ALTERNATIVE MEDICINE IN BANGLADESH by regan ahmed

COMPETITIVE ANALYSIS OF ALTERNATIVE MEDICINE IN BANGLADESH Introduction Alternative Medicine, the most favorite as well as the demandable market in todayâ&#x20AC;&#x2122;s world. Todayâ&#x20AC;&#x2122;s mammoth corporate Maknom International Inc. once started their operation with Therapeutic Items. With changing pattern of consumersâ&#x20AC;&#x2122; life style this medicine has turned in to much alternative medicine. Like acupuncture there are also many giant companies like E. M Therapist, operating their alternative medicine market throughout the world by franchising, licensing and many other ways to globalize the alternative medicine markets. Bangladesh is one of the great markets for Alternative medicine. There are more than one crore people represent a big market size for the marketers. Earlier people used to entertain their guests or acquaintances with medicine. But with changing time people become trendier. They are now approaching in to alternative including all kinds of medicine. This trend touches the medicine manufacturer. As a result we can see a lot of companies are now operating their business in this sector and many new companies are enthusiastic to enter in to the market. History of Mk-082, E.M Therapist There is an ancient Chinese proverb that says, "May you live in interesting times." While some scholars say this expression was originally a curse. We at MAKNOM see it differently. We celebrate the many interesting changes that have come our way over the last 12 yearsespecially when it comes to the people we work with. Our society is more diverse today than at any time in the past, a rich tapestry that comprises countless different backgrounds, ethnicities & attitudes. At MAKNOM we recognize that, just as the right blend of seasonings can give a dish its own unique taste, the many differences among us are what give life its fascinating flavor. In this spirit, we've created a plan that integrates best business practices to create a work place that reflects the unique diversity of a global life. Over the last 12 years Maknom International Inc. is working in several fields, one of which is sales & marketing. In this field there are several products in different series. MK-082 E.M therapist is one of them. This product belongs to therapeutic series. With the help of Chinese specialist this product is made by our own supervision in our own factory in U.S.A. Over the years this product has gained several certifications & successfully marketed in North America, UK, Ireland, and Australia. At last we have started in Asia. I hope this product will help the people of this zone for better health like other countries. The question whether alternating or pulsating magnetic fields have a biological effect, can be answered positively, in as much as the physical entity "magnetic field" is in a position to affect the organism in a bioenergetics way. We know that with many diseases the surface potentials of the cells in the organism seem to vary when compared with the normal values.

The magnetic field completely permeates the body and thus every single cell. The ions in the cells and the colloidal system are influenced, as we know, by magnetism and are moved in accordance with the magnetic pulsation that passes through them. Furthermore, recent experiments proved that the partial pressure of oxygen in the tissue may increase up to 1,000% compared to the initial value under the influence of pulsating magnetic fields of a certain intensity and frequency. Thus the pulsating magnetic field enables an effective therapy which can be used for a broad range of indications. The changes in the surface potentials of the cell, the colloidal state and the degree of ionization of the tissue, which occur in many diseases are markedly influenced by the entire body in rapid pulsation. This causes a better blood circulation in the vessels and capillaries, increasing the partial pressure of oxygen in the tissue and resulting in an accelerated transportation of metabolic waste products - a basic requirement for every healing process. Measurements by means of highly sensitive thermography devices showed a significantly improved circulation. Magnetic fields permeate the whole organism. When intensity and frequency are controlled properly, energy is accumulated in all tissues of the body. As a result of long-lasting changes in the condition of the colloidal tissues increases in cell activity and membrane potential will occur. In addition, intra-corporeal electric processes will intensity again and a regeneration of all functional parts and organs of the body can be clearly noted. “Magnetic fields can be localized and targeted,” says neurologist Michael J. McLean, MD of Vanderbilt University Medical Center, in Nashville, Tenn., where more than 5,000 patients have been treated with magnets. According to a new book, The Pain Relief Breakthrough: The Power of Magnets, co-authors Julian Whitaker, M.D., and Brenda Adderly say magnets can also help headaches, arthritis, menstrual cramps, carpal tunnel syndrome and a variety of other ailments. “My patients have reaped the benefits of magnets, and I believe that millions more can experience these miraculous results as well,” says Whitaker, director of the Whitaker Wellness Institute in Newport Beach, Calif., and founder of the American Preventative Medicine Association. Many studies in animals and humans have demonstrated that acupuncture can cause multiple biological responses. These responses can occur locally, i.e., at or close to the site of application, or at a distance, mediated mainly by sensory neurons to many structures within the central nervous system. This can lead to activation of pathways affecting various physiological systems in the brain as well as in the periphery. A focus of attention has been the role of endogenous opioids in acupuncture analgesia. Considerable evidence supports the claim that opioid peptides are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by their actions. That opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis. Stimulation by acupuncture may also activate the hypothalamus and the pituitary gland, resulting in a broad spectrum of systemic effects. Alteration in the secretion of neurotransmitters and neurohormones and changes in the regulation of blood flow, both centrally and peripherally, have been documented. There is also evidence of alterations in immune functions produced by acupuncture. Which of these and other physiological changes mediate clinical effects is at present unclear. Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. Even more

elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of ei, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture. Some of the biological effects of acupuncture have also been observed when "sham" acupuncture points are stimulated, highlighting the importance of defining appropriate control groups in assessing biological changes purported to be due to acupuncture. Such findings raise questions regarding the specificity of these biological changes. In addition, similar biological alterations, including the release of endogenous opioids and changes in blood pressure, have been observed after painful stimuli, vigorous exercise, and/or relaxation training; it is at present unclear to what extent acupuncture shares similar biological mechanisms. It should be noted also that for any therapeutic intervention, including acupuncture, the socalled "non-specific" effects account for a substantial proportion of its effectiveness and thus should not be casually discounted. Many factors may profoundly determine therapeutic outcome, including the quality of the relationship between the clinician and the patient, the degree of trust, the expectations of the patient, the compatibility of the backgrounds and belief systems of the clinician and the patient, as well as a myriad of factors that together define the therapeutic milieu. Although much remains unknown regarding the mechanism(s) that might mediate the therapeutic effect of acupuncture, the panel is encouraged that a number of significant acupuncture-related biological changes can be identified and carefully delineated. Further research in this direction not only is important for elucidating the phenomena associated with acupuncture, but also has the potential for exploring new pathways in human physiology not previously examined in a systematic manner. An Alternative Therapy for Better Health Alternative Medicine (Acupuncture)

Introduction:

Acupuncture is among the oldest healing practices in the world. As part of traditional Chinese medicine. A whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi (TCM), acupunctureA family of procedures that originated in traditional Chinese medicine. Acupuncture is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health. Aims to restore and maintain health through the stimulation of specific points on the body. In the United States, where practitioners incorporate healing traditions from China, Japan, Korea, and other countries, acupuncture is considered part of complementary and alternative medicineA group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. (CAM). Key Points: •

Acupuncture has been practiced in China and other Asian countries for thousands of years.

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Scientists are studying the efficacy of acupuncture for a wide range of conditions. Relatively few complications have been reported from the use of acupuncture. However, acupuncture can cause potentially serious side effects if not delivered properly by a qualified practitioner. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

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About Acupuncture: The term "acupuncture" describes a family of procedures involving the stimulation of anatomical 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, metallic needles that are manipulated by the hands or by electrical stimulation. Practiced in China and other Asian countries for thousands of years, acupuncture is one of the key components of traditional Chinese medicine. In TCM, the body is seen as a delicate balance of two opposing and inseparable forces: yin and yangThe concept of two opposing yet complementary forces described in traditional Chinese medicine. Yin represents cold, slow, or passive aspects of the person, while yang represents hot, excited, or active aspects. A major theory is that health is achieved through balancing yin and yang and disease is caused by an imbalance leading to a blockage in the flow of qi.. Yin represents the cold, slow, or passive principle, while yang represents the hot, excited, or active principle. According to TCM, health is achieved by maintaining the body in a "balanced state"; disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qiIn traditional Chinese medicine, the vital energy or life force proposed to regulate a person's spiritual, emotional, mental, and physical health and to be influenced by the opposing forces of yin and yang. (Vital energy) along pathways known as meridians. Qi can be unblocked, according to TCM, by using acupuncture at certain points on the body that connect with these meridians. Sources vary on the number of meridians, with numbers ranging from 14 to 20.

