODS AND RESINS ❖ Cedarwood (Cedrus atlanticia);—cedarwood is from the plant family Pinaceae and the needles, leaves, bark, and wood are for extracting the essential oil. The evergreen conifers have a soothing woodsy scent. Uses; as an antifungal, antiseptic, and astringent; for breaking up mucus; and as a calmative, insect repellent, lymphatic decongestant, and general tonic. Cont’d… ❖ Frankincense (Boswellia carteri);—this essential oil is in the plant family of Burseraceae and is from a Boswellia tree. Resin that is a hardened gumlike material is used in aromatic incense and perfumes. Uses; as an analgesic, antibacterial, antidepressant, anti-infectious, antimicrobial, and astringent agent; for immunity tonic; for reducing anxiety; as a sedative; and for soothing the nervous system and wound healing. Cont’d… ❖ Sandalwood (Santalum album);—this essential oil is from the plant family Santalaceae. The oil is extracted from wood, heartwood of the trunk, and sawdust. The essential oil from sandalwood is used in medications, skin beauty treatment, incense sticks, perfumes, mouthwashes, deodorants, and antiseptics. Uses; as an antibacterial, antidepressant, anti-inflammatory, antimicrobial, antiviral, aphrodisiac, and sedative; for soothing the soothes nervous system; and as a general tonic ROOTS AND RHIZOMES ❖ Ginger (Zingiber officinale); is distilled from the rhizome or underground stem of a root of the herb zingiber. Ginger also is known as the oil of empowerment for the feeling of confidence. Ginger root oil is a frequently used spice. Uses; as an analgesic, antibacterial, antispasmodic, digestive support, immunity harmonizer, and rubefacient. CONT’D… ❖ Vetiver (Vetiveria zizanoides); is derived from the aromatic roots and also called khus oil. It is derived from the vetiver plant that is a clumpy, green grass that can grow 5 feet or more. Uses; as an antiseptic, antispasmodic, anti-inflammatory, digestive stimulant, immunity booster, and sedative, and for skin support and soothing the nervous system.  GRASS ❖ Lemongrass (Cymbopogon citratus); is an essential oil that comes from the leaves and stalk of the lemongrass plant. This grassy plant is used in cooking and herbal tea. The oil from the grass has a lemony powerful scent and is bright or pale yellow. Uses; as an analgesic, antidepressant, antiviral, immunity booster, and general tonic. ❖ Palmarosa (Cymbopogon martinii var. motia) is an essential oil that comes from a tall herbaceous grass and can be called Indian geranium or rose oil. The oil has a sweet citrus lemony scent that has a yellow color.  METHODS OF ADMINISTRATION OF ESSENTIAL OILS 1. Topical application with skin absorption of the essential oil. Examples include massage, scented bath, cosmetics, and perfumes. 2. Absorption of the essential oil by inhaling in nostrils. Examples include direct inhalation via diffuser with steam, aroma stones, and oil-scented strip of cloth. Indirect absorption examples include scented room spray and heated candle wax, detergent, and bathroom and floor cleaners. 3. Oral absorption of the essential oil. Examples include gelatin capsules and safe dose of essential oil diluted. 4. Internal absorption of essential oil. Examples include scented mouthwash and scented suppository or vagina  PATHOPHYSIOLOGICAL MECHANISM OF AROMATHERAPY ❖ There are 2 common pathways triggering a pathophysiologic response to aromatherapy molecules. ❖ Below is a summary of the first pathway The olfactory stimulation by aromatherapy travels via nostrils to the olfactory bulb. The stimulus then travels to the brain for processing, where the amygdala triggers an emotional response and the hippocampus retrieves and/or forms memories. The limbic system interacts with the cerebral cortex, activating thoughts and feelings. CONT’D… The inhaled aromatherapy molecules travel to the upper respiratory tract and then to the lower respiratory tract. Molecules than travel to the pulmonary blood vessels to the blood stream then to organs and tissues. In summary, the inhaled aromatherapy molecules affect mind, body, and spirit. Cont’d… ❖ The second common pathway is through the skin, such as by a massage, in which molecules are absorbed through the skin. The pathway is summarized: The molecules travel to the upper respiratory track and then the lower respiratory tract. Molecules then travel to the pulmonary blood vessels, to the blood stream, and then to organs and tissues. Cont’d… The skin pathway can activate olfactory stimulation and also activates application of scented oil to the skin pathway triggering a mental and physiological response. The skin pathway absorption of essential oils can reduce a patient’s perceived stress, enhance healing, and increase communication  SAFEST WAYS TO USE ESSENTIAL OILS Aromatherapy accessories: Necklaces, bracelets and keychains made with absorbent materials you apply essential oils to and sniff throughout the day. Body oil: A mixture of essential oils with a carrier oil such as olive, jojoba or coconut oil that can be massaged into skin. Because essential oils are concentrated, they can cause irritation. Avoid using them full-strength on skin. Aroma stick: Also called an essential oil inhaler, these portable plastic sticks have an absorbent wick that soaks up essential oil. They come with a cover to keep the scent under wraps until you're ready. Clinical aromatherapy can be beneficial for symptom management  Cont’d… Heartszibah Place Gilbert Centre, 77 Obi Wali Road, Opposite Winners Chapel, Rumuigbo, Port Harcourt, Rivers Nigeria 0814 312 7165, 0814 961 2539 Unwind Rehabilitation Consult And Spa No 8 Nsikak Eduok, 2 Lane, Beside Paragon Ceiling, Uyo, Akwa Ibom State, Nigeria 0806 840 8280 AYURVEDA INTRODUCTION ❖ It is an ancient and sacred (Hindu) system of health care originating from India in over 3000 years ago. It is purely India in origin and has not been influenced by other countries or other medical systems.