Hasil untuk "Homeopathy"

Md. Abdul Kader, Md. Masuder Rahman, Shahin Mahmud et al.

Abstract Background Atherosclerosis is arteries’ thickening and stiffening condition manifested due to plaque formation by oxidized-LDL of abundant and deranged lipid metabolism. Traditionally, Melastoma malabathricum Linn (MM) leaves are used for anti-diabetics, abdominal problems, and high blood pressure. The current experiment unveils the potency of ethanol, acetone, and water MM extracts as antibacterial agents and alternative medicine during hyperlipidemic conditions. Methods A high cholesterol diet (HCD-2500 mg/kg) was provided with regular feeds for 3 weeks to induce hyperlipidemic mice. Afterward, comparing weight with Group-A (normal control), the hyperlipidemic mice were classified into five groups: Group-B (hyperlipidemic control), Group-C (MFA-500 mg/kg), Group-D (MSE-250 mg/kg), Group-E (MSE-500 mg/kg), and Group-F (ATOVAT-20 mg/kg). And the dosages were given orally for 28 days according to their body weight. Fasting blood was collected at the end of treatment, and serum was taken to test lipid profiling and liver enzymes. Results The body mass had waxed significantly (P < 0.001) in all the groups compared with Group-A. Subsequently, orally administered different doses where group-D and group-E demonstrated magnificent anti-hyperlipidemic potency (P < 0.001) compared with group-B. During treatment, rapid upward body mass was tardy in group-E (P < 0.001). However, the liver enzyme expression such as AST, ALT, and ALP was elevated (P < 0.001) in Group-F, they were significantly lessened (P < 0.001, P < 0.01) in Groups-C, D, and E, which indicates these extracts have significant anti-liver damaging potency. Alongside the antibacterial activity of MSE-1500 μg/disc, it exhibited the greatest (16.50 mm) zone of inhibition against Shigella dysenteriae. Conclusion However, in our current experiment, depending on the derived data, we can elicit that the Melastoma malabathricum shoot ethanolic (MSE) extract is a potential resource for developing alternative medicine to manage the hyperlipidemic condition.

Shital Patil, Deepak Patil

Pulmonary tuberculosis (TB) is the most common cause of bilateral pulmonary cavities with constitutional symptoms in India being endemic and more prevalent nature of the disease, irrespective of microscopy or nucleic acid amplification test abnormalities. Pulmonary manifestations of systemic vasculitis have very diverse involvement ranging from nodule, consolidation, and cavitation. In this case report, a 45-year-old female, presented with constitutional symptoms with lung parenchymal consolidations progressed to cavitation, and started empirical anti-TB treatment without mycobacterial microscopic or genome documentation in sputum with clinical or radiological worsening. Bronchoscopy workup is inconclusive and the tropical screen for bacterial, TB, and malignancy was negative and fungal yield Aspergillus colonization. A vasculitis workup was done in the presence of clinical and radiological worsening documented PR3-antineutrophil cytoplasmic antibody positive with very highly raised titers. We have started on steroids and cyclophosphamide with antifungals and clinical response was documented with a near-complete resolution of shadows in 24 weeks.

José Manuel Mazón-Suástegui , Milagro Ramona García Bernal , Guadalupe Fabiola Arcos-Ortega et al.