One commonly cited source describes meridians as 14 main channels "connecting the body in a weblike interconnecting matrix" of at least 2,000 acupuncture points. Acupuncture became better known in the United States in 1971, when New York Times reporter James Reston wrote about how doctors in China used needles to ease his pain after surgery. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries. Acupuncture Use in the United States: The report from a Consensus Development Conference on Acupuncture held at the National Institutes of Health (NIH) in 1997 stated that acupuncture is being "widely" practiced—by thousands of physicians, dentists, acupuncturists, and other practitioners—for relief or prevention of pain and for various other health conditions. According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, an estimated 3.1 million U.S. adults and 150,000 children had used acupuncture in the previous year. Between the 2002 and 2007 NHIS, acupuncture use among adults increased by three-tenths of 1 percent (approximately 1 million people). Acupuncture Side Effects and Risks: The U.S. Food and Drug Administration (FDA) regulates acupuncture needles for use by licensed practitioners, requiring that needles be manufactured and labeled according to certain standards. For example, the FDA requires that needles be sterile, nontoxic, and labeled for single use by qualified practitioners only. Relatively few complications from the use of acupuncture have been reported to the FDA, in light of the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. Practitioners should use a new set of disposable needles taken from a sealed package for each patient and should swab treatment sites with alcohol or another disinfectant before inserting needles. When not delivered properly, acupuncture can cause serious adverse effects, including infections and punctured organs. Status of Acupuncture Research: There have been many studies on acupuncture's potential health benefits for a wide range of conditions. Summarizing earlier research, the 1997 NIH Consensus Statement on Acupuncture found that, overall, results were hard to interpret because of problems with the size and design of the studies. In the years since the Consensus Statement was issued, the National Center for Complementary and Alternative Medicine (NCCAM) has funded extensive research to advance scientific understanding of acupuncture. Some recent NCCAM-supported studies have looked at: •

Whether acupuncture works for specific health conditions such as chronic low-back pain, headache, and osteoarthritis of the knee

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How acupuncture might work, such as what happens in the brain during acupuncture treatment Ways to better identify and understand the potential neurological properties of meridians and acupuncture points Methods and instruments for improving the quality of acupuncture research

Finding a Qualified Practitioner: Health care providers can be a resource for referral to acupuncturists, and some conventional medical practitioners—including physicians and dentists—practice acupuncture. In addition, national acupuncture organizations (which can be found through libraries or Web search engines) may provide referrals to acupuncturists. •

Check a practitioner's credentials. Most states require a license to practice acupuncture; however, education and training standards and requirements for obtaining a license to practice vary from state to state. Although a license does not ensure quality of care, it does indicate that the practitioner meets certain standards regarding the knowledge and use of acupuncture.

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Do not rely on a diagnosis of disease by an acupuncture practitioner who does not have substantial conventional medical training. If you have received a diagnosis from a doctor, you may wish to ask your doctor whether acupuncture might help.

What To Expect from Acupuncture Visits: During your first office visit, the practitioner may ask you at length about your health condition, lifestyle, and behavior. The practitioner will want to obtain a complete picture of your treatment needs and behaviors that may contribute to your condition. Inform the acupuncturist about all treatments or medications you are taking and all medical conditions you have. Acupuncture needles are metallic, solid, and hair-thin. People experience acupuncture differently, but most feel no or minimal pain as the needles is inserted. Some people feel energized by treatment, while others feel relaxed. Improper needle placement, movement of the patient, or a defect in the needle can cause soreness and pain during treatment. This is why it is important to seek treatment from a qualified acupuncture practitioner. Treatment may take place over a period of several weeks or more. Treatment Costs: Ask the practitioner about the estimated number of treatments needed and how much each treatment will cost. Some insurance companies may cover the costs of acupuncture, while others may not. It is important to check with your insurer before you start treatment to see whether acupuncture is covered for your condition and, if so, to what extent. (For more information, see NCCAM's fact sheet paying for CAM Treatment.)

ClinicalTrials.gov: ClinicalTrials.gov is a database of information on federally and privately supported clinical trials (research studies in people) for a wide range of diseases and conditions. It is sponsored by the National Institutes of Health and the U.S. Food and Drug Administration. Acupuncture May Help Symptoms of Posttraumatic Stress Disorder:

A pilot study shows that acupuncture may help people with posttraumatic stress disorder. Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or humancaused disasters, accidents, or military combat. Michael Hollifield, M.D., and colleagues conducted a clinical trial examining the effect of acupuncture on the symptoms of PTSD. The researchers analyzed depression, anxiety, and impairment in 73 people with a diagnosis of PTSD. The participants were assigned to receive either acupuncture or group cognitive-behavioral therapy over 12 weeks, or were assigned to a wait-list as part of the control group. The people in the control group were offered treatment or referral for treatment at the end of their participation. The researchers found that acupuncture provided treatment effects similar to group cognitivebehavioral therapy; both interventions were superior to the control group. Additionally, treatment effects of both the acupuncture and the group therapy were maintained for 3 months after the end of treatment. The limitations of the study are consistent with preliminary research. For example, this study had a small group of participants that lacked diversity, and the results do not account for outside factors that may have affected the treatments' results. References: â&#x20AC;˘

Michael Hollifield, Nityamo Sinclair-Lian, Teddy D. Warner, and Richard Hammerschlag, "Acupuncture for Posttraumatic Stress Disorder: A Randomized

Acupuncture Shows Promise in Improving Rates of Pregnancy Following IVF A review of seven clinical trials of acupuncture given with embryo transfer in women undergoing in vitro fertilization (IVF) suggests that acupuncture may improve rates of

pregnancy. An estimated 10 to 15 percent of couples experience reproductive difficulty and seek specialist fertility treatments, such as IVF. IVF, which involves retrieving a woman's egg, fertilizing it in the laboratory, and then transferring the embryo back into the woman's womb, is an expensive, lengthy, and stressful process. Identifying a complementary approach that can improve success would be welcome to patients and providers. According to Eric Manheimer of the University Of Maryland School Of Medicine's Center for Integrative Medicine and colleagues who conducted the systematic review, acupuncture has been used in China for centuries to regulate the female reproductive system. With this in mind, the reviewers analyzed results from seven clinical trials of acupuncture in women who underwent IVF to see if rates of pregnancy were improved with acupuncture. The studies encompassed data on over 1366 women and compared acupuncture, given within one day of embryo transfer, with sham acupuncture, or no additional treatment. The reviewers found that acupuncture given as a complement to IVF increased the odds of achieving pregnancy. According to the researchers, the results indicate that 10 women undergoing IVF would need to be treated with acupuncture to bring about one additional pregnancy. The results, considered preliminary, point to a potential complementary treatment that may improve the success of IVF and the need to conduct additional clinical trials to confirm these findings. References: •

Manheimer E, Zhang G, Udoff L, et al. Effect of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systematic review and meta-analysis. British Medical Journal. Published online February 2008.

Learning Objectives: •

Discuss the history of acupuncture

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Compare the differences between western medicine and Chinese medicine Identify how acupuncture research is conducted Describe research on the efficacy of acupuncture and the mechanisms underlying itsvarious uses

This lecture is part of the CAM Online Education Series. The series contains 10 chapters. Each lecture includes: •

A video lecture by one author, including the transcript

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A question and answer transcript An optional online test Additional resource links A certificate of completion

Although developed for health care professionals to receive continuing education, members of the public are invited to view the series and learn more about various aspects of CAM and CAM research.

Acupuncture: An Evidence-Based Assessment "Surgery or Acupuncture? Antibiotics or Herbs? BOTH ARE BETTER. More and more M.D.s are mixing Ancient Medicine and New Science to treat everything from the common cold to heart disease." said Life Magazine, Sept. 1996. Ancient Medicine is also called Alternative Medicine, which includes chiropractic, naturopathic, homeopathic, and Chinese therapies such as acupuncture, massage, and Traditional Chinese Medicine (TCM). As the world gets smaller, people expose and understand more to these alternative methods. The government, regulatory agencies, and medical professionals are also paying more attention and conducting more researches on them. In 1980, The World Health Organization released a list of 43 types of pathologies which can be effectively treated with acupuncture. A 1993 study found that one in three Americans had used alternative therapies. While Western techniques are clearly better at dealing with trauma and bacterial infection, the Ancient Medicine is more successful with chronic diseases such as asthma. The combination of Ancient Medicine with Western science provides better healing solutions for people looking for good health. Traditional Chinese Medicine Traditional Chinese Medicine (TCM) has been practiced in Asia for over 5,000 years. It is not surprising, therefore, that between 65 to 80 percent of the world's health care services are classified as "traditional medicine." The philosophy behind TCM is holistic health care, from diagnosis to treatment to maintenance. TCM works to regenerate the organ functions in one's body. Health is restored by bringing the bodily functions into balance, activating and increasing the body's natural immune system. In excess of 5,000 Chinese herbs have been categorized and classified according to the various properties which they contain. Over the years, more than 25,000 formulas were created and refined for specific types of infections, illnesses and diseases. These formula are specific combinations of herbs; most of them discovered over a thousand years ago. The combinations became necessary and more complex as experience shown that some herbs canceled out the effect of other herbs. It was also discovered that the medicinal properties of many herbs required certain other herbs to be present to act as a catalyst. The healing power of the ingredients found in these natural herbal formulas has never been doubted by most Asians. The difficulty in utilizing many of these ancient formulas has been determining which formula work with the individual person/symptom-complex combination. TCM prescribes a formula based upon the individual being treated as opposed to Western practices where treatments and preventatives are tested for their effectiveness on a group of people. Thus, the effectiveness of TCM in the past was largely determined by the doctor prescribing and administering the formula. These doctors drew upon all of their resources in prescribing a specific formula: Physiology and pathology of the human body, disease etiology, blood, bodily fluids, channels-collateral, and differentiation of symptom-complexes all relate to the physical manifestations of an illness. The doctors then interpreted these physical manifestations through the basic theories of Yin-Yang, the Five Elements, Zang-fu, and Qi. Modern Chinese Medicine

