Chinese Herbal Medicine, Alternative or Complementary, for Endometriosis-Associated Pain: A Meta-Analysis

Current medical treatments for endometriosis-associated pain (EAP) have limitations, including symptom recurrence and hormonal side effects. For this reason, it is important to elucidate any alternative or complementary treatments available, while Chinese herbal medicine (CHM) shows potential to be this treatment. This study aims to provide evidence for the efficacy and safety of CHM for EAP. Randomized control trials comparing CHM to other treatments for EAP in women with endometriosis were considered eligible, and they were searched for in Medline, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov, as well as in the Chinese databases Sino-Med and CNKI, from inception to October 2021. Numerous outcomes were put through meta-analysis using a weighted mean difference and a 95% CI, and the results of dichotomous data were presented as a pooled RR with a 95% CI. A total of 34 eligible studies with 3389 participants were included. Compared with no treatment, there was a statistically significant pooled benefit of CHM on dysmenorrhea at the end of 3-month treatment, and these effects continued for 3 months, but not 9 months, after treatment. Compared with conventional therapy, a significant difference was found in the levels of pelvic pain with a lower rate of hot flush and irregular vaginal bleeding at the end of treatment for 3 months, but not after treatment. Comparing combined treatment with CHM and conventional therapy with conventional therapy alone, significant decreases were found in dysmenorrhea, dyspareunia, and pelvic pain after a 3-month treatment cycle, and in dysmenorrhea after a 4-month treatment cycle with a lower hot flash rate. In conclusion, CHM, used alone or in combination with conventional therapies, appears to have benefits in relieving EAP with fewer side effects than traditional treatment.

Outcome Measures Following Tele-rehabilitation and Conventional Face to Face Rehabilitation in Paediatric Cochlear Implant Users during COVID-19 Pandemic: A Pilot Study in a Tertiary Care Setup

Background

Following the COVID-19 pandemic, majority of paediatric cochlear implantees (CI) lost follow ups for rehabilitation and tele-therapy was initiated. Present study thus compared the outcome measures of paediatric CI users on tele-therapy versus conventional face to face therapy following COVID-19 pandemic.

Method

Twenty seven unilateral paediatric cochlear implantees in the age range of 2–11 years were divided into two groups based on the therapy modality, viz, tele- and face-to-face therapy. Based on the hearing age, participants were further divided into three groups, viz, 0–2, 2–4, and greater than four years. A complete the test battery comprising Integrated Scales of Development, Speech Intelligibility Rating scale, and Revised Categorical Auditory Perception were administered. The speech & language test battery was performed prior to initiating the rehabilitation and post 12 months of rehabilitation.

Results

Results of the present study revealed that conventional rehabilitation had better outcomes compared to teletherapy. The rate of progress after one year of rehabilitation with respect to hearing-age showed a significant difference for the hearing-age group of 0–2 years across the domains of audition, speech and language.

Conclusion

The present study indicates that conventional method of the speech-language and auditory rehabilitation is far better compared to the tele rehabilitation services especially for those visiting tertiary care hospitals as most of them belong to lower and middle socioeconomic status. From the results, it can be delineated that with lesser hearing experience, paediatric CI users always need to initially enroll for conventional therapy for better speech-language and auditory outcomes.

Nanotechnology, a tool for diagnostics and treatment of cancer

Nanotechnology has shown promising advancements in the field of drug development and its delivery. In particular, the applications of nanoparticles for treatment and diagnostics of cancer reached such a precision that it can detect a single cancer cell and can target it to deliver a payload for the treatment of that cancerous cell. Conventional cancer therapy methods have side effects, and diagnostics techniques are time-consuming and expensive. Nanoparticles (NPs) such as polymeric nanoparticles (nanogels, nanofibers, liposomes), metallic nanoparticles such as gold NP (GNPs), sliver NP (AgNP), calcium nanoparticles (CaNPs), carbon nanotubes (CNTs), graphene, and quantum dots (QDs) have revolutionized cancer diagnostics and treatments due to their high surface charge, size and morphology. Functionalization of these nanoparticles with different biological molecules, such as antibodies, helps them to targeted the delivery and early detection of cancer cells through their plasmon resonance properties. While some of the magnetic properties of nanoparticles such as iron (Fe), copper (Cu), and carbon NT were also evaluated for detection and treatments of cancer cells. An advanced type of nanoparticles, such as nanobubbles and oxygen-releasing polymers, are helping to address the hypoxia conditions in the cancer microenvironment, while others are employed in photodynamic therapy (PDT) and photothermal therapy (PTT) due to their intrinsic theranostic properties. The green synthesis of nanoparticles has further increased biocompatibility and broadened their applications. In this review paper, we discussed the advancement in nanotechnology and its applications for cancer treatment and diagnostics and highlighted challenges for translation of these advanced nano-based techniques for clinical applications and their green synthesis.

A Randomized Clinical Trial of Insulin Glargine and Aspart, Compared to NPH and Regular Insulin in Children with Type 1 Diabetes Mellitus

OBJECTIVE

Appropriate treatment of patients with Type 1 diabetes mellitus (T1DM) is necessary to avoid further complications. This study was performed to compare the efficacy of insulin Glargine and Aspart with NPH insulin and regular insulin regimen in a group of children with T1DM.

METHODS

Forty patients with T1DM were enrolled in this study. During run-in, all subjects were treated with conventional therapy consisting of twice-daily NPH and thrice-daily regular. Following randomization, 20 subjects received Glargine and Aspart and 20 subjects received NPH and Regular insulin.

FINDINGS

Mean HbA1c was 8.8% and 8.6% at first and 8.4% and 8.2% at the end of study for subjects randomized initially to Glargine and Aspart and for those randomized to NPH and Regular, respectively (P>0.05). Mean fasting blood glucose (FBS) of the subjects randomized initially to Glargine and Aspart was 217±101 mg/dL, with no significant difference to 196±75 mg/dL for those randomized to NPH and Regular (P=0.48). This was also true at the end of the study. The difference in total cholesterol and triglyceride between the two groups in the beginning of study and at the end did not show any significance.

CONCLUSION

The current study showed no significant difference in glycemic control [Glycated hemoglobin (HbA1c) and FBS] and lipid profile (total cholesterol and triglyceride) between two regimes.