RESUMEN | En el Centro Ostrícola Tecnológico de Tabasco, COTET-México, se evaluó el efecto de medicamentos homeopáticos autorizados para uso humano por la Secretaría de Salud de México y productos homeopáticos diseñados por el CIBNOR, durante el acondicionamiento gonádico de reproductores de ostión americano Crassostrea virginica. En el diseño experimental se consideró una muestra inicial (T0), dos tratamientos homeopáticos [T1 (ViP-7C + ViA-7C), T2 (PhA-7C + SiT-7C)] y un tratamiento control T3 (agua destilada). La respuesta fisiológica se cuantificó mediante la frecuencia (%) de estadios de desarrollo gonádico en hembras y machos, durante un periodo de 30 días. Al concluir el bioensayo, los reproductores que recibieron los tratamientos T1 y T2 fueron capaces de re-madurar, desovar y producir larvas viables. Esto sugiere una potencial aplicabilidad de estos tratamientos en la producción comercial de semillas de C. virginica. ABSTRACT | At the Centro Ostrícola Tecnológico de Tabasco (COTET-MX), the effect of homeopathic medicines authorized for human use by the Ministry of Health of Mexico and homeopathic products designed by CIBNOR, were evaluated during gonadal conditioning of american oyster Crassostrea virginica broodstock. In the experimental design, an initial sample (T0), two homeopathic treatments [T1 (ViP-7C + ViA-7C), T2 (PhA-7C + SiT-7C)] and a control treatment T3 (distilled water) were considered. The physiological response was quantified by the frequency (%) of gonadal development stages in females and males, during a period of 30 days. At the end of the bioassay, the broodstock that received treatments T1 and T2 were able to re-mature, spawn and produce viable larvae. This suggests a potential applicability of these treatments in the commercial production of C. virginica seeds.

Ulas Serkan Topaloglu, Ali Saz, Onur Tatar et al.

Background: Homeopathy is applied as a supportive in the treatment of viral infections and in relieving their symptoms. Objective: To create an awareness that effective remedial results can be obtained by homeopathy in patients with loss of smell and taste in Coronavirus Disease 2019. Methods: A prospective, cohort and randomized study was conducted. The main inclusion criterion was the loss of smell and taste for at least one week. Homeopathic remedies were also applied as supportive therapy. Visual Analog Scale (VAS) was used to evaluate the loss of smell and taste perception before and after treatment. Results: A total of 30 patients, 32.17±10.25 years, were included in the study. The mean pre-treatment VAS-smell perception of the patients was 0.67±1.24, while the mean VAS-taste perception was 2.57±3.01. After the treatment, the mean of VAS-smell perception was 8.67±1.92, while the mean of VAS-taste increased to 9.43±1.22. There was a strong positive correlation between ΔVAS-smell perception and ΔVAS-taste perception (r: 0.563, p: 0.001). There was also a strong negative correlation between ΔVAS-taste perception and the level of ferritin (r: -0.552, p: 0.002). Conclusion: The present study on the effective improvement via homeopathy treatment in patients with loss of smell and taste in COVID-19 that “has spoiled the taste of life and living” should be supported by further studies.

Ubiratan Cardinalli Adler, Maristela Schiabel Adler, Livia Mitchiguian Hotta et al.