For years, the Chinese government and the government of the Republic of China on Taiwan have put great efforts into promoting the modernization of Chinese medicine. As a result, there are now professionals trained in both traditional Chinese Medicine and modern Western medicine to conduct research on the development of Chinese Medicine. The Western Science methodologies have been employed to analyze the effectiveness of herbs and treatment on various subjects. Many of the differences between TCM and Western scientific practices are now being studied for their synergistic potential. Joint research efforts with research institutes such as Stanford University, College of Physicians & Surgeons of Columbia University, and National Cancer Institute have been made to evaluate the effectiveness of Chinese Medicine and improve the classification and selection/prescription of formulas. This research indicates that Chinese Medicine is very effective in regenerating organic function and treating chronic diseases. A modern diagnosis technique is also used to enhance the old traditional diagnosis method. Taking a patient's pulse has been a traditional way of detecting illness. With new techniques developed through modern Chinese Medicine, pressure reactions convert variances in the patient's pulse into electromagnetic waves. These waves are analyzed by a computer and then registered on a screen. This represents the combination of modern scientific precision with the art of traditional Chinese Medicine. It opens up a new world of medical diagnosis and treatment. Western methodologies are also making the formula of TCM available globally. Originally, these ancient formulas once prescribed were taken home and slowly boiled into soup to be consumed. This four-hour process was done twice daily and the soup often smelled and tasted unpleasant. Modern technology has finally enabled the potent essence of these healing herbs to be extracted in their natural state for delivery to people in need around the world. Human Organ Restoration Theory The Human Organ Restoration Theory is a combination of Traditional Chinese Medicine (TCM) and Western Scientific methodologies. Initially, pathology, symptommatology and clinical therapeutics in the East and West were studied to bring about the best treatment possible. With the precision of western technology, the exact combination of herbs was determined and its effectiveness was evaluated. The restoration of organic function is done by using Chinese medicinal herbs. These herbs are formulated to regulate physiologic functions while at the same time repairing the dysfunction of the pathologic organ. With the help of modern technology, the effectiveness of TCM can be verified through analysis. Once the effectiveness of the treatment is determined, the normal physiologic metabolism is restored. The Advantages of TCM For most of its history Western medicine has approached health and a well being from a very different perspective. It has been reactive, rather than proactive. Symptoms and science have been the drivers. Western medicine examines and dissects to determine what is not working in the body and attempts to introduce external, often synthetic, chemical compounds to compensate. TCM, on the other hand, asks why the body is not functioning properly and

attempts to use individualized organic herbal formula to rejuvenate and to restore the body to its natural state. For example, Westerners determined that people with Diabetes Mellitus lack sufficient insulin and/or the ability to regulate the amount of insulin that their bodies produce. So they created an industry to allow diabetics to externally monitor and regulate this function by testing their blood and by injecting themselves with manufactured insulin. TCM instead focuses its treatment on restoring the natural balance and functionality of each person's organs. TCM, more specifically, has developed formula which helps to restore the pancreas and to revitalize natural insulin production and regulation within the body. TCM offers many advantages and can be used safely on its own or as a complement to Western pharmaceuticals. The most significant advantages of the TCM approach are: Thousands of years of classification, testing, and refinement of herbal formulas. • Few and often no side-effects due to natural ingredients. • Individualized treatment • No chemical residues, unlike many Western pharmaceuticals. • Treats the why (from the root), not the what (from the symptoms). • Rejuvenates the body's organs to correct symptoms at their root causes. • Revitalizes the body's natural immune system. • Long-term results. Diabetes and Hypoglycemic Effects of Selected Ingredients: Dia-Naturale, a Traditional Chinese Medicine formulated by Dr. Lian Jin Chong, is designed to restore pancreatic function and to proliferate insulin beta cells. Yu Xiao San has been shown to gradually and effectively lower blood-sugar levels and increase insulin secretion. In addition it has been shown to regulate carbohydrate metabolism, improve blood circulation, lower blood cholesterol and increase immune response1. The main herb components are Gui Jian Yu (Euonymus alatus). Clinical Results: From Feb. 1992 to Oct. 1992, 10,618 cases were selected as subjects based upon the diagnostic criteria established for diabetes mellitus by the World Health Organization. The patients were drawn for clinical assessment from the formerly China Beijing Chao Yang District Red Cross Hospital (presently Beijing Anyuan Hospital) and from 48 comparable hospitals nationwide. Treatment Criteria and Result: Clinical Recovery: The preferred criterion: FPG (Fasting Plasma Glucose) <6.1 mmol/L (110mg/dl), HbA1c <6.8%; symptoms and complications recovery; discontinuing medication after 3 months or more. Effect of Dia-Naturale of Hyperglycemia Using a Streptozotocin-Induced Insulin Resistant Diabetic Rat Model

In a placebo controlled experiment on the effect of Yu Xiao San 8805 on the treatment of hyperglycemia using a streptozotocin-induced insulin resistant diabetic rat model with the Medical School of Stanford University in the United States3 in 1994, about 100 rats were introduced and were divided into three groups - placebo, Yu Xiao San 8805, and a western drug "Metformin". Dr. Ida Chen, director of General Clinical Research Core Laboratory and senior research scientist of Stanford University School of Medicine, stated that ?Yu Xiao San 8805 has shown statistically significant effect on the increase in triglycerides (TG) in these streptozotocin-induced insulin resistant diabetic rats. Specifically, plasma TG concentration tends to increase in diabetic rats (and in diabetic patients); both Metformin and Yu Xiao San 8805 appeared to have a "controlling" effect - i.e. "they alleviated the increment of TG occurring in these rats."4 Pancreas Islet Cells Stimulation by Euonymus alatus Scientists from Japan have tested that Euonymus alata sieb has a blood sugar lowering action. The administration from the sodium oxalacetate, the effective component of Euonymus alata sieb brought about lowering of the blood sugar level in normal and alloxan diabetic animals. The same drug was given to diabetic patients, and it found effective in all of 10 of Type I and in 6 of 11 of Type II diabetics. It was also found that long-term administration of sodium oxalacetate induced hyperplasia and proliferation of the islet cells of the pancreas in rats, but no mentionable changes were found in other organs. The findings suggest that the active component of Euonymus alata sieb stimulates the islet cells, regulates the abnormal metabolic process, and enhances the secretion of insulin, and thereby controls the diabetic condition.6 Hypoglycemic Effects of this products & Other Selected Ingredients This product is composed of the following ingredients: Euonymus alatus, Cortex Lycii Radicis, Arctium Lappa L., Platycodon Grandiflorum, Litchi Chinensis, Curcuma longa, Panax quinquefolium L. Euonymus Alatus In an experiment with normal mice and Alloxan induced diabetic mice, Euonymus Alatus showed hypoglycemic effects. The fasting serum glucose level in diabetic mice was reduced significantly, but similar effect on fasting serum glucose level was not produced in normal mice.7 Cortex Lycii Radicis It is reported that soluble molecules of Cortex Lycii Radicis had hypoglycemic effects on rats.8 Arctium Lappa L. Animal data: Streptozotocin-induced diabetic mice given burdock experienced aggravation of hyperglycemia .9 However, studies in non-diabetic rats indicate some Platycodon Grandiflorum

The effect of Platycodon grandiflorum on the improvement of insulin resistance and lipid profile was investigated in lean (Fa/-) and obese (fa/fa) Zucker rats, a model for noninsulin dependent diabetes mellitus. Dietary Platycodon grandiflorum feeding for 4 weeks resulted in a significant decrease in the concentration of plasma triglyceride in both lean and obese Zucker rats. Furthermore, dietary Platycodon grandiflorum markedly decreased both plasma cholesterol and fasting plasma insulin levels, and significantly decreased the postprandial glucose level at 30 min during oral glucose tolerance test in obese Zucker rats. Although there was no statistical significance, the crude glucose transporter 4 protein levels of obese rats fed Platycodon grandiflorum tended to increase when compared with that of obese control rats. Therefore, the present results suggested that Platycodon grandiflorum may be useful in prevention and improvement of metabolic disorders characterized by hyperinsulinemia states such as noninsulin dependent diabetes mellitus, syndrome X, and coronary artery disease.12 Curcuma longa (Turmeric) In a research study of the effect of turmeric (Curcuma longa) and its active principle, curcumin, on diabetes mellitus in an Alloxan induced diabetic rat model. Administration of turmeric or curcumin to diabetic rats reduced the blood sugar, Hb and glycosylated hemoglobin levels significantly. Turmeric and curcumin supplementation also reduced the oxidative stress encountered by the diabetic rats. This was demonstrated by the lower levels of TBARS (thiobarbituric acid reactive substances), which may have been due to the decreased influx of glucose into the polyol pathway leading to an increased NADPH/NADP ratio and elevated activity of the potent antioxidant enzyme GPx. Moreover, the activity of SDH (sorbitol dehydrogenase), which catalyzes the conversion of sorbitol to fructose, was lowered significantly on treatment with turmeric or curcumin.13 Panax quinquefolium L. (American Ginseng) In a double blind, randomized, placebo-controlled preliminary short-term clinical study to examine the effects of postprandial glycemia in humans, American ginseng (Panax qinquefolius L) Ginseng attenuated postprandial glycemia in both diabetic and nondiabetic subjects. No differences were found in postprandial glycemia between placebo and ginseng when administered together with the glucose challenge to non-diabetic subjects. When ginseng was taken 40 minutes before the glucose challenge, significant reductions were observed (P<.05). In subjects with type 2 diabetes mellitus, the same was true whether capsules were taken before or together with the glucose challenge (P<.05). Reductions in area under the glycemic curve were 18%+/-31% for nondiabetic subjects and 19+/-22% and 22+/17% for subjects with type 2 diabetes mellitus administered before or together with the glucose challenge, respectively.14 Conclusion Yu Xiao San 8805, composed of material medica of Traditional Chinese Medicine has been used since 1988 as a Traditional Chinese Medicine for Type I and Type II diabetic patients in China Beijing Chaoyang District Red Cross Hospital (presently Beijing Anyuan Hospital) as well as other state hospitals in China. Clinical study in 1992 of 10618 cases, and an animal study in 1994 suggested that Yu Xiao San 8805 lowered blood sugar levels and had a

