scholarly journals A Panoramic view of most commonly used Regimenal Modalities (Tadabeer) for joint pain in Unani System of Medicine: A Critical Review

2021 ◽  
Vol 11 (2) ◽  
pp. 228-231
Author(s):  
Mohd Nayab ◽  
Abdul Nasir Ansari ◽  
Fatima Khan
Keyword(s):  
Clinical Trials ◽  
Musculoskeletal Disorders ◽  
Critical Review ◽  
Joint Pain ◽  
Clinical Problem ◽  
Large Sample Size ◽  
Journal Articles ◽  
Long Duration ◽  
Major Clinical Problem

Pain in joints (Waja ul Mafasil) is a major clinical problem that may or may not be associated with inflammation. Researchers and Clinicians are rigorously working to find out the best treatment modality in the management of joint pain. Unani physicians claimed the management of various joint disorders with the help of several Tadabeer. The objective of this critical review is to address the claims of Unani physicians and clinical studies conducted on the efficacy of Dalk or Hijama in the management of joint pain. Classical Unani literature, peer-reviewed journal articles and RCTs that predominantly focused on the use of regimenal modalities (Hijama and Dalk) in the joint pain were included in this review. Several published studies claiming the effect of Dalk and Hijama by Unani physicians, showing significant improvement, were included along with the literature. Various published clinical trials showed the effect of Dalk and Hijama in the management of joint pain, though, the effect showed by some clinical trials was short term. Hence, rigorous, controlled, randomized, blinded, and long duration follow up studies on large sample size are to be conducted by trained clinicians or researchers to establish the efficacy of Dalk or Hijama in the management of musculoskeletal disorders (MSDs). Keywords: Dalk; Hijama; Waja-ul-Mafasil; Joint Pain; Musculoskeletal Disorders; Unani

scholarly journals Evidence-Based Therapeutic Benefits of Cupping Therapy (Ḥijāma): A Comprehensive Review

2021 ◽  
Vol 11 (4-S) ◽  
pp. 258-262
Author(s):  
Hina V Kouser ◽  
Mohd Nayab ◽  
Ayesha Tehseen ◽  
Shaista Mahfooz ◽  
Baig Ruqaiyya ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Skin Surface ◽  
Cupping Therapy ◽  
The Body ◽  
Large Sample Size ◽  
Comprehensive Review ◽  
Therapeutic Benefits ◽  
Long Duration ◽  
Ancient Times

Ilaj bi’l tadbeer (regimenal therapy) is one of the preferred treatment methods used in Unani system of medicine since ancient times. Ḥijāma is one of the effective modalities of treatment in Ilaj bi’l tadbeer. It is a unique therapeutic procedure in which cup like vessels are placed on the body surface by creating a vacuum to either let out blood from below the skin surface or just plain suction without bloodletting. The objective of this comprehensive review paper is to address the claims of Unāni physicians and clinical studies conducted on the efficacy of Ḥijāma. Various published clinical trials showed the efficacy of Ḥijāma in the management of a number of diseases. Though, the effect showed by some clinical trials was short term. Hence, it is suggested that rigorous, well-designed, controlled, randomized and long duration follow up clinical trials on large sample size are to be conducted by trained clinicians or researchers to establish the efficacy of Ḥijāma in the management of various diseases. Keywords: Ilaj bi’l tadbeer, Ḥijāma, Therapeutic Benefits

Facilitating Transfer and Maintenance of Fluency in Stuttering Therapy

1977 ◽  
Vol 42 (1) ◽  
pp. 65-76 ◽  
Author(s):  
Richmond Hanna ◽  
Neville Owen
Keyword(s):  
Clinical Work ◽  
Clinical Problem ◽  
Self Control ◽  
Self Monitoring ◽  
Control Techniques ◽  
Treatment Techniques ◽  
Time Concepts ◽  
Major Clinical Problem ◽  
Clinical Problems

