#Non-pharmacological approach

[failtosucceedlife-blog]

12 Tips To Lower Your Blood Pressure Naturally

Learn 12 effective natural remedies to reduce high blood pressure without medication. Discover lifestyle changes, stress-reducing techniques, and healthy habits that can help manage hypertension in this informative blog post. High blood pressure or hypertension is a common health issue that affects millions of people around the world. It is often called the “silent killer” as it can cause severe…

[lifewithchronicpain]

New research shows that there’s not much evidence that antidepressants actually work at treating pain in people over 65 years old.

The study, which comes out of the University of Sydney in Australia, is concerning because older adults are often prescribed antidepressants for pain.

However, in a frustrating conclusion, the authors still do not recommend the one medication that is proven to treat pain in older adults: Opioids.

Instead, they suggest that doctors use a “multidimensional approach using non-pharmacological strategies, such as physical exercise and cognitive behavior therapy.”

In other words, they essentially conclude that pain patients should get no medications.

However, I am glad that more research is coming out to expose how ineffective antidepressants usually are at treating pain. That class of medication has long been held up as an opioid alternative, despite the fact that many patients don’t get much relief from them. (Read more at link)

Doctors just refuse to admit there is no good alternative right now to opioids. Honestly if you can find a pain reliever that works as well without the side effects of opioids, I’d be all over that. Until then, I will keep taking mine.

[alchemyofazeroth]

Human Alchemy & Medical Practice

The alchemical practices developed by the humans of Stormwind represent a fascinating blend of arcane magic and scientific methodology. Through centuries of experimentation and scholarly pursuits, Stormwind's alchemists have devised a systematic approach to transmuting matter and harnessing the latent energies found within organic and inorganic substances.

Their work often focuses on the distillation and recombination of herbs, minerals, and exotic reagents gathered from across Azeroth. By carefully controlling factors such as heat, pressure, and the precise ratio of ingredients, they are able to concoct an impressive array of potions, oils, salves and other alchemical creations imbued with restorative, enhancing or transmutative properties.

Stormwind's alchemists follow strict procedures and maintain meticulous records in bound ledgers, ensuring consistent results and allowing for incremental improvements to their formulas. Their most prized secrets and recipes are jealously guarded, passed down from master to apprentice only after years of tutelage and trust-building.

The potions and elixirs produced by human alchemists are highly sought after commodities, with the most potent commanding premium prices from discerning buyers like adventurers, nobles, and military leaders. Although the craft is often shrouded in an air of mystery, the dedicated practice of alchemy remains a well-respected intellectual and commercial pursuit among the learned citizenry of Stormwind.

Human Medical Practice

The medical practices employed by humans in the city of Stormwind are both sophisticated and highly advanced, reflecting centuries of accumulated knowledge and continuous refinement.

Stormwind's healers and physicians undergo extensive training in anatomy, herbalism, alchemy, and the magical healing arts in order to provide comprehensive care to the city's residents. The Stormwind Cathedral serves as a central hub for healing, with priests and paladins channeling the Light's power to mend wounds, cure diseases, and alleviate suffering. The city's apothecaries work in tandem with the healers, concocting potent elixirs, salves, and potions using exotic herbs and reagents to supplement the healing arts.

Stormwind's medical practitioners also emphasize preventative care, educating the populace on proper hygiene, nutrition, and healthy living to stave off illness. In cases of severe injury or disease resistant to conventional treatment, the city's most skilled healers may employ powerful magic, calling upon the Light to regenerate damaged tissue, purge corruption, or even resurrect the recently deceased. Through a combination of mundane medicine and divine magic, Stormwind's medical professionals maintain the health and well-being of the city's inhabitants, combating everything from common ailments to the most grievous of battlefield injuries.

Adaptations of Stormwind Medicine

The evolution of standard medical practice in Stormwind to accommodate the diverse physiology of the various races comprising the Alliance has been a gradual yet crucial development.

In the early days of the Alliance, medical knowledge was primarily focused on treating humans, as they made up the majority of Stormwind's population. However, as more races joined the Alliance, bringing their unique anatomical structures, metabolic processes, and susceptibilities to different diseases, it became clear that a one-size-fits-all approach to medicine was inadequate. Over time, medical practitioners in Stormwind began to study and document the specific healthcare needs of their non-human patients. This included analyzing anatomical differences, such as the heightened hearing sensitivity of night elves and the high-density musculature of dwarves, to tailor diagnostic techniques and treatment plans.

Pharmacological research expanded to explore how different races responded to medications, leading to customized dosing guidelines and specialized formulations. Medical training programs in Stormwind also adapted, incorporating comparative anatomy and physiology to ensure healthcare providers were equipped to treat patients from all walks of life.