controlling effect on triglycerides (TG) levels, respectively. Studies of ingredients of Yu Xiao San 8805 also suggested various hypoglycemic effects. Further studies are needed to investigate the mechanisms of Yu Xiao San 8805's functions in human body. Alternative Medicine Categories This classification system was designed by the National Center for Complementary and Alternative Medicine (NCCAM) to assist in prioritizing applications for research grants in complementary and alternative medicine (CAM). It is divided into seven major categories and includes examples of practices or preparations in each category. Mandated by Congress, the NCCAM was established under the Department of Health and Human Services to support high quality scientific research into both the safety and efficacy of alternative medical treatments. The fact that CAM therapies are being investigated does not mean that they are effective. Within each major category there are 3 sub-categories: â&#x20AC;˘

CAM: Medical practices that are not commonly used, accepted, or available in conventional medicine.

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Behavioral medicine: Those practices that fall mainly within the domains of conventional medicine.

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Overlapping: Practices that can be either CAM or behavioral medicine, depending on their application.

Information presented is for viewer education only. DoctorsCorner.Com does not endorse any particular form of alternative therapy. I. Mind-Body Medicine Mind-body medicine involves behavioral, psychological, social, and spiritual approaches to health. It is divided into four subcategories: Mindbody systems; Mind-body methods; Religion and spirituality; Social and contextual areas.

Mind-Body Systems This subcategory involves whole systems of mind-body practice that are used largely as primary interventions for disease. They are rarely delivered alone; instead, they are used in combination with lifestyle interventions, or are part of a traditional medical system. Mind-Body Methods This subcategory contains individual modalities used in mind-body approaches to health. These approaches are often considered conventional practice and overlap with CAM only

when applied to medical conditions for which they are not usually used (for example, hypnosis for genetic problems). CAM Yoga Internal Tai Chi

Qigong

Behavioral Medicine Psychotherapy Meditation Imagery

Hypnosis Biofeedback Support Groups

Overlapping Art Music Dance Therapy

Therapy Therapy

Journaling Humor Body Psychotherapy

Religion and Spirituality This subcategory deals with those no behavioral aspects of spirituality and religion that examine their relationship to biological function or clinical conditions. CAM Confession Nonlocality Nontemporality

Soul Retrieval Spiritual Healing "Special" Healers

Social and Contextual Areas This subcategory refers to social, cultural, symbolic, and contextual interventions that are not covered in other areas. CAM Caring-based Approaches (for example, Holistic Nursing, Pastoral Care) Intuitive Diagnosis Overlapping Placebo

Explanatory Models Community-based Approaches (for example, Alcoholics Anonymous, Native American "sweat" rituals)

Acupuncture and Oriental Medicine II. Alternative Medical Systems This category involves complete systems of theory and practice that have been developed outside of the Western biomedical approach. It is divided into four subcategories: Acupuncture and Oriental medicine; Traditional Indigenous systems; Unconventional Western systems; Naturopathy.

Acupuncture Herbal Formulas Diet External and Internal Qi Tai Chi Massage and Manipulation (Tui Na) Acupotomy

Gong

Traditional Indigenous Systems This subcategory includes major indigenous systems of medicine other than acupuncture and traditional oriental medicine. Native American Traditional Aboriginal Medicine Medicine Curanderismo Ayurvedic Medicine Unani-Tibbi, SIDDHI Central and South American Practices Psychic Surgery Kampo Medicine Traditional African Medicine

Unconventional Western Systems

This subcategory includes alternative medical systems developed in the West that are not classified elsewhere. CAM Homeopathy Functional Medicine Environmental Medicine Radiesthesia, Psionic Medicine

Cayce-based Systems Kneipp "classical" Homeopathy Orthomolecular Medicine Radionics

Overlapping Anthroposophically-extended Medicine Naturopathy: This subcategory is an eclectic collection of natural systems and therapies that has gained prominence in the United States. III. Lifestyle and Disease Prevention This category involves theories and practices designed to prevent the development of illness, identify and treat risk factors, or support the healing and recovery process. Lifestyle and disease prevention is concerned with integrated approaches for the prevention and management of chronic disease in general or the common determinants of chronic disease. It is divided into Three Subcategories: 1. Clinical preventative practices 2. Lifestyle therapies 3. Health promotion. Clinical Preventative Practices: This subcategory refers to unconventional approaches used to screen for and prevent healthrelated imbalances, dysfunction, and disease. Electro-dermal Medical Chiriography Lifestyle Therapies:

Diagnostics Intuition

Functional Cellular Enzyme Measures Panchakarma

This subcategory deals with complete systems of lifestyle management that include behavioral changes, dietary changes, exercise, stress management, and addiction control. To be classified as CAM, the changes in lifestyle must be based on a nonorthodox system of medicine, be applied in unconventional ways, or be applied across non-Western diagnostic approaches. Health Promotion: This subcategory involves laboratory and epidemiological research on healing, the healing process, health promoting factors, and autoregulatory mechanisms. IV. Biologically-Based Therapies This category includes natural and biologically-based practices, interventions, and products. Many overlap with conventional medicineâ&#x20AC;&#x2122;s use of dietary supplements. This category is divided into four subcategories: Phytotherapy or herbalism; Special diet therapies; Orthomolecular medicine; Pharmacological, biological and instrumental interventions.

Phytotherapy or Herbalism: This subcategory addresses plant-derived preparations that are used for therapeutic and preventive purposes. Individual Herbs: Ginkgo Biloba Hypericum Garlic Ginseng Echinacea Saw Palmetto Urtica Diocia (Nettle) Kava Kava Hawthorne Witch Hazel Bilberry Ginger Aloe Vera Capsicum Feverfew Green Tea

Tea Tree Oil Licorice Root Yohimbe Valerian Bee Pollen Cat's Claw Evening Primrose Dong Quai Fenugreek Marshmallow Psyllium Tumeric Mistletoe Mahonia Aquifolium Oleum Menthaepiperitea (Peppermint Oil)

Combinations: Padma

Hoxsey

Essiac JCL 2306

Saw Palmetto/Pygeum Africanium

Special Diet Therapies: This subcategory includes dietary approaches and special diets that are applied as alternative therapies for risk factors or chronic disease in general. Pritikin Ornish McDougall Gerson Kelly-Gonzales Wigmore Livingston-Wheeler Atkins Diamond

Vegetarian Fasting High Macrobiotic Mediterranean Paleolithic Asian Natural Hygiene

Fiber

Orthomolecular Medicine: This subcategory refers to products used as nutritional and food supplements (and not covered in other categories). These products are used for preventive or therapeutic purposes. They are usually used in combinations and at high doses. Examples include niacinamide for arthritis and melatonin to prevent breast cancer. Single Nutrients: Ascorbic Acid Carotenes Tocopherols Folic Acid Niacin Niacinamide Pantothenic Acid Pyridoxine Riboflavin Thiamine Vitamin A Vitamin D Vitamin K Biotin Choline S-adenosylmethionine Calcium Magnesium Selenium Potassium Taurine

Iodine Iron Manganese Molybdenum Boron Silicon Vanadium Co-enzyme Q10 Carnitine Probiotics Glutamine Phenylalanine Glucosamine Sulfate Chondroitin Sulfate Lipoic Acid Amino Acids Phosphatidylserine Melatonin DHEA Inositol Glandular Products

Lysine Tyrosine Gamma-oryzanol

Fatty Acids Medium Chain Triglycerides

Pharmacological, Biological and Instrumental Interventions: This subcategory includes products and procedures applied in an unconventional manner that are not covered in other categories. Products: Coleyâ&#x20AC;&#x2122;s Antineoplastons Cartilage EDTA Ozone H2O2 Hyperbaric IAT 714X MHT-68

Toxins

Gallo Immunotherapy Cone Therapy Revici System Enzyme Therapies Cell Therapy Enderlin Products T/Tn Vaccine Bee Pollen Induced Remission Therapy

Oxygen

Procedures/Devices: Apitherapy Neural Electrodiagnostics Iridology

Chirography Special Functional Tests Bioresonance MORA Device

Therapy

V. Manipulative and Body-Based Systems This category refers to systems that are based on manipulation and/or movement of the body, and is divided into three subcategories: Chiropractic medicine; Massage and body work; Unconventional physical therapies.