​ ❖ The literal translation of the word ‘Ayurveda’ from two words in Sanskrit- ayus, meaning ‘life principle’ and veda, referring to ‘system of knowledge  CONT’D… ❖ It is based on the idea that disease is due to an imbalance or stress in a person's consciousness ❖ Ayurveda encourages certain lifestyle interventions and natural therapies to regain a balance between the body, mind, spirit, and the environment. ❖ Ayurveda treatment starts with an internal purification process, followed by a special diet, herbal remedies, massage therapy, yoga, and meditation. Cont’d… ❖ In India, Ayurveda is considered a form of medical care, equal to conventional Western medicine, traditional Chinese medicine, naturopathic medicine, and homeopathic medicine. ❖ Practitioners of Ayurveda in India undergo state- recognized, institutionalized training.  Cont’d… ❖ Those who practice ayurveda believe every person is made of five basic elements found in the universe: space, air, fire, water, and earth. ❖ These combine in the human body to form three life forces, or energies, called DOSHAS. ❖ They control how your body works. They are vata dosha (space and air); pitta dosha (fire and water); and kapha dosha (water and earth). Cont’d… VOTA DOSHA Those who practice ayurveda believe this is the most powerful of all three doshas It controls very basic body functions, like how cells divide. It also controls your mind, breathing, blood flow, heart function, and ability to get rid of waste through your intestines. Things that can disrupt it include eating again too soon after a meal, fear, grief, and staying up too late.  Cont’d… ❖ If vata is your dominant dosha, you may be smart, creative, vibrant, and your moods change quickly. Physically, you may be thin and lose weight easily, and are usually cold. ❖ When you are out of balance, you can get overstimulated and have anxiety, phobias, and be forgetful. ❖ You can also be more likely to have conditions like asthma, heart disease, skin problems, and rheumatoid arthritis. ❖ In ayurveda, like increases like. For this dosha (space and air), you can balance out too much vata by doing things that are grounding like meditation, massage, keeping a regular sleep and wake schedule, and eating warm, mild foods. Cont’d… PITTA DOSHA This energy controls your digestion, metabolism (how well you break down foods), and certain hormones that are linked to your appetite. Things that can disrupt pitta are eating sour or spicy foods, spending too much time in the sun, and missing meals. If you are pitta dominant, then you may be goal- oriented, competitive, confident, and a natural leader. Physically, you may have a medium-sized, muscular Cont’d… When out of balance, you can be too competitive, cranky, quick to anger, and impulsive. If pitta is your main dosha, you’re thought to be more likely to have conditions like Crohn’s disease, heart disease, high blood pressure, indigestion, and fever when you are out of balance. To bring pitta (fire and water) back into balance, you can focus on things that are cooling and light, like salads, cucumbers, and practicing moderation and slow or restorative yoga.  Cont’d… KAPHA DOSHA is thought to control muscle growth, body strength and stability, weight, and your immune system. Things that can disrupt kapha include daytime naps, eating too many sweet foods, and eating or drinking things that contain too much salt or water. If kapha is your main dosha, you may like routine, stick to expectations, and be accepting, calm, and patient. Physically, you are more likely to have a broad frame and easily gain weight. Cont’d… When out of balance, you can easily get fatigued, avoid taking on new projects, and be possessive, stubborn, and depressed. If you are kapha dominant, you may be more likely to develop asthma and other breathing disorders, cancer, diabetes, nausea after eating, and obesity. To reduce excess kapha (earth and water) and be more balanced, you can increase the amount of fruits and vegetables in your diet, and do exercise that gets the blood flowing like jogging or sun salutations in yoga. TREATMENT MODALITIES Nidan Parivarjan(Avoidance of the disease-causing and aggravating factors) Shamana Therapy (Palliative Treatment) Shodhana therapy (Purification Treatment) Satvavajaya (Psychotherapy) Pathya Vyavastha (Prescription of diet and activity)  TOOLS USED IN AYURVEDIC MEDICINE 1. Herbal Medicine; used in different combinations, depending on your dosha, and includes licorice, red clover, ginger, and turmeric. 2. Yoga; 3. Meditation 4. Purification programs; Also known as panchakarma, these are used to cleanse your body of undigested food through practices like blood purification, massage, medical oils, herbs, enemas, and laxatives. 