Monday, October 31, 2016

Acupuncture Relieves Rhinitis & Prevents Oral Ulcers

Acupuncture relieves nasal congestion due to rhinitis. Research published in the Shanghai Journal of Acupuncture and Moxibustion demonstrates that acupuncture combined with moxibustion alleviates nasal congestion, swelling, post-nasal drip, and a runny nose.The research confirms that acupuncture exerts an anti-inflammatory action, enhances immunity, and is effective in the prevention of immunological related disease.

The research compared the effectiveness of acupuncture plus moxibustion with nasal drops containing nitrofurazone and ephedrine. The total effective rate of the nasal drop medication was 55%. Acupuncture combined with moxibustion achieved an 85% total effective rate for the alleviation of rhinitis signs and symptoms.


Friday, October 28, 2016

These 3 acupuncture points are banned for pregnant women, here's why..

Many Traditional Chinese Medicine therapists consider acupuncture to be a safe and effective form of alternative medicine for pregnant women. Complications arising from the application acupuncture therapy during pregnancy are rare; however some acupuncture points should be used with caution or avoided  during pregnancy.

Below we have listed three acupoints many acupuncturists would agree should be avoided throughout every trimester. Although these are three of the most popular and widely used acupoints in an acupuncturist’s arsenal, their dynamically powerful action on a patient’s qi makes them a risky choice during pregnancy.


Thursday, October 27, 2016

Musculoskeletal Injections: A Review of the Evidence

Injections are valuable procedures for managing musculoskeletal conditions commonly encountered by family physicians. Corticosteroid injections into articular, periarticular, or soft tissue structures relieve pain, reduce inflammation, and improve mobility. Injections can provide diagnostic information and are commonly used for postoperative pain control. Local anesthetics may be injected with corticosteroids to provide additional, rapid pain relief. Steroid injection is the preferred and definitive treatment for de Quervain tenosynovitis and trochanteric bursitis. Steroid injections can also be helpful in controlling pain during physical rehabilitation from rotator cuff syndrome and lateral epicondylitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis. There is little systematic evidence to guide medication selection for therapeutic injections. The medication used and the frequency of injection should be guided by the goal of the injection (i.e., diagnostic or therapeutic), the underlying musculoskeletal diagnosis, and clinical experience. Complications from steroid injections are rare, but physicians should understand the potential risks and counsel patients appropriately. Patients with diabetes who receive periarticular or soft tissue steroid injections should closely monitor their blood glucose for two weeks following injection.


Am Fam Physician. 2008 Oct 15;78(8):971-976.

Sunday, October 23, 2016

Providing Value-Based Regional Anesthesia: It’s a Matter of Angles

The value of the services that anesthesiologists provide is being examined more closely than ever. Indeed, determining the true value of regional anesthesia can only be done within the context of its many costs, most of which are not monetary.

“‘Value’ is the name of the game in medicine these days,” said Brian E. Harrington, MD, staff anesthesiologist at Billings Clinic Hospital, in Billings, Mont. “Yet I don’t think a lot of anesthesiologists have a great understanding of the concept of value and how we can impact it,” he said during the 21st Annual Jefferson Anesthesia Conference.

Value = Benefit/Cost

“Many anesthesiologists limit their perception of the value of regional anesthesia to its benefits: less pain, faster rehabilitation and better patient satisfaction,” Dr. Harrington said. “But value is actually benefit per cost.”


Saturday, October 22, 2016

The Effect of LI4 Acupressure on Labor Pain Intensity and Duration of Labor

One of the most pressing concerns and fears for pregnant women is the pain of labor, which leads to an increase in the number of cesarean sections. Pain relief in labor is an important issue in obstetric care, however, as yet, there is no standard and accepted technique for the relief of that pain without side effects.

Generally, there are two options for pain relief during labor, these use either pharmacological or non-pharmacological methods. Pharmacological methods have adverse side effects for the mother and fetus, whereas non-pharmacological methods are free from side effects.

Acupressure is a non-invasive method which is used to augment labor, provide pain relief, and shorten delivery time. It increases the intensity of uterine contractions (based on Montevideo unit) without affecting the duration and intervals of uterine contractions and, eventually, reduces the duration of delivery.

