School of Natural Medicine

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https://hdl.handle.net/10566/696

The School of Natural Medicine(SoNM), in the Faculty of Community and Health Sciences, offers professional training in four diciplines of Complementary and Alternative Medicine (CAM), namely Chinese Medicine and Acupuncture, Naturopathy, Phytotherapy and Unani-Tibb. The course work for all of these disciplines is a minimum of 5 years spread over two degree's.

Once qualified, SoNM graduates can request registration with the Allied Health Professions Council of South Africa (AHPCSA) as a Doctor within the scope of practice of each discipline (please note that all AHPCSA regulations need to be adhered too throught the study period for registration). Academics at SoNM are currently involved in a wide range of research activities, such as laboratory related medical science research as well as community and health related research. As our academics pioneer scholarship in these disciplines, the research portfolio is expected to grow significantly over the next few years with the aim to impact both medical science as well as health policies related to CAM in primary and public health fields.

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A comparative analysis and evaluation of the naturopathic curriculum in South Africa
(South African Medical Association, 2021) Ericksen-Pereira, Wendy; Roman, Nicolette; Swart, Rina
Naturopathy has been taught at tertiary level in South Africa (SA) for 18 years. This research paper examines the naturopathic curriculum to determine whether it is benchmarked to international standards and meets the needs of graduates in practice. It is the first research paper that critically reviews the curriculum of a complementary alternative medicine profession taught at a higher education institution (HEI) in SA.To critically review the naturopathy curriculum taught at an SA HEI. Methods. This research used a sequential two-stage qualitative methodology. In stage one, a comparative document analysis was conducted using the curriculum recommended by the World Health Organization (WHO), the World Naturopathic Federation (WNF) and the University of the Western Cape. Stage two consisted of a graduate review of the curriculum. Eighteen graduates participated in the review by providing input on all the subjects in the curriculum via email. The responses were summarised and thematically analysed.
The effect of legislation on the treatment practices and role of naturopaths in South Africa
(Springer Nature, 2020) Ericksen-Pereira, Wendy G.; Roman, Nicolette Vanessa; Swart, Rina
In South Africa naturopaths have been practising for over half a century. Over this period, changes in legislation have resulted in different levels of training and registration processes - which has impacted on the profession in various ways. This paper explores the effect of legislation on the treatment practices and role of naturopaths in South Africa. Methods: This was a qualitative study which used an exploratory approach. Participants were sampled from the list of naturopaths registered with the Allied Health Professions Council of South Africa (AHPCSA). A set of 15 openended survey questions were emailed to 59 naturopaths. Twenty one naturopaths participated: 13 responded via email and eight were interviewed. Responses were coded and thematically analysed. Results: It was found that despite differences in training and years of practice experience, four core treatment practices of diet therapy, lifestyle medicine, supplementation and physical therapies were common to all participants with the older, more experienced naturopaths using a wider range of treatment practices.
Effect of the metabolic syndrome on male reproductive function: a case-controlled pilot study
(Wiley, 2014) Leisegang, Kristian; Bouic, Patrick J.D.; Henkel, Ralf
The metabolic syndrome (MetS) is a constellation of various risk factors. This study aimed to investigate the effect of MetS on testosterone and progesterone, and semen parameters, in a case-controlled pilot study. Male patients (n = 54) had body mass index, waist-to-hip ratio (WHR) and blood pressure recorded. Blood was analysed for HDL cholesterol, triglycerides and glucose. Saliva was assayed for free testosterone and free progesterone. Ejaculates were analysed for volume, sperm concentration, total sperm count, motility, vitality, mitochondrial membrane potential (MMP), DNA fragmentation and leucocyte concentration. Participants were divided into the control group (n = 28) and the MetS group (n = 26). Differences were found between the groups for body mass index, WHR, blood pressure, high-density lipoprotein (HDL), triglycerides and glucose. The MetS group showed significant reductions in sperm concentration (P = 0.0026), total sperm count (P = 0.0034), total motility (P = 0.0291), sperm vitality (P = 0.002), MMP (P = 0.0039), free testosterone (P = 0.0093) and free progesterone (P = 0.0130), while values for DNA fragmentation increased (P = 0.0287). Results indicate that patients with MetS have compromised sperm parameters in the absence of leucocytospermia. A reduction in free progesterone suggests that steroidogenesis cascades may be compromised. It is hypothesised that a systemic pro-inflammatory state with oxidative stress associated with MetS may provide a novel explanation.
