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December, 2021 - VOL. 27, NO. 12  December, 2021
Ayurvedic Management of Hyperprolactinemia Secondary to Pituitary Microadenoma: A Case Report
Hemavathi Shivapura Krishnarajabhatt, BAMS, MD (Ayu);  Anjaly Muraleedharan, BAMS, MS (Ayu);  Parvathy Unnikrishnan, BAMS, MS (Ayu)
Hyperprolactinemia is a relatively common diagnosis to be expected in an adolescent age group with chronic menstrual disturbances. The present case report documents the efficacy of Ayurvedic management in a 21-year-old female with secretory pituitary microadenoma, which was found to be responsible for menstrual disturbances. The patient, with high prolactin levels with pituitary microadenoma, was subjected to an Ayurvedic management protocol, including Shamana nasya for 7 days followed by Shamana Cikitsa for 3 months. Patient follow-up was 6 months in duration. The clinical presentation of this case points towards the diagnosis of Asrgdara in Ayurveda. This is the first such case documented where Ayurveda was used as the intervention in a case of pituitary microadenoma with hyperprolactinemia, resulting in the complete absence of microadenoma and normalization of the prolactin level.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Lycopene-enriched, Organic, Extra Virgin Olive Oil on Benign Prostatic Hyperplasia: A Pilot Study
Ángel Abengozar, MD;  Luis Blanco, Lic Sc;  Cristina Carrasco, PhD;  Ana Beatriz Rodríguez, PhD
Context • Epidemiological evidence has shown that lycopene consumption may be effective in both the prevention and treatment of various diseases, particularly prostate cancer. However, the influence of this dietary carotenoid on some of the most basic aspects of human health remains unknown. Objectives • The aim of the study was to determine the effects of consumption of a lycopene-enriched commercial product of organic, extra virgin olive oil (EVOO) on prostate health, sleep quality, antioxidant status, and anxiety. Design • The research team designed a pilot study with two intervention groups. Setting: The study took place in the city of Badajoz (Extremadura, Spain). Participants • Participants were 20 men aged =50, some of whom were healthy and some of whom had received a diagnosis of benign prostatic hyperplasia. Intervention: Participants were divided into a healthy-men (HM) group (n = 10) and a benign prostatic hyperplasia (BPH) group (n = 10). Both groups consumed 20 ml of lycopene (0.4 mg/ml) daily in a lycopene-enriched commercial product of organic extra virgin olive oil, at breakfast and/or lunch, for 30 days. Outcome Measures • Sleep quality, prostate markers—prostatic specific antigen and protein C reactive—and symptomatology, urine total antioxidant status, and emotional health were assessed at baseline and postintervention. Results • The level of prostatic specific antigen and symptomatology remarkably improved in men with benign prostatic hyperplasia, although the changes wasn’t statistically significant, and the total antioxidant status was significantly increased in healthy men (P < .05). Sleep quality in terms of nocturnal activity was significantly improved in both groups (P < .05). No adverse events were reported. Conclusion • The consumption of a lycopene-enriched, organic, EVOO positively influenced prostate health and other physiological variables. These findings may help to advance the development of new preventive and/or chemotherapeutic strategies based on lycopene.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Attitudes and Knowledge of Community Pharmacists Toward Complementary and Alternative Medicine: A Narrative Review
Kevin Clayton, BPharm;  Yoni Luxford, PhD;  Ieva Stupans, PhD
Context • The use of complementary and alternative medicine (CAM) in Australia is widespread, and self-treatment with CAM often occurs. Community pharmacies are a major supplier of CAM in Australia; consequently pharmacists may be approached by consumers in relation to self-treatment. Objectives • The study intended to appraise peer-reviewed literature regarding the supply of CAM in retail pharmacies and pharmacists’ knowledge and attitudes in relation to it. Design • The research team performed a narrative review of peer-reviewed studies published between January 1997 and December 2017. Four electronic databases—Web of Science, ScienceDirect, CINAHL, and PubMed—were systematically searched using keywords. A search strategy was devised using 4 keywords: knowledge and attitude, complementary and alternative medicine, stress, and pharmacist. English-language, full-text studies were sought, and the team considered only the results of studies conducted in Australia or in countries with similar healthcare systems. Setting • The study is a literature study. Results • Performance rankings were considered, with 10 studies being identified. Pharmacists were generally positive about CAM; however, they displayed a degree of uncertainty, particularly about efficacy and safety, that pointed toward a lack of confidence and a desire for better education. Knowledge, both self-rated and assessed, was lacking. Few studies explored the use of CAMs for specific physical-health conditions and fewer still addressed mental health. Conclusions • Pharmacists are ideally placed to interact with consumers and are often the first point of contact for those people wanting to self-treat. Pharmacists may lack the necessary practice knowledge and skills to appropriately advise consumers about CAM or about those conditions where self-treatment products fall predominantly into the CAM category, such as for stress.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Clam Extract Decreases Nasal Symptoms and Improves Sleep Quality after Septoturbinoplasty
Szu-Chi Chen, MD;  Chun-Yen Ke, PhD;  Ru-Ping Lee, RN, PhD;  Lieber Po-Hong Li, MD, PhD
Context • Nasal septal deviation (NSD) causes nasal blockage, which results in lower sleep quality among patients. A high percentage of patients still suffer from nasal symptoms as a result of the inflammatory response that occurs with septoturbinoplasty. Freshwater clams are a common food with an anti-inflammatory effect and have been used for promoting liver function for patients in China. Objectives • The study intended to evaluate the effects of clam extract (CE) in reducing inflammatory response, alleviating nasal blockage, and improving sleep quality for NSD patients after septoturbinoplasty. Design • The study was a randomized, controlled pilot that used a prospective design. Setting • The study took place at the Cheng Hsin General Hospital in Taipei, Taiwan. Participants • Participants were 52 patients with NSD at a clinic at the hospital. Intervention • Patients were randomly assigned to 2 groups: (1) an intervention group that received CE capsules and (2) a control group that received empty capsules that were identical in appearance to the CE capsules. Participants received the treatments 3 times a day for 2 weeks after septoturbinoplasty. Outcome Measures • Participants were assessed for nasal-symptom severity, wound inflammation, serum concentration of tumor necrosis factor alpha (TNF-a), and sleep quality. All outcome measures were undertaken at baseline, on various days during the study depending on the measure, and postintervention on day 14 for wound assessment and sleep quality. Results • After the septoturbinoplasty, the intervention group had lower nasal-symptom severity, wound inflammatory response, TNF-a concentration, and sleep disruption than those in the control group (P < .05). Conclusions • After septoturbinoplasty, CE can reduce nasal-symptom severity and inflammatory response and also improve patients‘ sleep quality. The anti-inflammatory effects of CE indicate that it can be considered to be an adjuvant therapy to improve sleep quality after surgery.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Feasibility of Yoga to Improve Symptoms in Individuals With Severe, Chronic Traumatic Brain Injury: A Mixed-Methods Case Series
Ileana Herrin, MS, OTR/L;  Amirah Pittman, MOT, OTR/L;  Pey-Shan Wen, PhD, OTR/L
Context • People with severe traumatic brain injury (TBI) experience lifelong sequelae that affect physical, cognitive, and mental health. In other populations, yoga has shown potential to alleviate insomnia, pain, and depression and to improve cognition. Objective • The study intended to investigate the feasibility of a six-week, group-yoga intervention for adults with severe chronic TBI, focusing on sleep, pain, mood, and executive function. Design • The research team performed a feasibility study using a mixed-methods, case-series design. Setting • The study recruited participants by distributing flyers to local communities and TBI support groups. Participants • Participants were two people with severe, chronic, TBI. Intervention • The intervention was a six-week course of group yoga, with 70-minute classes twice a week. Outcome Measures • The study assessed outcomes at baseline and postintervention using validated measures to assess executive function, mood, sleep, and pain: the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Neuropathic Pain Scale (NPS). A semistructured interview was conducted during the week postintervention to obtain qualitative data. Results • The study had a 100% retention rate, a 91.67% attendance rate, and high satisfaction. One participant demonstrated improvement in all outcomes, while the other showed mixed results. Depression showed the most consistent improvement, 47.2% on average. For insomnia, one participant showed improved sleep at 14.29%. The qualitative data demonstrated positive changes in cognition, mood, sleep, and pain. Conclusions • A six-week group yoga intervention is feasible and appears to be beneficial in alleviating symptoms, especially depression and insomnia, in people with severe chronic TBI. A longer intervention period was suggested by the participants.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Traditional, Complementary and Alternative Medicine in Dermatology: A Scientometric Literature Review
Engin Senel, MD
Introduction • Scientific literature lacks a scientometric analysis of traditional, complementary and alternative medicine (TCAM) for dermatology. The aim of this study is to investigate the associations between TCAM and dermatology as seen in academic literature published between 1975 and 2018. Methods • All materials analyzed in this study were collected from 3 major academic databases, namely Web of Science, PubMed and Scopus, and all documents assessed were published between 1975 and 2018. A keyword string of “dermatology” AND (“complementary medicine” OR “alternative medicine” OR “traditional medicine” OR “integrative medicine”) was used to search the databases. Results • A total of 316 articles were retrieved from Web of Science, 388 from Scopus and 389 from PubMed. Original articles represented 92.208% of all literature found. In addition, the USA had the highest number of publications with 61 documents, followed by the UK, China and Germany, while only three developing countries were represented in the group of most productive countries. Notably, low income countries were not represented in the list of countries with the highest volume of publications. Of all the institutions in the most represented countries, the University of Oxford was found to be the most productive. The most used keywords in the literature were noted to be “dermatology”, “alternative medicine”, “traditional medicine” and “psoriasis”. Conclusion • In view of the underrepresentation of low income developing countries in the productive group, it is suggested that researchers from these countries should be supported to produce novel TCAM studies in dermatology.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effect of Oral Care with Black Mulberry Syrup on Oral Mucositis in Patients With COPD: A Mixed Study
Songül Karadag, RN, PhD;  Sevda Korkut, RN, PhD;  Salih Levent Çinar, MD
Background • Oral mucositis often affects the quality of life of patients living with Chronic Obstructive Pulmonary Disease (COPD). Its symptoms include loss of oral mucous membranes, ulceration, bleeding and pain as well as bacterial, fungal and viral infections of the oral mucosa. Objectives • This study was carried out to investigate the effect of oral care with black mulberry syrup on oral mucositis healing in patients with COPD. Design • This mixed study was carried out in two stages– quantitative and qualitative. The quantitative stage was conducted as a randomized controlled experimental study while the qualitative stage was conducted by in-depth interview method. Setting • This study was conducted at the chest diseases clinic of a tertiary hospital in Turkey. Participants • The randomized controlled experimental study was completed with a total of 40 patients who had been diagnosed with COPD and oral mucositis between March 2017 and June 2018. They were divided into intervention and control groups consisting of 20 patients each. The qualitative study was conducted on 10 patients in the intervention group. Intervention • Patients in the intervention group gargled with 5 ml of black mulberry syrup for an average of 1 minute and swallowed it upon completion. They did this 3 times a day after meals for a period of 15 days after which they were interviewed. Outcome Measures • The quantitative data was collected using the Patient Information Form, Oral Evaluation Guideline, and WHO Oral Mucositis Scoring Index, while the qualitative data was collected using the in-depth interview form. Patients’ oral mucosa was assessed a total of 3 times during 3 interviews held on the first, seventh and fifteenth days of the study. Results • There was a significant decrease in scores of oral mucositis of the patients in the intervention group at the second and third follow-ups. Oral mucositis of the intervention and the control groups healed at an average of 9.1 ± 2.5 days and 12.1 ± 1.4 days, respectively. In addition, oral care with black mulberry syrup was found to alleviate mucositis-related symptoms. Conclusion • Oral care with black mulberry syrup accelerates mucositis healing and alleviates mucositis-related symptoms.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Acute Effects of Cold Pack for Different Periods on the Biomechanical Properties of the Rectus Femoris Muscle
Nuray Alaca, PhD;  Nilüfer Kablan, PhD
Context • Cold packs are silica gel packs that are commonly used in clinics. However, the packs are applied for various amounts of time, and the relationship between these times and temperature changes isn’t fully understood. Objectives: The study intended to investigate the acute effects of cold-pack application for different periods of time on the biomechanical properties of the rectus femoris muscle. Design • The study was randomized, controlled trial. Setting • The study took place at Acibadem Mehmet Ali Aydinlar University in Istanbul, Turkey. Participants • Participants were 60 healthy volunteers from the community, aged 18 to 23 years. Interventions • Participants were divided into four groups with n = 15 in each group. The cold packs were applied on the dominant rectus femoris muscle: (1) for 10 minutes in Group 1, (2) for 12 minutes in Group 2, (3) for 15 minutes in Group 3, and (4) for 20 minutes in Group 4. Outcome Measures • The outcome measures were the skin temperature, determined using a thermal camera, and biomechanical properties—tone and stiffness and muscle decrement—using a device that delivers a short mechanical impulse to the tissue. Outcomes were measured at baseline before the cold application, immediately post intervention after the cold application, and at 5, 10, 15, 20, and 30 minutes post intervention. Results • The mean skin temperatures were significantly lower in all groups compared to those before cold application (P < .05), and no significant differences existed between any of the groups (P > .05). Post intervention, while Groups 1 and 2 showed an increase in muscle tone and stiffness and a decrease in elasticity (P < .05), they began to approach their baseline state by the fifth and fifteenth minutes, respectively (P > .05). In Groups 3 and 4, the muscle stiffness increased at all time points (P < .05). Conclusions • The study showed that the rectus femoris muscle of healthy people becomes stiffer and less elastic as a result of cooling with cold packs that were applied for different time periods. The amount of cold-pack time that minimized the biomechanical corruption of the muscle and provides cooling was 10 minutes. Careful warming up is recommended before and after intense athletic performance, and caution in cooling the skeletal muscle should be exercised.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Major Ozone Autohemotherapy on Physical Functionality and Quality of Life in Fibromyalgia Syndrome: A Prospective Cross-sectional Study
Mesut Bakir, MD;  Gülçin Gazioglu Türkyilmaz, MD;  Sebnem Rumeli, MD, PhD