The present state of stuttering therapy programs enables the clinician to render many stutterers virtually stutter-free in the clinic. A major clinical problem, however, is the transfer of fluency to nonclinical situations and its maintenance over time. Concepts and techniques extrapolated from the literature on behavior change are applied to assessment, treatment objectives, treatment techniques, and to a number of procedures designed to facilitate transfer and maintenance during therapy. When fluency has been established, self-control techniques based on speech practice, self-monitoring, and the deliberate use of self-administered and social contingencies are stressed. Guidelines for termination of therapy and follow-up are given. For many of these techniques, specific examples are offered from clinical work with stutterers. Other techniques are presented because of their potential relevance and their demonstrated effectiveness with a variety of clinical problems.

scholarly journals Hereditary thrombocytopenias: a growing list of disorders

Hematology ◽  
2017 ◽  
Vol 2017 (1) ◽  
pp. 385-399 ◽  
Author(s):  
Patrizia Noris ◽  
Alessandro Pecci
Keyword(s):  
High Throughput Sequencing ◽  
Hematological Malignancies ◽  
Bone Marrow Failure ◽  
Clinical Problem ◽  
Molecular Defects ◽  
Appropriate Treatment ◽  
Clinical Presentations ◽  
Current Scenario ◽  
Major Clinical Problem

Abstract The introduction of high throughput sequencing (HTS) techniques greatly improved the knowledge of inherited thrombocytopenias (ITs) over the last few years. A total of 33 different forms caused by molecular defects affecting at least 32 genes have been identified; along with the discovery of new disease-causing genes, pathogenetic mechanisms of thrombocytopenia have been better elucidated. Although the clinical picture of ITs is heterogeneous, bleeding has been long considered the major clinical problem for patients with IT. Conversely, the current scenario indicates that patients with some of the most common ITs are at risk of developing additional disorders more dangerous than thrombocytopenia itself during life. In particular, MYH9 mutations result in congenital macrothrombocytopenia and predispose to kidney failure, hearing loss, and cataracts, MPL and MECOM mutations cause congenital thrombocytopenia evolving into bone marrow failure, whereas thrombocytopenias caused by RUNX1, ANKRD26, and ETV6 mutations are characterized by predisposition to hematological malignancies. Making a definite diagnosis of these forms is crucial to provide patients with the most appropriate treatment, follow-up, and counseling. In this review, the ITs known to date are discussed, with specific attention focused on clinical presentations and diagnostic criteria for ITs predisposing to additional illnesses. The currently available therapeutic options for the different forms of IT are illustrated.

Abstract P223: Dietary Magnesium and the Risk of Stroke among Women

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Sally N Akarolo-Anthony ◽  
Kathryn M Rexrode ◽  
Donna Spiegelman ◽  
Walter C Willett
Keyword(s):  
Health Study ◽  
Large Sample Size ◽  
Parental History ◽  
Magnesium Intake ◽  
Long Duration ◽  
History Of ◽  
Cox Proportional Hazard Models ◽  
Stroke Type ◽  
Epidemiology Studies

Background: Epidemiology studies suggest that high magnesium intake may decrease the risk of stroke by reducing hypertension, endothelial dysfunction and carotid artery thickness, but the results are inconsistent. We therefore examined the association between magnesium intake and stroke type in a cohort with repeated measurement of diet, long duration of follow up, and a large sample size. Methods: We prospectively followed 86,149 women in the Nurses’ Health Study, aged 35 to 55 years, who were free of diagnosed cardiovascular disease and cancer at baseline in 1980. Data on dietary intake were collected with a semi-quantitative food frequency questionnaire at baseline in 1980, 1984, 1986 and then every 4 years, while data on stroke, stroke risk factors and potential confounders were collected at baseline and updated biennially. Strokes were classified according to the National Survey of Stroke criteria; and strokes for which medical records were not available were classified as probable/unknown. We calculated the hazard ratio (95% CI) of stroke by quintiles of magnesium intake, using multivariate Cox proportional hazard models, adjusting for potential confounders. Results: During 28 years of follow-up, 3237 total strokes (1664 ischemic, 544 hemorrhagic and 1029 probable/unknown) were documented. In multivariate analyses adjusting for age, total calories, smoking, body-mass index, parental history of heart disease, alcohol intake, physical activity, menopausal therapy, history of hypertension, hypercholesterolemia and diabetes at baseline, as well as use of multivitamin, aspirin, and thiazides, women in the highest quintile of magnesium intake had a relative risk (RR) of 0.85 (95% CI, 0.72 to 0.96; P for trend=0.03) for total stroke; 0.86 (95% CI, 0.72 to 1.01; P for trend=0.05) for ischemic stroke; and 0.85 (95% CI, 0.62 to 1.08; P for trend=0.37) for hemorrhagic stroke, compared with those in the lowest quintile. Further adjustment for potassium and calcium attenuated these associations; for total stroke the risk estimate was 0.90 (0.75 to 1.06; P for trend=0.38). Conclusions: Low magnesium intake may contribute to higher risk of stroke, but distinction from potential effects of potassium and calcium is difficult.