Effects of active galactic nucleus feedback on cold gas depletion and quenching of central galaxies
(American Astronomical Society, 2022-12-27) Davé, Romeel; Ma, Wenlin; Liu, Kexin
We investigate the influence of active galactic nucleus (AGN) feedback on the galaxy cold gas content and its connection to galaxy quenching in three hydrodynamical simulations of Illustris, IllustrisTNG, and SIMBA. By comparing to the observed atomic and molecular neutral hydrogen measurements for central galaxies, we find that Illustris overpredicts the cold gas masses in star-forming galaxies and significantly underpredicts them for quenched galaxies. IllustrisTNG performs better in this comparison than Illustris, but quenched galaxies retain too much cold gas compared with observations. SIMBA shows good agreement with observations, by depleting the global cold gas reservoir for quenched galaxies. We find that the discrepancies in IllustrisTNG are caused by its weak kinetic AGN feedback that only redistributes the cold gas from the inner disks to the outer regions and reduces the inner cold gas densities. It agrees with observations much better when only the cold gas within the stellar disk is considered to infer the star formation rates. From dependences of the cold gas reservoir on the black hole mass and Eddington ratio, we find that the cumulative energy release during the black hole growth is the dominant reason for the cold gas depletion and thus the galaxy quenching. We further measure the central stellar surface density within 1 kpc (Σ1) for the high-resolution run of IllustrisTNG and find a tight correlation between Σ1 and black hole mass. It suggests that the observed decreasing trend of cold gas mass with Σ1 is also a reflection of the black hole growth.
The efficacy of zingiber officinale on dyslipidaemia, blood pressure, and inflammation as cardiovascular risk factors: A systematic review
(Clinical Nutrition ESPEN, 2022) Daniels, Chelsea Courtney; Isaacs, Zaiyaan; Leisegang, Kristian; Finelli, Renata
Background & aims: Hypertension, dyslipidaemia, and chronic inflammation contribute to the development of cardiovascular disease (CVD). Zingiber officinale has been suggested to reduce these CVD risk factors; however, the clinical evidence remains unclear. This systematic review aims to analyse the effect of Z. officinale as a sole intervention on these risk factors. Methods: In this PRISMA-based systematic review, we included randomised clinical trials from PubMed, Scopus and Cochrane Database of Systematic Reviews (July 2020) analysing triglycerides, low- and highdensity lipoprotein (LDL, HDL), total cholesterol, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-a), interleukin 1, 6, 10, systolic and/or diastolic blood pressure as outcomes. Quality of studies was evaluated by JADAD and the Cochrane risk-of-bias tools. Results: A total of 24 studies were included, mostly (79.2%) showing low risk of bias. These were based on obesity and cardio-metabolic derangements (33.3%), type 2 diabetes mellitus (37.5%), and miscellaneous conditions (29.2%). While total cholesterol and triglycerides levels mostly improved after Z. officinale, results were inconsistent for other blood lipids markers. Inflammatory markers (CRP, TNF-a) were more consistently reduced by Z. officinale, while only 3 studies reported a non-significant reduction of blood pressure. Conclusions: Although there remains a paucity of studies, Z. officinale may be beneficial for improving dyslipidaemia and inflammation.
The geography of emergency department-based HIV testing in South Africa: Can patients link to care?
(Elsevier, 2021) Hansoti, Bhakti; Mishra, Anant; Nyanisa, Yandisa
: Emergency Departments (EDs) can serve as clinical sites for identification of new HIV infections and their entry into care. We examined if HIV-positive patients who present to EDs in South Africa are able to successfully link to care.We conducted a one-year longitudinal prospective cohort study in four hospitals across the Eastern Cape, South Africa, with participants followed between July 2016 and July 2018. All adult, non-critical patients presenting to the ED were systematically approached, asked about their HIV status, and, if unknown, offered a point-of-care (POC) HIV test. All HIV-positive patients were further consented to participate in a follow-up study to assess subsequent linkage to care and distance from “home” to ED. Linkage to care was defined as self-reported linkage (telephonic) or evidence of repeated CD4/viral load testing in the National Health Laboratory System (NHLS) at either the 6- or 12-months post index ED visit.