5. Couselling; 6. Oil massage 7. Breathing exercise (pranayama) BRANCHES OF AYURVEDA Kaya Chikitsa (Internal Medicine) Bala Chikitsa (Treatment of Children / Pediatrics) Graha Chikitsa (Demonology / Psychology) Urdhva Anga Chikitsa (Treatment of disease above the clavicle) Shalya Chikitsa (Surgery) Agada Tantra / Visha Chikitsa: Toxicology Jara / Rasayana Tantra: Geriatrics Vajikarana: Reproductive sciences  BENEFITS OF AYURVEDIC MEDICINE Rheumatoid arthritis Lowering BP and cholesterol Reduce risk of Heart diseases Yoga to reduce chronic pain and anxiety and improve circulation and digestion Fenugreek lowers LDL and increases good HDL Meditation reduces anxiety, manage stress better, improve sleep quality Meditation also helps in conditions of chronic pain, cancer, depression and IBS  Cont’d… La Reine Spa & Wellness Ltd Uyo, Nigeria +234 8056180350 Email: [email protected] Shilajit Nigeria 08064833957 Arogyadham Health Abuja  Cont’d… Hob Herbals And Spa Services Sagamu, Nigeria Phone: +234 9079715707 www.house-of-beauty-herbals-and-spa-services.business.si te Mosaic Temple Bajulaye Ro Shomolu, Ijebu-Ode, Lagos YOGA INTRODUCTION Yoga is a healthy way of life, originated in India. The word ‘Yoga’ is derived from Sanskrit root yuj which means ‘join’ or ‘unite’. This may be taken as the union of body, mind and soul, and is used in the literature both as an end as well as means. As an end, yoga signifies ‘integration of personality’ at the highest level. As means, yoga includes various practices and techniques which are employed to achieve the development of such integration. IMPORTANCE OF YOGA Yoga is one of the most powerful drugless system of treatment. It is having its own concept of wellness which has been scientifically understood and presented by many. Yoga can be adopted as lifestyle for promoting our physical and mental health. Yoga, if introduced at the school level, would help to inculcate healthy habits and lifestyle to achieve good health. Yoga helps in the development of strength, stamina, endurance and high energy at physical level. It also empowers oneself with increased concentration, calm, peace and contentment at mental level leading to inner and OBJECTIVES OF YOGIC PRACTICES To develop a understanding of yogic practices and apply this understanding accordingly in one’s life and living. To develop healthy habits and lifestyle in children. To develop humane values in children. To develop physical, emotional and mental health through yogic activities. GENERAL GUIDELINES FOR YOGIC PRACTICE The yogic practices should start with a quiet mood which could be attained by reciting a short prayer. It is essential that body should be prepared by activities such as ankle bending, knee bending, finger movements, hand clenching, wrist bending, wrist rotation, elbow bending, shoulder rotation and eye movement. After this, Surya Namaskara can be practised. Regularity of practice is essential both in the physical and mental aspects of yoga. CONT’D… Patience is an important requirement for yoga. Do not despair if you do not succeed today in doing a certain asana or in following a right principle of conduct. Perseverence in your efforts is needed. Success will come with time. Do not compete but cooperate. A spirit of competition is a definite hindrance on the path of yoga. Competitions feed our ego while yoga helps us to rise above our ego. Yogic practices should be learnt under the guidance of experienced teacher. CONT’D… Most of the asanas, pranayamas and kriyas should be practised on an empty or on a very light stomach. Bladders should be emptied and bowels should be evacuated before starting these practices. Early morning is the ideal time for yoga practice but it can also be practised in the evening with empty stomach about three hours after lunch. Yoga should not be practised in hurry or when you are exhausted. Select a well-ventilated, clean and non-disturbing place for your practice.  CONT’D… Yogic practices should not be performed on hard surface. A durry, a mat or a blanket can be used for this purpose. Bath before the practice is good. Use cold or warm water as per the requirement of the individual and season. Clothes should be loose and comfortable while performing the yogic practices. Breathing should be as normal/natural as possible. It is not to be manipulated unless instructed specifically to do so. There are limitations of yogic practices. If you are suffering from any problem or chronic disease, inform your teacher before starting yogic practices.  CONT’D… Yogic practices should be adopted on the basis of the principle of progress. At initial stage, easy practices should be adopted. Later on more difficult ones can be practised. Therefore, start with simple yogic practices and gradually proceed to do advanced practices. Yogic practices should not be combined with other physical activities in same session. These are two different types of activities and could be separately practised. Yogic practices can be carried on at home once they are properly learnt in the school. Yoga has a broader meaning. Therefore, apart from asana and pranayama, one should practise moral and ethical values in  YOGA POSE (FORWARD POSE) Stand up straight​ Inhale and keep arms close to the body​ Exhale and begin to bend forward​ Keep the chin tilted to the chest and look at the floor while bending​ Sink further down so that the torso settles towards the floor and the top of the head is facing the toes​ Hold this position for several breaths​ To get out of the pose, exhale and begin to lift the back and neck into a standing position.