As a result of these efforts, contemporary medical practice in Stormwind is characterized by a deep understanding and respect for the physiological diversity within the Alliance. Hospitals and clinics now boast specialists trained in the nuances of treating various races, ensuring that all citizens of the Alliance receive the highest standard of care.

[jcsmicasereports]

Use of acupressure to reduce nausea and vomiting in cancer patients receiving chemotherapy (literature study) by Maher Battat in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Nausea and vomiting are distressing and serious problems for cancer patients receiving chemotherapy despite the fact that they are receiving antiemetics according to the standard guidelines which this problem is a huge challenge to nurses involved in cancer care.

Purpose: To explore and assess the effectiveness of using acupressure as a non-pharmacological intervention in addition to pharmacological interventions in reducing nausea and vomiting in cancer patients receiving chemotherapy.

Method: A literature review was conducted of 8 articles published between 2006 and 2014. These included one study of a randomized, double-blind, placebo controlled trial; one quasi-experimental model with a control group; four articles reporting on randomized control trials (RCTs); one systematic review study; and one review study. Key Findings: Seven of the articles we read supported the effect of an acupressure P6 Wristband in reducing chemotherapy induced nausea and vomiting in cancer patients and other databases also supported that finding. The one article with neutral results showed that there was no difference between a combination of acupuncture and acupressure treatment at P6 and at the sham point for the nausea score, but the level of nausea was very low in both groups.

Conclusion: We conclude that the acupressure P6 wrist band when applied to acupuncture point P6 is effective, safe, convenient, cost effective, and provides an easy, self-administrated, non-pharmacological intervention that can be used to reduce chemotherapy induced nausea and vomiting.

Keywords: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting.

Introduction

Nausea and vomiting are serious and troublesome side effects of cancer therapy. We chose this research topic in order to become familiar with the topic of the nausea and vomiting facing cancer patients during their chemotherapy treatment, which we have observed during our experience in the Oncology departments.

As nurses, we normally use updated and standard guidelines for managing clinical challenges. We reviewed the literature to explore whether there are alternative approaches to pharmacological management that might reduce or eliminate this problem. We found there are many interventions, such as music, acupuncture, acupressure, and yoga. We decided to assess the effectiveness of using acupressure to reduce the nausea and vomiting in cancer patients receiving chemotherapy. Acupressure is a type of complementary and alternative medicine which the National Cancer Institute (NCI Dictionary of Cancer Terms) defines as follows: “Acupressure is the application of pressure or localized massage to specific sites on the body to control symptoms such as pain or nausea".

The Research Question

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

We have chosen to use the definitions of the NCI Dictionary of Cancer Terms:

“Nausea is an unpleasant wavelike feeling in the back of the throat and/or stomach that may lead to vomiting", and “Vomiting is throwing up the contents of the stomach through the mouth”.

Nausea and vomiting affect the patient’s whole life. These side effects lead to metabolic imbalance, fatigue, distress, and lowered quality of life. We would like to fine a simple, effective and cost effective way to manage these problems so we can put it to use in our hospital.

Method

A literature study is, “A critical presentation of knowledge from various academic written sources, and a discussion of the sources in view of a particular research question" (Synnes 2014). There are many challenges when doing a literature study. There are many databases and much literature and our search process had to find the correct, scientific and relevant databases. It required a lot of time and effort to find the full text of all relevant articles. Fortunately, we received excellent help from the librarian at the Betanien University High school.

We started the search process by making a PICO outline to narrow down the search and to find the correct key words and mesh terms.

P: (Population or participants) Cancer patients experiencing chemotherapy-induced nausea and vomiting.

I:  (Intervention or indicator) Acupressure.

C: (Comparator or control) No comparison or placebo.

O: (Outcome) Reduce nausea and vomiting.

We used PUBMED, Google scholar, scholar.najah.edu and other search engines. When we used Acupressure as a search word we found more than 800 studies. When we added chemotherapy, cancer patients, and nausea and vomiting, we brought this down to 14 articles. We read these and decided to use 8 articles only, one of which was a systematic review. We also used an unpublished Master’s thesis from An Najah National University. This thesis was cited in one of the articles that we decided to review. The key words used were: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting, with Acupressure as a mesh term.

We then critically appraised all the articles according to our checklist. We included only those articles that followed the IMRAD style (i.e. those including an introduction, method, results and discussion section). We excluded all articles that were more than ten years old (i.e. published before 2004), except for two articles: one was about the mechanism of acupressure, which seemed to be directly relevant to our research topic, while the second article was used in the discussion section to discuss certain factors related to the topic. We also excluded one of the review articles because its method appeared to be weak. One of the Cochran reviews was also dropped because it had not been updated.