Abstract Objectives To investigate the effectiveness and safety of homeopathic medicine Natrum muriaticum (LM2) for mild cases of COVID-19 in Primary Health Care. Trial design A randomized, two-armed (1:1), parallel, placebo-controlled, double-blind, clinical trial is being performed to test the following hypotheses: H0: homeopathic medicines = placebo (null hypothesis) vs. H1: homeopathic medicines ≠ placebo (alternative hypothesis) for mild cases of COVID-19 in Primary Care. Participants Setting: Primary Care of São Carlos – São Paulo – Brazil. One hundred participants aged 18 years or older, with Influenza-like symptoms and a positive RT-PCR for SARS-CoV-2. Willingness to give informed consent and to comply with the study procedures is also required. Exclusion criterium: severe acute respiratory syndrome. Intervention and comparator Homeopathy: 1 globule of Natrum muriaticum LM2 diluted in 20 mL of alcohol 30% and dispensed in a 30 ml bottle. Placebo: 20 mL of alcohol 30% dispensed in a 30 ml bottle. Posology: one drop taken orally every 4 hours (6 doses/day) while there is fever, cough, tiredness, or pain (headache, sore throat, muscle aches, chest pain, etc.) followed by one drop every 6 hours (4 doses/day) until the fourteenth day of use. The bottle of study medication should be submitted to 10 vigorous shakes (succussions) before each dose. Posology may be changed by telemedicine, with no break in blinding. Study medication should be maintained during home isolation. According to the Primary Care protocol, the home isolation period lasts until the 10th day after the appearance of the first symptom, or up to 72 hours without symptoms. Main outcomes The primary endpoint will be time to recovery, defined as the number of days elapsed before all COVID-19 Influenza-like symptoms are recorded as mild or absent during home isolation period. Secondary measures are recovery time for each COVID-19 symptom; score of the scale created for the study (COVID-Simile Scale); medicines used during follow-up; number of days of follow-up; number of visits to emergency services; number of hospitalizations; other symptoms and Adverse Events during home isolation period. Randomisation The study Statistician generated a block randomization list, using a 1:1 ratio of the two groups (denoted as A and B) and a web-based tool ( http://www.random.org/lists ). Blinding (masking) The clinical investigators, the statistician, the Primary Care teams, the study collaborators, and the participants will remain blinded from the identity of the two treatment groups until the end of the study. Numbers to be randomised (sample size) One hundred participants are planned to be randomized (1:1) to placebo (50) or homeopathy (50). Trial Status Protocol version/date May 21, 2020. Recruitment is ongoing. First participant was recruited/included on June 29,2020. Due to recruitment adaptations to Primary Care changes, the authors anticipate the trial will finish recruiting on April 10, 2021. Trial registration COVID-Simile Study was registered at the University Hospital Medical Information Network (UMIN - https://www.umin.ac.jp/ctr/index.htm ) on June 1st, 2020, and the trial start date was June 15, 2020. Unique ID: UMIN000040602. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Anna Garber MSc, Lianna Barnard BHSc, Chris Pickrell ND

Herpes simplex viruses, HSV-1 and HSV-2, are highly contagious and cause lifelong, latent infections with recurrent outbreaks of oral and/or genital lesions. No cure exists for HSV-1 or HSV-2 infections, but antiviral medications are commonly used to prevent and treat outbreaks. Resistance to antivirals has begun to emerge, placing an importance on finding new and effective therapies for prophylaxis and treatment of HSV outbreaks. Botanicals may be effective HSV therapies as the constituents they contain act through a variety of mechanisms, potentially making the development of antiviral resistance more challenging. A wide variety of plants from different regions in the world have been studied for antiviral activity against HSV-1 and/or HSV-2 and showed efficacy of varying degrees. The purpose of this review is to summarize research conducted on whole plant extracts against HSV-1 and/or HSV-2 in vitro and in vivo. The majority of the research reviewed was conducted in vitro using animal cell lines, and some studies used an animal model design. Also summarized are a limited number of human trials conducted using botanical therapies on HSV lesions.

Oluwakayode O. Odeja, Michael Gabriel Ibok, Ejike O. Okpala

Abstract Background Asparagus flagellaris leaves are ethnomedicinally used to treat syphilis, gonorrhea and other sexually transmitted diseases (STDs), with no reports on the volatile constituents. This study was aimed to quantitatively and qualitatively characterise the composition of essential oil, evaluates the free radical scavenging and antimicrobial capacity of the essential oil. Methods The essential oil was isolated by hydrodistillation method using all-glass Clevenger-type apparatus, while the identification and quantification of constituents were performed by gas chromatography-mass spectrometry (GC-MS) technique. The antioxidant activity on 2, 2-diphenyl-1-picrylhydrazyl (DPPH) was evaluated and the oil was also tested against 10 strains of microorganisms consisting of 6 bacteria: Escherichia coli, Salmonella typhi, Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus and Bacillus subtilis and 4 fungi: Candida albicans, Penicillium notatum, Aspergillus niger and Rhizopus spp. using broth dilution and surface plate methods, respectively. Results A pale yellow essential oil with a characteristic scent was obtained, with a yield of 0.80% (w/w). A total of 28 compounds accounting for 97.41% of the total oil contents were identified. The oil was predominated by Thymol and its derivatives, accounting for 57.48%. The most abundance (% area) constituents of the essential oil were 5-Thymyl tiglate (18.49%), Thymyl-2-methyl butyrate (17.34%), Thymol hydroquinone dimethyl ether (10.52%), Thymol methyl ether (9.42%) and 5-Propyl-1, 3-benzodioxole (4.59%). The essential oil showed a significant free radical scavenging activity compared to the standard antioxidant drugs used in this study, with % inhibition varying from 88.06 ± 0.0001 to 93.05 ± 0.0006. The leaf essential oil exhibited antimicrobial activity on all the tested organisms at 500–125 μg/mL, with an 18–10 mm inhibitory zone. Conclusion The leaf essential oil of A. flagellaris contains notable chemical compounds responsible for its antioxidant and antimicrobial activities.