​  YOGA POSE (BREATHING POSE) Keep kneel on the ground, keeping kneels a small distance apart.​ Cross the ankles and sit back on the top heel.​ Place palms over the knees​ Take a deep breath in​ Choose a focal point​ Open the mouth and stretch the tongue to the chin​ Exhale with a “ha” sound.​ Make sure the breath is coming from deep within the stomach.​ Hold this position for several breaths​ Switch the crossing of ankles to repeat on the other side.​ BENEFITS OF YOGA Improves strenght, balance and flexibility Helps with back pain relief Ease arthritis symptoms Benefits heart health Relaxes and help achieve better sleep More energy and brighter mood Manage stress promote s better self-care TRADITIONAL CHINESE MEDICINE (TCM)  INTRODUCTION ❖ Traditional Chinese medicine (TCM) has evolved over thousands of years. ❖ TCM practitioners use various psychological and/or physical approaches (such as acupuncture and tai chi) as well as herbal products to address health problems. ❖ Its basic concept is that a vital force of life, called Qi, surges through the body. ❖ Any imbalance to Qi can cause disease and illness. Cont’d… ❖ This imbalance is most commonly thought to be caused by an alteration in the opposite and complementary forces that make up the Qi. ❖ These are called yin and yang. ❖ Herbal remedies and acupuncture are the treatments most commonly used by TCM practitioners. ❖ Other TCM practices include moxibustion, cupping, massage, mind-body therapy, and dietary therapy.  ANCIENT BELIEFS FOR THE BASIS OF TCM ❖ The human body is a miniature version of the larger, surrounding universe. ❖ Harmony between two opposing yet complementary forces, called yin and yang, supports health, and disease results from an imbalance between these forces. ❖ Five elements—fire, earth, wood, metal, and water— symbolically represent all phenomena, including the stages of human life, and explain the functioning of the body and how it changes during disease. ❖ Qi, a vital energy that flows through the body, performs multiple functions in maintaining health.  THE 3 COMMONEST TECHNIQUES CHINESE HERBAL MEDICINE. ❖ The Chinese Materia Medica (a pharmacological reference book used by TCM practitioners) describes thousands of medicinal substances—primarily plants, but also some minerals and animal products. ❖ Different parts of plants, such as the leaves, roots, stems, flowers, and seeds, are used. ❖ In TCM, herbs are often combined in formulas and given as teas, capsules, liquid extracts, granules, or powders.  Cont’d… ACUPUNCTURE. ❖ Acupuncture is a family of procedures involving the stimulation of specific points on the body using a variety of techniques. ❖ The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metal needles that are manipulated by the hands or by electrical stimulation. TAI CHI. ❖ Tai chi is a centuries-old mind and body practice.  UNANI MEDICINE UNANI can be translated from the Arabic language to mean “GREEK”, From the Arabic word for Greece: ‘al- Yunaan’.​ As an alternative medicine, Unani has found favor in the Asia region especially, India. Unani practitioners can practice as qualified doctors, as the Indian government approves their practice.​ The principles of Unani medicines are based on the teaching of Hippocrates, Galen and Avicenna, and are based on the four humors (elements: phlegm (Balgham), blood (Dam), yellow bile (Safra) and black bile (Sauda).​ Cont’d… In Unani medicines, many medicines are based on honey, which is considered to have healing properties. Real pearls and metal are also used based on the kind of ailment to be treated.​ In today’s modern medicine, honey is often used in wound dressing to kill bacteria because of the high sugar concentration which causes the movement of water from inside the bacterial cell by osmosis, leading to massive dehydration and the eventual death of the affected organism.​​ The practice of Unani medicine is not currently in  Plants Of Interest in Unani Medicine Some plants used in Unani system of medicine are toxic, even deadly poisonous. The drugs having such plants as their components are detoxified before dispensed to the patients.​ Capsule Hudar with the plant Strychnos nux-vomica L. (Azraqi), effectively used in hypotension. ​ Zingibar officinalis (Ginger) improves nervous system, digestive system and cardiovascular system.​ Azadirachta indica (Neem plant) used in hair treatment.​ Cont’d… Ricinus communis (Castor bean plant) used in treatment of pain.​ Abrus precatorius (Rosary pea) used to treat tetanus and prevent rabies. Also used as an antiseptic, antitussive, and anti-allergy.​ Semiecarpus anacardium L., used to improve sexual power.​ SIDDHA MEDICINE  SIDDHA MEDICINE This system believes that all objects in the universe, including the human body are composed of five basic elements; earth, water, fire, air and sky. It is largely therapeutic in nature, and is a form of treatment of disease using substances of all possible origins in a way that balances the possible harmful effects of each substances.