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Psychotherapeutic practices in India observes a paradigm shift with the current focus on the indigenous movement which has hit the discipline of Psychology like any other stream in Social Sciences and Humanities. The professional challenges and issues faced by the mental health professionals in this country has always revolved around on the 'uncanny' realm of myths, beliefs and religions as far as mental illness is concerned (Prasadarao & Sudhir, 2001). Efforts have been initiated in exploring the cultural and social roots of the health-illness constructs as well as debating on the possibility of 'integration' of these different philosophies. This paper is designed to understand the various therapeutic forms and processes in indigenous healing practices and to analyse the negotiation between indigenous healing practices and psychotherapy with special reference to Karnataka, one of the States situated in the Southern part of India. The study approaches the cultural landscape of Karnataka state based on a qualitative research design wherein in-depth unstructured interview of healers and mental health practitioners and systematic observation of some indigenous healing forms are adopted as methods of data collection. The paper concludes by looking at the challenges of constructing ethnospecific interventions in psychotherapy and the need to develop more cultural-specific theories taking into account the cultural history of the community. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: Inspite of tremendous advances made in allopathic medical practices, herbs still play an important role in the management of various liver diseases. A large number of plants and formulations have been claimed to have hepatoprotective activity. Jaundice is a symptom, indicative of the malfunctioning of the liver. This paper provides ethnomedicinal information on the plants used to treat jaundice by three important indigenous communities, i.e., nomadic Gujjars, Tharu and Bhoxa of Sub-Himalayan region, Uttarakhand, India. Aims of the study: To record herbal preparations used by the studied indigenous communities in treatment of jaundice and discuss hepatoprotective properties of the recorded plants. Research strategy and methods: The traditional knowledge of the studied indigenous communities on herbal preparations used for treating jaundice was collected through structured questionnaire and personal interviews. The interviews were conducted with 91 traditional healers (29 Bhoxa, 35 Tharu and 27 nomadic Gujjars) in Sub-Himalayan region of Uttarakhand, India. More than 250 research papers reporting ethnomedicinal information on the hepatoprotective plants used by various communities from different parts of India were extensively reviewed. Results: A total of 40 medicinal plants belonging to 31 families and 38 genera were recorded to be used by the studied communities in 45 formulations as a remedy of jaundice. Bhoxa, nomadic Gujjars and Tharu communities used 15, 23 and 9 plants, respectively. To our knowledge eight plants reported in the present survey viz., Amaranthus spinosus L., Cissampelos pareira L., Ehretia laevis Roxb., Holarrhena pubescens Wall., Ocimum americanum L., Physalis divaricata D. Don, Solanum incanum L. and Trichosanthes cucumerina L. have not been reported earlier as remedy of jaundice in India. Literature review revealed that a total of 214 (belonging to 181 genus and 78 families), 19 (belonging to 18 genus and 12 families) and 14 (belonging to 14 genus and 11 families) plant species are used as internal, external and magico-religious remedies for jaundice, respectively by various communities in different parts of India. Most widely used hepatoprotective plant species for treatment of jaundice in India is Boerhavia diffusa L. followed by Tinospora cordifolia (Willd.) Miers, Saccharum officinarum L., Phyllanthus amarus Schumach. & Thonn., Ricinus communis L., Andrographis paniculata (Burm. f.) Nees., Oroxylum indicum (L.) Kurz, Lawsonia inermis L. and Eclipta prostrata (L.) L. Conclusions: The plants recorded in the present survey have also been discussed in relation to pharmacological studies and hepatoprotective phytoconstituents present in them. Most of the recorded plants have shown hepatoprotective effects on experimental animals in earlier studies but more studies are needed to assess hepatoprotective properties of some recorded medicinal plants viz., Averrhoa carambola L., Ehretia laevis Roxb., Holarrhena pubescens Wall., Mangifera indica L., Ocimum americanum L., Oroxylum indicum (L.) Kurz, Physalis divaricata D. Don, Solanum incanum L., Sphaeranthus senegalensis DC. and Tribulus terrestris L.. The plants enumerated in this study with high number of citations and wider distributions have given some useful leads for further biomedical research. Nevertheless more phytochemical, pharmaceutical and clinical studies are needed to evaluate hepatoprotective properties, efficacy and safety of all the claimed medicinal plants. [Copyright &y& Elsevier]

