Original Article
Sachin T Jose
Background: The global healthcare landscape is experiencing a paradigm shift as the limitations of reductionist allopathic biomedicine in managing chronic illnesses drive a resurgence of interest in Traditional, Complementary, and Integrative Medicine (TCIM). Although approximately 80% of the world's population relies on traditional systems, integrating these modalities requires systematic scientific validation, safety assessments, and inter professional collaboration. Objective: This review analyzes foundational philosophies, diagnostic frameworks, and therapeutic tools across prominent medical traditions, evaluates contemporary clinical evidence and pharmacognostic bridges, and proposes an integrative healthcare framework. Methods: A comprehensive narrative literature review was conducted across five major academic databases (PubMed, MEDLINE, Cochrane Library, Google Scholar, and the WHO repository) targeting peer-reviewed journals, systematic reviews, and meta-analyses published between 2000 and 2026 (utilizing a synthesized corpus of 10 key primary references and historical pharmacognostic data). Inclusion criteria prioritized peer-reviewed articles addressing philosophical frameworks, plant-derived pharmacognosy, randomized controlled trials (RCTs) of alternative modalities, and safety parameters such as herb-drug interactions. Main Findings: • Philosophical and Clinical Efficacy: While reductionist biomedicine excels in acute crisis care, holistic traditional systems address chronic degenerative conditions. Clinical meta-analyses confirm that acupuncture stimulates peripheral nerves for chronic pain, and functional neuroimaging shows mindfulness practices induce gray matter increases in the prefrontal cortex. • Pharmacognostic Bridge: Approximately 40% of contemporary pharmaceuticals derive from natural plant sources (e.g., Aspirin from Salix alba, Artemisinin from Artemisia annua, Vinblastine/Vincristine from Catharanthus roseus, and Digoxin from Digitalis purpurea). Safety & Toxicology: Safe integration demands strict regulation of botanical synergies to prevent adverse events, such as St. John's wort inducing CYP3A4 drug metabolism. Conclusion: Systematically unifying allopathic biomedicine and traditional therapeutics creates a patient-centered integrative paradigm that pairs acute biomedical crisis management with systems-based prevention, provided rigorous safety standards and inter professional collaboration are maintained.
Commentary
Mohammad Tayab
Mental health has become one of the defining challenges of contemporary society. The increasing prevalence of psychological distress among young people, changing patterns of social interaction, digital dependence, academic and occupational pressures, uncertainty about the future, social comparison and weakening connections with traditional community structures have created a particularly complex environment for Generation Z. At the same time, there is renewed international interest in traditional, complementary and integrative medicine and its potential contribution to health and wellbeing. This Commentary explores the relationship between psychology, mental wellbeing and traditional therapeutics, with particular attention to Generation Z and the potential contribution of culturally grounded approaches. Yoga, meditation, mindfulness, contemplative practices, traditional healing systems and Islamic spiritual practices are considered from a contemporary psychological perspective. Particular attention is given to Islamic concepts including sakinah, tawakkul, sabr, shukr, dhikr, salah, compassion, social responsibility and balance. These concepts provide a culturally meaningful framework for understanding psychological resilience, emotional regulation, purpose and existential wellbeing. The discussion does not propose traditional therapeutics as substitutes for established psychological or psychiatric care. Rather, it argues for scientifically responsible engagement with traditional knowledge, particularly where traditional practices may provide culturally congruent resources for prevention, resilience and supportive mental health care. Current evidence indicates potential benefits associated with selected mind body and contemplative practices, although the strength of evidence varies and methodological limitations remain. Generation Z presents a particularly important population for this discussion because its members have developed within an environment characterized by continuous digital connectivity, rapid social change and unprecedented access to information. Their mental health needs may therefore require approaches that combine scientific psychology with culturally meaningful practices and forms of human connection. The future of traditional therapeutics in mental health may consequently depend not on returning to the past, but on understanding how ancient knowledge can be critically examined and meaningfully adapted to contemporary psychological realities.