​ Over the centuries, the system has developed a rich and unique treasure of drug knowledge in which use of metals is very much advocated. ​ Cont’d… The use of metals like gold, silver and iron powders in some preparations is a special feature of Siddha medicine, which claims it can detoxify metals to enable them to be used for stubborn diseases such as psoriasis, UTI, postpartum anemia, rheumatoid arthritis etc.​ Siddha medicine practitioners have no place in Nigeria currently.​  Cont’d… The depth of knowledge required by practitioners of Siddha medicine is summarized below:​ 1. There are 25 varieties of water-soluble inorganic compounds called ‘Uppu’. These are different types of alkali and salts.​ 2. There are 64 varieties of mineral drugs that do not dissolve in water but emit vapors when burnt in a naked flame.​ 3. Seven drugs do not dissolve in water but emit vapor on heating​ 4. The system has classified separately metals and alloy MANUAL MANIPULATION INTRODUCTION Basically means the manipulation of part or the whole body by hand or mechanical means.​ ​ Can also be termed as Manual Therapy. It is a physical treatment primarily used by physical therapists, physiotherapist, occupational therapists to treat musculoskeletal pain and disability; it is also used by massage therapists, athletic trainers, osteopaths, and physicians.​ ​ The techniques include soft tissue mobilization, joint mobilization and joint manipulation.​ Cont’d… ❖ Joint mobilisations and manipulations techniques are used to safely stretch or snap structures to restore normal joint mechanics with less trauma ❖ To effectively use joint mobilisation for therapeutic purpose, the practitioner must know and be able to evaluate the Anatomy of bone and joint Arthrokinematics Pathology of the neuromusculoskeletal system Cont’d… The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) defines orthopaedic manual physical therapy as: "a specialised area of physiotherapy/ physical therapy for the management of neuro- musculoskeletal conditions, based on clinical reasoning, using highly specific treatment approaches including manual techniques and therapeutic exercises. Three Paradigms of Manual Therapy Therapeutic Effects 1. Physiological: A positive placebo response can be produced. 2. Biomechanical and Physical: Manual therapy facilitates tissue repair and modelling. 3. Psychological: Manual therapy can reduce pain which improves an individual's psychological state. This pain reduction is achieved by stimulating the pain-gate mechanism, muscle inhibition, reduction of nociceptive activity, and reduced intraarticular or periarticular pressure BENEFITS OF MANUAL THERAPY ❖ Modulate pain ❖ Increase joints mobility to stiff joints and range of motion ❖ Improve tissue repair ❖ Improving tissue stability and extensibility ❖ Reduce soft-tissue inflammation ❖ Reduce muscle tension ❖ Induce relaxation ❖ Facilitate movement and exercise therapy MIND BODY INTERVENTION INTRODUCTION Mind-body therapy is based on the belief that thoughts and physical health are closely connected. A person's attitudes, beliefs, and outlook can all affect physical health. Physical health also can impact mental and emotional well-being. By being aware of the connection and learning new ways to connect these areas, a person can learn to optimize their overall wellness and health. SPECIFIC MIND BODY INTERVENTIONS RELAXATION TECHNIQUES Includes; Biofeedback Breath therapy Hpno therapy Imagery and visualization Meditation Relaxation therapy/ progressive muscle relaxation Yoga Qigong CONT’D… CREATIVE ARTS TECHNIQUES includes; Art therapy Dance therapy Drama therapy Music therapy Poetry therapy CONT’D… OTHERS Horticultural therapy Pet therapy Prayer Psychotherapy Support groups BENEFITS Evidence suggests mind-body interventions in other chronic illness populations decrease symptoms of depression, regulate immune responses, and promote resilience.​ HYPNOTHERAPY INTRODUCTION The word “hypnosis” comes from the Greek word for sleep, hypnos Hypnosis is a familiar state, it is encountered when returning to waking state from sleep (hypnopompic), and when entering sleep (hypnogogic) It is a changed state of awareness and increased relaxation that allows for improved focus and concentration. It also is called hypnotherapy.​ Cont’d… Hypnosis usually is done with the guidance of a health care provider using verbal repetition and mental images.​ During Hypnosis, most people feel calm and relaxed. It usually make people more open to suggestions about behavioral changes. ​ Rather restricting the senses, hypnosis expands and magnifies the senses, with particularly enhanced selectivity for the focus of attention Cont’d… In hypnosis, the critical faculty of the mind is bypassed and the imaginative faculty engaged The critical faculty is the judge and censor of the conscious mind. When it is bypassed, selective thinking to help improve performance and overcome blockages can be established SIGNS OF HYPNOSIS BASED ON DIFFERENT SCHOLARS SANTANELLI The body taking a comfortable or easy position Eye turning up or converging Closed eyes Concentration (those with the greatest capacity are easiest to hypnotize) Cont’d… ELMAN, DAVE Body warmth Fluttering of the eyelids Increased lacrimation The whites of the eyes getting red or pinkish The eyeballs going up into the head Cont’d… ERICKSON, MILTON Flattening of the facial expression Staring Absence of blinking Almost complete immobility Cont’d… HICKMAN, IRENE Increased pallor of the skin Slowing of the breathing Lack of movement of any part of the body FOUR MAIN STAGE OF HYPNO THERAPY INDUCTION Close their eyes Imagine that they can’t open their eyes Try to open their eyes while pretending they can’t Relax the eys and the wholembody  OTHER TECHNIQUES Eye-fixation technique This technique involves fixating the gaze on some object until the eyelids become heavy and close, and the person drifts into deep relaxation. Arm-drop technique The individual fixes the gaze on one of their fingers with the forearm kept vertical, until the hand becomes heavy and starts drifting downward. As the arm lowers, the eyes become heavy and close, and hypnosis is achieved.  