Despite applying these strict criteria, we were still concerned lest we had left out some important articles or included an inappropriate one. However, we were reassured by the fact that the librarian at Betanien had guided us in our search.

Theoretical part

Nursing Need Theory and basic human needs

The Nursing Need Theory was developed by Virginia A. Henderson to define the unique focus of nursing practice. The theory focuses on the importance of increasing the patients’ independence to hasten their progress in the hospital. Henderson’s theory emphasizes the basic human needs and how nurses can assist in meeting those needs.

The 14 components of Need Theory present a holistic approach to nursing that covers the patient’s physiological, psychological, spiritual and social needs.

Physiological components

Breathe normally.

Eat and drink adequately.

Eliminate body wastes.

Move and maintain desirable postures.

Sleep and rest.

Select suitable clothes – dress and undress.

Maintain body temperature within normal range by adjusting clothing and modifying the environment.

Keep the body clean and well groomed and protect the integument.

Avoid dangers in the environment and avoid injuring others.

Psychological aspects of communicating and learning

Communicate with others in expressing emotions, needs, fears, or opinions. Spiritual and moral

Worship according to one’s faith. Sociologically oriented to occupation and recreation

Work in such a way that there is sense of accomplishment.

Play or participate in various forms of recreation.

Learn, discover, or satisfy the curiosity that leads to normal development and health, and use the available health facilities.

There is much similarity between Henderson’s 14 components and Abraham Maslow’s Hierarchy of Needs. Henderson’s Components 1 to 9 are comparable to Maslow’s physiological needs, with the 9th component also being a safety need. Henderson’s 10th and 11th components are similar to Maslow’s love and belonging needs, while her 12th, 13th and 14th components match Maslow’s self-esteem needs (Vera 2014).

The second of Henderson’s physiological needs is the need to “Eat and drink adequately”. Only the need to breathe is given a higher priority than the need for adequate nutrition. For cancer patients receiving chemotherapy and suffering from chemotherapy-induced nausea and vomiting, this need is the most critical.

Cancer prevalence and treatment

Cancer is a group of diseases characterized by uncontrolled growth and the spread of abnormal cells. It may be caused by internal factors, such as an inherited mutation, or a hormonal or immune condition, or it may result from a mutation from metabolism, or from external sources, such as tobacco use, radiation, chemicals and infectious organisms. Cancer is prevalent all over the world, in both developed and developing nations; it affects both sexes at all ages (Said 2009). The American Cancer Society (2010) estimated that 1,529,560 new cases of cancer were diagnosed in 2010 and that 80 % would be treated with chemotherapy; this means more than 1 million patients will be undergoing chemotherapy in any given year (Lee et al. 2010).

Cancer treatment may be based on chemotherapy, radiotherapy and surgical interventions. Chemotherapy is an important treatment in cancer care but it is associated with several side effects, such as bone marrow suppression, increased susceptibility to infection, diarrhea, hair loss, appetite changes, nausea and vomiting, among others (NCI Chemotherapy Side Effects Series, 2014).

Chemotherapy-induced nausea and vomiting (CINV) is the most prevalent and one of the hardest side effects to manage (Suh 2012).

Nausea and vomiting

Nausea and vomiting (N&V) can be acute or delayed. The incidence of acute and delayed N&V was investigated in highly and moderately emetogenic chemotherapy treatment regimens. Patients were recruited from 14 oncology practices in six countries. Overall, more than 35% of patients experienced acute nausea, and 13% experienced acute emesis. In patients receiving highly emetogenic chemotherapy, 60% experienced delayed nausea and 50% experienced delayed emesis. In patients receiving moderately emetogenic chemotherapy, 52% experienced delayed nausea and 28% experienced delayed emesis. CINV was a substantial problem for patients receiving moderately emetogenic chemotherapy in ten community oncology clinics. Thirty-six percent of patients developed acute CINV, and 59% developed delayed CINV (NCI, Nausea and Vomiting, 2015).

Chemotherapy is the most common treatment-related cause of N&V. The incidence and severity of acute emesis in persons receiving chemotherapy varies according to many factors, including the particular drug, dose, schedule of administration, route, and individual patient variables.

Risk factors for acute emesis include:

Poor control with prior chemotherapy

Female gender

Younger age

Emetic classification:

The American Society of Clinical Oncology has developed a rating system for chemotherapeutic agents with their respective risk for acute and delayed emesis.