Context • No specific treatment exists for fibromyalgia syndrome (FMS), and usually patients continue to experience pain indefinitely and their quality of life decreases. Major ozone autohemotherapy (MAH) is a complementary treatment for FMS that stimulates the body’s antioxidant system. Objective • This study aims to prospectively evaluate the effects of MAH on pain, quality of life, and general health status in FMS. Design • The research team designed a prospective cross-sectional study. Setting • The study took place at the algology clinic at Mersin University in Yenisehir, Mersin, Turkey. Participants • Participants were 40 patients with FMS, aged 18 to 65, who were admitted to the clinic between February 15 and August 15, 2019. Intervention • Participants completed 13 sessions of major ozone autohemotherapy (MAH), two sessions per week in the first five weeks and one session per month for the remaining three months. In the following three months, the last administered dose was repeated. Outcome Measures • Patients completed the Fibromyalgia Impact Questionnaire (FIQ) and the Quality of Life-short form (SF-36), at baseline (PRE), at five weeks after 10 sessions of MAH (PT), at 9 weeks after 11 sessions (PT1), and postintervention at 17 weeks after 13 sessions (PT3). Results • Significant improvement in FIQ and SF-36 scores was observed in all periods compared to the previous period (P < .05). Between two consecutive measurements the most prominent improvements in both FIQ scores (P < .001) and SF-36 scores was observed between baseline and the PT period (P < .001). Significant improvement also occurred in all SF36 subscale scores between PT and PT3 (P = .02). Conclusions • The study was the first to demonstrate the efficacy of MAH for fibromyalgia patients as found using FIQ and SF-36 questionnaires repeated at certain intervals. The study found that MAH provided improvements in quality of life and general health status for FMS patients.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Qigong Exercise on Physical and Cognitive Performance in Young Sedentary Females: A Quasi-Experimental Design, Placebo-Controlled Study
Martin Burtscher, MD, PhD;  Kultida Klarod, PhD;  Suphannika Ladawan, PhD;  Sanita Singsanan, PhD;  Niramon Thamaviriyasati, PhD
Background • Qigong exercise represents one type of traditional Chinese exercise that might positively affect physical and psychological functioning, slow down disease development and improve quality of life. However, study findings are somewhat conflicting and mechanisms contributing to expected beneficial effects are rather poorly known. Objective • This study aims to evaluate the effects of qigong exercise training for 8 weeks on selected physical, cognitive, and biochemical outcomes in young sedentary females. Method/Design • Quasi-experimental design, placebo-controlled study. Setting • The study was performed at the Department of Physical Therapy, Faculty of Allied Health Science, Burapha University, Bangsean, Chonburi province, Thailand. Participants • Participants were 41 females with sedentary lifestyles. Interventions • 41 sedentary females were allocated to qigong exercise (QG, n = 20) or to the control group (CG, n = 21). Primary Outcome Measures • VO2 max predicted from step testing, aspects of cognitive functions (e.g., digit span forward, DSF, and digit span backward, DSB, task), hematological and biochemical parameters, and body composition were assessed in both groups before and after the 8-week training period. Results • Physical performance (estimated VO2 max) significantly increased after qigong training compared to the CG (P < .001). Working memory (DSB) increased after intervention only within the QG (P = .009) but changes did not reach significance between the groups. Changes in neutrophils (potential mediators of inflammation) tended to be improved in the QG in comparison to the CG (P = .075). Body composition remained unchanged. Conclusion • These findings indicate that 8 weeks of qigong training increased aerobic capacity and tended to improve working memory in otherwise sedentary young females. Neutrophils tended to decrease within the QG. Thus, it was speculated that enhanced oxygen supply to the brain and the decrease of neutrophils adhering to cortical capillaries might have contributed to improved cognitive function.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effect of Acupressure Applied to Sanyinjiao (SP6) on Primary Dysmenorrhea
Yeliz Dincer, PhD;  Umran Oskay, PhD
Context • With the technological developments and advancement of scientific knowledge in the field of health, healthcare professionals are now expected to identify strategies for the use of complementary therapies and to guide healthy and ill individuals in their correct and effective use. Acupressure—a simple, effective, safe, and economical therapy—may reduce the pain caused by dysmenorrhea. Objective • The aim of the study was to determine the benefits of acupressure applied to the Sanyinjiao (SP6) acupressure point for treatment of primary dysmenorrhea. Design • The research team designed a randomized controlled trial. Setting • The study took place at the Health Services Vocational School at Duzce University in Duzce, Turkey. Participants • Participants were 67 students with dysmenorrhea, who were studying business administration at the university between October 2016 and January 2018. Intervention • Participants were randomly assigned to one of two groups, in compliance with the study’s criteria. The acupressure group pressed the SP6 acupressure point on each leg once a day for 10 minutes, for the first three days of each menstrual period for three months. The students in the acupressure and placebo group have been followed up for a total of four cycles. The participants in the acupressure group have been advised to press to the SP6 acupressure point for ten minutes every day on each leg for the first three days of each menstruation period for three months; the participants in the placebo group have been recommended to scrub the sham-acupressure point for ten minutes every day on each leg for the first three days of each menstruation period for three months. Within the last month(Month 4), evaluation forms have been applied without any further practices. The control group rubbed a false acupressure point on each leg once a day for ten minutes, for the same period. Outcome Measures • A diagnostic form was used to collect the study’s data and to determine participants’ demographic characteristics. A visual analogue scale (VAS) and the Brief Pain Inventory (BPI) were used to evaluate dysmenorrhea pain. A satisfaction form was used to evaluate participants’ satisfaction. Results • On the VAS, the severity of pain was lower in the acupressure group than in the control group. On the BPI, the scores were lower and the pain caused less discomfort in the acupressure group than in the control group. Moreover, both groups were satisfied with the practices. Conclusions • Acupressure can be used as an effective and reliable method for the management of primary dysmenorrhea.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Is Musical Auditory Stimulation Able to Influence the Recovery of Autonomic Modulation After Exercise?
Luana Almeida Gonzaga, MSc;  Vítor Engrácia Valenti, PhD;  Anne K. França Da Silva, PhD;  Rayana Loch Gomes, PhD;  Rafael Luiz de Marco, MSc;  Luiz C. Marques Vanderlei, PhD;  Sany Martins Pérego, BSc;  Felipe Ribeiro, MSc
Context • The effects of musical auditory stimulation on the human body have received considerable interest, especially when related to health and wellbeing, so the objective was to verify the influence of classical music exposure on autonomic modulation in recovery after exercise. Methods • 35 healthy young men aged 21.74 ± 2.59 years were evaluated. Volunteers perform 2-day evaluations, 1 day without musical stimulus and 1 with musical stimulation through classical music during exercise and recovery. Physical exercises were performed on a treadmill with an intensity of 6.0 km/hr + 1% of inclination in the first 5 minutes for physical “warm-up”, followed by 25 minutes with an intensity equivalent to 60% of the maximum velocity (Vmax), with a same slope according to the Conconi’s threshold. Finally, the volunteers remain at rest for 60 minutes for recovery. Heart rate variability (HRV) was analyzed in some moments of recovery by linear (RMSSD, SDNN, LF and HF (milliseconds squared and normalized unit) and LF/HF ratio, RRtri, TINN and the Poincaré plot: SD1, SD2 and SD1/SD2) and nonlinear indexes (DFA Total, DFA Alpha 1 and Symbolic Analysis: Shannon’s Entropy, 0V%, 1V%, 2LV% and 2ULV%). Results • No differences were found in the comparison between the values of the HRV indexes between protocols and interaction moments vs protocols. Differences were observed between the moments for most indexes (P < .05). Conclusions • Classical music did not significantly influence the autonomic control of heart rate in the recovery phase after submaximal exercise.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Fibromyalgia: A Report of 2 Cases Treated With Homeopathy
Vipul Gandhi, MD
Fibromyalgia is a chronic condition that is characterized by widespread pain and a multitude of other symptoms, including fatigue, sleep disturbances, cognitive dysfunction, stiffness, and depressive episodes. Fibromyalgia is most common in women, though it can occur in men as well. It most often starts in middle adulthood but can occur in the teen years and in old age. Fibromyalgia has also been termed central pain amplification disorder, meaning the volume of pain sensation in the brain is turned up too high. This study has been conducted to evaluate the role of homeopathic treatment in fibromyalgia, a chronic pain disorder which a physician may come across fairly commonly in their practice. Homeopathy has demonstrated great efficacy in mitigating the symptoms of widespread pain, sleep disturbance, and fatigue, which are the most commonly reported symptoms of fibromyalgia.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Progress in the Study of Epidemiologic Characteristics and Influencing Factors of Asymptomatic Malaria Infection in Africa
Yun Bai, MBBS;  Jing Chen, MBBS;  Zheng-xin He, MBBS;  Fu-Kun Wang, MBBS
Malaria is caused by protozoan parasitic Plasmodium infections. Plasmodium falciparum is common in Africa; P ovale, P malaria and P vivax infections are less prevalent and globally confined, contributing to major causes of global mortality and morbidity, particularly in children in sub-Saharan African countries. In 2018, the total incidence of malaria increased from 221 million to 229 million, with an estimated 503 000 deaths reported. Sub-Saharan Africa has the highest number of cases of malaria and highest mortality rate compared with other countries, like southeastern Asia, east Pacific, western, and America with an estimated 213 million cases. In addition, continuous exposure to Plasmodium parasites results in the production of partial immunity to guard against more problems, resulting in asymptomatic carriers. The diagnosis of asymptomatic malaria is not simple because of the apparent absence of clinical factors and sometimes low levels of parasites. The most basic concept appears to be parasitemia and a lack of malaria signs, primarily fever (axillary temperature <37.5° C). Thus, a better awareness of asymptomatic malaria epidemiology in affected countries will help improve strategies to reduce the local burden of malaria and its health consequences. Therefore, the objective of this study was to determine the magnitude of asymptomatic malaria pathology and related risk factors with epidemiologic characteristics in individuals on the African continent.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Valsalva Maneuver, EMLA Cream, and Stress Ball for Pregnant Women’s Venipuncture Pain
Gökhan Dogukan Akarsu;  Rukiye Höbek Akarsu, PhD;  Betül Kus, PhD
Context • Peripheral intravenous catheter (PIVC) practice is a common invasive procedure used in the diagnosis and treatment of pregnant women admitted to the hospital. Difficulties experienced during PIVC application are among the most common problems encountered in a medical facility. Objective • The study intended to evaluate the effects of the Valsalva maneuver, the application of eutectic mixture of local anesthetics (EMLA) cream, and use of a stress ball in controlling the pain and discomfort that developed due to PIVC administration for pregnant women. Design • The research team designed the study as a randomized, controlled, single-blind trial. Setting • The research took place at the obstetrics clinic at the Practice and Research Hospital at Yozgat Bozok University in Yozgat, Turkey, between January 2019 and February 2020. Participants • Participants were 120 pregnant women who visited the obstetrics clinic and were admitted to the maternity ward of the hospital during that time. Intervention • Participants were divided into four groups of 30 women each: (1) the Valsalva maneuver group, (2) the EMLA group, receiving an application of the cream, and (3) the stress-ball group, and (4) the control group. Outcome Measures • Data were collected through the use of a pregnancy information form and a visual analog scale. In the assessment of the data, variance analysis was used with the Kruskal Wallis and Dunn test. Results • Only the pain scores of the Valsalva maneuver group were found to be significantly lower than those of the control group, whereas the pain scores of the EMLA and stress-ball groups were similar to those of the control group. Conclusions • The current study can generate awareness in pregnant women in terms of choosing between pharmacological and nonpharmacological practices that nurses use during PIVC insertion. As the only randomized controlled blind study that has been performed on the topic, the current study offers nurses evidence of a way to reduce PIVC pain in pregnant women.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effect of Body Acupressure on Blood Pressure and Fatigue Levels in Individuals Suffering From Hypotension During Hemodialysis: A Randomized Controlled Trial
Sevil Biçer, PhD;  Sultan Tasci, RN, PhD
Background/Aim • Since hypotension is one of the most common complications experienced during hemodialysis (HD), and there are studies indicating that stimulation of the P6 (Neiguan) acupuncture point affects blood pressure, this study examines the effect of acupressure performed on this point on blood pressure regulation as well as its effect on symptoms such as hypotension-associated fatigue and pain. This randomized controlled trial was conducted in order to determine the effect of 12-session body acupressure, performed by electrostimulation device, on blood pressure, headache, and fatigue level in individuals suffering from hypotension during hemodialysis. Methods • The study was conducted with a total of 135 patients, including 67 patients in the intervention group and 68 patients in the placebo group at four hemodialysis centers located in two city centers. The data were gathered using a questionnaire, visual analog scale (VAS) for pain and fatigue, and the Piper fatigue scale. The forms were administered at the beginning of the application (first follow-up) and four weeks later (second follow-up). In the intervention group, the electrostimulation device was attached to the Neiguan (p6) acupuncture point and operated at the third hour of each dialysis session three times a week for one month. In the placebo group, the device was attached to the same acupuncture point but its batteries were removed and it was not operated. At the end of the four-week application, the forms were administered again. One-way analysis of variance, t test, Student-Newman-Keuls test, Pearson correlation analysis, Chi-square, McNemar test and McNemar Bowker test were used to assess the data. Results • It was found that systolic and diastolic blood pressure levels were higher in all sessions in the intervention group compared to the placebo group (P < .05). In the first follow-up, no difference was observed between the groups in terms of the scores of VAS pain, VAS fatigue, and Piper fatigue scale (P > .05); whereas, in the second follow-up, it was determined that VAS pain scores, VAS fatigue scores, and affective, sensory, and total scores of the Piper fatigue scale decreased in the intervention group compared to the placebo group (P < .05). Conclusions • As a conclusion; it was found that body acupressure, which was performed on the Neiguan (P6) acupuncture point using electrostimulation device, provided the systolic and diastolic blood pressure regulation and decreased VAS pain severity, VAS fatigue severity, and total score and subscale mean Piper fatigue scale scores.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Adjunctive Treatment of Pediatric Adenoidal Hypertrophy: A Review
Murat Çetkin, PhD;  Hatice Esra Çetkin, PhD
Context • Adenoids play an important role in the protection of the upper respiratory tract against pathogens. Nonphysiological enlargement of adenoids is defined as adenoid hypertrophy (AH). In treating AH, physicians prefer medical therapy and often disregard adjunctive methods. Studies on the effects of adjunctive methods on adenoid tissue are quite scarce. Objective • The current review aims to examine the clinical studies that have investigated adjunctive methods—nasal irrigation, herbal therapy, bacteriotherapy, and halotherapy—used to treat AH and its associated symptoms and to evaluate their effectiveness in pediatric patients. Design • The research team performed a narrative review by searching seven electronic databases (Pubmed, Cochrane Library, Google Scholar, Web of Science, EMBASE, Science Citation Index and Elsevier) were used for the literature search. The search used the keywords adenoid hypertrophy, adjunctive treatment, nasal irrigation, herbal medications, bacteriotherapy and halotherapy. Setting • This study was took place in Department of Anatomy, Medicine Faculty, Istanbul Medeniyet University. Results • The nasal irrigation with hypertonic solution decreased to size of enlarged adenoid tissue. The bacteriotherapy used with nasal spray and tablet form decreased to surgery rate and adenoid size.The adenoid and/or tonsillar hypertrophy were decreased by halotherapy used with micronized, iodized-salt aerosol. Conclusions • A review of studies on this matter indicates that the studied adjunctive methods can be used safely in the treatment of AH, either separately or in combination with conventional medical treatment. However further clinical studies are needed on this topic.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Burnout Syndrome: Therapeutic Approach With Beneficial Effects on Personality and Quality of Life