A PLEA FOR SIMPLICITY AND LARGE SAMPLE SIZE

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 823-823
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Sample Size ◽  
Large Scale ◽  
Large Sample Size ◽  
Large Sample ◽  
Health Care Interventions ◽  
Scientific Value

"Most [clinical] trials would be of much greater scientific value if they collected ten times less data, both at entry and during follow-up, and were therefore much larger. Peto R, Collins R, Gray R. Large-scale randomized evidence: large, simple trials and overviews of trials. In: Warren KS, Mosteller F, eds. Doing More Good Than Harm: The Evaluation of Health Care Interventions."

The use of cannabinoids for sleep: A critical review on clinical trials.

2019 ◽  
Vol 27 (4) ◽  
pp. 383-401 ◽  
Author(s):  
Nirushi Kuhathasan ◽  
Alexander Dufort ◽  
James MacKillop ◽  
Raymond Gottschalk ◽  
Luciano Minuzzi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Critical Review

Ongoing randomized clinical trials for the treatment of thrombosis in the antiphospholipid syndrome

2001 ◽  
Vol 21 (02) ◽  
pp. 77-81 ◽  
Author(s):  
G. Finazzi
Keyword(s):  
Clinical Trials ◽  
Large Scale ◽  
Low Dose ◽  
Randomized Clinical Trials ◽  
Oral Anticoagulants ◽  
Collaborative Study ◽  
Clinical Problem ◽  
Vascular Events ◽  
Dose Oral ◽  
Adverse Pregnancy

SummaryThrombotic events are a major clinical problem for patients with antiphospholipid antibodies (APA). However, current recommendations for their prevention and treatment are still based on retrospective studies. Data from large scale, prospective clinical trials are required to ultimately identify the optimal management of these patients. To date, at least four randomized studies are underway. The WAPS and PAPRE clinical trials are aimed to establish the correct duration and intensity of oral anticoagulation in APA patients with major arterial or venous thrombosis. The WARSS-APASS is a collaborative study to evaluate the efficacy and safety of aspirin or low-dose oral anticoagulants in preventing the recurrence of ischemic stroke. The recently announced UK Trial compares low-dose aspirin with or without low-intensity anticoagulation for the primary prevention of vascular events in APA-positive patients with SLE or adverse pregnancy history, but still thrombosis-free. It is hoped that the results of these trials will be available soon since clinicians urgently need more powerful data to treat their patients with the APA syndrome.

Epidemiology and antimicrobial resistance of Acinetobacter

2018 ◽  
Vol 2 (4) ◽  
pp. 46-59
Author(s):  
A.G. Salmanov ◽  
O.M. Verner ◽  
L.F. Slepova
Keyword(s):  
Antibiotic Resistance ◽  
Laboratory Testing ◽  
Immunocompromised Host ◽  
Clinical Problem ◽  
Healthcare Associated Infections ◽  
Opportunistic Bacteria ◽  
Acinetobacter Spp ◽  
Healthcare Associated ◽  
Major Clinical Problem

Species of the Acinetobacter represent opportunistic bacteria with a growing clinical significance for Healthcare-associated infections (HAIs). In this literature review, we focus on the current role of Acinetobacter in infectious pathology and describe taxonomy, pathogenicity, and antibiotic resistance of these bacteria. Pathogenesis and regulation of virulence factors in Acinetobacter spp. are described in detail. The majority of acinetobacterial infections are associated with A. baumannii and occur predominantly in an immunocompromised host. Usually, acinetobacterial  infections  are characterized by local purulent inflammation; in severe cases, meningitis and sepsis may develop. Antibiotic resistance of Acinetobacter is a major clinical problem; therefore we give special attention to laboratory testing of resistance to antibiotics as well as identification of Acinetobacter.