Chiropractic Medicine: Massage and Body Work Osteopathic Manipulative Therapy (OMT) Cranial-Sacral OMT Swedish Massage Applied Kinesiology Reflexology Pilates Method

Polarity Body Psychotherapy Trager Body Work Alexander Technique Feldenkrais Technique Chinese Tui Na Massage

and

Acupressure Rolfing Unconventional Physical Therapies: Hydrotherapy Diathermy Light and Color Heat and Electrotherapies

Colonics Alternate Nostril Breathing Techniques Therapies

VI. Biofield: Biofield Medicine involves systems that use subtle energy fields in and around the body for medical purposes. Therapeutic Healing Healing Natural SHEN

Touch Science Touch Healing

Mariue Reiki Huna External Gong Biorelax

VII. Bioelectromagnetics: Bioelectromagnetics refers to the unconventional use of electromagnetic fields for medical purposes. STATUS OF CURRENT TRIALS: At least five large, multi-institution randomized controlled trials currently under way at the center. A study on the use of Hypericum (St John's wort) for depression at Duke University School of Medicine, Durham, NC, with additional support from the National Institute of Mental Health, is about 60% enrolled. It will be fully enrolled this year, and findings could be available for publication next year. Other agents undergoing trials are Ginkgo biloba for preventing dementia, acupuncture for osteoarthritis pain, glucosamine/chondroitin sulfate for osteoarthritis, and shark cartilage for lung cancer. Four new controlled trials are planned for this year and next. They will address the treatment of hepatitis and liver injury with milk thistle; treatment of insomnia with valerian and melatonin; the use of feverfew to treat headaches; and the effect of Echinacea, one of the largest-selling botanical products, on resistance to upper respiratory infection. Congress has charged the center with facilitating the integration of CAM practices into mainstream medicine. The way to do this is to provide evidence of efficacy and safety, publish it in a peer-reviewed journal, and support educational programs for students and practitioners.

The public is increasingly using CAM. In 1997, 42% of Americans used one or more complementary modalities, up by about one third from 6 years earlier. The public chooses these practices because they believe, and some evidence suggests, that some of them sustain and improve health. But they need guidance about which practices are safe and effective." Some CAM practices are already accepted for certain situations including hypnosis, biofeedback, and behavioral therapy, transcutaneous nerve stimulation for chronic pain, acupuncture, spiritual counseling, dietary changes, and aerobic exercise.

Herbal Medicine An herb is a plant or plant part used for its scent, flavor or therapeutic properties. Herbal medicine products are dietary supplements that people take to improve their health. Many herbs have been used for a long time for claimed health benefits. They are sold as tablets, capsules, powders, teas, extracts and fresh or dried plants. However, some can cause health problems, some are not effective and some may interact with other drugs you are taking. To use an herbal product as safely as possible • • • •

Consult your doctor first Do not take a bigger dose than the label recommends Take it under the guidance of a trained medical professional Be especially cautious if you are pregnant or nursing

Herbals at a Glance Series Shown below: 1. Aloe Vera 2. Asian Ginseng 3. Green Tea 4. Garlic 5. Ginger 6. Turmeric 7. Astragalus 8. Bilberry 9. Bitter Orange 10. Black Cohosh 11. Cat's Claw 12. Peppermint Oil 13. Noni Aloe Vera Introduction: Common Names—aloe vera, aloe, burn plant, lily of the desert, elephant's gall. Latin Names —Aloe vera, Aloe barbadensis. This fact sheet provides basic information about aloe vera— common names, uses, potential side effects, and resources for more information. Aloe vera's use can be traced back 6,000 years to early Egypt, where the plant was depicted on stone

carvings. Known as the "plant of immortality," aloe was presented as a burial gift to deceased pharaohs.

What It Is Used For • • • •

Traditionally, aloe was used topically to heal wounds and for various skin conditions, and orally as a laxative. Today, in addition to traditional uses, people take aloe orally to treat a variety of conditions, including diabetes, asthma, epilepsy, and osteoarthritis. People use aloe topically for osteoarthritis, burns, and sunburns. Aloe vera gel can be found in hundreds of skin products, including lotions and sunblocks. The Food and Drug Administration (FDA) has approved aloe vera as a natural food flavoring.

How It Is Used • •

Aloe leaves contain a clear gel that is often used as a topical ointment. The green part of the leaf that surrounds the gel can be used to produce a juice or a dried substance (called latex) that is taken by mouth.

What the Science Says •

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Aloe latex contains strong laxative compounds. Products made with various components of aloe (aloin, aloe-emodin, and barbaloin) were at one time regulated by the FDA as oral over-the-counter (OTC) laxatives. In 2002, the FDA required that all OTC aloe laxative products be removed from the U.S. market or reformulated because the companies that manufactured them did not provide the necessary safety data. Early studies show that topical aloe gel may help heal burns and abrasions. One study, however, showed that aloe gel inhibits healing of deep surgical wounds. Aloe gel does not prevent burns from radiation therapy. There is not enough scientific evidence to support aloe vera for any of its other uses.

Side Effects and Cautions • •

Use of topical aloe vera is not associated with significant side effects. Abdominal cramps and diarrhea have been reported with oral use of aloe vera.

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Diarrhea, caused by the laxative effect of oral aloe vera, can decrease the absorption of many drugs. People with diabetes who use glucose-lowering medication should be cautious if also taking aloe by mouth because preliminary studies suggest aloe may lower blood glucose levels. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Asian Ginseng Introduction Common Names—Asian ginseng, ginseng, Chinese ginseng, Korean ginseng, Asiatic ginseng. Latin Name—Panax ginseng. This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Asian ginseng—common names, uses, potential side effects, and resources for more information. Asian ginseng is native to China and Korea and has been used in various systems of medicine for many centuries. Asian ginseng is one of several types of true ginseng (another is American ginseng, Panax quinquefolius). An herb called Siberian ginseng or eleuthero (Eleutherococcus senticosus) is not a true ginseng.

What It Is Used For Treatment claims for Asian ginseng are numerous and include the use of the herb to support overall health and boost the immune system. Traditional and modern uses of ginseng include: • Improving the health of people recovering from illness • Increasing a sense of well-being and stamina, and improving both mental and physical performance • Treating erectile dysfunction, hepatitis C, and symptoms related to menopause • Lowering blood glucose and controlling blood pressure How It Is Used The root of Asian ginseng contains active chemical components called ginsenosides (or panaxosides) that are thought to be responsible for the herb's medicinal properties. The root is dried and used to make tablets or capsules, extracts, and teas, as well as creams or other preparations for external use.

What the Science Says •

Some studies have shown that Asian ginseng may lower blood glucose. Other studies indicate possible beneficial effects on immune function.

•

To date, research results on Asian ginseng are not conclusive enough to prove health claims associated with the herb. Only a handful of large clinical trials on Asian ginseng have been conducted. Most studies have been small or have had flaws in design and reporting. Some claims for health benefits have been based only on studies conducted in animals.

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NCCAM supports studies to better understand the use of Asian ginseng. Areas of recent NCCAM-funded research include Asian ginseng's interactions with other herbs and drugs and the herb's potential to treat chronic lung infection, impaired glucose tolerance, and Alzheimer's disease.

Side Effects and Cautions •

When taken by mouth, ginseng is usually well tolerated. Some sources suggest that its use be limited to 3 months because of concerns about the development of side effects.

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The most common side effects are headaches and sleep and gastrointestinal problems.

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Asian ginseng can cause allergic reactions.

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There have been reports of breast tenderness, menstrual irregularities, and high blood pressure associated with Asian ginseng products, but these products' components were not analyzed, so effects may have been due to another herb or drug in the product.

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Asian ginseng may lower levels of blood sugar; this effect may be seen more in people with diabetes. Therefore, people with diabetes should use extra caution with Asian ginseng, especially if they are using medicines to lower blood sugar or taking other herbs, such as bitter melon and fenugreek that are also thought to lower blood sugar.

Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. Green Tea Introduction Common Names—green tea, Chinese tea, Japanese tea. Latin Names—Camellia sinensis. This fact sheet provides basic information about green tea—common names, uses, potential side effects, and resources for more information. All types of tea (green, black, and oolong)

are produced from the Camellia sinensis plant using different methods. Fresh leaves from the Camellia sinensis plant are steamed to produce green tea.

What It Is Used For •

Green tea and green tea extracts, such as its component EGCG, have been used to prevent and treat a variety of cancers, including breast, stomach, and skin cancers.