TM Archana, K Soumya, Jesna James et al.

Abstract Background Hyperglycemia is the hallmark of diabetes, and the associated oxidative stress is a major concern that invites an array of diabetic complications. The traditional practices of medicare are of great, current interest due to the high cost and side effects of conventional diabetic medications. The present in vitro study focuses on evaluating the potential of various A. occidentale root extracts for their antihyperglycemic and antioxidant potentials. Materials and methods The four different solvent extracts petroleum ether (PEAO), chloroform (CHAO), ethyl acetate (EAAO), and 80 % methanol (80 % MAO) of A. occidentale roots were evaluated for their total phenolic, flavonoid, and antioxidant capacity. Using MIN6 pancreatic β-cells, the cytotoxicity of the extracts was evaluated by MTT assay and the antidiabetic potential by quantifying the insulin levels by ELISA at a higher concentration of glucose. The effect of 80 % MAO on INS gene expression was determined by qRT PCR analysis. Results Among the four different solvent extracts of A. occidentale roots, 80 % MAO showed the highest concentration of phenolics (437.33 ± 0.03 µg GAE/mg), CHAO to be a rich source of flavonoids (46.04 ± 0.1 µg QE/mg) and with the highest total antioxidant capacity (1865.33 ± 0.09 µg AAE/ mg). Evaluation of the free radical scavenging and reducing properties of the extracts indicated 80 % MAO to exhibit the highest activity. The MTT assay revealed the least cytotoxicity of all four extracts. 80 % MAO enhanced INS up-regulation as well as insulin secretion even under high glucose concentration (27mM). Conclusions The present study demonstrated that the A. occidentale root extracts have effective antihyperglycemic and antioxidative properties, together with the potential of normalizing the insulin secretory system of β-cells. Above mentioned properties have to be studied further by identifying the active principles of A. occidentale root extracts and in vivo effects. The prospect of the present study is identifying drug leads for better management of diabetes from the A. occidentale root extracts. Graphical abstract

Swati Garg, Arpita Jain, Urvashi Sharma et al.

Ovarian hyperstimulation syndrome (OHSS) is a disorder that usually occurs with ovulation induction. It is rare in pregnant women and only a very few cases have been reported in spontaneous unstimulated conceptions. We report a case of spontaneous OHSS with primary hypothyroidism in a 19-year-old primigravida, where the imaging and laboratory findings confirmed the diagnosis of “Van Wyk–Grumbach syndrome” with pregnancy. This rare event in pregnancy needs attention, as early institution of thyroid hormone replacement therapy results in resolution of cysts and avoids unnecessary evaluation and surgical misadventures.

Gururaghavendran Rajesh, Almas Binnal, Mithun B H. Pai et al.