Mari? Adina;  Aurel Nirestean, MD, PhD;  ?tefan Cristian Vesa, MD, PhD
Context • The World Health Organization (WHO) has defined burnout syndrome (BOS) as resulting from chronic workplace stress that hasn’t been successfully managed. Until now, BOS has been treated using allopathic drugs and psychotherapy because it has been confused with major depressive syndrome. Objective • The aim of the study was to examine the effectiveness of hypnotherapy combined with cognitive-behavioral therapy in changing the personality traits and lifestyles of people in professions vulnerable to stress who have developed BOS. Design • The research team designed a one-group pre-and posttest study. Setting • The study was conducted in a private-practice office in Targu Mures, Romania. Participants • Participants were 30 patients at the private practice who had been diagnosed with BOS and volunteered to participate in the study. Intervention • The study alternated hypnotherapy sessions with psychological-counseling sessions, using a general therapeutic plan for all patients and customizing the plan for each participant. Outcome Measures • The study measured participants’ BOS symptomatology and personality dimensions using the Maslach Burnout Inventory (MBI), the DECAS Personality Inventory, the Personality Inventory for DSM-5 (PID5), and the Survey of Work Styles (SWS). Results • Significant changes occurred between baseline an postintervention in the dimensions of extraversion, agreeability, and emotional stability as well as impatience, anger, work involvement, time urgency, job dissatisfaction, and competitiveness. Significant differences existed in almost all personality traits evaluated with the PID-5 (P < .05). Conclusions • The combination of hypnotherapy and psychological counseling can treat BOS, increasing patients’ quality of life by decreasing negative personality traits. The present study is important because it proposes a new therapeutic approach to BOS.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Red Pepper, Ginger, and Turmeric on Energy Metabolism: Review of Current Knowledge
Nilüfer Acar Tek, MSc, PhD;  Mehmet Arif Icer, MSc
Context • Energy metabolism is the main determinant of obesity etiology. Consumption of some spices, such as red pepper, ginger, and turmeric, can be considered to be an environmental factor affecting energy metabolism. Objective • This review aimed to examine the effects of red pepper, ginger, and turmeric on weight control, weight loss, and energy metabolism. Design • The research team performed a narrative review by searching the Google scholar, Scopus, PubMed, ResearchGate, Web of Science, and Science Direct databases. The search used the keywords red pepper, ginger, and turmeric in combination with energy metabolism, energy expenditure, energy balance, thermogenesis, anti-obesity, weight management, weight control, weight loss, metabolic rate, and oxygen consumption, without considering any time limitation. Setting • This study has been carried out in Ankara / Turkey. Results • Red pepper, ginger, and turmeric affect energy metabolism through various mechanisms. Dietary red pepper and its pungent principle capsaicin affects satiety and has a promising thermogenic influence. Ginger has positive effects on weight control, obesity prevention, and energy metabolism. In addition, curcumin inhibits the conversion of preadipocytes to mature adipocytes. Conclusions • Red pepper, ginger, and turmeric affect energy metabolism using mechanisms related to thermal effect, BMR, total energy expenditure, oxygen consumption, and lipid oxidation. These spices haven’t been assigned appropriate doses and periods of use, and no definite judgments can be made on their use. Therefore, it’s necessary to conduct further randomized controlled research to reach absolute conclusions and determine by which mechanisms these spices show this effect on energy metabolism.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Anthocyanin Supplementation Alleviates Antithrombotic Risk by Inhibiting Platelet Activity in Humans
Natalie Colson, PhD;  Almottesembellah Abdalruhman Gaiz, MB, ChB, PhD(c);  Avinash R Kundur, PhD;  Elham Nikbakht, PhD;  Sapha Shibeeb, PhD;  Indu Singh, PhD;  Lada Vugic, PhD
Background • Platelet hyperactivity has a crucial role in initiating vascular thrombosis and subsequent cardiovascular disease (CVD). Objective • This study aimed to assess the effect of anthocyanins (AC) on platelet aggregation and activation and lipid profile. Study Design • A total of 26 healthy participants consumed 320 mg of AC/day in the form of Medox® capsules for 28 days. Setting • This study was conducted in the laboratories of the School of Medical Sciences, Griffith University, Gold Coast, Australia. Participants • A total of 26 randomly recruited healthy 25- to 75-year-old participants completed this study. Primary Outcome Measures • Fasting blood samples were collected pre- and post-the intervention period to perform platelet activation studies by measuring platelet surface marker expression of CD41a and P-selectin, and platelet-monocyte aggregates in adenosine diphosphate (ADP) stimulated platelets. Platelet aggregation studies were performed by stimulating platelets with various agonists such as ADP, collagen and arachidonic acid. Full blood examination, coagulation and biochemistry profile analyses were also performed pre- and post-intervention. Flow cytometric analysis showed a significant effect of AC on the expression of P-selectin as measured by the platelet surface expression of CD62p. Results • There was a significant reduction of ADP-stimulated platelet aggregation. Hematologic analysis showed a significant reduction of mean platelet volume, mean cell hemoglobin, and mean cell hemoglobin concentration. Coagulation analysis demonstrated significant attenuation of fibrinogen level in the blood. Conclusion • This study showed inhibition of platelet activity, platelet aggregation and mean platelet volume (MPV). These results suggest that AC has a positive impact on attenuating platelet activity, which might minimize thrombotic risk.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Reflexology on Pain, Fatigue, and Quality of Life in Multiple Sclerosis Patients: A Clinical Study
Hatice Dilek Dogan, PhD;  Mehtap Tan, PhD
Context • Multiple Sclerosis (MS), occupies the first row among the diseases which leads to loss of neurological ability without depending on a trauma in the adults. Reflexology is one of complementary therapies based on activating a body’s power to recover itself by special hand techniques applied to feet and hands. Positive changes in spasticity, pain, fatigue, depression, cortisol levels, anxiety, and blood pressure levels have been observed in MS patients after reflexology. Objectives • This study was conducted to determine the effect of reflexology on pain, fatigue and quality of life in MS patients. Design • The study was conducted experimentally by taking pretest and repeated measurements on reflexology and control groups determined by simple randomization. Setting • The study took place in the neurology clinics at two university hospitals in Turkey. Participants • Potential participants were 685 patients at the clinics who had been diagnosed with MS 6 months at least prior to the study. Of that group, 66 patients were included in the study, 33 in the intervention group and 33 in the control group Intervention • Reflexology was applied on each patient in the intervention group for 3 sessions a week for 12 weeks, and weekly pain and fatigue and monthly quality of life were evaluated. No intervention was made to the control group. Both groups received routine treatment. Outcome Measures • Measurements occurred at baseline, weekly and monthly throughout the trial, and postintervention. Pain and fatigue were evaluated weekly using a Visual Analogue Scale (VAS) and the Fatigue Severity Scale (FSS), respectively and quality of life was evaluated monthly using the Multiple Sclerosis Quality of Life-54 (MSQOL-54) scale. Results • In the intervention group, significant decreases were observed in the pain scores from the seventh week and in the fatigue scores from the fifth week (P < .001). In the assessment of quality of life, the combined physical health and combined mental health scores were found to be higher in the intervention group than in the control group (P < .001). Conclusion • The study indicates that reflexology can be used as a complementary and alternative therapy to reduce pain and fatigue and enhance quality of life in MS patients.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Cardiac Rehabilitation Perceptions Among Healthcare Providers in China: A Mixed-Methods Study
Biao Ding, BA, RN;  Sherry L Grace, PhD, CRFC, FCCS, FAACVPR;  Liwen Liang, BA, MA;  Xia Liu, RN, PhD(c);  Zhimin Xu, BA, MD;  Yaqing Zhang, PhD
Background • Cardiac rehabilitation (CR) in China has not been widely adopted for a variety of reasons, including healthcare provider (HCP)s’ lack of awareness and beliefs. Objective • To explore HCP’s perceptions of CR in China. Methods • An exploratory, sequential design was used in this mixed-methods study. Face-to-face semi-structured interviews were performed; this was followed by a cross-sectional survey. Setting • The interviews were conducted in a university-affiliated hospital and a rehabilitation hospital in Shanghai. The survey was conducted in the cardiac departments of primary, secondary, or tertiary hospitals in Shanghai or Yunnan Province, China. Participants • Saturation was achieved upon interviewing 13 HCPs (5 doctors, and 8 nurses). A total of 610 HCPs (185 doctors [30.5%], 417 nurses [68.8%]) completed the survey. Results • Analysis of the interviews revealed 4 themes: the perceived value of CR, the need for pro-CR policy, variability in CR awareness, and obstacles to CR delivery. HCP approaches to the treatment of patients with cardiac conditions did not universally include exercise training (only approximately 60% of HCPs), or all other recommended domains of secondary prevention, and assessment of the major risk factors was quite low. Familiarity with CR was moderate (48.7%). HCPs perceived that philosophies of Traditional Chinese Medicine (TCM) were highly compatible with, and could add value to, CR. HCP approaches to secondary preventive care and CR perceptions varied significantly according to their highest level of education, clinical profession, job seniority, type of hospital where they worked, whether the hospital had a CR program and the hospital’s location. Conclusion • HCPs recognize the value of CR, particularly considering secondary preventive care practices were not comprehensive. Education is needed to improve HCPs CR awareness.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effect of Herbs on Postoperative Intestinal Obstruction: A Case Report
Hai-Yong Chen, PhD, MD;  Lixing Lao, PhD;  Baoyi Shao;  Shuiyan Zhang, MD
Postoperative intestinal obstruction is one of the most common and challenging complications after patients receive pelvic or abdominal surgery. The effectiveness of conventional therapies is varied and they are associated with a high recurrence rate. Traditional Chinese Medicine can be beneficial in the treatment of intestinal obstruction. In this case, a 65-year-old woman had progressively increasing abdominal pain, distension, and constipation following total hip replacement surgery. The patient was diagnosed with partial intestinal obstruction and was treated for 6 days without success using conventional Western medicine, including Enema Glycerini and Sodium Phosphates Rectal Solution. We received a request from the surgical department for a Chinese medicine consultation. Two doses of modified Dachengqi Decoction herbal formula were prescribed for the patient. The patient had her first flatus and defecation within 2 hours after ingestion of the first dose of herbal medicine and subsequently all of the symptoms were relieved. The patient was soon discharged without any further complications; a 5-year follow-up indicated that the patient had no recurrence of intestinal obstruction. This case is the first to report the effect of a Chinese herbal decoction in achieving remission of intestinal obstruction with only 1 dose. Large scale randomized controlled trials are warranted to confirm our findings.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Aggravated Respiratory Failure From COVID-19 Infection: Patient Care Management From Nurses in the Intensive Care Unit
Ying Cao, MD;  Jianying Xiong, BD;  Hua Xu, PhD;  Shanggan Zeng, PhD
Context • About 19% of COVID-19-patients undergo hypoxic breathing problems, approximately 14% require intensive oxygen therapy, and 5% require mechanical ventilation and ICU admission. These patients can deteriorate rapidly, so nurses must closely watch them. Objective • The study intended to examine the role of emergency nurses as care providers in intensive care units (ICUs). Design • The research team performed a narrative review by searching the Mendeley, Medline, Google Scholar, ScienceDirect, Springer, and PubMed databases. The search used the keywords COVID-19 infection, epidemiology of respiratory failure pathology in COVID-19 infection, involvement of viral spike protein S of SARSCoV-2, SARS CoV2 transmission, pathophysiology of SARSCoV-2 attack-mediated ARDS, transmission of viral particles of SARSCoV-2 in lungs, mechanism of cytokines in lungs, immunomodulatory response changes in lung physiology, and involvement of nursing officer in nursing patient care management in ICU respiratory failure. Setting • This study were conducted at The First Affiliated Hospital of Nanchang University, China. Results • Nurses are necessarily not only responsible for adequate oxygen management but also for other critical health services to benefit patients, such as control of oxygen saturation and vital signs, to reduce respiratory failure in the ICU. Conclusions • The diagnosis of the root cause of respiratory failure and its treatment are complex because a variety of pulmonary and extrapulmonary conditions can cause respiratory failure. Methods of treating acute respiratory failure and other respiratory illness require a multidisciplinary, collaborative approach. Nurses are in the best position to determine patients’ risks for respiratory distress, observe them during hospitalizations, and evaluate their treatments.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Neem (Azadirachta Indica A. Juss) Capsules for Prophylaxis of COVID-19 Infection: A Pilot, Double-Blind, Randomized Controlled Trial
Mohini Barde, MBBS, MD;  Anju Bhardwaj, MD;  Nidhi Chaudhary, MD;  Asim Das, MD;  Shivani Ghildiyal, MD;  Tanuja Manoj Nesari, MD;  Anil Kumar Pandey, MD;  Galib Ruknuddin, MD;  Rajagopala ShriKrishna, MD;  Girish Soman, MTech
Context • SARS-CoV-2 is a global public-health concern. Interventions to prevent infection are urgently needed. The anti-inflammatory and antiviral effects of neem make it a potential agent for COVID-19 prophylaxis. Objective • The study intended to evaluate the prophylactic effects of neem capsules for persons at high risk of COVID-19 infection due to contact with COVID-19 positive patients. Design • The research team designed a prospective, randomized, double-blind, placebo-controlled, parallel-design study. Setting • The study was conducted at a single center in India. Participants • Participants were 190 healthcare workers at the hospital or relatives of patients with COVID-19 infection. Intervention • Of the 190 participants, 95 were in the intervention group and 95 in the control group. Participants received 50 mg of a proprietary, patent-pending, neem-leaf extract or a placebo orally in capsules, twice a day for 28 days. Outcome Measures • The number of individuals positive for COVID-19 between baseline and follow-up on day 56 was the primary outcome measure. Secondary measures included an evaluation of neem’s safety and its effects on quality of life (QOL) and changes in biomarkers. Results • The mean age of participants was 36.97 years, and 68.42% were male. Total 13 subjects tested positive during the study. All were asymptomatic. Of the 154 participants who completed the study per-protocol, 11 tested positive, 3 in the intervention group and 8 in the control group. The probability of COVID-19 infection in participants receiving the intervention was 0.45 times that of participants receiving the placebo, a relative risk of 0.45, with the effectiveness of the intervention being around 55%. Treatment-emergent adverse events (TEAEs) in both groups were minimal and were of grade 1 or 2 in severity. Biomarkers and QOL remained stable in both groups. Conclusions • The study found a reduced risk of COVID-19 infection in participants receiving neem capsules, which demonstrates its potential as a prophylactic treatment for the prevention of COVID-19 infection. The findings warrant further investigation in clinical trials.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Acupressure for Cancer-Related Fatigue in Elderly Cancer Patients: A Randomized Controlled Study
Ülkü Özdemir, PhD, RN;  Sultan Tasci, RN, PhD