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Green tea and green tea extracts have also been used for improving mental alertness, aiding in weight loss, lowering cholesterol levels, and protecting skin from sun damage.

How It Is Used Green tea is usually brewed and drunk as a beverage. Green tea extracts can be taken in capsules and are sometimes used in skin products. What the Science Says •

Laboratory studies suggest that green tea may help protect against or slow the growth of certain cancers, but studies in people have shown mixed results.

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Some evidence suggests that the use of green tea preparations improves mental alertness, most likely because of its caffeine content. There are not enough reliable data to determine whether green tea can aid in weight loss, lower blood cholesterol levels, or protect the skin from sun damage. NCCAM is supporting studies to learn more about the components in green tea and their effects on conditions such as cancer, diabetes, and heart disease.

•

Side Effects and Cautions •

Green tea is safe for most adults when used in moderate amounts.

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There have been some case reports of liver problems in people taking concentrated green tea extracts. This problem does not seem to be connected with green tea infusions or beverages. Although these cases are very rare and the evidence is not definitive, experts suggest that concentrated green tea extracts be taken with food, and

•

that people should discontinue use and consult a heath care practitioner if they have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice. Green tea and green tea extracts contain caffeine. Caffeine can cause insomnia, anxiety, irritability, upset stomach, nausea, diarrhea, or frequent urination in some people. Green tea contains small amounts of vitamin K, which can make anticoagulant drugs, such as warfarin, less effective.

Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. Garlic Introduction Common Names—garlic. Latin Names—Allium sativum. This fact sheet provides basic information about garlic—uses, potential side effects, and resources for more information. Garlic is the edible bulb from a plant in the lily family. It has been used as both a medicine and a spice for thousands of years.

What It Is Used For •

Garlic's most common uses as a dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements. are for high cholesterol, heart disease, and high blood pressure.

•

Garlic is also used to prevent certain types of cancer, including stomach and colon cancers.

How It Is Used Garlic cloves can be eaten raw or cooked. They may also be dried or powdered and used in tablets and capsules. Raw garlic cloves can be used to make oils and liquid extracts. What the Science Says

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Some evidence indicates that taking garlic can slightly lower blood cholesterol levels; studies have shown positive effects for short-term (1 to 3 months) use. However, an NCCAM-funded study on the safety and effectiveness of three garlic preparations (fresh garlic, dried powdered garlic tablets, and aged garlic extract tablets) for lowering blood cholesterol levels found no effect.

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Preliminary research suggests that taking garlic may slow the development of atherosclerosis (hardening of the arteries), a condition that can lead to heart disease or stroke.

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Evidence is mixed on whether taking garlic can slightly lower blood pressure.

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Some studies suggest consuming garlic as a regular part of the diet may lower the risk of certain cancers. However, no clinical trials have examined this. A clinical trial on the long-term use of garlic supplements to prevent stomach cancer found no effect.

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Recent NCCAM-funded research includes studies on how garlic interacts with certain drugs and how it can thin the blood.

Side Effects and Cautions •

Garlic appears to be safe for most adults.

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Side effects include breath and body odor, heartburn, upset stomach, and allergic reactions. These side effects are more common with raw garlic.

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Garlic can thin the blood (reduce the ability of blood to clot) in a manner similar to aspirin. This effect may be a problem during or after surgery. Use garlic with caution if you are planning to have surgery or dental work, or if you have a bleeding disorder. A cautious approach is to avoid garlic in your diet or as a supplement for at least 1 week before surgery.

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Garlic has been found to interfere with the effectiveness of saquinavir, a drug used to treat HIV infection. Its effect on other drugs has not been well studied.

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Ginger Introduction Common Names—ginger. Latin Names—Zingiber officinale. This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Ginger— uses, potential side effects, and resources for more information. Ginger is a tropical plant that has green-purple flowers and an aromatic underground stem (called a rhizome). It is commonly used for cooking and medicinal purposes.

What It Is Used For •

Ginger is used in Asian medicine to treat stomach aches, nausea, and diarrhea.

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Many digestive, antinausea, and cold and flu dietary supplements sold in the United States contain ginger extract as an ingredient.

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Ginger is used to alleviate postsurgery nausea as well as nausea caused by motion, chemotherapy, and pregnancy.

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Ginger has been used for rheumatoid arthritis, osteoarthritis, and joint and muscle pain.

How It Is Used The underground stems of the ginger plant are used in cooking, baking, and for health purposes. Common forms of ginger include fresh or dried root, tablets, capsules, liquid extracts (tinctures), and teas. What the Science Says • • • •

Studies suggest that the short-term use of ginger can safely relieve pregnancy-related nausea and vomiting. Studies are mixed on whether ginger is effective for nausea caused by motion, chemotherapy, or surgery. It is unclear whether ginger is effective in treating rheumatoid arthritis, osteoarthritis, or joint and muscle pain. NCCAM-funded investigators are studying:

Whether ginger interacts with drugs, such as those used to suppress the immune system.  Ginger's effect on reducing nausea in patients on chemotherapy.  The general safety and effectiveness of ginger's use for health purposes, as well as its active components and effects on inflammation. 

Side Effects and Cautions •

Few side effects are linked to ginger when it is taken in small doses.

• •

Side effects most often reported are gas, bloating, heartburn, and nausea. These effects are most often associated with powdered ginger. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Turmeric Introduction Common Names—turmeric, turmeric root, Indian saffron. Latin Names—Curcuma longa. This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Turmeric—common names, uses, potential side effects, and resources for more information. Turmeric, a shrub related to ginger, is grown throughout India, other parts of Asia, and Africa. Known for its warm, bitter taste and golden color, turmeric is commonly used in fabric dyes and foods such as curry powders, mustards, and cheeses. It should not be confused with Javanese turmeric.

What It Is Used For •

In traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi. And Ayurvedic medicineA whole medical system that originated in India. It aims to integrate the body, mind, and spirit to prevent and treat disease. Therapies used include herbs, massage, and yoga. turmeric has been used to aid digestion and liver function, relieve arthritis pain, and regulate menstruation.

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Turmeric has also been applied directly to the skin for eczema and wound healing.

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Today, turmeric is used for conditions such as heartburn, stomach ulcers, and gallstones. It is also used to reduce inflammation, as well as to prevent and treat cancer.

How It Is Used

Turmeric's finger-like underground stems (rhizomes) are dried and taken by mouth as a powder or in capsules, teas, or liquid extracts. Turmeric can also be made into a paste and used on the skin. What the Science Says •

There is little reliable evidence to support the use of turmeric for any health condition because few clinical trials have been conducted.

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Preliminary findings from animal and laboratory studies suggest that a chemical found in turmeric—called curcumin—may have anti-inflammatory and anticancer properties, but these findings have not been confirmed in people.

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NCCAM-funded investigators are studying the active chemicals in turmeric and their effects—particularly anti-inflammatory effects—in people to better understand how turmeric might be used for health purposes.

Side Effects and Cautions •

Turmeric is considered safe for most adults.

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High doses or long-term use of turmeric may cause indigestion.

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In animals, high doses of turmeric have caused liver problems. No cases of liver problems have been reported in people.

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People with gallbladder disease should avoid using turmeric as a dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration have special labeling requirements for dietary supplements. as it may worsen the condition.

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Astragalus Introduction Common Name—astragalus, bei qi, huang qi, ogi, hwanggi, milk vetch. Latin Name— Astragalus membranaceus, Astragalus mongholicus This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Astragalus—common names, uses, potential side effects, and resources for more information. Native to China, astragalus has been used for centuries in traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi.. In the United States, the herb gained popularity in the 1980s.

There are actually over 2,000 species of astragalus; however, the two related species Astragalus membranaceus and Astragalus mongholicus are the ones primarily used for health purposes.

What It Is Used For •

• •

Historically, astragalus has been used in traditional Chinese medicine, usually in combination with other herbs, to support and enhance the immune system. It is still widely used in China for chronic hepatitis and as an adjunctive therapy in cancer. It is also used to prevent and treat common colds and upper respiratory infections. Astragalus has also been used for heart disease.

How It Is Used The root of the astragalus plant is typically used in soups, teas, extracts, or capsules. Astragalus is generally used with other herbs, such as ginseng, angelica, and licorice. What the Science Says •

The evidence for using astragalus for any health condition is limited. Results from small or preliminary studies suggest that astragalus may benefit heart function and help the immune system fight infections.

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A few studies have shown potential benefits for using astragalus—in combination with another herb, glossy privet (Ligustrum lucidum)—as an adjunctive therapy for cancer. In general, however, these studies were not well designed.

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NCCAM-funded investigators are studying the effects of astragalus on the body, particularly on the immune system.

Side Effects and Cautions •

Astragalus is considered safe for most adults. Its possible side effects are not well known because astragalus is generally used in combination with other herbs.

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Astragalus may interact with medications that suppress the immune system, such as the drug cyclophosphamide taken by cancer patients and similar drugs taken by organ transplant recipients.

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People should avoid using astragalus species such as "locoweed" that grow in the United States, as these other species may have different effects and side effects.