scholarly journals Real-World Experience with Bezlotoxumab for Prevention of Recurrence of Clostridioides difficile Infection

2020 ◽  
Vol 10 (1) ◽  
pp. 2
Author(s):  
Rosa Escudero-Sánchez ◽  
María Ruíz-Ruizgómez ◽  
Jorge Fernández-Fradejas ◽  
Sergio García Fernández ◽  
María Olmedo Samperio ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Real World ◽  
Recurrence Rates ◽  
Factors Associated ◽  
Clostridioides Difficile ◽  
Multicentre Cohort Study ◽  
Clostridioides Difficile Infection ◽  
Prevention Of Recurrence ◽  
Multicentre Cohort

Bezlotoxumab is marketed for the prevention of recurrent Clostridioides difficile infection (rCDI). Its high cost could be determining its prescription to a different population than that represented in clinical trials. The objective of the study was to verify the effectiveness and safety of bezlotoxumab in preventing rCDI and to investigate factors related to bezlotoxumab failure in the real world. A retrospective, multicentre cohort study of patients treated with bezlotoxumab in Spain was conducted. We compared the characteristics of cohort patients with those of patients treated with bezlotoxumab in the pivotal MODIFY trials. We assessed recurrence rates 12 weeks after completion of treatment against C. difficile, and we analysed the factors associated with bezlotoxumab failure. Ninety-one patients were included in the study. The cohort presented with more risk factors for rCDI than the patients included in the MODIFY trials. Thirteen (14.2%) developed rCDI at 12 weeks of follow-up, and rCDI rates were numerically higher in patients with two or more previous episodes (25%) than in those who had fewer than two previous episodes of C. difficile infection (CDI) (10.4%); p = 0.09. There were no adverse effects attributable to bezlotoxumab. Despite being used in a more compromised population than that represented in clinical trials, we confirm the effectiveness of bezlotoxumab for the prevention of rCDI.

scholarly journals Disability improvement as a clinically relevant outcome in clinical trials of relapsing forms of multiple sclerosis

2021 ◽  
pp. 135245852110002
Author(s):  
Bruce AC Cree ◽  
Jeffrey A Cohen ◽  
Anthony T Reder ◽  
Davorka Tomic ◽  
Diego Silva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Therapeutic Benefit ◽  
Disease Modifying Therapies ◽  
Long Term Follow Up ◽  
Post Hoc ◽  
Switch Group ◽  
Relevant Outcome

Background: Disease-modifying therapies (DMTs) can reduce the risk of disability worsening in patients with relapsing forms of multiple sclerosis (RMS). High-efficacy DMTs can lead to confirmed or sustained disability improvement (CDI and SDI). Objective and Methods: Post hoc analyses of data from the TRANSFORMS, FREEDOMS, and FREEDOMS II trials and their extensions assessed the effects of fingolimod (0.5–1.25 mg/day) on stabilizing or improving disability over ⩽8 years in participants with RMS. CDI and SDI rates were compared between participants initially randomized to fingolimod, interferon (IFNβ-1a), or placebo. Results: At 8 years’ follow-up in TRANSFORMS, 35.1% (95% confidence interval [CI], 28.2%–43.1%) of assessed participants in the IFNβ-1a–fingolimod switch group and 41.9% (36.6%–47.6%) on continuous fingolimod experienced CDI; disability did not worsen in approximately 70%. Similar results were seen in the combined FREEDOMS population. Proportionally fewer TRANSFORMS participants achieved SDI in the IFNβ-1a–fingolimod switch group than on continuous fingolimod (5.4% [3.0%–9.5%] vs 14.2% [10.8%–18.4%], p = 0.01). Conclusion: CDI and SDI are outcomes of interest for clinical trials and for long-term follow-up of participants with RMS. Monitoring CDI and SDI in addition to disability worsening may facilitate understanding of the therapeutic benefit of RMS treatments.

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