Role of oral inositol supplementation in women with polycystic ovarian syndrome

Background: PCOS is one of the most common endocrine disorder in women of reproductive age, it affects about 5-10% of women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. 30-40% of PCOS women have impaired glucose tolerance.Methods: This was prospective observational study carried out on 100 patients of PCOS visiting outpatient Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur from 1st July 2018 to 30th June 2019. Patients were diagnosed as PCOS on basis of Rotterdam criteria. In these 100 patients, oral inositol 2 gm twice daily was given for 3 months to 6 months depending upon the response of the patient and patients were examined every 4 week for menstrual regularity, acne improvement, hirsutism, spontaneous ovulation and pregnancy.Results: With inositol supplementation, menstrual abnormality corrected in 80% cases, 45% cases having acne improved. Ovulation occurred in 75.5% cases and 66.6% cases conceived with inositol supplementation.Conclusions: Insulin resistance is the basic pathophysiology for PCOS hence inositol supplementation is supposed to be very good medicine for management of PCOS to improve insulin sensitivity. Inositol leads to improvement in regularity of menstrual cycle, insulin resistance, hyperandrogenic features like hirsutism, acne, restores ovulation and improves oocyte quality.

Biological Therapy with Complementary and Alternative Medicine in Innocuous Integrative Oncology: A Case of Cervical Cancer

Good medicine is based on good science, inquiry driven and open to new paradigms. For a complex disease such as cancer, a complex treatment regime that is well structured and multifactorial is indispensable. In the present day, Complementary and Alternative Medicine (CAM) therapies are being used frequently for cancer, alongside modern biological therapies and allopathic medicine, in what is called integrative oncology. In all conscience, the use of natural, less invasive interventions whenever possible is ideal. However, a comprehensive understanding of not only the etiopathology of individual cancers, but also the detailed genetic and epigenetic characteristics, the cancer hallmarks, that clearly show the blueprint of the cancer phenotype is a requisite. Different tumors have a common behavioral pattern, but their specific features at the genetic and epigenetic levels vary to a great extent. Henceforth, with so many failed attempts to therapy, drug formulations and combinations need a focused pre-assessment of the inherent features of individual cancers to destroy the tumors holistically by targeting these features. This review therefore presents innocuous therapeutic regimes by means of CAM and integrative medicine approaches that can specifically target the hallmarks of cancer, using the case of cervical cancer.

Coroless, effective ingredient isolated from traditional Chinese medicine for the prevention and treatment of Covid-19

We believe that a good medicine for the prevention and treatment of Covid-19 requires three points: 1. Effectively inhibit the cells from being infected by Covid-19; 2. Quickly repair lung damage; 3. Non-toxic and harmless. Fortunately, from the treasure depot of Chinese traditional medicine, we found Kyllinga brevifolia Rottb, which is sufficient for three points and can be used for prevention, treatment and rehabilitation. Not only that, we have isolated the active ingredient of the Kyllinga brevifolia Rottb, named it Coroless, and verified that Coroless inhibits the Covid-19 from infecting cells through in vitro cell experiments.

Cerebrovascular assessments to help understand brain-related changes associated with aerobic exercise after stroke

Evidence suggests exercise is ‘good medicine’ post-stroke, yet consensus is lacking on the time to initiate, type, exertion level, and duration per session. It remains a challenge to identify outcome measures for stroke-exercise trials that are sufficiently sensitive to intervention parameters. Cerebrovascular assessments, namely cerebral blood flow and intracranial pulsatility, are herein discussed as examples of quantitative brain-specific measures that may be useful to monitor exercise-related brain changes and help to guide stroke rehabilitation interventions. Bullets: Cerebral blood flow and arterial stiffness are potential vascular targets for stroke exercise trials.

How do managers and physicians reconcile between financial and clinical considerations in hospitals?

Background Hospital managers and physicians may face dilemmas due to their role as dual agents, committed both to their hospitals and their patients. We aim to pinpoint situations where economic and clinical considerations are aligned or conflicting; and to explore how managers and physicians reconcile different considerations in their decision-making in Germany and Israel. Methods Qualitative, thematic analysis based on 47 in-depth interviews with managers, ward directors and physicians in five hospitals in Germany and five in Israel. Results Economic and clinical considerations are aligned when gaps between hospital payments and costs are small, and economic incentives do not distort clinical considerations or when good medicine avoids complications while saving costs. Dilemmas arise when procedures are underpriced, resulting in financial losses to the hospital, and represent barriers for adoption of new, costly, medical equipment. In many instances, managers and ward directors choose one of the principals (hospital or patient), yet sometimes they develop reconciliation strategies that include: (1) improving coding of activities and diagnoses to assure higher payments; (2) reducing costs per case by choosing cheaper supplies with the same quality, bulk purchasing or reducing unnecessary lengths-of-stay; (3) providing clear treatment guidelines that support decision-making. Hospitals in Germany increase efficiency through specialization, and try to find alternative, less costly, care settings such as rehabilitation facilities. In Israel, hospitals balance the amount of unprofitable cases with many other profitable cases. Conclusions While sometimes one principal prevails, agents reconcile economic and clinical considerations. In Germany, a high-expenditure hospital market, there is some flexibility to change the character of hospitals activity, while in Israel, a middle-expenditure market, agents balance activities within the existing framework. Key messages Dilemmas exist regardless of the amount of hospitals’ funds. In Germany there is flexibility to change hospitals’ activity, while in Israel agents balance activities within the existing framework.

Ethical and Social Issues in Medicine

So rapidly has the field of health care ethics continued to grow that, when recently “googled,” the term produced 28.2 million hits. The challenge is to address the ethical and social issues in medicine in this very limited article space. It remains an impossible task to present more than a superficial discussion of these complex issues and the complicated cases in which they are to be found. Like good medicine, good ethics cannot be practiced by algorithm. The authors have opted to provide an operational guide to help clinicians sort through the ethical and social quandaries they must face on a daily basis. To that end, the authors have chosen to divide this chapter into the following sections: 1. A brief description of the biopsychosocial nature of ethics and how it differs from personal morality 2. A method for identifying and dealing with ethical issues 3. A discussion of the role of bioethicists and ethics committees 4. The professional fiduciary role of clinicians 5. Listings of some of the common key bioethical and legal terms (online access only) 6. A very brief discussion of the terms cited in the above listings (online access only) This reviews contains 4 tables, 8 references, 1 appendix, and 20 additional readings. Keywords: Ethical, social, right, wrong, good, bad, obligation, moral authority, critically reflective, and multiperspectival activity, Curiosity, Honesty, Patience, Open-mindedness