The co-existence of different types of medical systems (medical pluralism) is a typical feature of India's healthcare system. For conditions such as influenza-like illness (ILI), where non-specific disease signs/symptoms exist, clinical reasoning in the context of medical pluralism becomes crucial. Recognising this need, we undertook a qualitative study, which explored factors underpinning clinical decisions on diagnosis and management of ILI. The study involved semi-structured interviews including clinical vignettes with 20 healthcare practitioners (working within allopathy, homeopathy and Ayurveda) working in the private healthcare sector in Solapur city, India. An inquiry was conducted into criteria influencing the diagnosis, treatment, referral to specialist care and role of treatment guidelines for ILI. Thematic analysis was used to identify aspects relating to ILI diagnosis, treatment and referral. The diagnosis of influenza was based largely on clinical symptoms suggestive of influenza in the absence of other diagnoses. Referral for laboratory tests was only initiated if illness did not resolve, generally after 2–3 consultations. Antibiotics were often prescribed for persistent illness, with antivirals rarely considered. Some differences between practitioners from different medical systems were observed in relation to treatment and referral in case of persistent illness. A combination of analytical and intuitive clinical reasoning was used by the participants and clinical decisions were based on both social and clinical factors. Clinical decision-making was rarely a linear process and respondents felt that broad guidelines on influenza that allowed doctors to account for the sociocultural context within which they practised medicine would be helpful. [ABSTRACT FROM AUTHOR]

Globally, musculoskeletal lumbopelvic pain (LPP) predominates among women. This high predominance of LPP is attributed to the complex interaction of biomechanical, psychological, and social factors among women. The deleterious effect of LPP has increased the likelihood of LPP-care seeking among women. The need for care seeking is influenced by a person's perception, beliefs, and attitude toward pain; which in turn, is framed by his/her culture and community. Thus, this qualitative research aimed to seek insights into LPP-care seeking behaviors among women from Indian cultural background. Semi-structured interviews were administered among 18 women living in urban as well as semi-urban areas of North India. Analysis of interview scripts lead to generation of three themes: LPP-care seeking behavior, non-adherence to LPP rehabilitation and barriers to LPP rehabilitation. LPP-care seeking behavior was influenced by unawareness about physiotherapy (PT), self-help practices and beliefs about LPP. We also found that lack or incomplete knowledge incite false assumptions, resulted in non-adherence in LPP rehabilitation. In addition, unsupportive family, lack of time, and difficulty in memorizing LPP exercises were the cultural, work, and old age-related barriers to LPP-care seeking, respectively. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Being one of the most common types of life threatening diseases in Southern Assam, India, the digestive system disorders (DSD) have gained much attention in recent decades. Traditional beliefs and inadequate income of mass population result in the use of alternative phytotherapies to treat the diseases. Aim of the study The present paper documents the medicinal knowledge and utilization of plants for treatment of digestive system disorders in Southern Assam, India by Disease Consensus Index (DCI). It also determines the most suitable plant species used to treat digestive system disorders in the study area. Materials and methods The study was based on ethnomedicinal field survey covering a period of 1 year from 2014–2015. The ethnomedicinal information was collected by using semi-structured questionnaires from different traditional Bengali people having knowledge on medicinal plants. Collected data were analyzed by calculating DCI. Results During the survey, 29 informants were interviewed and a total of 49 plants under 46 genera belonging to 33 families were listed. Data analysis revealed that Litsea glutinosa , Momordica charantia , Andrographis paniculata , Lawsonia inermis , Cleome viscosa , Psidium guajava , Ageratum conyzoides , Cuscuta reflexa , Cynodon dactylon and Carica papaya are the most prominent plants among the people of Southern Assam for treating DSD. Conclusion This explorative survey emphasizes the need to preserve and document the traditional healing practices for managing DSD inviting for more imminent scientific research on the plants to determine their efficacy as well as safety. With the help of statistical analysis (DCI), we propose 10 priority plants for DSD in present work. Systematic pharmacological study with these plants may contribute significant result. [ABSTRACT FROM AUTHOR]

Objectives: This study explored the subjective accounts of the main barriers to self-monitoring of blood-glucose (SMBG) and medication-management among Indian patients with type 2 diabetes (T2DM), their primary family-members (PFMs) and physicians. Methods: Using convenience sampling, patients with T2DM, their PFMs, and physicians, residing in a South Indian capital city, were recruited for semi-structured, audio-recorded interviews. Thematic analysis was used to analyze the data. Results: Fifty patients (female = 14; mean age = 42.5 years) and their PFMs (female = 38; mean age = 39 years), and 25 physicians (female = 4; mean age = 49.8 years) were recruited. Three superordinate themes were identified: (i) complex medication-regimen: confusion, forgetting and reduced motivation, (ii) family recommendations of alternative therapies due to the social pressures of avoiding stigma, intrusiveness and being misrepresented for injecting insulin, and (iii) an expensive illness: choosing to spend money on only medication. Discussion: Implications of the findings highlight the need to (i) train physicians in communication and empathy skills, (ii) empower patients to communicate their barriers to physicians through triadic communication models and question-prompt lists, (iii) educate communities on the benefits of insulin for managing T2DM to reduce stigma, and (iv) equip communities with information about health insurance to address the financial toll of T2DM management. