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      Complementary and alternative medicine use in thalassemia patients in Shiraz, southern Iran: A cross-sectional study

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          Abstract

          This study aimed to determine the frequency and pattern of complementary and alternative medicine (CAM) use in thalassemia patients in south of Iran. The survey was done using a validated questionnaire which was distributed among 122 thalassemia patients. Only 108 questionnaires were completed and turned back (response rate 88.5%). Patients referred to an outpatient thalassemia clinic in Shiraz, southern Iran for blood transfusion. The mean age of the patients was 22.9 ± 7.9 years (range 4–45 years) with female/male ratio 1.84. Seventy four (68.5%) of the responders used CAM at least once during their life, and about half of them used it concurrently with their conventional treatments. The most reported CAM product was mint juice (50%). The most common reason of CAM use was increased general health. The most common information source about CAM was physicians who were the most trusted source as well. CAM is frequently being used in thalassemia patients to ensure their sense of well-being and help them overcome the complications of their illnesses.

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          Use of complementary and alternative medicines for children with chronic health conditions in Lagos, Nigeria

          Kazeem A Oshikoya, Idowu Senbanjo, Olisamedua F. Njokanma … (2008)
          Background The use of complementary and alternative medicine (CAM) is on the increase globally with a high prevalence in children and adults with chronic illnesses. Many studies have evaluated the epidemiology of medicine use for children in developing countries but none has evaluated the use of CAM for children with chronic illnesses. The aim of this study was therefore to determine the prevalence, pattern of use, parental sources of information, perceived benefits, cost, and adverse effects of CAM in children with epilepsy, sickle cell anaemia and asthma in Lagos, Nigeria. Methods Parents of children with epilepsy (122), asthma (78) or sickle cell anaemia (118) who presented consecutively to the paediatric neurology, respiratory and haematology clinics of the Lagos State University Teaching Hospital (LASUTH), Ikeja were interviewed with a structured open- and close-ended questionnaire. The information obtained comprised the demography of both the patients and their parents; past and present treatments received by the patients; the type of CAM, if any, used by the patients; and the sources, cost, benefits and adverse effects of the CAM used. Results A total of 303 CAMs were used by the patients, either alone or in combination witother CAM. CAM was reportedly used by 99 (31%) patients (epilepsy -38%, sickle cell anaemia – 36% and asthma – 25%). The majority (84%) of these patients were currently using CAM. The use of CAM was stopped six months prior to the study by 16 patients (16%). Biological products were the most frequently used CAMs (58%), followed by alternative medical systems (27%) and mind-body interventions (14%). Relations, friends and neighbours had a marked influence on 76% of the parents who used CAM for their children. Eighty-five (86%) parents were willing to discuss the use of CAM with their doctors but were not asked. CAM use was associated with adverse reactions in 7.1% of the patients. Conclusion Parental use of CAMs to treat their children with epilepsy, asthma and sickle cell anaemia is common in Nigeria. Efforts should be made by doctors taking care of these patients to identify those CAM therapies that are beneficial, harmless and cheap for possible integration with conventional therapy.
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            Complementary and alternative medicine use in Iranian patients with diabetes mellitus.

            Mojtaba Heydari, Mohammad Hashem Hashempur, Seyyed Taghi Heydari … (2015)
            There is increasing interest in complementary and alternative medicine generally, and especially by those affected by chronic diseases, such as diabetes mellitus. We aimed to determine the prevalence and pattern of complementary and alternative medicine use among patients suffering from diabetes mellitus in Shiraz, southern Iran. Another objective was to explore associated factors for use of complementary and alternative medicine among patients with diabetes mellitus.
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              Response to hydroxyurea treatment in Iranian transfusion-dependent beta-thalassemia patients.

              Cornelis Harteveld, Piero C. Giordano, Majid Yavarian … (2004)
              Hydroxyurea (HU) is known to increase gamma-globin chain expression in postnatal life. The efficacy of HU treatment in thalassemia patients is still unclear. The aim of this study was to monitor treatment of a large cohort of patients with beta-thalassemia major in order to establish the response to HU and the associated elements. HU therapy was started in 133 patients diagnosed with transfusion-dependent beta-thalassemia in 1999. The molecular background of the disease, the polymorphisms of the promoter region of the genes, the haplotype of the beta-globin gene cluster, the alpha-gene deletions and the HS2 polymorphism at the locus control region (LCR) of the beta-globin gene cluster were studied. We were able to classify three categories of response: a good response (61%) in patients who shifted from monthly blood transfusion dependency to a stable transfusion-free condition at an average Hb level of more than 10 gm/dL; a moderate response (23%) in patients who remained transfusion dependent but at longer intervals (6 months or more), and non response in patients who, after one year of treatment, remained at the same level of transfusion dependency. The correlations with the molecular defects were found to be secondary to the presence of the (C-->T) at -158 of the Ggamma gene (XmnI polymorphism). The T allele, in linkage to the haplotype I (+----) and to the internal beta-globin gene framework 2, was the most significant modulating factor involved. The good response to HU treatment that a significant number of southwest Iranian patients with beta-thalassemia patients had seems to correlate with particular haplotypes. This indicates that HU treatment is a sensible option for transfusion-dependent beta-thalassemia patients with a favorable molecular background.
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                Author and article information

                Contributors
                Sezaneh Haghpanah
                Journal
                Journal ID (nlm-ta): J Tradit Complement Med
                Journal ID (iso-abbrev): J Tradit Complement Med
                Title: Journal of Traditional and Complementary Medicine
                Publisher: Elsevier
                ISSN (Electronic): 2225-4110
                Publication date PMC-release: 26 May 2017
                Publication date Collection: January 2018
                Publication date (Electronic): 26 May 2017
                Volume: 8
                Issue: 1
                Pages: 141-146
                Affiliations
                [a ]Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
                [b ]Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
                [c ]Islamic Azad University, Isfahan (Khorasgan) Branch, Iran
                [d ]Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
                Author notes
                [∗ ]Corresponding author. Hematology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, P.O. Box: 7193711351, Shiraz, Iran. Fax: +98 713 6473239.Hematology Research CenterNemazee HospitalShiraz University of Medical SciencesP.O. Box: 7193711351ShirazIran haghpanah@ 123456sums.ac.ir
                Article
                Publisher ID: S2225-4110(17)30053-6
                DOI: 10.1016/j.jtcme.2017.05.002
                PMC ID: 5755989
                PubMed ID: 29322002
                SO-VID: 36a60c6c-44fb-49cc-a9e7-d9393005a7aa
                Copyright © © 2018 Center for Food and Biomolecules, National Taiwan University. Production and hosting by Elsevier Taiwan LLC.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 23 November 2016
                Date revision received : 24 April 2017
                Date accepted : 9 May 2017
                Categories
                Subject: Original Article

                Keywords: complementary and alternative medicine,thalassemia,hemoglobinopathy,traditional persian medicine,iran
                Data availability:
                Keywords: complementary and alternative medicine, thalassemia, hemoglobinopathy, traditional persian medicine, iran

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