Background: The frequency of occurrence of disasters is on the rise all over the world. Workforce shortage can be a major impediment toward efficient disaster management. Incorporation of other health-care workers along with conventional medical personnel might be critical for efficient and effective management of disasters. Objective: The objective of this study was to assess various aspects pertaining to disaster management among various health-care students in India. Methods: Final-year students pursuing medicine, dentistry, nursing, physiotherapy, pharmacy, Ayurveda, and homeopathy at various institutions in Mangalore, India, were the study participants. Participants' willingness to partake in disaster management and knowledge, attitude, behavior, and perceived effectiveness pertaining to disaster management was ascertained by a questionnaire method. Their previous history of training and familiarity with standard operating procedures was assessed. Results: A total of 437 students belonging to seven health-care institutions participated in the study. Overall, 98.40% of the participants were willing to partake in disaster management. The mean knowledge, attitude, behavior, and perceived effectiveness scores were 49.19%, 81.75%, 47.28%, and 66.20%, respectively. Step-wise multiple linear regression analysis revealed that course (β = 0.247, P < 0.001), attitude (β = 0.154,P = 0.001), and behavior (β = 0.284, P < 0.001) were significant predictors of perceived effectiveness. Conclusions: Participants in the present study revealed that they were willing to partake in disaster management. The participants also reported poor behavior and knowledge scores but appropriate attitude scores. The present study highlights the need for curriculum changes and policy implications for effective integration of various sectors for disaster management, particularly in developing nations such as India, which have a definite scarcity of resources.

Benedikt M. Huber, Tido von Schoen-Angerer, Oswald Hasselmann et al.

BACKGROUND In Switzerland, complementary medicine (CM) is officially recognised within the healthcare system and mainly practised in an integrative manner, in conjunction with conventional medicine. As in other countries, there is high demand for and use of CM with children. However, there has so far been no research into the attitude towards, training in and offer of CM among paediatricians in Switzerland. Our study addresses this gap by investigating these topics with an online survey of paediatricians in Switzerland. METHODS We conducted a national online survey using a 19-item, self-reporting questionnaire among all ordinary and junior members of the Swiss Society of Paediatrics (SSP). A comparison of the study sample with the population of all paediatricians registered with the Swiss Medical Association (FMH) allowed an assessment of the survey’s representativeness. The data analysis was performed on the overall group level as well as for predefined subgroups (e.g. sex, age, language, workplace and professional experience). RESULTS 1890 paediatricians were approached and 640, from all parts of Switzerland, responded to the survey (response rate 34%). Two thirds of respondents were female, were aged between 35 and 55 years, trained as paediatric generalist and worked in a practice. Apart from young paediatricians in training, the study sample was representative of all Swiss paediatricians. 23% had attended training in CM, most frequently in phytotherapy, homeopathy, acupuncture/traditional Chinese medicine (TCM) and anthroposophic medicine. 65% were interested in CM courses and training. 16% provide CM services to their patients and almost all paediatricians (97%) are asked by patients/parents about CM therapies. More than half of the responding paediatricians use CM for themselves or their families. 42% were willing to contribute to paediatric CM research. CONCLUSIONS In a representative sample of paediatricians in Switzerland, their personal attitude towards CM is positive, emphasised by great interest in CM training, a willingness to contribute to CM research and a high rate of paediatricians who use CM for themselves and their families. In contrast, the percentage of paediatricians offering CM is currently rather low despite strong demand for CM for children. This study provides key pointers for the future development of complementary and integrative medicine for children in Switzerland.

Pingping Zhong PhD, Hong Yang MD, Shan Lin PhD et al.

In this study, hepatocellular carcinoma (HCC) mouse xenograft model, MTT assay, colony formation, nuclear staining, and Annexin-V/PI staining assays were used to evaluate the effect of Qingjie Fuzheng granules (QFG) on cell proliferation and apoptosis of HCC cell in vivo and in vitro. Furthermore, Western blotting was performed to detect the expression of Fas, FasL, Bcl-2, Bax, and the activation of caspase-3/-8/-9. The results showed that QFG reduced tumor weight ( P < .05) but had no effect on body weight gain in HCC mice in vivo. QFG significantly reduced HCC cell viability and attenuated cell proliferation in a dose-dependent manner ( P < .05). QFG increased the expression of Fas, FasL, and Bax ( P < .05). QFG downregulated the expression of Bcl-2 and promoted the activation of caspase-8, -9, and -3 ( P < .05). These results suggested that QFG possessed anticancer effects, and the mechanisms of action may involve the death receptor pathway and mitochondrion-dependent pathway-mediated apoptosis.

Rifky Tkatch PhD, Dawn Bazarko DNP, MPH, RN, Shirley Musich PhD et al.