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance During the last few decades there has been an increasing interest in the study of medicinal plants with their traditional use and related pharmacological research all over the World. This paper enumerated folk medicinal plants used by Malayali tribal people in an unexplored and biodiversity rich region of Eastern Ghats in southern India. Aim of study The aim of this study is to collect and identify the plants used in medicinal therapy by the local people and professional traditional healers with quantitative analysis. Materials and methods An ethnobotanical survey was carried out during January to December 2014 among the Malayali tribal people in four villages of Palamalai region in Eastern Ghats, India. The information was obtained through open and semi-structured face-to-face interviews with the local knowledgeable people and professional traditional healers. The statistical analysis, use value, family use value, informants’ consensus factor, fidelity level, frequency of citation, relative frequency citation and informants’ agreements ratio were calculated for the quantitative study of ethnomedicinal data. Results A total of 118 plant species belonging to 95 genera and 55 families dominated by the families like Leguminosae, Asteraceae and Lamiaceae were enumerated with detailed information on parts used, method of preparation, mode of administration and ailments treated. Leaves were mostly used plant part and predominantly used herbal preparations were decoction and paste. Moringa oleifera Lam. was reported by all the interviewed informants and gives the highest UV of 3.9 with 78 use reports due to its diverse medicinal uses. Conclusion The present study demonstrated the need for importance of documenting the traditional knowledge of forest dwelling people. As a result of the study, Abutilon indicum (L.) Sweet., Andrographis echioides (L.f.) Nees., Bacopa monnieri (L.) Wettst., Canarium strictum Roxb., Centella asiatica (L.) Urban., Senna auriculata (L.) Roxb. and Tribulus terrestris (L.) were recommended for further ethnopharmacological studies since these plants were recorded with high UV, IAR, RFC and FL values. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: Dysentery and diarrhoea are major causes of morbidity and mortality in rural communities of developing world. The Bhoxa community is an important primitive indigenous community of Uttarakhand, India. In this paper we have tried to scientifically enumerate ethnomedicinal plants and herbal preparations used by Bhoxa community to treat dysentery and diarrhoea, and discuss their antidiarrhoeal properties in the light of previous ethnomedicinal, pharmacological, microbiological and phytochemical studies. To record plants and herbal preparations used by Bhoxa community of district Dehradun, Uttarakhand, India in treatment of dysentery and diarrhoea, and to discuss antidiarrhoeal and antimicrobial properties of the recorded plants. Materials and methods: Ethnomedicinal survey was conducted in different villages of Bhoxa community located in district Dehradun, Uttarakhand, India. Thirty Bhoxa traditional healers were interviewed to collect information on plants used by them for treating dysentery and diarrhoea. For each of the recorded plant species the use value (UV) and fidelity level (FL) was calculated. Detailed literature survey was conducted to summarize ethnomedicinal, pharmacological, microbiological and phytochemical information on the medicinal plants listed in the present study. Results: Fifty medicinal plants (45 genera and 30 families) were used by Bhoxa community to treat dysentery and diarrhoea, among which 27 species were used for dysentery, 41 for diarrhoea and 18 for both dysentery and diarrhoea. Three plants viz., Dioscorea bulbifera L., Euphorbia thymifolia L. and Prunus persica (L.) Stokes, recorded in the present survey have been reported for the first time in treatment of dysentery and diarrhoea by any indigenous communities in India. FL and UV values revealed that most preferred species for the treatment of dysentery and diarrhoea by Bhoxa community are Euphorbia hirta L. followed by Holarrhena pubescens Wall., Helicteres isora L. and Cassia fistula L. Earlier pharmacological studies confirmed that 27 of the recorded plants have some proven antidiarrhoeal properties and remaining 23 plants have to be pharmacologically evaluated for their antidiarrhoeal properties. Except 6 plants all the other recorded plants have shown antimicrobial properties in previous microbiological studies. Previous studies have corroborated the ethnomedicinal claims made by the traditional healers of the Bhoxa community. Conclusions: Present study has provided new information on many medicinal plants and their uses. All the three newly reported plants for treatment of dysentery and diarrhoea have not been pharmacologically evaluated yet for their possible antidiarrhoeal properties. Twenty-three and six plants have not been evaluated pharmacologically and microbiologically, respectively. The present information may serve as a baseline data to initiate further research for discovery of new compounds and biological activities of these potential plants. Further research on these plants may provide some important clues for development of new drugs for dysentery and diarrhoea or other related diseases. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: Vapour-based medicines are an aspect of traditional medicine in North East India. However, no collective studies on this therapy in the region have been attempted. With the changing perception of traditional knowledge, documenting these herbal preparations and the subsequent development of baseline data for applications in further ethnopharmacological research are needed. Aims of the study: To survey and document the plant species associated with vapour therapy in Manipur, North East India, and to evaluate these traditional practices. Materials and methods: Semi-structured questionnaires were used to collect information from the Meitei community in the Imphal valley and the Jiribam area in Manipur. Traditional disease concepts were studied along with their corresponding medical terminologies. Plant samples collected from fields, healers' private collections and home gardens were identified. Evaluation of the ethnobotanical data was performed with a modified fidelity level index. Results: In the study, 41 traditional disease complexes were treated by 13 different routes of administration using 48 mono-ingredient and 17 multi-ingredient compositions. Preparation methods included boiling in water (28%), burning the materials (48%), crushing the materials to release the aroma (21%) and slight heating of the materials (3%). Some of the mono-ingredient recipes reported in the study were observed to have similar uses in other parts of the world, whereas polyherbal remedies were found to be unique without any similar report. Conclusion: Many compositions mentioned in the paper are still used by the Meitei community. Traditional healers follow their own criteria for selecting medicinal plants. Plants recorded in this ethnobotanical study can suggest methods for selecting and identifying potentially effective plants for future drug candidates. Scientific characterisation of the herbal remedies can contribute to the endorsement of traditional vapour-based therapies in the modern health care systems. Findings from these “new usage” reports of plants and unique combinations of polyherbal compositions indicate the importance of such documentation efforts. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: India has a population with high degree of medical pluralism. Siddha system of Indian traditional medicine is practiced dominantly by the people in Tamil Nadu. The traditionally trained Siddha healers still play an important role in the rural health care. Their knowledge is comparatively more vulnerable than the documented traditional knowledge. Thus, the present study was aimed to document and quantitatively analyze the local knowledge of the traditional Siddha healers in Virudhunagar district of Tamil Nadu, India. Materials and methods: The results presented in this paper are the outcome of series of interviews conducted between January and August, 2010 consisting of 196 field days. After getting prior informed consent, interviews were conducted and successive free-listing was used in the interviews in order to make informants cite the medicinal plants that they have used. By this way 96 healers were interviewed and their data were quantitatively analyzed using various indices such as Informant Consensus Factor (F ic), Fidelity Level (FL), Informant Agreement on Remedies (IAR) and Cultural Importance Index (CII). Results: This study recorded the ethno-medicinal usage of 227 species which were used to prepare 611 formulations for the treatment of 36 illness categories. The knowledge holders had the experience of minimum 20 years. There was unevenness in male–female ratio. Regarding the medicinal plants, easily available plants were holding significantly high number of citations, IAR and CII values. Nine illness categories had a high F ic value, compared to others. Species with high citations in these groups were Moringa oleifera (aphrodisiacs), Acalypha indica (dermatological ailments), Dodonaea viscosa (musculo-skeletal disorders), Solanum trilobatum (pulmonary ailments), Phyllanthus amarus (jaundice), Piper nigrum (adjuvant) Allium cepa (hemorrhoids), Azadirachta indica (antiseptic) and Tribulus terrestris (urinary ailments). Conclusion: Quantitative analysis of the data had revealed that the easily available species hold a high consensus and cultural importance. Future biomedical studies using the medicinal plants enumerated in this study, particularly those with high number of citations and high F ic values might yield some novel prototypes. Such studies will also be useful to assess the efficacy and safety of these herbal treatments to take decisions on the health care of rural India. [Copyright &y& Elsevier]