A single-blinded, randomized, control trial was carried out over a seven-month period, between October 2011 and April 2012, at Dr. Shariati University Hospital in Bandar Abbas, Iran. The trial was approved by the Ethics Committee of Hormozgan University of Medical Sciences (HUMS), Iran.

Our study suggests that L14 acupressure is a suitable non-pharmacological technique that is easy to perform and effective in elevating pain, without causing adverse side effects for the mother or baby. It can be used to reduce pain during the active phase of labor rather than using pharmacological methods. According to the World Health Organization’s policies to reduce the rate of cesarean deliveries and promotion of safe childbirth, it is necessary to make childbearing pleasant and reduce maternal fear of natural childbirth using safe methods to reduce labor pain and increase the rate of vaginal delivery. In order to make this possible, midwives need training in using non-pharmacological techniques and the attitudes and policies of the hospitals need to be altered. Due to the simplicity and safety of the acupressure technique, additional research using a larger sample size and in combination with other techniques to apply pressure on different points of body is suggested.


Oman Med J. 2014 Nov; 29(6): 425–429. doi:  10.5001/omj.2014.113

Friday, October 21, 2016

Palliative care viewed as a stigma, despite improving quality of life

Study indicates education, rebranding could help spread benefits

The term palliative care carries a stigma for patients and their caregivers, who regard it as synonymous with impending death. Education, and possibly a name change, will be necessary to be able to integrate palliative care into routine advanced cancer care, according to new research in CMAJ (Canadian Medical Association Journal).

Palliative care is designed to improve the quality of life of patients with a serious illness and their families. The World Health Organization and all major national and international cancer societies encourage early access to palliative care. Research indicates that for people with advanced cancer, early palliative care benefits both physical and mental health and can even extend life.


Thursday, October 20, 2016

Peri-op Clonidine: Benefits Not There, But Hypotension Is

Anesthesiologists who use perioperative clonidine in the hope of reducing acute postoperative pain or opioid consumption need to reconsider their efforts.

According to a randomized controlled trial at the Cleveland Clinic, in Ohio—the largest such trial ever—researchers found that the drug has neither of these perceived benefits, and its use may come at the expense of hypotension.

“Anesthesiologists have been using clonidine for sedation and analgesia for years, even though it’s primarily a blood pressure medication,” said Alparslan Turan, MD, professor of anesthesiology and vice chair of the Department of Outcomes Research at the Cleveland Clinic. “However, the only place where it’s been proven to work is in epidural and caudal analgesia. Oral and transdermal use have not been tested in large trials, and the data in the literature is not that solid.”


Wednesday, October 19, 2016

Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway

Videolaryngoscopes are aggressively marketed, but independent evaluation in difficult airways is scarce. This multicentre, prospective randomized controlled trial evaluates six videolaryngoscopes in patients with a simulated difficult airway.

This trial revealed differences in the performance of six videolaryngoscopes in 720 patients with restricted neck movement and limited mouth opening. In this setting, first-attempt success rates were 85–98%, except for the A.P. Advance™ difficult airway blade. Highest success and lowest tissue trauma rates were achieved by the McGrath™ and C-MAC™ D-blade, highlighting the importance of the videolaryngoscope blade design. 


Br. J. Anaesth. 116 (5): 670-679. doi: 10.1093/bja/aew058

Tuesday, October 18, 2016

How Chinese Medicine and Acupuncture Can Help Intrauterine Insemination Succeed?

Overall success rates for IUI are 15-20%, with 6% from natural IUIs and up to 30% for IUIs done with fertility drugs. Chinese Medicine, however, can greatly improve these success rates by combining acupuncture, reproductive organ massage and Chinese herbs, all of which have a proven positive effect on conception and implantation.

Acupuncture assists the body in regulating the Hypothalamus-Pituitary-Ovarian axis thus balancing the hormones to produce an increased number of follicles and better quality eggs. It also increases the blood flow to the uterus and increases the thickness of the uterine lining to improve implantation rates. Acupuncture also relaxes the nervous system and decreases stress levels to dramatically improve chances of pregnancy. It diminishes the side effects of ovulation and hormonal support drugs. And, for men, acupuncture improves sperm samples by increasing semen counts, motility, and morphology thus aiding in the natural fertilization process during IUI.