Review Article
Santhy Shetty
Endometriosis is a chronic inflammatory condition affecting approximately 1 in 10 people assigned female at birth in the United Kingdom, characterised by endometrial-like tissue growing outside the uterus. It causes persistent pelvic pain, dysmenorrhoea, dyspareunia, dyschezia, and systemic symptoms including fatigue and bloating, alongside significant psychological morbidity including anxiety, depression, and pain catastrophising. A bidirectional relationship exists: physical pain amplifies psychological distress, which in turn augments pain perception through central sensitisation and descending pain modulation pathways. Conventional pharmacological and surgical interventions often provide incomplete relief and carry significant side effect burdens, creating a need for integrated, person-centred approaches that address both physiological and psychological dimensions of suffering. This narrative review synthesises the evidence and clinical rationale for combining medical acupuncture and Cognitive Behavioural Therapy (CBT) as complementary interventions within a biopsychosocial model of holistic pain management for endometriosis. Drawing on systematic reviews, meta-analyses, randomised controlled trials, and national clinical guidelines, this paper examines the distinct and synergistic mechanisms of action, evaluates the current evidence base, and proposes an integrated clinical protocol for implementation in UK practice. Medical acupuncture modulates pain through multiple biological pathways: stimulation of endogenous opioid release; reduction of pro-inflammatory cytokines; improvement of pelvic circulation and reduction of venous congestion; neuromodulation of spinal and supraspinal pain processing; and regulation of prostaglandin synthesis and hypothalamic-pituitary-ovarian axis activity. CBT targets the cognitive-behavioural cycle of pain through: cognitive restructuring to reduce catastrophising and fear-avoidance behaviours; pain neuroscience education to normalise central sensitisation; graded activity pacing to replace the boom–bust cycle; relaxation and stress reduction to lower cortisol and pelvic floor muscle guarding; and development of pain self-efficacy. A 2024 systematic review and meta-analysis of 14 studies (n = 793) found acupuncture significantly reduced overall pelvic pain, dysmenorrhoea, and dyspareunia. A 2025 network meta-analysis of 33 randomised controlled trials (n = 2,323) confirmed acupuncture's particular benefit for non-cyclic pelvic pain (SMD = −4.53). The 2026 Healing Pelvic Pain Intervention (HaPPI) randomised controlled trial demonstrated that 8-week telehealth CBT produced large clinically meaningful improvements in endometriosis-specific quality of life, pain intensity, pain catastrophising, and psychological distress (Cohen's d = −0.28 to −0.93). National Institute for Health and Care Excellence (NICE) guidelines recommend CBT as first-line non-pharmacological management for chronic primary pain, while acupuncture is recognised as an adjunct with low-to-moderate evidence quality but consistent clinical benefit. Combining medical acupuncture and CBT creates a dual-action biopsychosocial intervention: acupuncture reduces nociceptive input and inflammation, lowering the physiological pain signal; CBT concurrently modulates top-down pain processing, emotional response, and behavioural function. This synergy breaks the pain–stress–pain cycle, with clinical benefits emerging after 6–8 weeks of combined care, offering immediate symptomatic relief alongside sustained long-term resilience and coping skills. Both interventions are best delivered as adjuncts to standard medical and surgical care, with medical cupuncture provided by HCPC-registered practitioners with appropriate British Medical Acupuncture Society (BMAS) training and CBT accessible via NHS Improving Access to Psychological Therapies (IAPT) services or qualified independent therapists. In conclusion, endometriosis pain is a multifaceted experience shaped by interconnected biological, psychological, and social factors. Medical acupuncture and CBT target complementary pathways - one modulating the body's pain signalling systems, the other transforming how pain is perceived, interpreted, and managed. Current evidence supports their integration within a holistic, person-centred care plan, offering an empowering, evidence-informed foundation for reducing pain, improving quality of life, and restoring wellbeing for people living with endometriosis. Further large-scale, placebo-controlled trials evaluating combined interventions are warranted to strengthen the evidence base and inform future clinical guidance.