Hierarchies of power among healthcare professionals are well documented, nonetheless, power remains neglected, understudied and under-theorised in health systems analysis and policy discussions, especially in the domain of Traditional, Complementary and Alternative Medicine (TCAM). Sociological and public health scholarship has documented the persistence of medical dominance in the health system, theorised as the limitation, subordination, exclusion and incorporation of other professions. This paper explores how interprofessional power dynamics shape the integration of TCAM into Indian primary healthcare centres, as part of a nationwide policy of TCAM integration and medical pluralism implemented since 2005. We conducted interviews (n = 37) with health system administrators, nurses, pharmacists, TCAM and biomedicine doctors, and observed day-to-day activities of primary healthcare centres for six months in Odisha state, India. Thematic analysis enabled the identification of themes and exploration of sub-themes. The analysis revealed multilayered forms of medical dominance within the primary healthcare system and identified multiple sites where everyday power is mobilised. Biomedicine practitioners exercised authoritative power and restricted TCAM doctors' access to facility-level resources, i.e. financial and workforce support, which inhibited the integration policy implementation. Significantly, TCAM doctors were 'ordered' to practice biomedicine at primary healthcare centres, which was beyond the scope of the integration policy. However, TCAM doctors were also able to exercise countervailing power in their day-to-day activities in the primary healthcare centres and sought to assist patients' health behaviour change through their authoritative knowledge about 'how to live a healthy life'. The health system actors involved in policy implementation hold a range of forms of power specific to the circumstances, influencing the integration processes. We explain these dynamics in relation to existing theories of medical dominance and countervailing power, while introducing a previously unreported dimension of dominance: 'co-optation', which enrols TCAM practitioners in the practice of biomedicine. • Medical dominance in Indian primary health care centres (PHCs) is multi-layered. • AYUSH doctors working in PHCs experience subordination, exclusion and limitation. • A new form of medical dominance – co-optation – was also uncovered in this setting. • Co-optation here involved AYUSH doctors being ordered to undertake biomedical tasks. • Via countervailing power, AYUSH doctors retained autonomy in community-based work. [ABSTRACT FROM AUTHOR]

Background: The ethnic communities in Nagaland have kept a close relationship with nature since time immemorial and have traditionally used different kinds of insects and their products as folk medicine to treat a variety of human ills and diseases. The present study was conducted to record the entomotherapeutic practices of seven different ethnic groups of Nagaland. Method: Documentation is based on semi-structured questionnaires and group discussions with a total of 370 informants. The data collected were analysed using fidelity level (FL) and informant consensus factor (ICF). Results: Fifty species of medicinal insects belonging to 28 families and 11 orders were identified in connection with treatments of at least 50 human ailments, of which the most frequently cited were coughs, gastritis, rheumatoid arthritis, stomach ache and wound healing. Mylabris sp. showed the highest fidelity level (FL) of 100% for its therapeutic property as a dermatologic agent, while the informant consensus factor (ICF) ranged from 0.66 to 1.00. The use of medicinal insects varies amongst the seven ethnic groups, suggesting that differences in cultures and geographic location can lead to the selection of specific insect species for specific medicinal purposes. The largest number of insect species appear to be used for treating gastrointestinal, dermatological and respiratory diseases. Conclusion: The list of medicinal insect species, many of which are reported for the first time in the present study, suggests the presence of a considerable diversity of therapeutically important insect species in the region and elaborate folk medicinal knowledge of the local ethnic groups. This knowledge of insects not just as a food, but also as therapy is passed down verbally from generation to generation, but is in danger of being lost if not documented in a systematic way. Having stood the test of time, traditional folk medicinal knowledge and its contribution through entomotherapy should not be regarded as useless as it has the potential to lead to the development of novel drugs and treatment methods. [ABSTRACT FROM AUTHOR]

Although more maternal deaths occur in the postpartum period, this period receives far less attention from the program managers. To understand how the women and their families perceive postpartum health problems, the culturally derived restrictions, and precautions controlling diets and behavior patterns, we conducted a mixed-method study in Rajasthan, India. The study methods included free listing of maternal morbidity conditions, interviews with 81 recently delivered women, case interviews with eight cases of huwa rog (postpartum illness), and interviews with nine key informants. The study showed that huwa rog refers to a broad category of serious postpartum illness, thought to affect women a few weeks to several months after delivery. Prevention of the illness involves a system of precautions referred to as parhej, which includes a distinctive set of “medicinal dietary items” referred to as desi dawai, or “country medicine,” and restrictions about mobility and work patterns of a postpartum woman. This cultural framework around the concept of huwa rog and peoples’ beliefs about it are of central importance for planning postpartum health interventions, including place of contact and communication messages. [ABSTRACT FROM AUTHOR]