High risk: Emesis has been documented to occur in more than 90% of patients on the following chemotherapeutic agents:

Cisplatin (Platinol).

Mechlorethamine (Mustargen).

Streptozotocin (Zanosar).

Cyclophosphamide (Cytoxan), 1,500 mg/m2 or more.

Carmustine (BiCNU).

Dacarbazine (DTIC-Dome).

Moderate risk: Emesis has been documented to occur in 30% to 90% of patients on the following chemotherapeutic agents:

Carboplatin (Paraplatin).

Cyclophosphamide (Cytoxan), less than 1,500 mg/m2.

Daunorubicin (DaunoXome).

Doxorubicin (Adriamycin).

Epirubicin (Pharmorubicin).

Idarubicin (Idamycin).

Oxaliplatin (Eloxatin).

Cytarabine (Cytosar), more than 1 g/m2.

Ifosfamide (Ifex).

Irinotecan (Camptosar).

Low risk: Emesis that has been documented to occur in 10% to 30% of patients on the following chemotherapeutic agents:

Mitoxantrone (Novantrone).

Paclitaxel (Taxol).

Docetaxel (Taxotere).

Mitomycin (Mutamycin).

Topotecan (Hycamtin).

Gemcitabine (Gemzar).

Etoposide (Vepesid).

Pemetrexed (Alimta).

Methotrexate (Rheumatrex).

Cytarabine (Cytosar), less than 1,000 mg/m2.

Fluorouracil (Efudex).

Bortezomib (Velcade).

Cetuximab (Erbitux).

Trastuzumab (Herceptin).

Minimal risk: Emesis that has been documented to occur in fewer than 10% of patients on the following chemotherapeutic agents:

Vinorelbine (Navelbine).

Bevacizumab (Avastin).

Rituximab (Rituxan).

Bleomycin (Blenoxane).

Vinblastine (Velban).

Vincristine (Oncovin).

Busulphan (Myleran).

Fludarabine (Fludara).

2-Chlorodeoxyadenosine (Leustatin).

In addition to the emetogenic potential of the agent, the dose and schedule used are also extremely important factors. For example, prescribing a drug with a low emetogenic potential to be given in high doses may cause a dramatic increase in its potential to induce N&V. For example, standard doses of cytarabine rarely produce N&V, but these often occur with high doses of this drug. Another factor to consider is the use of drug combinations. Because most patients receive combination chemotherapy, the emetogenic potential of all of the drugs combined needs to be considered, and not only that of individual drug doses.

Delayed (or late) N&V is that which occurs more than 24 hours after chemotherapy administration. Delayed N&V is associated with cisplatin and cyclophosphamide, and with other drugs (e.g., doxorubicin and ifosfamide) when given at high doses, or if given on 2 or more consecutive days.

Delayed emesis: Patients who experience acute emesis with chemotherapy are significantly more likely to have delayed emesis as well.

Risk factors: All the predicative characteristics for acute emesis are also considered risk factors for delayed emesis (NCI, Nausea and Vomiting, 2015).

The nausea and vomiting that are often associated with chemotherapy are a serious problem for cancer patients. Despite recent improvements in pharmaceutical technology, about 60% of cancer patients who receive antiemetic medications with their chemotherapy still suffer from nausea and vomiting, and as many as 20% of patients refuse to continue chemotherapy due to the severity of the nausea and vomiting (Shin et al. 2004). Early studies reported that patients cited nausea and vomiting as the most distressing symptoms when receiving chemotherapy. The distressing effect of severe nausea and vomiting can lead to nutritional deficiencies, dehydration, electrolyte imbalance, fatigue, depression and anxiety; they can also disrupt the activities of daily living and cause a lot of work time to be lost (Said 2009).

Uncontrolled nausea and vomiting can interfere with adherence to treatment regimens, and may cause the oncologists to reduce chemotherapy doses. Chemotherapy-induced nausea and vomiting is classified as being either “acute” if it happens within 24 hours post chemotherapy, or “delayed” if it occurs on days 2–5 of the chemotherapy cycle. The latter is particularly troublesome because there is no reliable pharmacological treatment for this problem. The American Society of Clinical Oncology’s (ASCO) recommendations include giving 5-HT3 (5-hydroxytryptamine, or serotonin) receptor antagonists plus corticosteroids before chemotherapy to patients who are at high risk for emesis. Nevertheless, many patients still experience nausea and vomiting related to chemotherapy, and approximately one-third of patients have nausea of at least moderate intensity, resulting in a significant reduced quality of life (QOL). Therefore, the experts emphasize the need for an evaluation of additional ways to reduce these symptoms (Said 2009).