Original Article
Santhy Shetty
Androgen Deprivation Therapy (ADT) remains the cornerstone of systemic treatment for locally advanced and metastatic prostate cancer, with over 50,000 men in the UK currently receiving long-term ADT. While effective at suppressing testosterone and controlling disease, ADT is associated with significant treatment-related toxicities most notably severe hot flushes experienced by 60–80% of recipients — alongside fatigue, sleep disturbance, sexual dysfunction, mood changes, and reduced quality of life. These adverse effects are compounded by the additional physiological and psychological burdens of radiotherapy and chemotherapy, contributing to high rates of non-adherence and treatment discontinuation. Conventional management of hot flushes includes venlafaxine, gabapentin, and hormonal agents, which provide only partial relief and carry their own side effect profiles, creating an unmet need for safe, effective, and well-tolerated supportive interventions. This narrative review evaluates the evidence base, mechanisms of action, and clinical application of medical acupuncture as an integrated supportive care intervention in prostate cancer, with specific focus on ADT-related hot flushes, symptom burden, and overall wellbeing following radiotherapy and chemotherapy. Drawing on randomised controlled trials, systematic reviews, meta-analyses, and international clinical guidelines, this paper synthesises current evidence and proposes an evidence-informed clinical protocol for implementation within UK oncology practice. Medical acupuncture modulates hot flushes through multiple complementary pathways: regulation of central thermoregulatory centres in the hypothalamus; stimulation of β-endorphin and serotonin release; reduction of sympathetic nervous system overactivity; improvement of sleep quality and autonomic balance; and modulation of inflammatory cytokine profiles elevated by cancer treatment and ADT. High-quality clinical evidence — including three Cochrane reviews and a 2024 individual patient data meta-analysis — demonstrates that acupuncture significantly reduces hot flush frequency by 30–50% and severity by 40–60%, with effects comparable to pharmaceutical interventions but superior tolerability and sustained benefit persisting 3–6 months posttreatment. Acupuncture also demonstrates significant benefit for cancer-related fatigue, sleep disturbance, anxiety, pain, and overall quality of life, with emerging evidence for improved sexual function and bone health. National and international guidelines increasingly recognise acupuncture as a valid supportive care option: the American Society of Clinical Oncology (ASCO) and Society for Integrative Oncology (SIO) recommend acupuncture for hot flushes and cancer-related fatigue; the British Medical Acupuncture Society (BMAS) provides specific guidance for oncology practice; and the National Institute for Health and Care Excellence (NICE) acknowledges acupuncture as a consideration for supportive care where evidence supports clinical benefit. Importantly, acupuncture is safe when delivered by appropriately trained practitioners, with no known interactions with ADT, chemotherapy, or radiotherapy, and no increased risk of bleeding or infection in appropriately selected patients. In conclusion, medical acupuncture represents a robust, evidence-based, and well-tolerated supportive care intervention that addresses multiple dimensions of the prostate cancer treatment experience. By integrating acupuncture alongside conventional oncology care, clinicians can improve symptom control, enhance treatment adherence, reduce the burden of adverse effects, and support the holistic wellbeing of men living with and beyond prostate cancer. Further largescale UK-based trials and implementation research are warranted to support commissioning and routine integration within NHS prostate cancer care pathways.