Context • Fatigue is the most common symptom experienced by elderly cancer patients. It negatively affects their daily functioning and quality of life. Integrative approaches such as acupressure can be used to treat cancer-related fatigue in elderly patients. Objectives • The aim of this study was to investigate the effect of acupressure on the severity and level of cancer-related fatigue in elderly patients with cancer. Design • This study was carried out in two stages comprising a quantitative study (pretest, posttest, randomized controlled) and a qualitative study (in-depth interview). Setting • The study was conducted at the hematology and medical oncology clinic in a university hospital in Turkey. Participants • The study included 31 cancer patients aged 65 and over, who were experiencing cancer-related fatigue. Intervention • Participants were randomly assigned to the acupressure group (intervention group) or the control group. The intervention group was administered acupressure on three acupuncture points on the hands and legs (LI4, SP6, ST36) by caregivers or the patients themselves for three minutes twice daily, for a period of four weeks. The acupressure group was examined before and after the four-week intervention. The control group was similarly examined though no intervention was applied. Outcome Measures • Data were collected using Patient Information Form, Visual Analog Scale (VAS), Piper Fatigue Scale (PFS), and Acupressure Experience Patient Opinion Form. Results • In the follow-up examination of individuals in the acupressure group, there was a significant reduction in the severity and level of fatigue compared to the first examination. However, there was no significant difference between the first and second examination of individuals in the control group. The qualitative findings obtained during the in-depth interview support the quantitative findings of the study. Conclusion • Acupressure can be recommended as an integrative treatment for cancer-related fatigue because it is effective, easy to use, tolerable and does not cause serious side effects.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effectiveness of Mouthwashes With Various Ingredients in Plaque Control: A Systematic Review and Meta-Analysis
Nuha Helayl Al Waqdani, MS (Endodontics);  Mohammed Katib Alruwaili, PhD;  Khalid Nafea Alsharari, BDS;  Ibrahim Eid Alroudhan, BDS;  Mohammed Gamal, PhD;  Kiran Kumar Ganji, MDS;  Assad Mehmood Khan, FDS RCPS
Objective • Our study sought to present a solid comprehensive overview of the efficiency of active ingredients in mouthwash to control dental plaque. Source • Cochrane Library, the Library of Medicine, (MEDLINE-PubMed), Web of Science database core collection, the database of the American Dental Association (ADA) Center for Evidence-based Dentistry and Scopus database were used for our review and meta-analysis. Methodology • This was a systematic review that included papers with and without a meta-analysis on the efficacy of mouthwashes with various active ingredients in the control of dental plaque. In vitro and animal experiments were excluded from the study. Methodologic quality assessment was carried out with AMSTAR. The estimated plausible risk of unfairness was calculated according to the recording, reporting and methodologic quality of the selected systematic reviews per the PRISMA recommendations for systematic reviews. Results • 580 initial hits were reported and 22 papers were chosen for the overview (kappa = 0.89; good agreement). Of these, 12 studies presented moderate methodologic consistency. In these studies, chlorhexidine (CHX) was the most beneficial in monitoring dental plaque data, and 4 meta-analyses showed that essential oils (EO) also had substantial antiplaque activity. Conclusion • Descriptive and experimental studies have shown that CHX and EO have antiplaque activity that is useful in maintaining good oral hygiene.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Association of Sudarshan Kriya Yoga with Happiness: A Case-Control Observational Study from Singapore
Divya Kanchibhotla, MS;  Robert A. Sloan, MA, PhD
Happiness is a complex subjective experience that is essential to societal progress. This study investigated the association between Sudarshan Kriya Yoga (SKY) and subjective happiness in Singapore. Subjective happiness data were collected from a convenience sample (N = 733) comprised of 2 groups: SKY (n = 385) and non-SKY (n = 348) practitioners. SKY was categorized into non-, monthly, weekly, and daily practitioners and happiness was categorized into lower, middle and higher tertile groups. Confounding variables included age, gender, ethnicity, marital status, education level, body mass index (BMI), smoking status, alcohol consumption and self-reported health. Daily SKY participation was positively associated with a 2-fold higher likelihood of being happier in a multivariate regression analysis. The trend analysis showed that as SKY frequency increases, the odds of being happier increases. These findings help generate the hypothesis that yogic breathing may promote happiness. Further experimental and prospective investigations are warranted.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Effect of Hypnotherapy for Obesity
E. Erdal Ersan, MD
Objectives • The aim of this study was to evaluate the effects of hypnotherapy on the treatment of obesity, which seriously affects people’s quality of life. We evaluated the changes in Body Mass Indexes with hypnotherapy used to treat obesity. Methods • A total of 230 subjects with a Body Mass Index of 25 and over, who completed a minimum of 10-week sessions, were included in the study. The participants were first identified with the information form and the Body Mass Index. Then, once a week hypnotherapy session was performed for at least 10 weeks. This study is a non-randomized prospective study examining the effect of hypnotherapy on body mass index. Results • There was no statistically significant difference between the, dinner heavy meals and regular exercise or movement, and there was no statistically significant difference in terms of the baseline and endpoint of hypnotherapy (P = .777 and P = .770). There was a statistically significant difference in terms of sex and night feeding status at the beginning and end of hypnotherapy (P = .042 and P < .001). According to the Body Mass Indexes at the beginning and end of hypnotherapy; The initial Body Mass Index was 34.83 ± 5.81 and the end Body Mass Index was 32.61 ± 5.66. The difference was statistically significant (P < .001). Conclusions • It has been found that hypnotherapy is an effective method in the obesity treatment. It is easy to apply, cheap, effective, no side effect potential, the advantages of being added either alone or in other treatments.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Changes in Hematological Parameters by Quantifying HRCT Chest Results in Patients With COVID-19 in Tertiary Care Hospital
Fahad A Al-Abbasi, PhD;  Ziyad S. Almalki, PhD;  Ruchita Banseria, MD;  Imran Kazmi, PhD;  Mohd Faiyaz Khan, PhD;  Sunil Kumar Gothwal, MD;  Haradayal Meena, MD;  Gaurav Meratwal, MD;  Mayank Shrivastava, MD;  Yogendra Singh, MPharm;  Veer Bahadur Singh, MD
Aim • To find changes in hematologic parameters in patients who are COVID-19-positive with respect to high resolution computed tomography (HRCT) chest scan so that the exact picture of the disease course can be identified and an adequate treatment protocol can be planned to combat the COVID-19 pandemic. Methods • Patients’ health-related data including age, gender, symptomatology, associated co-morbidities, laboratory test results and HRCT results were collected. Results • The radiologic findings showed ground glass opacities (GGOs) was the most common manifestation. Analysis of HRCTs of patients with COVID-19 showed that lesions were mainly confined to the right and left lower lobes, suggesting that the COVID-19 virus is mainly harbored in the basal areas of the lungs. Conclusion • Radiologic and laboratory investigations can greatly help in early detection of COVID-19, thus allowing for timely interventions.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects on Anxiety and Vital Signs of the Emotional Freedom Technique and Music Before Surgery for Lumbar Disc Hernia
Remziye Cici, PhD;  Meral Özkan, PhD
Context • Patients hospitalized for surgical treatment for lumbar disc herniation (LDH) are adversely affected psychologically, with fury, anger, helplessness, anxiety, and depression being observed in patients. Anxiety in particular is a common problem, with an incidence of around 90%. Objective • This study intended to determine the effects on patients’ anxiety and vital signs of the emotional freedom technique (EFT) and music before LDH surgery. Design • The research team designed a quasi-experimental study. Setting • The research was carried out in the neurosurgery clinic of a university hospital in Turkey. Participants • Participants were 162 adult patients at the clinic who had LDH surgery between February 2018 and September 2019. Intervention • Using the nonprobability sampling method, participants were allocated to one of three groups: (1) 54 to the music group, an intervention group; (2) 54 patients to the EFT group, an intervention group; and (3) 54 to the control group. Outcome Measures • The Patient Information Form, the Life Findings Form, the Subjective Units of the Distress Scale (SUDS), and the State-Trait Anxiety Inventory-State Anxiety (STAI-S), were used to collect data. In the data analysis, the numbers, percentages, means, standard deviations, and chi-square values were found, and the t test and an analysis of variance (ANOVA) were used in the dependent and independent groups, respectively. The Tukey test was used for further analysis. Results • EFT and music were determined to significantly reduce participants’ state anxiety and subjective discomfort (P < .001). EFT significantly reduced the pulse and respiratory rates and the systolic blood pressure, and music significantly lowered the diastolic and systolic blood pressures (P < .05). Further analyses showed that EFT was more effective on state anxiety and reducing the respiratory rate than music. Conclusions • Both music and EFT before LDH surgery reduced anxiety and regulated vital signs, and EFT was found to be more effective than music in regulating anxiety and respiratory rate.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Psoriasis Management Using Herbal Supplementation: A Retrospective Clinical Case Study
Samir Alhilo, MD;  Iman Alhilo, MD;  Buthaina Alkhatib, PhD
Background • Currently, there is no effective long-term treatment for psoriasis by conventional medicine. Thus, several alternative treatments are currently used to attenuate the severity, including herbal and dietary supplements. Primary Study Objective • The aim of this study was to investigate the effect of a mixture of traditional Jordanian herbal supplements on psoriasis treatment. Methods/Design • A retrospective case study was conducted at The Herbal Dynasty Medical Center, Jordan. Three psoriasis patients were selected to participate (2 males; 1 female); patients obtained their diagnosis by a physician. Participants were prescribed a specific dose of 2 capsules daily of the herbal supplement, which consisted of dandelion, olive leaf, nettle leaf, and turmeric, along with 2 capsules of milk thistle half an hour before breakfast. Participants were instructed to follow therapy protocol for 5 consecutive months. The psoriasis area and severity index score was calculated pretreatment and posttreatment. Results • The 3 psoriasis cases were diagnosed as mild, moderate, and severe at the study onset. The severity index scores were 3.2, 14, and 16.2, respectively, and improved posttreatment to 0, 0.8, and 2, respectively. Conclusion • Traditional herbal supplementation was shown to be beneficial for the treatment of psoriasis.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Nurses’ Emotional Stress Levels When Caring for COVID-19 Patients in an Intensive Care Unit
Qingqing Lin, BD;  Yuanren Zheng, BD
Context • The COVID-19 pandemic has had an effect on many communities’ physical and mental well-being, especially that of healthcare workers. During the pandemic, health workers have shown signs of depression and anxiety and have experienced sleep disturbances. Few studies have examined health workers’ resilience during the pandemic. Objective • The current study intended to examine the job stress and mental well-being of nurses who have supported, worked with, and cared for COVID-19 patients in an intensive care unit. Design • The research team performed a narrative review by searching the Mendeley, ScienceDirect, Medline, PubMed, Google Scholar, and Springer databases. The search used many keywords, both alone and in combination, such as COVID-19, pandemic, nurses, healthcare professionals, stress, and frontline workers. The review considered only English journals. Setting • This study was take place in Second Affiliated Hospital of Hainan Medical University, Hainan Province, China. Results • During the current pandemic, COVID-19 prevention in social settings, governmental regulation during the pandemic, and provision of frontline care have faced notable challenges. In general, nurses who have assisted during the COVID-19 pandemic have been under severe strain. The key factors that influenced nurses’ stress were being only children, their working time per week, and their levels of anxiety. Conclusions • COVID-19 has posed a vast threat to public health worldwide. The psychological stress of nurses should be managed in public-health emergencies.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Medicinal Plants and Nonsteroidal Anti-inflammatory Drugs (NSAIDs) in Treatment of Arthritis: A Literature Review
Azharul Islam, BSc, MSc, MPhil;  Muhammad Maaz Ali;  Saeed Ur Rashid Nazir, BPharm, MPhil, MBA, PhD;  Taha Nazir, BPharm, MPhil, PhD;  Ruqaiya Rasheed Kayani, Pharm D, MPhil;  Humayun Riaz, BPharm, MPhil, PhD;  Rahat Shamim, BPharm, MPhil, MBA, PhD;  Misbah Sultana, BPharm, MPhil, PhD;  Safia Sultana Munir, MBBS, DGO, FCPS
Context • Arthritis is an inflammatory disease of diarthrodial joints and is associated with swollen inflamed joints, disruption of joints, and loss of integrity of articular cartilage and synovial joints. Objective • The current review intended to examine the data on the epidemiology, causes, clinical diagnosis, and prevention and control of different types of arthritis and on the use of medicinal plants in gouty arthritis. Design • The research team performed a literature review, searching relevant literature databases, including bioRxiv, medRxiv, Google Scholar, Embase, PsychINFO, and PubMed. The search terms were arthritis, diarthodial joints, use of medicinal plants in gouty arthritis, and synovial joints. Setting • The study took place in the main library of the University of Sargodha in Sargodha, Pakistan. Results • The research team identified 135 studies, and eventually 92 unique academic publications were included in the analysis. Arthritis can develop and progress in any musculoskeletal joint, and most commonly occurs in knees, hips, shoulders, and hands. Major risk factors for arthritis include age, obesity, trauma, other diseases, and smoking. Arthritis is classified into various types, including rheumatoid arthritis (RA), osteoarthritis (OA), gouty arthritis, septic arthritis, and psoriatic arthritis (PsA). RA and OA are the most common types worldwide. RA is an autoimmune disease in which the body’s immune cells attack the joints. OA develops due to damage of cartilage, tissues, and joints due to age, obesity, or stress on joints. Gouty arthritis develops due to hyperuricemia; deposits of monosodium urate crystals can lead to gouty arthritis. Septic arthritis occurs due to a microbial infection in synovial joints because in synovial joints the basement membrane is absent. PsA develops due to the psoriasis—skin disease. Conclusions • The current review showed that different types of arthritis has different causes and pathogeneses. Pain in joints is a major and common symptom in all types of arthritis. Arthritis is managed pharmacologically and nonpharmacologically. Treatment is different for each class of arthritis according to its cause and symptoms.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Tai Chi and Qigong in Medical Research: A Comprehensive Bibliometric Analysis
Gabriella Morandi;  Daniele Pepe, PhD
Objective • Tai Chi and Qigong are mind-body practices deriving from Traditional Chinese Medicine (TCM) which are used clinically as therapeutic interventions. The objective of this study was to identify patterns and research trends in reviews about Tai Chi and/or Qigong through bibliometric analysis. Methods • Based on a search of Scopus, authors, collaborations and source journal impact were analyzed, along with citation counts and alternative metrics. Results • In all, 205 documents were retrieved, 72% of which concerned the practice of Tai Chi. According to the type of practices, the average citation per year was 2.2 for Qigong studies, 3.2 for Tai Chi and 5.6 for Tai Chi and Qigong reviewed together. The most productive authors were Lee, Ernst and Pittle who shared a high number of papers. The strongest institutional connection was between universities in Korea and Exeter, UK. The source journals had good ranking positions both among journals belonging to the alternative medicine category and specialized clinical journals. Conclusion • The level of collaboration among universities, the increasing number of meta-analysis studies, and the prestige of the journals in which articles were published attest that Tai Chi and Qigong practices are creating new opportunities in the traditional medicine.