Highly Cited Articles in the Field of Male Infertility and Antioxidants: A Scientometric Analysis
(Worlds J Mens Health, 2021) Agarwal, A; Selvam, MK; Baskaran, S; Finelli, R
Purpose The objective of this scientometric analysis was to recognize the top 100 cited articles on ‘Male infertility and Antioxidants’ and analyze its publication characteristics. Materials and Methods The Scopus database was used to retrieve related articles and the top 100 identified based on citation rate. Results The articles were published in 56 journals between 1995 and 2019 with a median (interquartile range) citation score of 17 (5–62). Among the top 100 articles, 69 were clinical studies, which included controlled and blinded (33.33%), prospective (27.54%), randomized-controlled trials (26.09%), uncontrolled (11.59%), and retrospective (1.45%) studies. In addition to conventional semen parameters, advanced sperm function tests such as oxidative stress (51%) and sperm DNA damage (23%) were reported. Pregnancy rate (33%) was found to be the most reported reproductive outcome. Antioxidant therapy was mostly investigated in male cohorts with sperm abnormalities such as asthenozoospermia (28%) and clinical conditions such as idiopathic male infertility (20%), varicocele/varicocelectomy (17%) and general male infertility (16%). Conclusions The most influential publications on antioxidants and male infertility were identified for the first time in the literature. This will serve as a reliable source of information for researchers and clinicians alike.
The impact of male overweight on semen quality and outcome of assisted reproduction
(Medknow Publications, 2014) Leisegang, Kristian; Henkel, Ralf
The impact of obesity on male reproductive health remains a contested topic as evidence is inconclusive and inconsistent. Even more debatable is the effect of male obesity in assisted reproduction. In the manuscript, “the impact of male overweight on semen quality and outcome of assisted reproduction” published in Asian Journal of Andrology, Thomsen et al. investigated the effect of male obesity on fertilization outcomes in intrauterine insemination, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) programs further contributes to the increasing body of evidence in this field.
The in vitro modulation of steroidogenesis by inflammatory cytokines and insulin in TM3 Leydig cells
(BioMed Central, 2018) Leisegang, Kristian; Henkel, Ralf
BACKGROUND: Cytokines and hormones, including insulin, are known to modulate the hypothalamic-pituitary-testes axis and steroidogenesis, both centrally and peripherally. In the context of chronic inflammation and hyperinsulinaemia mediating male hypogonadism associated with obesity, metabolic syndrome and type 2 diabetes mellitus, these mechanisms are poorly understood and the impact of cytokines and insulin on Leydig cell steroidogenesis has not been fully elicited. This study aimed to further investigate the in vitro impact of TNFα, IL1ß, IL6, IL8 and insulin on Leydig cell function and steroidogenesis. METHODS: hCG-stimulated TM3 Leydig cells were exposed to various concentrations of TNFα, IL1ß, IL6, IL8 (100 ng/ ml, 10 ng/ml, 1 ng/ml and 0.1 ng/ml) and insulin (10 ng/ml, 1 ng/ml, 0.1 ng/ml and 0.01 ng/ml) in optimal cell culture conditions over 48 h. Cell viability (XTT) and testosterone and progesterone concentrations (ELISA) were assessed using standardised laboratory techniques. RESULTS: TNFα significantly decreased cell viability and progesterone and testosterone concentrations in a dosedependent relationship. IL1ß and IL6 had a subtle but significant negative effect on cell viability and testosterone concentrations, with a marked significant decrease in progesterone concentration at all concentrations investigated. IL8 showed an increase in cell viability, with no significant effect on testosterone concentrations alongside a significant decrease in progesterone concentrations. Insulin significantly increased cell viability and testosterone concentrations in a dose dependent relationship, but interestingly significantly decreased progesterone concentrations. CONCLUSIONS: The inflammatory cytokines TNFα, IL1β and IL6 cause a dose dependent decline in steroidogenesis in TM3 Leydig cells. These results suggest that chronic inflammation may downregulate steroidogenesis in males via direct modulation of Leydig cell function. However, IL8 may stimulate TM3 Leydig cell growth. Insulin is associated with a dose-dependent increase in testosterone synthesis, with a significant decline in progesterone synthesis. With the phenomenon of insulin resistance, the literature is unclear on the potential role of hyperinsulinaemia in steroidogenesis. Further studies are warranted in order to fully elicit the molecular mechanisms and interactions of these molecules on male steroidogenesis.