Case Report
Meenakshi Chauhan
Polycystic Ovary Syndrome (PCOS) is a common and complex endocrine disorder affecting women of reproductive age. It is characterised by varying combinations of androgen excess, ovulatory dysfunction, and polycystic ovarian morphology, resulting in diverse reproductive, metabolic, endocrine, and cosmetic manifestations. Polycystic Ovary Syndrome (PCOS) is one of the leading causes of menstrual irregularity and anovulatory infertility and is also associated with long-term metabolic complications. Due to its heterogeneous presentation and absence of a single definitive diagnostic marker, the Rotterdam criteria are widely used for diagnosis. According to the Rotterdam consensus, Polycystic Ovary Syndrome (PCOS) is diagnosed when at least two of three criteria are present: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology. Polycystic ovaries are defined by the presence of ≥12 follicles measuring 2–9 mm in diameter and/or an ovarian volume greater than 10 mL in at least one ovary. According to the Ayurvedic perspective, Polycystic Ovary Syndrome (PCOS) can be correlated with Artava Kshaya (diminution or disturbance of menstrual function) based on its clinical manifestations. In Ayurvedic scriptures, gynaecological disorders are primarily described under the broader concept of Yonivyapada, which encompasses various disorders affecting the female reproductive system. In this case study, we will discuss a case of a 35-year-old female who had Polycystic Ovary Syndrome (PCOS), which was managed by Ayurvedic medicines.
Case Report
V Chauhan*, M Chauhan
Immune Thrombocytopenia (ITP) is an autoimmune disorder that can be characterised by immune-mediated destruction of platelets that leads to an increased risk of bleeding. Platelets are responsible for blood clotting. In this condition, the platelet count is low, which leads to easy bruising, red or purple spots (Petechiae), nasal or gum bleeding, heavy menstrual bleeding etc. According to Ayurvedic principles, Immune Thrombocytopenia (ITP) can be correlated with Tiryakgata Raktapitta, a Tridoshic disorder with predominant involvement of Pitta Dosha. Due to the severity of this condition, it is considered under Ashta Mahagadas (eight major diseases) in Ayurveda texts. According to Ayurveda, Raktapitta develops when aggravated Pitta Dosha vitiates the blood (Rakta), increasing its quantity and causing it to flow abnormally through different body channels. Based on the direction of bleeding, Raktapitta is classified into three types: Urdhvaga, where bleeding occurs from the upper orifices such as the nose, mouth, ears, and eyes; Adhoga, where bleeding occurs from the lower passages including the anus, urinary tract, and genital tract; and Tiryakgata, in which vitiated blood spreads through the skin and subcutaneous tissues, producing hemorrhagic manifestations. In this study, we will discuss a case of a 52-year-old female who had Immune Thrombocytopenia (ITP), which was managed by Ayurvedic formulations.
Original Article
Tariqul Islam MD*
Background: Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder characterized by abdominal pain, altered bowel habits, bloating, and food intolerances, significantly impairing quality of life. Conventional management primarily offers transient symptomatic relief. Targeted homeopathic protocols and bowel nosodes present a potential noninvasive, structured therapeutic option. This retrospective case series evaluates the clinical symptom resolution and dietary tolerance recovery in patients with IBS undergoing a combined homeopathic protocol alongside dietary advice. Methods: A retrospective analysis was conducted on 30 patients presenting with IBS-M (Mixed) and IBS-D (Diarrhea-predominant with dysenteric features) diagnosed per Rome IV criteria. Symptoms included frequent evacuation (3–4 times daily), incomplete clearance, mucus-laden stools, dairy/lipid intolerances, and concurrent gastritis. Patients were evaluated over a 3-month period receiving a paired remedy protocol (Mercurius vivus 200C, Chelidonium majus 30C, Mercurius solubilis 6C, Ipecacuanha 30C, Dysentery Compound 30C, and Nux Vomica 30C) alongside a structured 4-week initial trigger food avoidance (Low-FODMAP guidance) followed by gradual reintroduction. Results: High rates of clinical symptom resolution were observed across all 30 patients within the 12-week timeframe. Stool frequency normalized to 1–2 evacuations daily, rectal tenesmus resolved, and epigastric discomfort was alleviated. Furthermore, oral tolerance to previously restricted foods (milk, fatty meals, leafy greens) was successfully restored without reported adverse events. Conclusion: The observational findings suggest that structured homeopathic protocols paired with bowel nosodes and lifestyle/dietary guidance may serve as a beneficial adjunct management strategy in IBS. Given the retrospective and uncontrolled design, prospective randomized controlled trials (RCTs) are warranted to evaluate causality and long-term efficacy.