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December, 2021 - VOL. 27, NO. 12  December, 2021
A Single Mindfulness-Based Meditation Session Can Produce Reductions in Cardiovascular Risk in Hypertensive Patients: A Pilot Study
Beatriz Trancoso Lopes;  Alessandra Medeiros, PhD;  Fábio Tanil Montrezol;  Vinícius Demarchi Silva Terra, PhD
Background • Several non-drug treatment approaches for systemic arterial hypertension have been studied aimed at reducing the adverse effects of this clinical condition. In addition to exercise training, which already has many of its modalities consolidated in the scientific field, body and mind practices have gained strength and deserve attention in the science and treatment of hypertension. The literature shows that meditation practices have numerous health benefits, one of which is blood pressure (BP) control. Objective • This study aimed to evaluate the acute effects of a single mindfulness-based meditation on BP in adults with hypertension. Methods • Research was developed that evaluated the BP of 5 adult women with controlled hypertension. As a data collection instrument, we used 2 sessions of ambulatory BP monitoring (ABPM): the first was a control session and the second a meditation session. Systolic (SBP), diastolic (DBP) and mean blood pressure (MBP) were evaluated at the pre- and post-session in addition to heart rate (HR), with clinical and ambulatorial measurements, during the day, night, morning surge and a 24-hour period. Data analysis was performed using one-way analysis of variance (ANOVA) for the ABPM data and two-way ANOVA to analyze blood pressure. Results • The main results found were a statistically significant reduction in SBP in the morning and a tendency toward a significant decrease in MBP during the same period (P = .057). There were no significant changes in the other variables analyzed. Conclusion • Therefore, we concluded that a single meditation session was effective only in reducing morning SBP.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Analysis of Clinical Trial Registry of India for Evidence of Anti-Arthritic Properties of Withania somnifera (Ashwagandha)
Amitabha Dey, PhD;  Ashok Kumar Gupta, PhD;  Satyajyoti Kanjilal;  Ranjana Saksena Patnaik, PhD
Background • Withania somnifera (Ashwagandha) is an herb with anti-inflammatory properties used in managing arthritis. There is significant clinical data in the public domain on the effects of Ashwagandha and this study was aimed at compiling and analysing these data in a structured manner. The major sources of evidence data were clinical trials and systematic review of extant literature. Methodology • Retrospective database search was conducted in the Clinical Trial Registry of India for trials registered from April 2008 to March 2020, and published literature related to the anti-arthritic effects of Withania somnifera were reviewed. Results • In all, 77 registered clinical trials were analysed and common among them were interventional, single-centre, randomized, double-blind, two-arm studies with Placebo being the comparator. Similar findings were observed in the 10 published clinical trials on arthritis evaluated for this study. While industry- and government-sponsored trials were identified, government funded sites with approvals from Institutional Ethics Committees were preferred. Most trials were registered as Phase 2 with the highest number of sites in the state of Maharashtra. The solid dosage form was most preferred. Conclusion • While the effects of Withania somnifera on various disorders are being investigated by several clinical trials, the ones evaluated for this study provide insight on its potential in managing arthritis when given for a specific duration. Evidence shows a dosage of 6 gm in powder form or extracts in tablets, or 500 -1000 mg capsule consumed for a duration of 8 – 12 weeks may be useful in managing symptoms of arthritis in patients.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Disordered Eating Attitudes Among University Students: The Role of Psychological Distress
Guanqing Chen, BD;  Lianping He, PhD;  Tinghui Li, BD;  Zhipeng Li, BD;  Yi Lin, BD;  Xiaozheng Liu;  Chenchen Pan, BD;  Xiaohua Ren, MD;  Mengjun Wu, BD;  Wenying Zhao, BD
Objective • The aim of this study was to explore the relationship between psychological distress and disordered eating attitudes. Methods • The study design was cross-sectional study. The 12-item General Health Questionnaire (GHQ-12) and Eating Attitude Test-26 (EAT-26) were used to measure psychological distress and disordered eating attitudes, respectively. The data were analyzed using SPSSversion 20.0 Software (SPSS Inc, II, Chicago, IL, USA). Description statistics were used for height, weight, BMI), age, eat-26 scores and ghq-12 scores. Pearson’s correlation analysis was performed to explore the relationship between the EAT-26 scores and the GHQ-12 scores. Results • The overall prevalence of disordered eating attitudes was 4.6%. The mean GHQ-12 score in subjects with disordered eating attitude was higher than that of the control group (P < .05) in both the male and female groups. Conclusion • Our study suggested that psychological distress is associated with disordered eating attitudes. BMI and gender turned out to not be correlated with disordered eating attitude. The findings of this study revealed that university students who have psychological distress also have a tendency toward disordered eating attitudes.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Herbal Formulation Comprised of Methanol Extracts of Tribulus terristris L. and Zingiber officinale Roscoe Has Antihypertensive Effects
Muhammad Naeem Aamir, PhD;  Khizar Abbas, PhD;  Muhammad Imran Qadir, PhD;  Muhammad Naeem Qaisar, PhD;  Ghazala H Rizwani, PhD;  Talal Shaheer, MPhil;  Faheem Ahmad Siddique, PhD;  Asif Wazir, MPhil;  Muhammad Younis, MPhil
People prefer to use medicinal plants rather than chemical compounds because they are low cost and have fewer adverse events. Zingiber officinale Roscoe is a natural dietary rhizome with anti-oxidative, anti-inflammatory and anti-carcinogenic properties. Tribulus terrestris L. has been used for the treatment of impotence, to enhance sexual drive and performance and for its diuretic and uricosuric effects. The aim of this study was to evaluate the combined effect of 2 extracts, Tribulus terristris and Zingiber officinale (TZ) for antioxidant, enzyme modulation, liver function, kidney function, blood profile and anti-hypertensive effects, which may pave the way for possible therapeutic applications. Antioxidant potential was measured with the 2,2-diphenyl-1-picryl-hydrazyl-hydrate free radical method antioxidant assay (DPPH) and kojic acid was used as the standard drug for tyrosine inhibition assay. The effect of TZ on biochemical parameters of the liver (alanine transferase [ALT], alkaline phosphatase [ALP], aspartate aminotransferase [AST], total serum protein, total serum albumin, serum bilirubin), kidney (blood urea and creatinine) and hematology (hemoglobin, red blood cells [RBC], platelets, thin-layer chromatography, neutrophils, eosinophils, lymphocytes, monocytes, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration) of Wister rats were studied by administering 100, 250 and 500 mg/kg-1 body weight TZ dose orally for 28 days. Antihypertensive effects were measured by the invasive method. The results showed that the scavenging percentage of TZ was 78.5 to 80.4, with an IC50 value of 1166.7 µg/ ml and tyrosinase inhibition was 72% compared with 93% for kojic acid. Different doses (100, 250 and 500 mg/kg) did not show an increase in serum biomarkers of liver and renal parameters. A significant increase in hemoglobin, erythrocytes, hematocrit, white blood cells (WBC) and lymphocytes with no significant increase/decrease in platelet count was observed but blood pressure was significantly decreased. Therefore, we concluded that TZ is safe and can be used in the treatment of hypertension.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Comparative Evaluation of Homeopathic Therapy in the Treatment of Chronic Periodontitis
Miriam Alhanati, DDS;  Antonio Canabarro, PhD;  Lucio S Gonçalves, PhD;  Carla Holandino, PhD;  Leila C Mourão, PhD
Context and Objective • Periodontitis and type 2 diabetes (T2D) are chronic diseases generally treated with conventional therapies alone. The aim of this study was to compare the effects of homeopathy as an adjunct to conventional periodontal therapy in individuals with periodontitis and T2D. Design • 85 individuals, age between 35 and 70 years, of both genders, participated in this randomized study; 70 patients were from the Institute of Endocrinology and Diabetes of Rio de Janeiro, Brazil. They were divided into 2 groups: G1, individuals with periodontitis without systemic conditions; and G-2, individuals with periodontitis and T2D. Both groups received homeopathic treatment and were evaluated in clinical and laboratory examinations. The medication used was chosen based on the similarity principle: Berberis 6CH, Mercurius Solubilis/Belladona /Hepar Sulfur and a Pyrogenium 200CH biotherapic. Medications were prescribed in diluted low ultra-diluted concentration doses for all signs and symptoms, while biotherapics were used for chronic stimulation. Setting • The study was performed in Brazil by university research professors of homeopathy and periodontics. Results • Both groups showed significant clinical and laboratory improvements during the study from baseline to 1 year with reductions in total cholesterol (total-C), triglycerides, glucose, glycated hemoglobin (A1cHb), uric acid and C-reactive protein (CRP). Statistical and descriptive analyses were performed. For most parameters, G1 performed better than G2 (P < .05). Conclusion • Homeopathy as an adjunct to periodontal treatment improves local and systemic clinics and can provide better health conditions for patients with or without T2D.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Impact of Dog-Assisted Therapy for Institutionalized Patients With Dementia: A Controlled Clinical Trial
Jose Manuel Hernández Garre, PhD;  Eva Vegue Parra;  Paloma Echevarría Pérez, PhD
Context • Animal-assisted interventions have been used in recent years to complement other therapies of various types for dementia patients. Objective • The study intended to evaluate the benefits of dog-assisted interventions for the emotional, behavioral, cognitive, and functional areas of the lives of dementia patients . Design • The research team designed an experimental study that used dog-assisted therapy (DAT) as the intervention. Setting • The study was conducted at the Enoc Center, a nursing home, in Azucaica, Toledo, Spain. Participants • Participants were 21 residents who had been living at the center for more than one year, were over 65 years old, and had symptoms associated with dementia or affective disorders. Intervention • Participants were randomly divided into three groups: the control, intervention, and healthy groups. The intervention and healthy groups attended the DAT in addition to the center’s regular therapies. The control group didn’t attend the DAT but did attend the center’s regular therapies. The program occurred over six months, with weekly sessions of 45 minutes in both cases. Outcome Measures • Participants were evaluated at baseline and postintervention using specific scales appropriate to an area: (1) cognitive—Mini-Mental Status Examination (MMSE), (2) functional—Modified Barthel Index, (3) affective—Yesavage Geriatric Depression Scale: Short Form and (4) behavioral—Neuropsychiatric Inventory Scale (NPI). Results • The study revealed significant differences between the control group and the intervention group and between the control group and the healthy group in the cognitive, affective, and behavioral areas but not in the functional area. Conclusions • The program was beneficial for elderly institutionalized patients with dementia in the emotional, behavioral, and cognitive areas.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Efficacy of Cyclical Prescription in Homoeopathic Management of Polycystic Ovary Disease: A Case Report
Asmita Alekar, MD;  Jayant Mahajan, MS;  Vineet Sinnarkar, MD
Polycystic ovarian disease is a very common condition affecting women of reproductive age. Homoeopathy believes in a holistic approach and, when prescribed, can correct hormonal imbalances, regulate ovulation, and deal with associated complaints, as well as help to cure the condition from its root cause. A case of a 17-year-old female came into the Homoeopathic outpatient department with complaints of irregular menses and hyperpigmented patches on her back. Hormonal assay and thyroid function tests were done to rule out other disorders, and ultrasound of the abdomen and pelvis was done to confirm the diagnosis of polycystic ovarian disease. In this case Sulphur, Calcarea Carb, and Lycopodium were prescribed in a cyclical manner and proved to be beneficial.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Respiratory Failure in Intensive Care Unit Patients with Progressive COPD: Nursing Approaches to Patient Care
Li Ai, BD;  Wei Bo, BD;  Jing Zhang, BD
Chronic obstructive pulmonary disease (COPD) is a set of heterogeneous diseases characterized by a not entirely reversible and in most cases gradual restriction of expiratory flow. Tobacco smoke is a common risk factor for the development of COPD, but the effects of coming into contact with indoor air pollutants are also significant, and the exacerbation of COPD is one of the most significant reasons for intensive care unit (ICU) admission. Registered nurses play a key role with regard to dealing with the adverse events associated with respiratory dysfunction. They track the condition of patients through their physiologic activity. The clinical treatment provided by nurses depends on the cause and type of insufficiency present in patients with respiratory failure. The aim of this study was to understand how emergency nurses could better develop their roles in ICU patients with respiratory failure due to COPD. There are many different interventions for different causes of respiratory failure. The clinical measures of respiratory dysfunction, such as changes in respiratory velocity, and occurrence of dyspnea, hypoxemia and acidosis are significant factors in the diagnosis of respiratory dysfunction and the evaluation of the risk for adverse events. Thus, nursing aims include avoiding hypoxia, reducing hypercapnia-associated acidosis and reducing complications and agitation in patients with respiratory failure due to COPD.