CONT’D… Progressive relaxation technique The individual settles down comfortably, focuses on breathing in and out, and relaxes their body from the feet up to go into complete relaxation. Imagery Imagery involves having the individual breathing deeply and imagining a scene that makes them feel safe and comfortable.  HOW TO PERFORM HYPNOSIS Make your subject relaxed and comfortable: Have the person lie down on a bed nor couch, or sit in a chair. Eliminate distracting noises, you may want to play a soothing music.​ Begin the induction: this is the process of bringing someone into a hypnotic trance. ​ Use progressive relaxation to help them relax physically: talk them through relaxing every part of the body. You can do this by describing to them a flowing warmth creeping down or up their body.​ CONT’D… Ask the person to count to help them feel calm. The more difficult your subject, the longer you’d need to count for. While counting, you can inject calming phrases between each number such as ‘you are becoming to feel relaxed, you feel calmer and safer’ etc.​ Try the Ericksonian pattern for a conversational approach. Discuss what they are experiencing, how they’re feeling, and things they are seeing. With the inclusion of suggestion such as ‘and you are noticing your body is growing more still and beginning to feel warmer?’. ​ CONT’D… Suggest that they close their eyes as they relax. This will increase the depth of trance. ​ Deepen their trance. A second induction technique can help them go deeper. Slowing and deepening your voice.you can also just repeat phrases such as ‘the deeper you go the deeper you go’.​ Provide consensual suggestions. Begin giving suggestions that they agree to. If you’re unsure your subjects would be willing to respond to your ideas, try framing them as light suggestions, with phrases such as ‘would you like to?’, ‘do you think you could…?’ etc​ CONT’D.. Wake your subject. The most common way of doing so is by counting. Simply count from 10 to 1 or 20 to 1 , saying soothing, encouraging words between the count. Explaining to them that they are becoming awake, more awake and they can open their eyes.,​ BENEFITS OF HYPNOSIS ❖ Reducing pain ❖ Quitting smoking ❖ Reducing anxiety ❖ Treating depression ❖ Overcoming fears or phobia HOMEOTHERAPY INTRODUCTION Homeopathy is a medical system based on the belief that the body can cure itself. A basic belief behind homeopathy is “like cures like.” In other words, something that brings on symptoms in a healthy person can -- in a very small dose -- treat an illness with similar symptoms. This is meant to trigger the body’s natural defenses. For example, red onion makes your eyes water. That’s why it’s used in homeopathic remedies for allergies. CONT’D… It can also be referred to as Homeopathy.​ Which is a complementary or alternative medicine (CAM). It is based on a series of ideas developed by a German doctor in 1790 called Samuel Hahnermann.​ METHOD OF PREPARING HOMEOPATHIC REMEDIES ❖ In the first method, the original substance or extract is mixed in alcohol, stored for a while and then sifted. This is called the Mother Tincture. Many remedies are used in this form such as Carduus Marianus in liver diseases. Eight to ten drops dissolved in water and taken by mouth are very useful in many liver disorders. The letter Q tells us that the homoeopathic remedy is a Mother Tincture. CONT’D… ❖ In the second method, he Mother Tincture is diluted with alcohol or distilled water in a bottle, one drop in ninety-nine drops of the diluent and shaken vigorously two to four times so that it becomes completely homogeneous. ❖ Thus prepared, the potency of the medicine is 1. ❖ For example, a drop of Mother Tincture of Aconite shaken well in ninetynine drops of the diluent, alcohol or distilled water is Aconite potency 1.  CONT’D… ❖ A drop of Aconite 1 added to ninty-nine drops of alcohol and shaken well will make Aconite 2. ❖ A drop of Aconite 2 vigorously shaken in ninety-nine drops of alcohol will make Aconite 3 and so on. ❖ If the process is repeated thirty times, we have prepared Aconite 30. ❖ Most of the routine homoeopathic remedies are prepared in this way. ❖ The letter C written along with the potency indicates that in each dilution, the medicine is diluted one in a hundred. However the use of letter C and D are outdated though  GENERAL PRINCIPLE ❖ Generally speaking, chronic illnesses, which have gradually invaded and taken over the body systems over a long period, are amenable only to slow but progressively acting remedies. ❖ These remedies should be continued for six to twelve months. ❖ One should start with low potency 30 and when it stops working, advance to the next potency of 200 