Male fertility and the COVID-19 pandemic: Systematic review of the literature
(Korean Society for Sexual Medicine and Andrology, 2020) Leisegang, Kristian; Khalili, Mohammad Ali; Majzoub, Ahmad A.
Purpose: Since its discovery in December 2019, the novel coronavirus SARS-CoV-2 has spread globally, causing the current COVID-19 (coronavirus disease-19) pandemic. As there is an increase of infections in the male population, concerns have emerged about the potential impact of COVID-19 on male reproductive organs and male fertility. Therefore, this study systematically investigates the current evidence of SARS-CoV-2 impact on male reproduction and pregnancy outcomes, discussing them in light of the evidence published on other coronaviruses. Materials and Methods: Literature search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 24 original articles were included for the analysis, investigating the effects of the infection on semen parameters, male reproductive hormones, and pregnancy outcomes.
Nutritional value of cooked offal derived from free-range rams reared in South Africa
(Elsevier, 2013) Hoffman, L.C.; Laubscher, L.L.; Leisegang, Kristian
Nutritional value of Dorper (n=10) and Merino (n=10) by-products were evaluated. Proximate composition differed between organs and breeds with Merino heart (68.9 g/100 g), spleen (77.2 g/100 g) and testicles (83.7 g/100 g) having higher moisture contents than their Dorper counterparts. Dorper brain (10.1 g/100 g), heart (15.2 g/100 g), spleen (20.4 g/100 g) and testicles (12.9 g/100 g) had higher protein contents than Merino. Dorper organs also tended to have a lower fat content. Amino acid and fatty acid profiles differed between organs and breeds. Few differences were noted in total SFA and MUFA. Dorper heart (1.8%) had significantly lower total PUFA than Merino heart (7.3%). All the organs showed favourable P:S ratios, with the exception of the tongue, heart and stomach. Dorper and Merino brain, lungs and testicles had favourable n−6/n−3 ratios. Cholesterol content differed between both organs and breeds. The value of offal as food is discussed further.
Obesity and male infertility: Mechanisms and management
(Blackwell Publishing Ltd, 2021) Leisegang, K; Sengupta, P; Agarwal, A
Obesity is considered a global health problem affecting more than a third of the population. Complications of obesity include cardiovascular diseases, type 2 diabetes mellitus, malignancy (including prostatic cancer), neurodegeneration and accelerated ageing. In males, these further include erectile dysfunction, poor semen quality and subclinical prostatitis. Although poorly understood, important mediators of obesity that may influence the male reproductive system include hyperinsulinemia, hyperleptinemia, chronic inflammation and oxidative stress. Obesity is known to disrupt male fertility and the reproduction potential, particularly through alteration in the hypothalamic-pituitary-gonadal axis, disruption of testicular steroidogenesis and metabolic dysregulation, including insulin, cytokines and adipokines. Importantly, obesity and its underlying mediators result in a negative impact on semen parameters, including sperm concentration, motility, viability and normal morphology. Moreover, obesity inhibits chromatin condensation, DNA fragmentation, increases apoptosis and epigenetic changes that can be transferred to the offspring.