Acupuncture Relieves Cerebral Palsy Complications

Acupuncture alleviates cerebral palsy related hearing disorders and excess drooling.

Hospital researchers find acupuncture effective for relieving excessive drooling and for improving hearing in cerebral palsy patients. In a surprise finding, the optimal acupuncture needle retention time for benefitting hearing was not the longest retention time. A shorter duration produced superior patient outcomes. Take a look at the findings and protocols to learn what the researchers discovered.

Acupuncture is an effective treatment for cerebral palsy related complications, including drooling and hearing disorders. In a clinical study conducted at Neijiang Second People’s Hospital, researchers Xie and Lu determined that acupuncture and massotherapy significantly alleviate drooling and improve quality of life scores for cerebral palsy patients. Evidence suggests that cerebral palsy (CP) related drooling is correlated with motor impairments affecting swallowing (Senner et al.). This condition affects the overall quality of life and may impede speech and increase risk of infectious diseases.

Xie and Lu conclude that cerebral palsy patients treated with acupuncture and massotherapy had significantly greater positive patient outcomes than patients in the control group that did not receive either acupuncture or massotherapy. Patients receiving acupuncture with massotherapy demonstrated less drooling and significant improvements in fine motor movements, adaptive behavior, and social behavior over the control group. Acupuncture plus massotherapy patients also demonstrated the ability to take meals independently more significantly than the control group.


Thursday, October 13, 2016

Misunderstanding of palliative care leads to preventable suffering

A new review says palliative care's association with end of life has created an "identity problem" that means the majority of patients facing a serious illness do not benefit from treatment of the physical and psychological symptoms that occur throughout their disease.

The editorial is co-authored by palliative care experts at Harvard Medical School, Massachusetts General Hospital, the American Cancer Society, and Johns Hopkins University, and appears in the New England Journal of Medicine. The authors say palliative care should be initiated at the same time as standard medical care for patients with serious illnesses, and not brought up only after treatment has failed.


Early provision of specialty palliative care improves quality of life, lowers spending, and helps clarify treatment preferences and goals of care for patients with advanced cancer. However, widespread integration of palliative care with standard medical treatment remains unrealized, and more evidence is needed to show the potential gains of early palliative care in other populations. This will require improved public and professional awareness of the benefits of palliative care and coordinated action from advocacy groups, health professionals, educators, and policymakers. Patients who access earlier specialty palliative care have better clinical outcomes at potentially lower costs — a compelling message for providers, policymakers, and the general public.


Sources: ScienceDaily ,   N Engl J Med

Wednesday, October 12, 2016

The Role of Acupuncture in Assisted Reproductive Technology

The aim of this paper was to provide reliable evidence by performing a systematic review and meta-analysis for evaluating the role of acupuncture in assisted reproductive technology. All randomized controlled trials that evaluated the effects of acupuncture, including manual, electrical, and laser acupuncture (LA) techniques, on the clinical pregnancy rate (CPR) and live birth rate (LBR) of in vitro fertilization (IVF) or artificial insemination were included. The controlled groups consisted of no acupuncture and sham acupuncture groups. The sham acupuncture included sham acupuncture at acupoints, sham acupuncture at non- or inappropriate points, sham LA, and adhesive tapes. Twenty-three trials (a total of 5598 participants) were included in this paper. The pooled CPR from all acupuncture groups was significantly higher than that from all controlled groups, whereas the LBR was not significantly different between the two groups. However, the results were quite distinct when the type of control and/or different acupuncture times were examined in a sensitivity analysis. The results mainly indicate that acupuncture, especially around the time of the controlled ovarian hyperstimulation, improves pregnancy outcomes in women undergoing IVF. More positive effects from acupuncture in IVF can be expected if a more individualized acupuncture programs are used.


World Arthritis Day 2016 - The Future is in Your Hands

This year's theme for World Arthritis Day is 'It's in your hands, take action.'
People with rheumatic and musculosceletal diseases (RMDs) are taking action everyday to live their lives to the fullest.