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Bilberry Introduction Common Names—bilberry, European blueberry, whortleberry, huckleberry. Latin Names— Vaccinium Myrtillus. This fact sheet provides basic information about bilberry—common names, uses, potential side effects, and resources for more information. Bilberry is a relative of the blueberry, and its fruit is commonly used to make pies and jams. It has been used for nearly 1,000 years in traditional European medicine. Bilberry grows in North America, Europe, and northern Asia.

What It Is Used For •

Historically, bilberry fruit was used to treat diarrhea, scurvy, and other conditions.

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Today, the fruit is used to treat diarrhea, menstrual cramps, eye problems, varicose veins, venous insufficiency (a condition in which the veins do not efficiently return blood from the legs to the heart), and other circulatory problems.

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Bilberry leaf is used for entirely different conditions, including diabetes.

How It Is Used The fruit of the bilberry plant can be eaten or made into extracts. Similarly, the leaves of the bilberry plant can be made into extracts or used to make teas. What the Science Says •

Some claim that bilberry fruit improves night vision, but clinical studies have not shown this to be true.

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There is not enough scientific evidence to support the use of bilberry fruit or leaf for any health conditions.

Side Effects and Cautions •

Bilberry fruit is considered safe. However, high doses of bilberry leaf or leaf extract are considered unsafe due to possible toxic side effects.

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BITTER ORANGE Introduction Common Names—bitter orange, Seville orange, sour orange, Zhi shi. Latin Names—Citrus aurantium. This fact sheet provides basic information about bitter orange—common names, uses, potential side effects, and resources for more information. The bitter orange tree is native to eastern Africa and tropical Asia. Today, it is grown throughout the Mediterranean region and elsewhere, including California and Florida. Bitter orange oil is used in foods, cosmetics, and aromatherapyA therapy in which the scent of essential oils from flowers, herbs, and trees is inhaled to promote health and well-being. products. Bitter orange oil from the tree's leaves is called petitgrain, and oil from the flowers is called neroli.

What It Is Used For •

Bitter orange has been used in traditional Chinese medicine a whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi. And by indigenous people of the Amazon rainforest for nausea, indigestion, and constipation.

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Current uses of bitter orange are for heartburn, loss of appetite, nasal congestion, and weight loss. It is also applied to the skin for fungal infections such as ringworm and athlete's foot.

How It Is Used

The dried fruit and peel (and sometimes flowers and leaves) are taken by mouth in extracts, tablets, and capsules. Bitter orange oil can be applied to the skin. What the Science Says •

There is not enough scientific evidence to support the use of bitter orange for health purposes.

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Many herbal weight-loss products now use concentrated extracts of bitter orange peel in place of ephedra. However, bitter orange contains the chemical synephrine, which is similar to the main chemical in ephedra. The U.S. Food and Drug Administration banned ephedra because it raises blood pressure and is linked to heart attacks and strokes; it is unclear whether bitter orange has similar effects. There is currently little evidence that bitter orange is safer to use than ephedra.

Side Effects and Cautions •

Because bitter orange contains chemicals that may speed up the heart rate and raise blood pressure, it may not be safe to use as a dietary supplement a product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements.. There have been reports of fainting, heart attack, and stroke in healthy people after taking bitter orange supplements alone or combined with caffeine. People should avoid taking bitter orange supplements if they have a heart condition or high blood pressure, or if they are taking medications (such as MAO inhibitors), caffeine, or other herbs/supplements that speed up the heart rate.

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Due to lack of safety evidence, pregnant women should avoid products that contain bitter orange.

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Bitter orange oil used on the skin may increase the risk of sunburn, particularly in light-skinned people.

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BLACK COHOSH Introduction Common Names—black cohosh, black snakeroot, macrotys, bugbane, bugwort, rattleroot, rattleweed. Latin Names—Actaea racemosa, Cimicifuga racemosa This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Black cohosh—common names, uses, potential side effects, and resources for more information. Black cohosh, a member of the buttercup family, is a plant native to North America. It was used in Native American medicine and was a home remedy in 19thcenturyAmerica.

What It Is Used For •

Black cohosh has a history of use for rheumatism (arthritis and muscle pain) but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.

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Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor.

How It Is Used The underground stems and roots of black cohosh are commonly used fresh or dried to make strong teas (infusions), capsules, solid extracts used in pills, or liquid extracts (tinctures). What the Science Says •

Study results are mixed on whether black cohosh effectively relieves menopausal symptoms. An NCCAM-funded study found that black cohosh, whether used alone or with other botanicals, failed to relieve hot flashes and night sweats in postmenopausal women or those approaching menopause.

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Most studies to date have been less than 6 months long, so the safety of long-term use is unknown.

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NCCAM is funding studies to further understand the potential effects of black cohosh on hot flashes and other menopausal symptoms.

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There are not enough reliable data to determine whether black cohosh is effective for rheumatism or other uses.

Side Effects and Cautions: •

United States Pharmacopeia experts suggest women should discontinue use of black cohosh and consult a health care practitioner if they have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice. There have been several case reports of hepatitis (inflammation of the liver), as well as liver failure, in women who were taking black cohosh. It is not known if black cohosh was responsible for these problems. Although these cases are very rare and the evidence is not definitive, scientists are concerned about the possible effects of black cohosh on the liver.

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Black cohosh can cause headaches and stomach discomfort. In clinical trials comparing the effects of the herb and those of estrogens, a low number of side effects were reported, such as headaches, gastric complaints, heaviness in the legs, and weight problems.

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No interactions have been reported between black cohosh and prescription medicines.

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It is not clear if black cohosh is safe for women who have had breast cancer or for pregnant women.

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Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides), which has different properties, treatment uses, and side effects than black cohosh. Black cohosh is sometimes used with blue cohosh to stimulate labor, but this therapy has caused adverse effects in newborns, which appear to be due to blue cohosh.

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CAT’S CLAW Introduction Common Names—cat's claw, uña de gato. Latin Names—Uncaria tomentosa, Uncaria guianensis.This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Cat’s claw—common names, uses, potential side effects, and resources for more information. Cat's claw grows wild in many countries of Central and South America, especially in the Amazon rainforest. The use of this woody vine dates back to the Inca civilization.

What It Is Used For •

Cat's claw has been used for centuries in South America to prevent and treat disease.

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It has been used for a variety of health conditions, including viral infections (such as herpes and HIV), Alzheimer's disease, cancer, and arthritis.

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Cat's claw has been used to support the immune system and promote kidney health, as well as to prevent and abort pregnancy.

How It Is Used The inner bark of cat's claw is used to make liquid extracts, capsules, and teas. Preparations of cat's claw can also be applied to the skin. What the Science Says •

There is not enough scientific evidence to determine whether cat's claw works for any health problem, including arthritis, HIV, or cancer.

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Small studies in humans have shown a possible benefit of cat's claw in osteoarthritis and rheumatoid arthritis, but no large trials have been done. In laboratory studies, cat's claw stimulates part of the immune system, but it has not been proven to reduce inflammation or boost the immune system in humans.

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The National Institute on Aging is studying how cat's claw may affect the brain. Findings may point to new avenues for research in Alzheimer's disease treatment.

Side Effects and Cautions •

Few side effects have been reported for cat's claw when it is taken at recommended dosages. Though rare, side effects may include headaches, dizziness, and vomiting.

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Women who are pregnant or trying to become pregnant should avoid using cat's claw because of its past use for preventing and aborting pregnancy.

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Because cat's claw may stimulate the immune system, it is unclear whether the herb is safe for people with conditions affecting the immune system.

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PEPPERMINT OIL Introduction Common Names—peppermint oil. Latin Names—Mentha x piperita. This fact sheet provides basic information about peppermint oil—uses, potential side effects, and resources for more information. The herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Peppermint, a cross between two types of mint (water mint and spearmint), grows throughout Europe and North America. Peppermint is often used to flavor foods, and the leaves can be used fresh or dried in teas.

What It Is Used For •

Peppermint oil has been used for a variety of health conditions, including nausea, indigestion, and cold symptoms.

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Peppermint oil is also used for headaches, muscle and nerve pain, and stomach and bowel conditions such as irritable bowel syndrome.

How It Is Used Essential oil of peppermint can be taken in very small doses in capsule or liquid forms. The essential oil can also be diluted with other oil and applied to the skin. What the Science Says •

Results from several studies suggest that peppermint oil may improve symptoms of irritable bowel syndrome.

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A few studies have found that peppermint oil, in combination with caraway oil, may help relieve indigestion, but this evidence is preliminary.

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Although there are some promising results, there is no clear-cut evidence to support the use of peppermint oil for other health conditions.

Side Effects and Cautions •

Peppermint oil appears to be safe for most adults when used in small doses. Possible side effects include allergic reactions and heartburn.

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Capsules containing peppermint oil are often coated to reduce the likelihood of heartburn. If they are taken at the same time as medicines such as antacids, this coating can break down more quickly and increase the risk of heartburn and nausea.