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December, 2021 - VOL. 27, NO. 12  December, 2021
From Progressive Asthma to Intensive Care Unit Respiratory Failure: Approaches Nursing Approach to Patient Care
Yi Lin, BD;  Dan Liu, BD
Asthma is a systemic inflammatory disease characterized by complex and reversible airflow obstruction resulting from various bronchial reactions triggered by a combination of genetic and environmental variables. Allergens, smoking, pollen and air pollution are all common causes, and asthma exacerbations are one of the more common reasons for intensive care unit (ICU) admission. Nurses have a significant effect on the care of patients with asthma via the use of particular teaching approaches and health promotion templates focused on the principles of the Ottawa Charter for Health Promotion. By monitoring the patient’s condition via physiologic exercise, nurses are able to provide therapeutic care based on the causes and types of asthmatic insufficiency. Respiratory nurse practitioners play an important role in ICU management, asthma control, inhaler training, asthma action plan planning and emergency room management.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Maqams in Music on Anxiety: A Preliminary, Randomized Controlled Trial
Ozan Eroy, PhD;  Hakan Gulmez, MD
Introduction • Music is widely used to reduce anxiety, and the beneficial effects of music on anxiety are well established. Maqams represent a system of melodic modes used in traditional Turkish music. Different maqams may have different effects on anxiety. Objective • The current study intended to investigate the effects of Hicaz and Huseyni maqams on anxiety and to evaluate whether a difference in effects exists. Design • The research team performed a preliminary, randomized controlled trial. Setting • The study took place in the Department of Family Medicine, Faculty of Medicine and the Department of Music, Faculty of Fine Arts, at Izmir Democracy University in Izmir, Turkey. Participants • The participants were 87 volunteers between the ages of 18 and 27, who were students studying at the university. Intervention • The participants were randomly divided into three groups, with 29 participants in each group. One intervention group listened to the music in the Hicaz maqam—the Hicaz group—and the second listed to the music in the Huseyni maqam—the Huseyni group—for 30 minutes a day for a week. The control group received no intervention. Outcome Measures • The Beck Anxiety Inventory (BAI) was used to measure participants’ level of anxiety. Results • No significant differences existed between the three groups in the BAI scores at baseline (P = .97). For the Hicaz and Huseyni groups, a significant decrease was found in the mean BAI scores between baseline and postintervention (P < .001), but no statistically significant difference was found for the control group (P = .29). No statistically significant difference in the BAI scores existed postintervention between the Hicaz and the Huseyni groups (P = .66) or between the Hicaz group and the control group (P = .06), but a statistically significant difference did exist between the Huseyni and the control groups (P = .01). Conclusions • Listening to music is an effective auxiliary method for reducing anxiety. The type of music to which an individual listens can affect this benefit, with some types having a greater positive effect than others.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Chinese Herbal Fumigation Steam Therapy and Acupuncture in the Treatment of Knee Osteoarthritis: A Three-armed, Randomized, Controlled Trial
Shang-Chih Chang, CS, MD;  Jung-Peng Chiu, JP, MD;  Chung-Hua Hsu, CH, MD, PhD;  Shu-Yi Lin, SY, MStat;  Anthony J Venuti, DiplOM;  Kai-Chiang Yu, KC, MD
Context • Knee osteoarthritis is a common form of joint disease found in humans and one of the leading causes of disability globally. Knee osteoarthritis (KOA) is responsible for a higher number of disabilities than any other medical condition affecting activities of daily living (ADL). To date no definitive, conventional medical protocol is available to deal with KOA. Objectives • The study intended to clinically investigate whether the benefits of acupuncture in the treatment of KOA) could be augmented by the addition of Chinese herbal fumigation steam therapy (CHFST) to the treatment protocol and to what degree it had benefits. Design • The research team designed a three-armed, randomized, controlled trial. The sample size was determined by analysis of power; for a sample size of 42, the power was 83.5%; the effect size was 0.5; and the a was 0.05. Setting • The setting was the traumatology department in the Chinese Medicine Branch of Taipei City Joint Hospital in Kun Ming, Taiwan. Participants • Participants were 45 males and females between the ages of 35 and 75, who were patients in the traumatology department and who were suffering from bilateral knee osteoarthritis. Three participants were lost to follow-up. Interventions • Participants were randomly assigned to one of three groups, each with 15 participants; (1) the control group, who received acupuncture only; (2) the normal CHFST group, an intervention group who received acupuncture plus a normal dose of CHFST; and (3) the one-sixteenth CHFST group, an intervention group who received acupuncture plus one-sixteenth of a normal dose of CHFST. Participants underwent biweekly treatments for four consecutive weeks. Outcomes Measures • The primary outcome measures included a visual analog scale (VAS) to assess variations in pain intensity and a goniometer measure for range of motion (ROM). Results • The addition of CHFST to acupuncture in the treatment of KOA significantly reduced pain (P = .0017) for the normal CHFST group compared to the control group and the one-sixteenth CHFST group. Chinese medical interventions overall for all groups showed a decrease in pain and increases in ROM, and health related quality of life (HrQoL). Conclusions • CHFST, in conjunction with acupuncture, showed promise in the treatment of KOA in reducing pain, increasing ROM, and improving quality of life (QoL).
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December, 2021 - VOL. 27, NO. 12  December, 2021
Therapeutic Use of Trace Elements in Dermatology
Anita Gade, DO;  Karl Hoegler, MD;  Jacqueline R Hwang, BS;  Amor Khachemoune, MD;  Samiya Khan, BS
Trace elements (microminerals) play a role in many physiological functions, including hormone production and cellular growth. However, their importance in diagnosing and treating dermatologic disease has not been well examined. In this review, we discuss the functions, sources, and recommended requirements of each micromineral. In addition, we analyze the systemic and dermatological manifestations associated with micromineral imbalances. The pathogenesis of genodermatoses, such as Wilson disease, Menkes disease, acrodermatitis enteropathica, and allergic dermatitis, are also discussed. Included are studies examining the potential therapeutic role of zinc, selenium, and copper in inflammatory diseases, skin cancer, and photoaging.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Inhibition of Nuclear Factor Kappa B as a Therapeutic Target for Lung Cancer
Mengjie Li, BD;  Peng Liu, BD;  Biao Wang, BD;  Jian Yang, MD;  Jie Zhou, BD
Context • A wide variety of malignancies common to humans display abnormal constitutive expression of nuclear factor kappa beta (NF-?ß). The study of NF-?ß can increase understanding of its role in cancer, especially in lung-tumor formation. Objective • This review intended to examine the research on the impact of the NF-?ß signaling pathway on the development of malignancies of the lungs and the advances in the regulation of that pathway to mitigate and provide treatment for lung carcinoma. Design • The research team performed a narrative review by searching the PubMed, EMBASE, and Web of Science databases. The search used the keywords NF-?B or NF-kappa B or nuclear factor kappa B and non-small-cell lung cancer or non-small-cell lung carcinoma or NSCLC or lung cancer or lung adenocarcinoma or lung squamous carcinoma. Setting • This study were conducted at Department of Respiratory and Critical Care Medicine, Qingxian People’s Hospital, Cangzhou City, Hebei Province, People’s Republic of China. Results • As a major cell survival signal, nuclear factor-kappaB (NF-kappaB) is involved in multiple steps in carcinogenesis and in cancer cell’s resistance to chemo- and radio-therapy. Recent studies with animal models and cell culture systems have established the links between NF-kappaB and lung carcinogenesis, highlighting the significance of targeting NF-kappa signaling pathway for lung cancer treatment and chemoprevention. Conclusions • While no convincing evidence exists that survival of lung cancer cells is dependent on NF-?ß, inhibition of NF-?ß is a potent supporting therapy for enhancing the therapeutic effects of chemotherapy and radiotherapy. Constitutive and therapeutically induced activation of NF-?ß reduces the tumor-massacre effect of treatment, so inhibiting NF-?ß might increase antitumor activity.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effect of Acupressure on Pre-Exam Anxiety in Nursing Students
Eunkyung Lee, PhD, GNP, RN;  Jin-Hwa Park, PhD, APRN-BC, RN
Background • Academic stress and anxiety are experienced by students as a consequence of examinations. Objective • The purpose of this study was to explore whether or not auricular acupressure therapy can reduce exam anxiety, state anxiety and trait anxiety in nursing students. Methods/Design • A single blinded randomized control trial was designed. Setting • The study was conducted at one univeristy in Daegu City, South Korea. Participants • A total of Fifty-eight sophomore nursing students were initially recruited for the study and were randomly assigned to either the experimental or control group (n = 29 each). In the experimental group, 2 participants dropped out and 1 dropped out in the control group before completing the study, resulting in a final count of n = 27 for the experimental group and n = 28 for the control group. Intervention • Participants in the experimental group received auricular acupressure at the Shen Men point and endocrine point bilaterally, and participants in the control group received the intervention at a sham point bilaterally. Primary Outcome Measures • Test anxiety levels were rated with the Korean version of the Revised Test anxiety Scale and state-trait anxiety levels were determined with the Korean version of the State-Trait Anxiety Inventory Form Y before the intervention and immediately after the examination. Data analysis was performed using the IBM SPSS WIN 25.0 software program. Results • After controlling for baseline outcome values, auricular acupressure therapy was effective in decreasing the test anxiety level; however, no differences were found in state anxiety or trait anxiety. Conclusion • Auricular acupressure therapy is effective in reducing test anxiety in students prior to taking an examination.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Ocimum Sanctum: An All-Round Treatment for Cancer?
Pulkit Kumar;  Dhaniket Patel
Background • This review is a great route for future researchers on the topic of alternative medicine. The review goes in depth with respect to Ocimum sanctum and its proposed mechanism of action for different types of cancers. Primary Study Objective • The primary objective of the study was to bring traditional therapy back, which can prove to be economically beneficial and may be helpful to many patients with cancer with few to no adverse events. Intervention • Ocimum sanctum (OS), commonly known as Holy Basil or tulsi, is a very important medicinal herb in parts of India and Southeast Asia. OS has been found to lower blood pressure and cholesterol, reduce the risk for heart attacks and may also be effective for treating depression and anxiety. It also protects the body from prolonged physical exertion, ischemia, exposure to cold and excessive noise, but its anti-tumorigenic effect remains largely unexplored. A few studies have observed that extracts of OS have inflammatory, analgesic, antipyretic, antidiabetic, hepatoprotective, hypolipidemic, anti-stress, and immunomodulatory activities. A few cell culture and animal studies have also shown that some of its phytochemicals like eugenol, rosmarinic acid, apigenin, myretenal, luteolin, ß-sitosterol and carnosic acid prevent chemical-induced skin, liver, oral and lung cancers and mediate these effects by increasing antioxidant activity, altering gene expression, inducing apoptosis and inhibiting angiogenesis and metastasis. They are also shown to prevent radiation-induced DNA damage. This review details the different chemoprotective and radioprotective properties of OS and also gives an idea for future research.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Intuitive Eating on the Quality of Life and Wellbeing of Yoga Practitioners, Physical Activity Practitioners and Sedentary Individuals
Maria Carolina Alves De Martini, MS;  Everton Artuso, PhD;  Dalila Moter Benvegnú, PhD;  Yana Cristina de Barba, BS;  André Lazarin Gallin, PhD;  Angela Khetly Lazarotto, MS;  Eduardo Henrique Szpak Gaievski, MS
This study is a comparative analysis of the effects of intuitive eating and correlations with quality of life and wellbeing in Yoga practitioners, physical activity practitioners and sedentary individuals. The study involved 204 participants, comprising 66 Yoga practitioners, 74 physical activity practitioners and 64 sedentary individuals, between the ages of 20 and 59, who were resident in Brazil at the time of the study. Quantitative research was conducted through Facebook and the application questionnaires via Google Forms to measure intuitive eating, food consumption, quality of life, stress level, satisfaction with body image and level of mindfulness. The study found that while intuitive eating did not differ between Yoga practitioners and physical activity practitioners, both showed greater adoption of intuitive eating as compared to inactive individuals. Still, Yoga practitioners had better confidence in their physiological signs of hunger and satiety, as well as better eating behavior, quality of life, satisfaction with body image, healthy body weight, and stress-related emotional regulation, as compared to the other groups. In addition, there was a positive correlation between intuitive eating and quality of life, body esteem, mindfulness and eating behaviors that discouraged eating in response to external or psychological influences, and a negative correlation to stress and weight gain. This study finds that physical exercise, in particular the practice of Yoga, is linked to the promotion of better intuitive eating behavior as well as better quality of life and wellbeing.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Osteopathic Manual Treatment Compared to Kaltenborn-Evjenth Orthopedic Manual Therapy for Chronic Low Back Pain: A Randomized Study
Jaroslaw Jaszczur-Nowicki;  Wojciech Kobza, PhD, BMed;  Pawel Lizis, PhD;  Damian Wisniewski, PhD, BMed
Context • Low back pain (LBP) is a painful pathology causing pain and disability despite treatment with the best evidence-based therapies. Osteopathic manual therapy (OMT) and Kaltenborn-Evjenth orthopedic manual therapy (KEOMT) are alternative treatments for LBP. Objective • The study intended to evaluate the efficacy of OMT compared to that of KEOMT for patients with chronic LBP. Design • The research team designed a randomized study. Setting • The study was held at the Medita Health Center in Warsaw, Poland. Participants • The study included 68 participants of both genders, aged 30 to 60, with chronic LBP. Intervention • Participants were randomly assigned to one of two parallel groups, each with 34 members. The OMT group received, as a direct technique, a high-velocity/low-amplitude (HVLA) impulse, and as indirect techniques, strain counterstrain (SCS), myofascial release (MFR), and visceral mobilization therapy (VMT). The KEOMT group received lumbar segmental traction and lumbar segmental mobilization—flexion and gliding therapy grade 3. The participants in both groups received 10 treatments, two per week for five weeks. Outcome Measures • The primary outcome was pain severity, using a numeric pain rating scale (NPRS). The secondary outcome was measurement of functional disability, using the Oswestry Disability Index (ODI). Results • The OMT and KEOMT both decreased pain and disability; however, the changes on the NPRS and ODI postintervention were statistically greater for the OMT group compared to the KEOMT group (P < .05) . Conclusions • OMT was better at reducing pain and improving quality of life. It reduced functional disability more than KEOMT in patients with chronic LBP.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Dynamics of Decision-Making in Medical Pluralism: A Systematic Review of Conceptual Models