This year, World Arthritis Day is asking people to share their stories about how they have taken action to live their life to the fullest with a rheumatic and musculoskeletal disease (RMD) in order to provide greater education to people both within the RMD community and the general public. You can share your story via social media, using the hashtag #WADStory, or upload your story directly to the World Arthritis Day website

The Future in your hands’ forms part of the wider two-year World Arthritis Day campaign:
'It's in your hands, take action'
  • RMDs affect a quarter of all people in the European Union – that’s over 120 million people –
    more individuals than any other disease group
  • RMDs can affect people of all ages including children and babies and if not treated
    appropriately, daily activities such as walking, climbing stairs, cooking and personal hygiene
    and working are affected – reducing quality of life and impacting on physical abilities
  • The prevalence of clinical anxiety and depression in those with RMDs is about twice that
    seen in the general population

Facts and figures
  • RMDs affect a quarter of all people in the European Union – over 120 million people
  • Almost every family in Europe is affected by RMDs in some way
  • In the industrialised world, RMDs affect more individuals than any other disease group
  • RMDs affect both men and women of all ages, including children and babies. However, some RMDs are more common among certain populations. For example, rheumatoid arthritis, scleroderma, fibromyalgia, and lupus predominantly affect women. Spondyloarthropathies and gout are more common in men
  • RMDs are the biggest cause of sick leave and premature retirement worldwide
  • RMDs have a huge economic burden on global healthcare systems. In Europe, public spending totals over €200 billion per year. They are the most expensive diseases for the European health and socio-economic systems. The costs are associated with diagnosis, treatment, drugs, care, assistive devices, home modifications, and research. In addition, decreased productivity and absence from work as a result of RMDs contributes significantly to these costs
  • If left untreated, some RMDs may reduce life expectancy
"Taking part in the ‘The Future in your Hands’ campaign as an individual is easy
Get Active Now. Get Involved ! "

Tuesday, October 11, 2016

Effect of palliative care-led meetings for families of patients with chronic critical illness

Among families of patients with chronic critical illness, the use of palliative care-led informational and emotional support meetings compared with usual care did not reduce anxiety or depression symptoms, according to a study appearing in the July 5 issue of JAMA.

Patients are considered to have developed chronic critical illness when they experience acute illness requiring prolonged mechanical ventilation or other life-sustaining therapies but neither recover nor die within days to weeks. It is estimated that chronic critical illness affected 380,000 patients in the United States in 2009. Family members of patients in the intensive care unit (ICU) experience emotional distress including anxiety, depression, and posttraumatic stress disorder (PTSD). Palliative care specialists are trained to provide emotional support, share information, and engage patients and surrogate decision makers in discussions of patient values and goals of care.


Monday, October 10, 2016

Fluid Management Strategy for Thoracic Surgery

San Diego—The optimal range of fluid administration in patients undergoing lung resection surgery has been a controversial topic in anesthesia. There are hazards at both ends of the spectrum: Liberal o verhydration can lead to fluid-induced lung injury, while conservative fluid-management strategies have a risk for organ ischemia.

According to a review of the recent literature, however, researchers may be closer to establishing “safe” fluid limits.

“The evidence has shown that intraoperative fluid administration should be at a base rate of 1 to 2 mL/kg per hour plus replacement of blood losses,” said Jens Lohser, MD, MSc, FRCPC, associate professor and head of thoracic anesthesia at the University of British Columbia, in Vancouver. “In addition, overall fluid administration of more than 6 mL/kg per hour intraoperatively and a 24-hour fluid balance in excess of 20 mL/kg should be avoided, as they have been associated with acute lung injury.” Dr. Lohser presented the findings at the Society of Cardiovascular Anesthesiologists 2016 annual meeting.


Sunday, October 09, 2016

Acupuncture Point Vitamin Injections Alleviate Menstrual Pain

Vitamin K3 injections into acupuncture point SP6 relieves menstrual cramping and pain. Researchers from institutions including Columbia University (New York), Stanford University School of Medicine (Palo Alto), and University of California at San Francisco (UCSF) completed a six year study of dysmenorrhea. The study design was : double-blind, double-dummy, randomized controlled trial. The researchers concluded, “Acupuncture point injection of vitamin K3 relieves menstrual pain rapidly and is a useful treatment in an urban outpatient clinic.”

Primary dysmenorrhea affects approximately 85% of women and the pain is severe in approximately 20% of women experiencing menstrual pain. Although the pathophysiology is not identical in all cases, uterine prostaglandin hormones at high levels contribute to cramping and lower abdominal pain. The pain may last from several hours to days.