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NONI Introduction Common Names—noni, morinda, Indian mulberry, hog apple, canary wood. Latin Names— Morinda citrifolia. This fact sheet provides basic information about noni-common names, uses, potential side effects, and resources for more information. Noni is an evergreen shrub or small tree that grows throughout the tropical regions of the Pacific Ocean, from Southeast Asia to Australia and especially in Polynesia. Noni has been traditionally used in Polynesia as a dye.

What It Is Used For • •

Noni has a history of use as a topical preparation for joint pain and skin conditions. Today, people drink noni fruit juice as a general health tonic, as well as for cancer and chronic conditions such as cardiovascular disease and diabetes.

How It Is Used • •

Traditionally, the leaves and fruit of noni have been used for health purposes. Today, the fruit is most commonly combined with other fruits (such as grape) to make juice. Preparations of the fruit and leaves are also available in capsules, tablets, and teas.

What the Science Says •

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In laboratory research, noni has shown antioxidant, immune-stimulating, and tumorfighting properties. These results suggest that noni may warrant further study for conditions such as cancer and cardiovascular disease. However, noni has not been well studied in people for any health condition. Recent NCCAM-funded research includes a study on noni for cancer to determine its safety and potential effects on tumors and symptoms. The National Cancer Institute is funding preliminary research on noni for breast cancer prevention and treatment.

Side Effects and Cautions •

Noni is high in potassium. People who are on potassium-restricted diets because of kidney problems should avoid using noni.

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Several noni juice manufacturers have received warnings from the U.S. Food and Drug Administration about making unsubstantiated health claims.

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Although there have been few reported side effects from using noni, its safety has not been adequately studied.

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There have been reports of liver damage from using noni. It should be avoided if you have liver disease because it contains compounds that may make your disease worse.

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Findings and Analysis: 1.1 Consumers’ choice of Brand Name of the Brand Medicine Homeopathic Harbal Vassas Alternative Medicine

No of consumers support 70 10 12 4 4

Percentage 70% 10% 12% 4% 4%

The world wide brand leader in medicine market, Allopathic is still a favorite brand to our local consumers. More than 70% attendants expressed the Allopathic as their first choice brand. The second position is Homeopathic brand has captured an important share to the mind of consumers. Though Herbal is a new in the market but they have started a determined start to capture in the mind of consumers as a strong brand. 1.2 Consumers’ choice of flavor

Name of the flavor Alternative Medicine Herbal Vases

No of consumers 60 20 10

Percentage 60% 20% 10%

There are madly expressions in the choice of flavor. Here most of the consumers those are the village in Bangladesh are expressed that their first choice is Herbal flavor. So in this perspective herbal flavor still popular to the consumers. The second choice of consumers is Vases and this choice of flavor is increasing. Thatâ&#x20AC;&#x2122;s why we have observed that alternative medicine a new brand in the name of TEEM and they have also introduced a new idea of consumers. 1.3 Consumersâ&#x20AC;&#x2122; consumption among following brand: Name of the brand Medicine Homeopathic Herbal Vases Alternative Medicine

No of consumers 70 121 8 7 0

Percentage 70% 12% 8% 7% 0%

No of consumers 70 121 8 7 0

Percentage 70% 12% 8% 7% 0%

No of consumers 35 25 30 9 0

Percentage 35% 25% 30% 9% 0%

The size and type of pack is much important in medicine market. All medicine products comprise plastic pack size and todayâ&#x20AC;&#x2122;s consumers are much feeling comfortable to plastic pack size. Only Alternative Medicine made by Electronic goods. 1.8 No of consumers consume different pack sizes: Pack sizes 100ml 200ml 300ml 500ml More

No of consumers 40 10 33 14 3

100ml is much favorable to the consumers. Every marketer manufactures the 200ml more than any other pack sizes. Only exception is Herbal brand. They didnâ&#x20AC;&#x2122;t have the 200ml; instead they are marketing the 300ml in the market with lower prices than others. Another choice able pack size to the consumers is 500ml. In this case Herbal & Vases have a good no of consumers. 1.9 Choice of advertising: Name of the Brand

No of Consumers

Medicine

Homeopathic

Herbal

Vases

Alternative Medicine

â&#x20AC;&#x153;Business without Advertising to see a girl in a dark placeâ&#x20AC;?. So advertising is crucial to operate a business. Every company in the market advertises their product by print media and electronic media. But not very advertising stimulates consumers to purchase the products. Major consumers raise their feelings to the advertising of Alternative Medicine. The advertising of Alternative Medicine is also pursuable to the consumers. 2.0 Consumersâ&#x20AC;&#x2122; choice of different parts in Advertising: Different parts in Ad Medicine Homeopathic Herbal Vases Alternative Medicine Others

No of consumers choice 27 21 8 20 16 8

Percentage 27% 21% 8% 20% 16% 8%

Many consumers held many choices and opinion in the medicine market. 27% consumers expressed that they like the melody song in advertising and in this circumstances we observed that the Ad of herbal brand is much favorable to the consumes. 21% raises their expression to

the dialogue part. Here the Ad of Alternative Medicine brand is much attractive to the consumers. Alternative brand highlights the comedy or cartoon to their advertising strategy to suit their target consumers. 2.1 New Arena in Beverage Market: Name of drinks Health Energy Diet

No of consumers choice 28 60 12

New things for new consumers or the consumers those are exhausted to the existing product and expecting the new one. Among the three new therapy a major number of young consumers are expecting the herbal that should come in the market. Another important thing is that today’s consumers are getting conscious to their health. That’s why there is a tendency to reduce the consumption of homeopathic. A good number of consumers expect the herbal health drinks. Recommendations The following suggestions are strongly recommended to the Marketers: •

All of the marketers in the alternative market should give priority about the health of the consumers. Because today’s consumers are much cautious about their health. That’s why a new kind of medicine like Herbal should health.

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Plastic bottle, which is much harmful to the environment. A new kind of package should be marketing in the near future.

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Pricing strategy of the companies is much higher in the rural area than urban/city. Companies can follow segmentation pricing strategies in some very deep rural area.

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The behavior of the distribution channel is much important to make a good relationship between the producer and the customers.

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There must have research cell in every companies to continuous research about the new kind alternative medicine with new design, pack sizes, in the future.

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A high range of promotional activities required to make a good consumers relationship.

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Do marketing by gardening consumers not hunting.

Conclusion Maknom International strives above all, for top quality products at the least cost reaching the lowest rungs of the economic class of people in the country. Maknom value their social obligations. Maknom International Ltd. has so far experienced no challenge from any competitor regarding the high quality of medicine. Maknom International committed to develop sense of belongingness of all member of the team towards the organization and full participation in quality improvement activities. They ensure all activities through documented quality management system complies the requirement of ISO 2001 in every phase of Manufacturing and quality assurance. Maknom Strive for fulfillment of our reasonably to the Government through payment of entire range of due taxes, duties and claims to various public agencies like municipalities etc. and the best co-operation of the creditors & debtors the bank & financial institutions who provide financial support when we need them, the suppliers the provides of utilities-power, gas & water etc. and the customers who buy our products & services by redeeming their claim in time buy making prompt payment and by distributing proper product on due dates. In the other hand the most important tools of production and operation management “Deming Wheel” will be used to control and monitor Maknom production and as well as marketing. Plan – do-check-act, this sequence will be strictly adhered to. The management of the outlet will be responsible for their operation. References 1. Acupuncture. Natural Standard Database Web site. Accessed at http://www.naturalstandard.com on June 28, 2007. 2. Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. CDC Advance Data Report #343. 2004. 3. Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of Internal Medicine. 2004; 141(12):901–910. 4. Eisenberg DM, Cohen MH, Hrbek A, et al. credentialing complementary and alternative medical providers. Annals of Internal Medicine. 2002; 137(12):965–973. 5. Ernst E. Acupuncture—a critical analysis. Journal of Internal Medicine. 2006; 259(2):125–137. 6. Kaptchuk, TJ. Acupuncture: theory, efficacy, and practice. Annals of Internal Medicine. 2002; 136(5):374–383. 7. Lao L. Safety issues in acupuncture. Journal of Alternative and Complementary Medicine. 1996; 2(1):27–31.

8. MacPherson H, Thomas K. Short-term reactions to acupuncture—a cross-sectional survey of patient reports. Acupuncture in Medicine. 2005; 23(3):112–120. 9. National Cancer Institute. Acupuncture (PDQ). National Cancer Institute Web site. Accessed at 10. http://www.cancer.gov/cancertopics/pdq/cam/acupuncture on August 16, 2007. 11. National Institutes of Health Consensus Panel. Acupuncture: National Institutes of Health Consensus Development Conference Statement. National Institutes of Health Web site. Accessed at http://consensus.nih.gov/ 1997/1997acupuncture 107html.htm on June 22, 2007. 12. Reston J. Now, about my operation in Peking; now, let me tell you about my appendectomy in Peking…. New York Times. July 26, 1971:1. 13. U.S. Food and Drug Administration. Acupuncture needles no longer investigational. FDA Consumer. 1996; 30(5). Also available at http://www.fda.gov/fdac/departs/596_upd.html.