once a day for seven to ten days. ❖ After that, potency, 1000 is to be given every fortnight a few times. ❖ The last dose should be in potency CM to be repeated after  PRESERVATION OF HOMEOPATHIC REMEDIES ❖ In general, homoeopathic remedies last a long time. ❖ They may not even expire in a hundred years or more ❖ In general, they should be kept in a dry temperate place with the covers of of the bottles tightly closed ❖ The temperature as such does not alter the effectiveness of of the medicine, but, if the cover is not airtight, the remedy will evaporate. ❖ If the bottle has completely dried out, the remedy should be made afresh. ❖ If even a drop remains, it may be made up again by adding more of the diluent. CONT’D… ❖ In this way, the potency will increase by one, such as from 30 to 31 or from 200 to 201. ❖ This however, does not reduce the effectiveness of the remedy. ❖ As a caution, homoeopathic remedies should not be placed in direct sunlight. ❖ As a rule, all homoeopathic remedies must be kept in separate bottles but some remedies may be mixed without losing their individual effectiveness.  SOME SUBSTANCES IN THE MATERIA MEDICA AND USES NAME OTHER NAMES MAIN USE Absinthium Common worm Epilepsy wood Acetic Acidum Vinegar-an acidic Cancer of the (acetic acid) solution stomach Aloe Socotrine laxative Belladonna Deadly night shade Severe acute pain of the gall bladder  SOME SUBSTANCES IN THE MATERIA MEDICA AND USES NAME OTHER NAMES MAIN USE Borax Eye diseases camphora Camphor cholera Ipecacuanha Ipecac-Root Induce vomiting and in malaria treatment and bleeding Nux vomica Poison nut Plague, hysteria, rheumatism and rabies USES OF HOMEOPATHY 1. Ear infection​ 2. Hay fever​ 3. Stress and anxiety​ 4. Allergies​ 5. Dermatitis​ 6. Arthritis​ 7. High blood pressure.​ MASSAGE THERAPY INTRODUCTION ❖ Massage therapy is a type of physical therapy that involves the pressing and kneading of soft tissues in the body. ❖ They promote relaxation, flexibility, and blood flow. They additionally assist in relieving acute and chronic pain, muscle tension, and stress. ❖ the first practices of which began in India, thousands of years ago. ❖ There several types of massage. Few will however be discussed here  Swedish Massage They are relatively gentle in regard to pressure and mainly focus on relaxation and tension relief. Movements generally involve long strokes, kneading, circular movements, and joint movements. Target areas Neck Shoulders Lower back Benefits ; Relaxation, Stress reduction, Improved posture, Increased range of motion and flexibility, Headache relief, Improved sleep  Deep Tissue Massage Deep tissue massages use more pressure than Swedish massages. Rather than relaxation, it is intended to focus on pain and tension relief. Movements involve similar stroking and kneading, but done slower and with much firmer pressure. Target areas Muscles Tendons Connective tissues deep under skin Benefits; Reduce inflammation, Reduce muscle pain, Lowers blood pressure, Helping with injuries, Reduce arthritis symptoms  Trigger Point Massage Trigger point massages are a newer type of massages. They focus on detecting and releasing trigger points, also known as “knots.” These knots are spots in muscle tissue that cause aching and stiffness. When these knots are pressed on, they produce pain in a different area of your body. It combines the techniques of Swedish and deep tissue. Various levels of pressure are applied to the knots, and then the areas are stretched. Target areas Areas of muscle tightness Benefits; Pain and ache relief, Reduce lower back pain, Reduce  Reflexology Massage The theory behind reflexology is that certain reflex points on the feet, hands, and ears are mapped to different areas of the body. However, foot reflexology is the most common treatment. The massage therapist will rub, press, and squeeze your feet. The area of your foot will depend on the target area of your body. Target areas; Feet, Hands, Ears Benefits; Reduce pain, Reduce stress and anxiety, Improved sleep, Reduce, headaches Other Techniques ❖ Shiatsu ❖ Thai Massage BENEFITS OF MASSAGE THERAPY ❖ Back pain ❖ Anxiety ❖ High blood pressure ❖ Migraine headache ❖ Carpal tunnel symptoms ❖ Side effects of cancer and cancer therapy DIET AND LIFESTYLE INTRODUCTION Diet therapy is a branch of dietetics concerned with the use of food for therapeutic purpose It concerns with recovery from illness by giving good diet and prevention of disease It may involve the modification of the existing dietary lifestyle to promote optimum health PRINCIPLES OF DIETARY THERAPY ❖ maintain good nutritional status, ❖ correct deficiencies or disease, if any, ❖ provide rest to the body, ❖ help metabolize the nutrients, and ❖ make changes in body weight, when necessary  THERAPEUTIC DIET Therapeutic diet refers to a meal plan that controls the intake of certain foods or nutrients They are adaptation of the normal regular diet Therapeutic diets are usually prescribed by dieticians, nutritionists or physicians Example are clear liquid diet, diabetic diet, renal diet, gluten free diet, low fat diet, high fibre diet etc Diet Therapy is use of appropriate foods as a tool in the recovery from illness. All therapeutic diets are modifications of the normal diet made in order to meet the altered needs resulting from disease. DIETS TYPES 1. Liquid diet a. Clear fluid diet b. Full