Praheli Dhar Chowdhuri, MPhil;  Kaushik Kundu, PhD;  Suman Meyur, MBBS, MD, MRSPH (UK)
Purpose • Plurality of treatment choice is often observed, as in many instances people choose to use both conventional and complementary and alternative medicine (CAM). The existing models of healthcare utilization or healthcare behavior do not specifically address this medical pluralism. Hence, to understand an individual’s pluralistic choice of treatment, major studies describing this have been systematically reviewed in this study in order to extract the principal factors driving such choice. Also, applicability of current healthcare models is qualitatively analyzed in order to identify whether they properly explain the factors driving such pluralistic choices. Methodology • A systemic literature review was performed of 20 studies including 6 National Surveys. The major variables included were prevalence of integrative medicine in the last 12 months, nature of pluralism, major factors driving plurality of choice and the underlying model describing such choices. Results • Mean usage of plurality was 44.48% (95% CI, 44.12-44.84%). The major drivers of plurality were enabling (access) and cognitive factors, followed by post-decision dissonance, philosophical congruence and social factors. The studies followed several established conceptual models with almost equal distribution. These major factors and the underlying treatment models were significantly dependent upon each other (Fisher’s exact test; P = .025), but the cognitive and personality factors were found to be significantly exclusive (t = 2.39; P = .017). Conclusion • Medical pluralism incorporates a multitude of decision factors, which are separately related to different healthcare-decision models. Among them, personality trait was observed to be an important but neglected component of existing models. From the existing studies, no single pluralism-driven integral model could be established, satisfying all the important conditions of pluralistic choice.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Long-Term Effects of Hatha Yoga on Heart Rate Variability In Healthy Practitioners: Potential Benefits For Cardiovascular Risk Reduction
Bindu Balakrishnan, MSc, PhD;  Jacob Day, BS;  Mohan Ganesan, PT, PhD;  Kashinath G Metri, MD, PhD
Hatha yoga is commonly practiced in Western countries and is claimed to reduce risk of cardiovascular disease. The purpose of this study was to evaluate and compare time-domain and frequency-domain metrics of heart rate variability (HRV) in Hatha yoga practitioners and healthy controls. This cross-sectional study, which was conducted at a regional university and community wellness center, included convenience sampling of 19 Hatha yoga practitioners and 8 healthy controls. Using a lead II ECG system, 10 minutes of electrocardiogram (ECG) recording was collected for each participant. Artifact-free, 5-minute signals were used to derive time-domain and frequency-domain measures of HRV. The mean duration of Hatha yoga practice among practitioners was 11.47 ± 8 years. Demographic and anthropometric characteristics did not differ significantly between groups. Compared with the control group, the yoga group had significantly greater mean high frequency (HF) power (859.2 ± 1342.1 vs 175.5 ± 121.1; P = .04) and mean HF normalized units (nu) (57.0 ± 16.6 vs 36.7 ± 13.4; P = .02) and a significantly lower low frequency (LF)/HF ratio (1.1 ± 0.5 vs 2.2 ± 1.1; P = .01). No significant intergroup differences were observed for LF power, LF nu, or any time-domain measures of HRV. These results lack generalizability due to small sample size and lack of blinded assessment of outcome measures. Hatha yoga practitioners showed parasympathetic predominance compared with healthy controls. Analyzing frequency-domain HRV metrics enables detecting changes in cardiac autonomic function earlier than by analysis of time-domain metrics. Parasympathetic predominance demonstrated in the yoga group suggests Hatha yoga practitioners may be at lower risk for stress-related comorbidities.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effect of Low-Frequency Electro-Acupuncture in Unmarried Women With Polycystic Ovary Syndrome: A Randomized Controlled Study
Ling Cheng, PhD;  Haoxu Dong, PhD;  Dongmei Huang, PhD;  Qing Wang, PhD;  Zhi Wang, MSc;  Xiaoke Wu, PhD;  Li Yang, MSc;  Zhongming Zhou, PhD
Objectives • We aimed to evaluate the effect of low-frequency electro-acupuncture (EA) in unmarried women with polycystic ovary syndrome (PCOS). Design • A total of 54 women with PCOS were randomly assigned to either the acupuncture group (n=27) or the sham acupuncture group (control, n=27) for a total of 32 treatments over 16 weeks. In the acupuncture group 26 patients and in the control group 20 patients completed the trial. Outcome Measures • Main measures were androgen levels including 17-a-hydroxyprogesterone (17-a-OHP), androstenedione (A2), testosterone (T) and dehydroepiandrosterone (DHEA) at 0, 24 and 48 hours after stimulation with a dose of human chorionic gonadotropin (HCG). Other measures included body mass index, waist-to-hip ratio, sex hormone levels, etc. Results • After treatment, there was no significant difference in the main measures between the 2 groups (P > .05), except for the DHEA level at 0 h of HCG stimulation (P = .024) and acne score (P < .05). Comparison within the acupuncture group found that 17-a-OHP and A2 levels at 0 h and DHEA levels at 24 h of HCG stimulation after treatment were significantly decreased (P < .05), whereas T levels at 24 h were significantly increased (P < .05). Comparison within the control group showed 17-a-OHP level at 0 h and 17-a-OHP and A2 and DHEA levels at 24 h after treatment were significantly lower (P < .05). In addition, weight, BMI, HCG and Ferriman-Gallwey score in the acupuncture group and LH/FSH ratio was significantly reduced in the control group. Conclusion • Traditional EA is slightly more effective than sham acupuncture in reducing DHEA secretion and the acne score. Meanwhile, sham acupuncture is not completely ineffective. The specific mechanism of the two may be different.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Development of Rickets in Children and Nursing Contributions to Treatment
Yanan Cao, MD;  Hongyu Huang, MD;  Yunxi Li, BD
Rickets is one of the most prevalent non-communicable diseases in children in the developing world. It is often found in cultures in which children follow strict vegetarian diets and are not exposed to vitamin D-enhanced foods. While a rare occurrence, X-linked hypophosphatemic rickets may be the most frequent type of the disease seen outside the Third World today. However, there is not much credible information on the extent of the development of rickets. Therefore, pediatric nurses must be able to recognize children at risk and provide best practice care for the prevention and treatment of rickets. When caring for children in hospitals, communities or classrooms, nurses play a vital role in identifying children at risk for hypovitaminosis D and advising families to, if possible, follow safe diets and take supplements in order to avoid health complications associated with low levels of vitamin D. This study examines the prevalence and variables contributing to rickets, including hypovitaminosis vitamin D, the consequent orthopedic problems and the role of nurses in preventing and managing the pathogenesis of rickets and ultimately avoiding extreme deficits that result in bone deformities and the need for corrective surgery.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Schizophrenia and Homoeopathy: A Review
Gaurav Gupta, PhD
Context • Schizophrenia is a mental condition that is affecting approx. 1.0 percent of the worldwide population, with devastating consequences for affected individuals and their families. Homoeopathy could be an effective alternative mode of treatment and can minimize the consequences of it. Objective • This study is done to have a brief review of the condition of Schizophrenia and to evaluate the role of Homoeopathy as an alternative mode of treatment in patients suffering from this condition. Design • The research team performed a narrative review by searching Pubmed, IJRH, ISOR-JDMS, WHO, and Medscape databases. Reference books related to medicine and homoeopathy were also reviewed. The search used the keywords like Schizophrenia, Homoeopathy, psychiatry, hallucinations, paranoia, ICD-10, DSM-5, etc. Setting • This study is conducted at Faculty of Homoeopathic Sciences in Jayoti Vidyapeeth Women’s University. Results • Schizophrenia alters the thinking, feeling and behavior of affected person and is presented in form of delusion, hallucination with social withdrawal. Homoeopathy can be an alternative mode of treatment to not only help in improving this condition but also treat the same. There are not much studies that has been conducted to evaluate the role of Homoeopathy in schizophrenia. Out of few, one study has suggested improvement in the symptoms of paranoid schizophrenia using Brief Psychiatric Rating Scale (BPRS) score system. Conclusions • Schizophrenia is a psychiatric condition not only affecting routine of daily of life but also the Quality of life. Homoeopathy is a non-toxic, gentle, permanent treatment which is based on totality of symptoms (TOS) and individualization. In the process of construction of TOS and individualization, more importance is given to mental symptoms. As again pschizophrenia is a psychiatric condition which affects the mental process of patient, Homoeopathy can be used as an effective method of treatment but to establish the efficacy of it, more studies including randomized controlled trials are suggested.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Correlations of RENAL, PADUA and NePhRO Scores With Complications and Outcomes in Patients After CT-Guided Microwave Ablation of Renal Tumors
Zhi-Xin Bie, MM;  Run-Qi Guo, MD;  Xiao-Xiao Guo, MM;  Yuan-Ming Li, MBBS;  Bin Li, MD;  Xiao-Guang Li, MD
Objective • This retrospective study aimed to access the correlations of RENAL, PADUA and NePhRO scores with operative complications, chronic kidney disease (CKD) upstaging, and oncologic outcomes after CT-guided percutaneous Microwave Ablation (MWA) of renal tumors in order to determine their status as independent predictors of outcomes after MWA. This study also aimed to generally evaluate the efficacy of MWA in treating renal tumors. Methods • From January 2017 to December 2019, 18 patients with 27 renal tumors who had undergone simultaneous biopsy and MWA were recruited in this single-center retrospective study. Data collection included tumor characteristics, procedural protocols, complications, CKD upstaging data, local tumor control data and overall survival. All lesions were evaluated using RENAL, PADUA and NePhRO scores, and further analysis was performed to determine whether the scores were correlated with operative complications, CKD upstaging, local tumor control and overall survival. Results • The minor and major complication rates were 16.7% and 0%, respectively. Two patients with solitary kidney experienced CKD upstaging. Local tumor recurrence was identified in one type of tumor (3.7%) in the first year of follow-up. L. parameter (P = .031), longitudinal (polar) location score (P = .011), Ne. parameter (P = .036), number of kidneys (P = .005), and number of lesions (P = .008), were predictive factors significantly associated with the occurrence of complications. Besides, CKD upstaging was associated with A. parameter (P = .032) and urinary collecting system score (P = .028). RENAL, PADUA, and NePhRO scores were significantly correlated with complications, overall survival, and CKD upstaging, respectively (P < .05). Conclusion • CT-guided percutaneous MWA was found to be a valuable alternative in the treatment of renal tumors for selected patients. Furthermore, RENAL, PADUA and NePhRO scores were not independent predictors of outcomes of MWA.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Preliminary Study of Virtual-reality-guided Meditation for Veterans with Stress and Chronic Pain
Joyce S Chung, PhD;  Odette A Harris, MD, MPH;  Colin S Kalahar, LCSW;  Kevin Liu, BA;  Esmeralda Madrigal, LCSW;  Donald Nguyen, BS;  Mira Parekh, BS;  Molly Timmerman, DO
Context • Studies have found evidence for meditation’s positive effects on health and well-being, but the difficulty of learning and engaging in meditation practice has been identified as a major barrier. Virtual reality (VR) technology may facilitate meditation practice by immersing users in a distraction-free and calming virtual environment, although this theory has yet to be rigorously tested. Objective • This study intended to examine the efficacy of VR-guided meditation in a population of US veterans as a tool to facilitate meditation and relaxation practice for reduction of stress and chronic pain as well as to elicit participants’ feedback regarding their perceptions of VR-guided meditation. Design • The research team designed a preliminary study to identify the scope of future investigations. Setting • The study was conducted at an outpatient polytrauma clinic in a Veterans Affairs (VA) Palo Alto Health Care System, located in Palo Alto, California. Participants • Participants were a convenience sample of 31 veterans, with an average age of 55.2 years, who were patients at the polytrauma clinic and who had conditions with varying levels of stress and chronic pain. Intervention • All participants completed a 10-minute, VR-guided-meditation session based on the Zen form of meditation. Outcome Measures • At baseline immediately before and postintervention immediately after the VR meditation session, self-report ratings of pain and stress, physiological measures testing heart rate (HR) and blood pressure (BP), and participants’ survey responses that assessed their experiences with, attitudes toward, and concerns about VR for clinical therapy were obtained. Results • Participants showed statistically significant reductions in self-reported pain and stress, HR, and systolic and diastolic BP. Participants reported high satisfaction with VR-guided meditation, and few reported negative side-effects. Conclusions • The study provided evidence for the usefulness of VR technology as a facilitator of meditation practice for reduction of stress and chronic pain. Future studies are needed to examine the long-term effects of repeated VR-guided-meditation sessions for patients with stress and chronic pain.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Gentle, Massage-like, Head Stroking Provokes Salivary Oxytocin Release
Yoshitaka Koshino, MD;  Naohisa Tomosugi, MD
Context • The evidence is growing that oxytocin (OXT), a hypothalamic hormone, can induce parturition and lactation, modulate affiliative behavior, and regulate stress and energy metabolism. Although the physiological effects of massage aren’t fully understood, massage may affect OXT release and facilitate adaptive responses to stressors. Objectives • This study intended to examine the effects of gentle, massage-like head, stroking to determine whether it could have a direct influence on the release of OXT. Design • The research team performed a preliminary study. Setting • The study was conducted at Kanazawa Medical University in Kahoku and Mizuho Hospital, Tsubata, Ishikawa, Japan. Participants • Participants were 14 volunteers from Mizuho Hospital. Intervention • The 14 recruited participants were assigned to the massage group and received gentle, massage-like, head stroking, which lasted 60 minutes. Seven of those participants were randomly recruited to become a control group that rested only, without massage, on a different day than the massage occurred. Outcome Measures • Participants’ saliva for both groups was drawn at baseline and postintervention on the different days. Salivary OXT was assayed using a highly sensitive chemiluminescence immunoassay. Analyses were performed at baseline before the intervention and postintervention. Results • The OXT secretion increased significantly in the massage group unlike in the rest group, which had no change. Conclusions • Gentle, massage-like, head stroking is an effective method of releasing endogenous OXT. These findings open up the possibility of using endogenous OXT as an adjunct therapy in both clinical and research settings.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Complementary and Alternative Medicine: Consumers’ Experience With Food Therapy in Traditional Chinese Medicine in Hong Kong
Gigi Kai Yin Au Yeung, PhD;  Crystal Yan Pui Lee, PhD;  Alice Hoi Ying Yau, PhD;  Matthew Wai Lung Yeung, PhD