Obesity is associated with increased seminal insulin and leptin alongside reduced fertility parameters in a controlled male cohort
(BioMed Central, 2014) Leisegang, Kristian; Menkveld, Roelof; Bouic, Patrick J.D.; Henkel, Ralf
Obesity appears to be associated with male reproductive dysfunction and infertility, although this has been inconsistent and inconclusive. Insulin and leptin are known mediators and modulators of the hypothalamus-pituitary-testes axis, contributing to the regulation of male reproductive potential and overall wellbeing. These hormones are also present in semen influencing sperm functions. Although abdominal obesity is closely associated with insulin resistance (hyperinsulinaemia), hyperleptinaemia and glucose dysfunction, changes in seminal plasma concentrations of insulin, leptin and glucose in obese males has not previously been investigated.
An online educational model in andrology for student training in the art of scientific writing in the COVID-19 pandemic
(Blackwell Publishing Ltd, 2021) Leisegang, K; Agarwal, A; Panner Selvam, M.K
In 2020, the COVID-19 pandemic led to the suspension of the annual Summer Internship at the American Center for Reproductive Medicine (ACRM). To transit it into an online format, an inaugural 6-week 2020 ACRM Online Mentorship Program was developed focusing on five core pillars of andrology research: scientific writing, scientific methodology, plagiarism understanding, soft skills development and mentee basic andrology knowledge. This study aims to determine mentee developmental outcomes based on student surveys and discuss these within the context of the relevant teaching and learning methodology. The mentorship was structured around scientific writing projects established by the team using a student-centred approach, with one-on-one expert mentorship through weekly formative assessments. Furthermore, weekly online meetings were conducted, including expert lectures, formative assessments and social engagement. Data were collected through final assessments and mentee surveys on mentorship outcomes. Results show that mentees (n = 28) reported a significant (p <.0001) improvement in all criteria related to the five core pillars. These results illustrate that the aims of the online mentorship program were achieved through a unique and adaptive online educational model and that our model has demonstrated its effectiveness as an innovative structured educational experience through the COVID-19 crisis.
An overview of the history and development of naturopathy in South Africa
(AOSIS, 2018) Ericksen-Pereira, Wendy G.; Roman, Nicolette V.; Swart, Rina
BACKGROUND: A huge growth in complementary and alternative medicine (CAM) took place in South Africa in the 1960s which paralleled what was happening in other parts of the western world. Naturopathy has been practised in South Africa for over 60 years, and the history of naturopathy is entwined with the broader history of CAM. No laws existed at that stage to regulate the curriculum, education and training of CAM practitioners. With the passage of time, various statutes were introduced which eventually led to changes in legislation and the establishment of a recognised training programme. Naturopathy became a legally regulated profession, the full history of which has never been documented. OBJECTIVE: This article explores the history of naturopathy in South Africa. METHOD: A two-phase qualitative research design was used, consisting of a document search and semi-structured interviews with key informants who were identified through a process of snowballing. Information collected from the naturopaths who participated in the interviews was triangulated with documentation uncovered in the archives of the Allied Health Professions Council of South Africa (AHPCSA) and other literature available. RESULTS: The result is a history of events which took place and reveals the effect of various legislations on the profession. CONCLUSION: Changes in the political system paved the way for changes in legislation which allowed for the registration and training of naturopathic practitioners. However, the lack of a functioning association and the small number of naturopathic graduates have hampered the growth of the profession, preventing it from becoming a significant contributor to the health care system.
Protective effects of asiatic acid in a spontaneous type 2 diabetic mouse model
(Spandidos Publications, 2017) Sun, Wen; Xu, Guangyuan; Matsabisa, Motlalepula
Asiatic acid (AA) has been demonstrated to exhibit anti‑diabetic activity. However, the mechanisms and underlying signaling pathways remain to be elucidated. The present study was performed to confirm the protective effect of AA and demonstrate its ability to regulate the phosphatidylinositol 3‑kinase (PI3K)/protein kinase B (AKT)/glycogen synthase kinase‑3β (GSK‑3β) signaling pathway in db/db mice. Db/db mice fed on a high‑fat diet were used to model diabetes mellitus. Modeled mice were divided randomly into the model control, pioglitazone hydrochloride tablet (PH) and AA groups. Age‑matched C57 BL/6J mice served as normal controls.
Shelf-Life Stability of Ready-to-Use Green Rooibos Iced Tea Powder—Assessment of Physical, Chemical, and Sensory Properties
(MDPI, 2021) Human, C.; De Beer, D.; Muller, M.