Saturday, October 08, 2016

World Hospice and Palliative Care Day 2016

8 October 2016

Living and dying in pain: It doesnt have to happen

The theme of World Hospice andPalliative Care Day 2016 is: ‘Living and dying in pain: It doesn’t have to happen’.

75% of the world population does not have adequate access to controlled medications for pain relief.
As a result, millions of people suffer from pain which is avoidable and could be managed with proper access to the correct medications.

Various barriers prevent people in need from accessing these essential medications. 

The World Day campaign will examine three major barriers for access to pain relief, and provide case studies, advocacy resources, and examples of good practice to help address these.

Restrictive regulations
    • Unduly restrictive regulations limit access to pain relief and palliative care for people and families in need
    • Balance is needed to ensure access to essential controlled medicines for pain management while ensuring that they are not used for illicit purposes
    • Pain management is the right of the person with pain
    • Pain management without significant risk of dependence is possible through education of healthcare workers and patients
    • Many national laws and regulations exceed the measures required by the Single Convention on Narcotic Drugs
      • Examples:
        • Most countries limit morphine prescriptions to 10 mg injectable twice daily, guaranteeing that pain will not be effectively controlled.
        • In some jurisdictions, physicians can be charged with a crime should they make documentation errors that are not prosecuted elsewhere.
        • Restrictions and expensive requirements discourage pharmaceutical companies from producing morphine, and pharmacies from stocking it
        • Legally available morphine is difficult, if not impossible, to obtain in some countries.
        • This forces some patients or their family members to buy opioids through illegal channels, which puts them in danger of arrest and prosecution.
      • How is this being addressed?
        • Romania has removed all excessive regulatory restrictions on opioid prescribing with no reported cases of misuse.
        • In Kerala, India, a two-year study of people being treated for pain with oral morphine found no instances of misuse or diversion
        • In Uganda specially trained nurses are legally allowed to prescribe liquid morphine solution for people accessing palliative care.
    • Oral morphine and other WHO essential palliative care medications should be legally available and accessible in all countries
Poor education
    • Opiophobia is the fear in the health professions of prescribing opioid medications which prevents people from receiving pain relief
      • Examples
        • Doctors and nurses are not educated about pain management and prescribing morphine or are taught that morphine and other opioids are dangerous and should be used as little as possible
        • Doctors and nurses are not taught how to assess and manage pain
        • There is fear that anyone using opioids will become addicted/dependent
        • In most countries, there is no way to qualify as a palliative care specialist and no inclusion of palliative care training in medical or nursing schools, as well as no continuing education for health professionals to counteract opiophobia.
      • How is this being addressed?
        • An increasing number of countries are now including palliative care education for medical and nursing students
        • The Hospice Africa Uganda morphine initiators’ course at the Institute of Hospice and Palliative Care in Africa trains healthcare workers from all over Africa in how to safely prescribe and administer morphine.
        • The University of Cape Town runs a Master’s course and Postgraduate Diploma in Palliative Medicine which use distance learning so that busy professionals can expand access to palliative care and pain management, as well as the research base on this topic.
        • In Tajikistan a course on pain relief and palliative care is being developed for police professionals.
    • Unreasonable fear of opioid use leads to increased suffering worldwide
Economic barriers
    • Morphine is inexpensive to produce yet expensive to bring to market in many places with unduly restrictive regulations. As a result the pharmaceutical industry has no incentive to produce and market oral morphine for pain management.
      • Examples
        • The profit margin for oral morphine tablets is too low to be of interest to most pharmaceutical producers
        • Higher cost analgesics such as fentanyl are easier to obtain in many countries than oral morphine, which is the standard of pain management in palliative care.
      • How is this being addressed?
        • Lebanon requires pharmaceutical importers to register and import inexpensive immediate and slow release morphine to be allowed to import expensive opioids.
        • In Colombia the Fondo Nacional de Estupefacientes (FNE) is responsible for the purchase and national distribution of opioid medications (morphine, hydromorphone, and methadone) in the country.
        • A morphine manifesto ( has been signed by 64 organizations calling for universal availability of immediate release morphine.