Context • The trend of people using complementary and alternative medicine (CAM) has been an increasing globally. To enact policies and regulations that promote the safe use of CAM, a detailed investigation is needed into people’s knowledge, practices, and beliefs related to CAM. Food therapy has long been regarded as an important part of traditional Chinese medicine (TCM), a type of CAM. Objective • This study intended to empirically examine the public’s knowledge about TCM food therapy, including the sources of that knowledge, actual practices, and the public’s beliefs about the therapy. Design • The research team designed a questionnaire to test the public’s understanding of food properties as designated in TCM food therapy and to identify the public’s sources of knowledge and experience in using food therapy. Setting • The study took place at the College of Professional and Continuing Education, the Hong Kong Polytechnic University, and the University of Hong Kong in Hong Kong, China. Participants • Participants were 447 Chinese students participating in postsecondary or tertiary education at the two higher education institutions mentioned above. Outcome Measures • The survey’s quantitative questions examined respondents’ prior TCM knowledge, sources of knowledge, and food therapy experience compared to their ability to correctly categorize 24 foods. The survey’s qualitative questions examined the general practice of food therapy and the cultural beliefs underlying the food therapy strategies that participants used. Results • The study showed that: (1) having prior and partial knowledge of food properties (P = .000); (2) seeking information from the internet (P = .000), television (P = .0473) and friends (P = .0181); and (3) having used food therapy for chronic conditions (P = .0034) significantly improved participants ability to correctly categorize foods as to their food therapy characteristics. Conclusions • Participants relied less on traditional medical sources such as parents and health professionals but more on the internet, which may have empowered them through wider access to information. The study has further contributed to the study of Complementary and Alternative Medicine (CAM) by highlighting the role of cultural practices and beliefs in TCM food therapy.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Preventive Effects of Lithium Carbonate on Antidepressant-Induced Switch During Depressive Episodes: Chinese Data Analysis
Sun Fengli, MD;  Tao Hejian, MD;  Lv Wangqiang, MD;  Jin Weidong, MD
Context • Some patients experiencing depressive episodes can switch to mania or become mania during treatment with antidepressants. Avoiding a switch is an important part of any therapeutic plan, whether a patient suffers from unipolar or bipolar depression. One method of avoiding switching is use of a mood stabilizer, such as lithium carbonate. Design • The research team performed a narrative review by searching Chinese electronic databases: the Chinese Biomedical Database (CBM), the China National Knowledge Infrastructure (CNKI), WANFANG, and the Chinese Social Sciences Citation Index (VIP). The search used the keywords depression—bipolar depression and depressive episode—and lithium carbonate. Results such as comments, letters, reviews, and case reports were excluded. Setting • The study took place at Jinhua Second Hospital, China. Results • A random effect model was used to account for the data, using Revman 5.2. The switch rate for the intervention groups was 8.28% or 29 out of 351 participants and of the control groups was 25.29% or 87 out of 344 participants (OR = 0.25, 95% CI: 0.16 to 0.39). Lithium carbonate reduced the switch rate by 67.25% [(25.29%-8.28%) /25.29%]. In the bipolar depression group, lithium carbonate reduced the switch rate by 68.11% [(25.84%-8.24%) /25.84%]. In the depression and unipolar depression groups, lithium carbonate reduced the switch rate by 67.07% [(25.29%-8.26%) /25.29%]. In the group of patients treated with selective serotonin reuptake inhibitors (SSRIs), lithium reduced the switch rate by 60.3% [(29.85%-11.85%) /29.85%]. In group of patients treated by tricyclic antidepressants (TCAs), lithium carbonate reduced the switch rate by 73.14% [(22.28%-6.01%) /22.28%]. Conclusions • As typical mood stabilizer, lithium carbonate can reduce the antidepressant-induced switch rates in patients with depressive episodes regardless of the type of antidepressant and the type of depressive episode. Further research should compare the effectiveness of lithium carbonate to that of other mood stabilizers in preventing switching associated with antidepressants
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December, 2021 - VOL. 27, NO. 12  December, 2021
Traditional Chinese Medicine Syndrome Types Among Single-Syndrome Bipolar Mania Cases Described in Chinese Literature
Sun Fengli, MD;  Zhu Jianfeng, MD;  Jin Weidong, MD;  Gao Zhihan, MD
Primary Objective • The aim of this study was to identify and understand the syndromes of mania in traditional Chinese medicine (TCM), as described in Chinese literature on the integrated treatment of mania using TCM and Western medicine. Methods • A literature search conducted in Chinese databases identified 27 articles that were included in a statistical analysis to determine the proportion of mania cases represented by various TCM syndromes. Results • After combining similar syndromes, we found that the TCM syndromes of mania could be categorized as phlegm-fire disturbance of the mind (Tanhuoraoshen), phlegm-heat stagnation (Tanreyujie), qi stagnation and blood stasis (Qizhixueyu), liver qi stagnation (Gandanyure), and fire injury Yin (Huoshengshnagyin). These syndrome categories accounted for 55.6%, 18.5%, 14.8%, 7.4% and 3.7% of mania cases, respectively. Manic symptom severity scores differed significantly among phlegm-fire disturbance of the mind (26.8 ± 1.6), phlegm-heat stagnation (31.1 ± 1.9), and qi stagnation and blood stasis (23.5 ± 2.2). Conclusion • The largest proportion of mania cases involved phlegm-fire disturbance of the mind, phlegm-heat stagnation, or qi stagnation and blood stasis. Cumulatively, these syndromes accounted for 88.9% of cases; the severity of manic symptoms different significantly among the 3 syndrome categories. Smaller proportions of cases represented liver qi stagnation or fire injury Yin.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effectiveness of Mindful Self-Compassion Training Supported by Online Peer Groups in China: A Pilot Study
Xiaoxia Guo, MD, PhD;  Bettina Hoeppner, PhD;  Xiaoyu Huang, MA;  Felipe A Jain, MD;  Xiaoqin Mai, MD, PhD;  David Mischoulon, MD, PhD;  Emily K Tan, BA;  Qionghui Xie, PhD;  Albert Yeung, MD, ScD
Context • Self-compassion training involves the cultivation of feelings of warmth and safety, presence, and interconnectedness. Mindful Self-Compassion (MSC) training in a group setting has been found to increase self-compassion, mindfulness, and emotional well-being. Objective • The current study intended to examine the outcomes of live, online, videoconference-based MSC training with online peer-support for nonclinical populations in different cities in China. Design • The research team designed a pre-post pilot study. Setting • The study took place at Renmin University in Beijing, China. Participants • Participants were 253 Chinese individuals who were recruited from different regions in China through online advertisements. Intervention • Participants took part in online MSC training in a two-hour, group class each week for eight weeks and received support from online peer groups and through a half-day in-person retreat. Outcome Measures • Self-report outcomes were obtained at baseline and postintervention, using the Self Compassion Scale (SCS) and the Compassion for Others Scale (CS) for primary outcomes, and the Depression, Anxiety, and Stress Scale (DASS-21), the Fear of Compassion Scale (FOCS), the Satisfaction with Life Scale (SWLS), the Subjective Happiness Scale (SHS), and the Cognitive and Affective Mindfulness Scale (CAMS-R), for secondary outcomes. A fixed effects model was used to test for within-group changes in the scales. Results • The online MSC program yielded a high retention rate. Of the 206 first-time participants, 179 (86.9%) attended six or more of the eight MSC sessions, and 183 (88.8%) completed the assessments at both baseline and postintervention. Of the 183 retained participants, 97.8% were female, with an average age of 37.8 ± 7.9; 94% had college or higher education. For all scales, the within-person changes occurred in the expected direction; positive attributes and experiences increased, while negative attributes and experiences decreased. Conclusions • The study showed that first-time participants in China in an online MSC training that was supported by online peer groups had high attendance rates, high assessment completion, and favorable results. These preliminary outcomes suggest that future studies with more rigorous designs are warranted to further investigate online training with peer support as an effective and efficient approach to disseminate MSC training in China.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Olive Oil on Striae Gravidarum in Primiparous Women: A Randomized Controlled Clinical
Derya Kanza Gul, MPH, PhD;  Ayça Solt Kirca, PhD
Context • The development of striae gravidarum (SG), stretch marks, is one of the most common skin changes during pregnancy. The number of studies conducted on the reduction or prevention of SG, especially on the effects of olive oil, is limited. Objective • The study intended to evaluate the clinical efficacy of olive oil in reducing the severity and preventing the progression of SG when used from the third trimester of pregnancy to the child’s birth. Design • The study was designed as a randomized controlled trial. Setting: The data was collected at the private Medipol Nisa Hospital. The trial registry number is NCT04489901. Participants • Participants were 156 Turkish women having their first pregnancies and in their third trimester. Intervention • Participants were randomly assigned to either the intervention or the control group. Women in the intervention group applied olive oil to their abdomens twice a day, in the morning and evening. The control group used no intervention. Outcome Measures • The participants’ striae levels were assessed using the Fitzpatrick Skin Type Scale and Davey’s Severity Score. Results • A statistically significant difference existed between the intervention and the control groups in terms of incidence and type of striae gravidarum, with the intervention group having a 50% incidence and 85.9% type 2 striae compared to the control group’s 69.2% incidence and 35.9% type 4 striae. According to Davey’s Severity Score, the severity of striae was significantly lower in the intervention group compared to the control group, with the scores being 2 and 4, respectively. Conclusions • Using olive oil was very effective in reducing the severity and preventing the progression of striae gravidarum.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Effects of Curcuma longa L., Eucommia ulmoides Oliv. and Gynostemma pentaphyllum (Thunb.) Makino on Cytokine Production in Stimulated Peripheral Blood Mononuclear Cells in Patients with Tuberculosis
Chien-Ming Chu, MD;  Li-Pang Chuang, MD;  Han-Chung Hu, MD;  Kuo-Chin Kao, MD;  Yin-Ku Lin, MD;  Huang-Pin Wu, MD
Background • Tuberculosis (TB) infection triggers the innate and adaptive immune responses. Eucommia ulmoides Oliv., Gynostemma pentaphyllum (Thunb.) Makino, and Curcuma longa L. extracts exhibit various immunomodulatory effects. Objective • This study aimed to determine the effects of 3 extracts used in Traditional Chinese Medicine (TCM) on cytokine production in peripheral blood mononuclear cells (PBMCs) obtained from patients with TB. Design • The research team performed an in vitro study with self controls. Setting • The study took place at the Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taiwan. Participants • 18 patients diagnosed with pulmonary TB were enrolled in the study. Intervention • Purified protein derivative (PPD)-stimulated PBMCs were cultured for 48 h in the presence and absence of 0.05 or 0.1 mg/mL of herbal extracts. Outcome Measures. Cytokine levels of interferon (IFN)-?, interleukin (IL)-10, IL-12, tumor necrosis factor (TNF)-a and transforming growth factor (TGF)-ß1 in the culture supernatant were measured. Results • C longa L., E ulmoides Oliv. and G pentaphyllum (Thunb.) Makino extracts decreased IFN-? production in PPD-stimulated PBMCs. C longa L. extract did not exhibit a marked and consistent effect on the production of IL-10, IL-12, TNF-a and TGF-ß1. E ulmoides Oliv. extract increased the production of IL-10, TNF-a and TGF-ß1. G pentaphyllum (Thunb.) Makino extract increased the production of IL-10, IL-12, TNF-a and TGF-ß1. Conclusion • These results show that G pentaphyllum (Thunb.) Makino might enhance cell immunity since it increased the production of IL-12 and TNF-a with dose effect.
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December, 2021 - VOL. 27, NO. 12  December, 2021
Initial and Continuous Effects of Essential Oil Therapy in Relieving Knee Pain Among Older Adults With Osteoarthritis
Shu-nu Change-Lee, PhD;  Hun-En Liao, PhD;  Cheng-yuan Lin, MS;  Yea-yin Yen, PhD
Background • For older adults, osteoarthritis (OA) is a common chronic disease that may cause pain, stiffness, and even disability of the affected knee joints. Aromatherapy might presumed to be an alternative and supplemental therapy. Primary Study Objective • To investigate the effects of aromatherapy on relieving knee pain and improving physical functions among older adults with OA. Methods/Design • A true experimental design with randomized assignment of both treatment (aromatherapy) and control (placebo) groups was used for this study. Participants • Volunteers from 3 local communities aged =50 y with self-reported OA-related knee pain were recruited. Interventions • A synergistic blend of essential oils diluted to a concentration of 3% was administered to participants in treatment (essential oil) group, whereas mineral oil without essential oil was applied to participants in control (placebo) group. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), including subscales of pain, stiffness, and physical function, was employed to record scores before intervention, 4 wk postintervention, and 8 wk postintervention. Pain scores were also measured and collected by using the visual analog scale at the above counterparts. The Stata v.13 software was used to perform referent statistics with a significance level (a) of 0.05 adopted. Results • The progressive linear model showed that continuous use of essential oils for 8 wk not only relieves pain immediately, but also further reduces the pain scores of participants, thus proving the long-term effect of aromatherapy on alleviating knee arthritis. Repeated measures analysis of variance further showed that time (intervention duration) is an important factor affecting all outcome scores. Except for stiffness subscales measured by WOMAC, all interactions between groups were significant. Conclusions • Aromatherapy is validated to be an effective alternative therapy in improving clinical outcomes for patients with OA-induced knee conditions. In addition, longer intervention duration (8 wk instead of 4 wk) yielded better treatment results for participants.
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December, 2021 - VOL. 27, NO. 12  December, 2021
The Role of Nurses in Taking Care of Children With Type 1 Diabetes
Qiurong Chen, BD;  Hongju Dai, MBBS;  Hongyu Huang, MD;  Kaili Wu, MBBS;  Xue Yang, MBBS
Type 1 diabetes (T1D) is an autoimmune disease leading to an insulin deficiency that causes hyperglycemia and associated symptoms. It is considered the most common type of diabetes, with the 4Ts (going to the toilet a lot, being really thirsty, feeling more tired than usual, losing weight or looking thinner than usual) being the most prevalent symptoms. Non-specific signs and symptoms are also possible, and delaying or missing the diagnosis can have a devastating effect on a child’s health. Children with a definitive diagnosis of diabetes often require medical treatment for problems such as ketoacidosis, hypoglycemia and hyperglycemia. To reach glycated hemoglobin (HbA1c) values of 48 mmol/mol, lifetime rigorous monitoring and management of blood glucose levels via insulin replacement treatment is needed in T1D. Physical and psychosocial issues arise frequently with a diabetes diagnosis, resulting in poor management. Nurses play a significant role in detecting diabetes in a number of healthcare settings, resulting in quick diagnoses and prompt initiation of treatment. Not only do they provide critical assistance to help children and their families with the diagnosis, they also place particular emphasis on managing difficult days and common problems with ongoing management. Nurses can provide invaluable assistance managing this chronic condition by coping with day-to-day challenges.
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