Green rooibos extract (GRE), shown to improve hyperglycemia and HDL/LDL blood cholesterol, has potential as a nutraceutical beverage ingredient. The main bioactive compound of the extract is aspalathin, a C-glucosyl dihydrochalcone. The study aimed to determine the effect of common iced tea ingredients (citric acid, ascorbic acid, and xylitol) on the stability of GRE, microencapsulated with inulin for production of a powdered beverage. The stability of the powder mixtures stored in semi-permeable (5 months) and impermeable (12 months) single-serve packaging at 30 C and 40 C/65% relative humidity was assessed
Sperm DNA fragmentation: A new guideline for clinicians
(Korean Society for Sexual Medicine and Andrology, 2020) Leisegang, Kristian; Agarwal, Ashok; Majzoub, Ahmad A.
Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative stress) mechanisms are implicated in the etiology of sperm DNA fragmentation (SDF), which affects both natural and assisted reproduction. Several clinical and environmental factors are known to negatively impact sperm DNA integrity. An increasing number of reports emphasizes the direct relationship between sperm DNA damage and male infertility. Currently, several assays are available to assess sperm DNA damage, however, routine assessment of SDF in clinical practice is not recommended by professional organizations.
Tongkat Ali as a Potential Herbal Supplement for Physically Active Male and Female Seniors—A Pilot Study
(John Wiley & Sons Ltd, 2013) Henkel, Ralf; Wang, Ruxiang; Bassett, Susan; Chen, Tao; Liu, Na; Zhu, Ying; Tambi, Mohd
Tongkat Ali (Eurycoma longifolia; TA) is known to increase testosterone levels and alleviate aging males’ symptoms. This study aimed at investigating TA as an ergogenic supplement for elderly people. Thirteen physically active male and 12 physically active female seniors (57–72 years) were supplemented with 400-mg TA extract daily for 5 weeks. Standard hematological parameters were taken. In addition, the concentrations of total and free testosterone, dihydroepiandrosterone, cortisol, insulin-like growth factor-1, and sex hormone-binding globulin were analyzed. As additional biochemical parameters, blood urea nitrogen and creatine kinase as parameters of kidney function and muscle damage, respectively, as well as the muscle strength by a simple handgrip test were determined. After treatment, hemoglobin, testosterone, and dihydroepiandrosterone concentrations, and the ratio of total testosterone/cortisol and muscle force remained significantly lower in female seniors than in male seniors. Hematocrit and erythrocyte count in male seniors increased slightly but were significantly higher than in female seniors. Treatment resulted in significant increases in total and free testosterone concentrations and muscular force in men and women. The increase in free testosterone in women is thought to be due to the significant decline in sex hormone-binding globulin concentrations. The study affirms the ergogenic benefit of TA through enhanced muscle strength
Unani Tibb practitioners’ perceptions and attitudes towards spirituality and spiritual care in Unani Tibb practice in South Africa
(BMC, 2023) Hoosen, Mujeeb; Roman, Nicolette Vanessa; Mthembu, Thuli Godfrey
Unani Tibb is an Arabic term which means Greek medicine. It is an ancient holistic medical system based on the healing theories of Hippocrates, Galen and Ibn Sina (Avicenna). Despite this, spirituality and spiritual care practices are deficient in the clinical setting. This cross-sectional descriptive study was used to describe Unani Tibb practitioners’ perceptions and attitudes regarding spirituality and spiritual care in South Africa. A demographic form, Spiritual Care-Giving Scale, Spiritual and Spiritual Care Rating Scale and Spirituality in Unani Tibb Scale were used to collect data. A response rate of 64.7% (n = 44 out of 68) was achieved. Positive perceptions and attitudes regarding spirituality and spiritual care were recorded for Unani Tibb practitioners. The spiritual needs of their patients were considered vital towards enhancing the Unani Tibb treatment approach. Spirituality and spiritual care were regarded as fundamental to Unani Tibb therapy. However, most practitioners agreed that adequate training in spirituality and spiritual care was lacking and future training initiatives were imperative for Unani Tibb clinical practice in South Africa.

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