fluid diet 2. Normal diet 3. Soft diet 4. Liquid diet is further classified into  NORMAL DIET ❖ Normal diet is planned according to the recommended daily dietary intakes, which are designed to meet the needs of all healthy persons ❖ It aims to meet the recommended dietary allowances of nutrients through a planned diet ❖ The nutritional requirements depend on the activity, the increased or decreased demands for certain nutrients, which need to be considered in planning the diet ❖ A normal diet may be adapted to suit different cultural or socio economic circumstances  MODIFICATION OF NORMAL DIET ❖ The normal diet may be modified to Change in consistency of foods, such as liquid diet, soft diet, low fibre diet, high fibre diet ❖ Increase or decrease in energy value of the diet such as low calorie diet for weight reduction, high calorie diet for burns ❖ Increase or decrease in specific nutrients or type of food consumed such as sodium restricted diet, lactose restricted diet, high fibre diet, high potassium diet ❖ Elimination of spices and condiments, such as bland diets ❖ Omission of specific foods such as allergy diets, gluten free diet CONT’D… ❖ Adjustment in the ratio and balance of proteins, fats and carbohydrate such as diabetic diet, renal diet and cholesterol lowering diets ❖ TEST DIETS These are single meals or diets lasting one or few days that are given to patients in connection with certain tests eg the fat absorption test used to determine if steatorrhoea is present ❖ Change in frequency of meals, feeding intervals, re arrangement of the number and frequency of the meals such as diabetic diet, diet for peptic ulcer disease LIQUID DIET These diets are prepared for persons suffering from fevers, persons who have just undergone an operation or whenever a person is unable to tolerate solid foods As the nutrient content is diluted, the interval between feeds is reduced and the number of feeds is increased to six or more It includes drinks such as tea, coffee, clear fruit juices, coconut water, sherbets, extracts of dal rice, popped cereals, fat free broth, carbonated drinks CONT’D… Feeds are offered in small portions of about 20 25 ml every hour or two and the volume is increased gradually as the condition of the patient improves Liquid diet helps to maintain liquid and electrolyte balance, relieve thirst and stimulate the digestion system to function, after an operation or disturbance in the system due to infection  FULL DIET In full liquid diet, foods included are liquids and foods which are liquid at body temperature. It can provide adequate nutrition, with the exception of iron. As the nutrient density is not high, six or more feedings are given. Skim milk powder is added to increase the protein content of the diet.  Cont’d… Full liquid diet is prescribed for patients: post operatively after clear liquid diet phase, in acute infections of short duration, in acute gastrointestinal upset, after clear liquid diet phase, and (iv) In situations when patient is unable to chew food  SOFT DIET Soft diet is used after full liquid diet and before moving on to a normal diet. It is nutritionally adequate. Foods included are those, which are easy to mix with saliva, swallow and digest. Exclude foods, which contain harsh fiber , strong flavours and too much fat. Soft Diets include several variations such as mechanically soft diet, pureed diet and fiber restricted soft diet MECHANICALLY SOFT DIET In this diet the modification of normal diet is in texture only. This is also called Dental Soft Diet, as it is prescribed for those who cannot chew, due to absence or removal of teeth or ill fitting dentures.  PUREED DIET Pureed diets include foods, which are smooth, soft and need hardly any chewing. These are good for patients who have difficulty in swallowing. All foods (except those that are already soft or smooth) are blended or pureed in a mixer. Liquids are added to get the consistency needed by the patient. To increase calories, fat and/or sugars are added.  SOFT FIBRE RESTRICTED DIET Indigestible carbohydrates are excluded from this diet such as cellulose, hemicellulose, lignin, pectic substances, gums and mucin ). The amount of indigestible carbohydrates in the diet can be reduced by using: ○ refined cereals and breads ○ immature vegetables ○ fruits without skins and seeds and ○ cooked vegetables and fruits DIETARY COUNSELLING It has been observed that malnourished patients take longer to recover Hence nutritional assessment should be a routine part of all patients’ care all patients do not need in depth assessment A simple method of clinical observation helps to detect those at risk of malnutrition Only patients at risk need to undergo comprehensive nutritional assessment PRACTICE QUESTIONS 1. Give the John Hopkins classification of CAM listing two under each category 2. List the 5 evidence-based indications of acupuncture 3. Give a detailed explanation on how acupuncture works 4. Discuss in details two hydrotherapy procedures 5. State the effect of hydrotherapy on the cardiovascular and Nervous systems 6. Explain 5 methods of administering essential oils 7. Name any 5 essential oils, their plant sources and their indications 8. Give the principles of dietary therapy and explain in details 5 diet types 9. Briefly explain the benefits of dietary therapy and explain briefly therapeutic diet