Interventions to reduce caregiver burden are of great interest as the number of informal family caregivers continues to grow. The purpose of this study was to test the feasibility of an online mindfulness meditation intervention for community-dwelling older adult caregivers and to evaluate its impact on quality of life, caregiver burden, and psychological well-being. A total of 40 caregivers were recruited from 2 community center support groups to participate in an 8-week online mindfulness intervention. Pre and post surveys were administered. Retention rates were high with 55% completing the post surveys and attending at least 5 out of 8 sessions. Matched pairs t test indicated that the intervention reduced caregiver burden, perceived stress, anxiety, and loneliness and improved mental well-being. Online interventions offer flexibility for caregivers regardless of their responsibilities. Future research should expand this opportunity and explore the scalability of online mindfulness interventions.

Amy L. Eva PhD, Natalie M. Thayer BS

Mindfulness-based curricular interventions can support adolescents who are at risk of school failure as they negotiate the transition from high school into young adulthood. Researchers hypothesized that a 6-week mindfulness-based intervention would lower participants’ perceived stress while increasing their reported levels of self-esteem. Participants (N = 23) ranged in age from 17 to 20 years while the majority were male students of color. Pre- and postintervention survey mean responses revealed statistically significant differences on the Single-Item Self-Esteem Scale and 3 items on the Perceived Stress Scale (with small to moderate effect sizes). Postintervention focus group (n = 8) data indicated that the most valued daily practice was the body scan technique. Open coding of the focus group data also revealed several key themes in the form of overarching codes as participants discussed intervention benefits. These included ( a ) self-regulation, ( b ) attention-awareness, and ( c ) positive thinking.

Frank Zimmermann-Viehoff MD, Nico Steckhan Dipl Biol, Karin Meissner MD et al.

We tested the hypothesis that a suggestive placebo intervention can reduce the subjective and neurobiological stress response to psychosocial stress. Fifty-four healthy male subjects with elevated levels of trait anxiety were randomly assigned in a 4:4:1 fashion to receive either no treatment (n = 24), a placebo pill (n = 24), or a herbal drug (n = 6) before undergoing a stress test. We repeatedly measured psychological variables as well as salivary cortisol, alpha-amylase, and heart rate variability prior to and following the stress test. The stressor increased subjective stress and anxiety, salivary cortisol, and alpha-amylase, and decreased heart rate variability (all P < .001). However, no significant differences between subjects receiving placebo or no treatment were found. Subjects receiving placebo showed increased wakefulness during the stress test compared with no-treatment controls ( P < .001). Thus, the suggestive placebo intervention increased alertness, but modulated neither subjective stress and anxiety nor the physiological response to psychosocial stress.

A. G. Solopova, A. A. Safarov, A. D. Makatsariya

Recently there has been a great increase in the number of patients suffering from mastopathy, 30-70% in women of reproductive age, and the risk of changes in the mammary gland increases to 70% if a woman has any gynecological pathology. It is proved that in mastopathy cancers (including breast cancer) develop in 3-5 times often.The basic principles of treatment of fibrocystic mastopathy is the normalization of hormonal levels (ratio of sex hormones in a women's blood), elimination of stress and increase of the body's resistance to stressful situations. But homeopathy is not less important in the treatment of mastopathy. We have analysed the effectiveness of homeopathic Mastopol in the treatment of mastopathy, associated with mastalgia.

Manish Kumar Singh, Kumar Avinash Bharati, Rajesh Kumar

The aim of the present study is to find out the use of ethnomedicinal plants in alternative medicines and their scientific validation through literature review. A total of 32 medicinal plants were selected by random sampling method in study area. The selected medicinal plants were studied for pharmacological properties and their uses in different alternative systems of medicines in India viz., Ayurveda, Unani, Homeopathy, Siddha and Tibetan. The pharmacological properties and their earlier studies have shown that the percentage of natural products in modern drug is considerable, with estimates varying from 35%–50%. The data from indigenous systems of Sikkim have range of similarity with different traditional health care system like Ayurveda (59.37%), Unani (37.50%), Homeopathy (18.75%), Tibetan (15.62%) and Siddha (12.50%). Almost 72% of ethnomedicinal plant species shows scientific validations for their ethnic uses. The present study indicates that considerable numbers of ethnomedicinal plant species are used in two or more alternative medicinal systems for the treatment of same or similar ailment, suggesting potential pharmacological opportunities in the future.

