No abstract

Scalp AP is a safe complementary modality when combined with LT and has a significantly positive effect on language development in children with autism.

The continuation of warfarin throughout pregnancy in patients with a mechanical valve prosthesis is a valid anticoagulation regimen, provided that warfarin dose does not exceed 5 mg/day. Two decades after being introduced, the efficacy and safety of this regimen merit evaluation. We performed a systematic review for cases published between January 1991 and January 2013. We compiled our prospective data on 55 pregnancies and calculated pooled estimates (95% confidence interval) of adverse foetal and maternal outcomes. Events were expressed as proportions of total pregnancies, except embryopathy and maternal death, which were related to the number of live births and number of patients, respectively. There were 494 eligible pregnancies reported in 11 studies. The rate of embryopathy was 0.9% (0.4-2.4%) and most of the 13.4% (8.4-24.7%) foetal losses were due to the 12.8% (7.7-22.7%) rate of spontaneous abortion. No maternal mortality was encountered (0-1.3%) but 0.6% (0.3-2%) prosthetic valve thrombosis, 1.8% (1.1-3.6%) total thromboembolic events and 3.4% (2-5.1%) major maternal bleeding events were recorded. Foetal loss, spontaneous abortions and foetal embryopathy dropped to 8.1% (2.9-13.7%), 7.3% (3.1-11.8%) and 0.6% (0.1-2.1%) among the 344 pregnancies (69.6%) observed in the 6 prospective studies (54.5%). Prosthetic valve thrombosis (0.6%; 01-2%), total thromboembolic (2.3%; 1.2-4.6%) and major bleeding events (2.9%; 1.8-6%) remained comparable with overall results. Foetal embryopathy and prosthetic valve thrombosis were not robust on sensitivity analysis, regardless of the study design. A prospective subgroup of 96 patients (19.4%) received smaller warfarin dose, through targeting a lower international normalized ratio (INR) between 1.5 and 2.5. The associated rate of foetal loss (2.1%; 0.5-6.9%) was significantly lower than that observed in the remaining patients targeting a higher INR between 2.5 and 3.5 (16.1%; 13.1-34.4%). Adverse maternal outcomes were also fewer but rates remained comparable. Limited dose warfarin throughout pregnancy was associated with improved foetal outcomes, without jeopardizing maternal safety. Foetal outcomes were better when patients were followed up prospectively or receiving smaller warfarin doses through targeting a lower INR than recommended (1.5-2.5). Large randomized controlled trials are mandatory to evaluate our findings.

Background Laser acupuncture is one of the complementary modalities used for treating osteoarthritis. The study was performed to evaluate the effectiveness of laser acupuncture in the treatment of grade 2 knee osteoarthritis. Patients and methods Forty patients having bilateral knee osteoarthritis were divided into two groups (20 patients in each group). The patients of the first group were subjected to 12 laser sessions at the following acupoints (St 35, St36, Sp9, Sp10 and Gb 34). During each session, laser of 90 mw was directed to each acupoint for 1 min giving energy of 5.4 joules. Energy of 21.6 joules was directed to ashi points. The laser had a wavelength of 808 nm, beam diameter 2 mm and was applied with a continuous wave. The cases of the second group were used as controls. Each patient is exposed to sham laser (laser probe is directed to the same acupoints while the device is off). Results The 20 patients receiving laser showed significant improvement in pain on (VAS), increase in serum beta-endorphin and a decrease in substance P more than those exposed to sham laser. Conclusions Laser acupuncture is a safe and cheap tool for management of grade 2 knee osteoarthritis.

YNSA acupuncture is effective in immediate pain relief among females suffering from degenerative OA.