SARIT SHARMA, SHRUTI SHARMA, JAGDEEP WHIG et al.

Background: Early diagnosis and proper treatment under RNTCP guidelines, forms the mainstay of management of a TB patient. A large proportion of patients with presumptive tuberculosis (TB) visit a Private Practitioner (PP) in the first place. Studies have shown that PPs rely more on X-rays and other diagnostic tools rather than referring the patient to the nearest Designated Microscopy Centre (DMC) for sputum microscopy. Aim: The present study was planned to look in to factors responsible for non-referral of patients with presumptive pulmonary TB to the DMCs for diagnosis by PPs. Materials and Methods: Present study was a case-control study conducted over a period of one year among registered PPs in urban areas of Punjab. The study was carried out in five major cities which have approximately half of the urban population of Punjab. Forty three Private Practitioners per city for referral group and 43 matched PPs for non-referral group were selected. Results: Knowledge regarding RNTCP was low in both the referral (38.1%) as well as non-referral (25.6%) group of PPs. Allopathic doctors had significantly higher knowledge regarding TB as compared to ayurvedic and homeopathy doctors, and Registered Medical Practitioners (RMP). Both the knowledge of PPs regarding nearest DMC as well as perception about accessibility of the nearest DMC for the patients were found to be significantly higher in the referral group. Only 15.3% of practitioners in the non-referral group said that they had been contacted by RNTCP staff. Conclusion: The main factors responsible for non-referral of pulmonary TB suspects to DMCs for diagnosis in the present study included low knowledge regarding RNTCP, lack of awareness regarding place and accessibility of nearest DMC, and inadequate sensitization of PPs by the RNTCP staff.

Simonetta Bernardini, Franco Cracolici, Rosaria Ferreri et al.

The hospital in Pitigliano (Tuscany) is the first hospital in Italy to put into practice a model of Integrated Medicine. This clinical setting caters for the use of complementary medicine (homeopathy and acupuncture (針灸 zhēn jiǔ)) alongside orthodox therapies (conventional medicine). The therapeutic model implicates doctors who are experts in complementary and alternative medicine (CAM; 補充與替代醫學 bǔ chōng yǔ tì dài yī xué) and the rest of the hospital personnel working together as equals. This contribution explains the difficulties, critical aspects and potential of this innovative setting. The clinical setting for Integrated Medicine was evaluated in part through observation and in part through the analysis of approval questionnaires. The writers of the questionnaires were the orthodox medical personnel and the hospital patients. The project is still evolving today in spite of the initial partial contrariety of some doctors in the hospital and some external doctors in the area. However, it can already be considered a positive experience, as confirmed by the high approval gained from many health workers and most of the hospital patients. Moreover, the follow-up carried out through specific surgeries dedicated to CAM is extremely positive. Up to now 532 inpatients suffering from acute illnesses, relapse of a chronic illness or neurological or orthopaedic rehabilitation following strokes, brain haemorrhage, neurological illness or limb prosthesis operations have been treated. This work has tried to illustrate the innovative and positive experience for the Italian public health authorities so that it may also be useful to anyone who would like to promote similar initiatives within its public health Institution.

Chandrashekhar A Sohoni

Acquired small bowel diverticulitis is an uncommon condition, predominantly affecting elderly population. It is exceedingly rare in young adults. Such a rare case of jejunal diverticulitis in a young female is presented here. Due to the nonspecific clinical presentation, accurate clinical diagnosis of this condition is difficult. Computed tomography (CT) scan provides early and specific diagnosis, thus facilitating successful nonsurgical treatment.