Pharmacological interventions for the management of nausea and vomiting

Historically, antiemetic treatment has steadily improved since the introduction, in 1981, of high-dose metoclopramide which reduced the amount of emesis. This was followed by the development of serotonin (5-HT3) antagonist in the early 1990s, and the 5-HT3 antagonists proved to be more effective than the prior medications in preventing CINV. The concomitant use of corticosteroids was found to further improve the control of emesis. Despite these improvements, nausea and vomiting still remain a problem for many patients. Recently, a new drug, the neurokinin NK (1) receptor antagonist has been shown to be more effective at preventing both acute and delayed CINV for patients treated with highly emetogenic chemotherapy (Said 2009).

Non-pharmacological intervention for management of nausea and vomiting

Traditional Chinese medicine offers a possible intervention for the non-pharmacological treatment of nausea and vomiting in cancer patients. Traditional Chinese medicine (TCM) is a system of medical care that was developed in China over thousands of years. It looks at the interaction between mind, body and environment, and aims to both prevent and cure illness and disease.

TCM is based on Chinese views and beliefs about the universe and the natural world. It is a very complex system. In this essay we can only give a brief overview of what TCM involves. It is very different from Western medicine; Chinese medicine practitioners believe there is no separation between the mind and body and that illness of every kind can be treated through the body. They use a combination of various practices that may include:

Herbal remedies (traditional Chinese medicines).

Acupuncture or acupressure.

Moxibustion (burning moxa – a cone or stick of dried herb).

Massage therapy.

Feng shui.

Breathing and movement exercises called qi gong (pronounced chee goong).

Movement exercises called tai chi (pronounced tie chee).

TCM practitioners say that TCM can help to:

Prevent and heal illness.

Enhance the immune system.

Improve creativity.

Improve the ability to enjoy life and work in general.

Beliefs behind TCM

According to traditional Chinese belief, humans are interconnected with nature and affected by its forces. The human body is seen as an organic whole in which the organs, tissues, and other parts have distinct functions but are all interdependent. In this view, health and disease relate to the balance or imbalance between the various functions. TCM treatments aim to cure problems by restoring the balance of energies.

There are important components that underlie the basis of TCM:

Yin-yang theory is the concept of two opposing but complementary forces that shape the world and all life. A balance of yin and yang maintains harmony in the body, the mind and the universe.

Qi (pronounced chee) energy or vital life force flows through the body along pathways known as meridians, and it is affected by the balance of yin and yang. It regulates spiritual, emotional, mental, and physical health. If there is a blockage or an imbalance in the energy flow, the individual becomes ill. TCM aims to restore the balance of qi energy.

The five elements – fire, earth, metal, water, and wood – is a concept that explains how the body works, with the elements corresponding to particular organs and tissues in the body.

The TCM approach uses 8 principles to analyse symptoms and puts particular conditions into groups: cold and heat, inside and outside, too much and not enough, and yin and yang (Cancer Research, UK, 2015).

In summary, chemotherapy related nausea is not well controlled by pharmacological agents and identifying methods to prevent and alleviate treatment-related nausea remains a major clinical challenge. Non-pharmacological interventions such as music, progressive muscle relaxation (Said 2009), and ginger herbal therapy (Montazeri A et al. 2013) have all been shown to reduce CINV. Among the non-pharmacological interventions that reduce CINV are acupuncture and acupressure, based on the assumption that the individual’s welfare depends on a balance of energy in the body and their overall energy level (Said 2009). Yarbro et al. (2011, p. 645) also indicate in Cancer nursing: principles and practice book that acupuncture and acupuncture-related interventions (electroacupoint stimulation, acupressure, acustimulation wrist bands, and electroacupuncture) can be used to control nausea and vomiting in cancer patients.

Molassiotis et al. (2007) claim that the need for additional relief has led to the interest in non-pharmacological adjuncts to drugs, such as acupuncture or acupressure, since combining anti-emetics with other non-pharmacological treatments may prove to be more effective, safe and convenient in decreasing nausea than antiemetics alone.

From the National Cancer Institute website we found that acupressure is recognised as one of the non-pharmacologic strategies used to manage nausea and vomiting (Nausea and Vomiting, 3 September 2014). We used this website to get up to date, relevant information.

Acupressure

Acupressure involves putting pressure with the fingers, or with bands, on the body’s acupoints and is easy to perform, painless, inexpensive, and is effective. The P6 (Pericardium 6) point (Nei-Guan) refers to a point located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease and between the tendons of flexor carpiradialis and Palmaris longus (figure1). P6 can be stimulated by various methods. The most well-known technique is manual stimulation by the insertion and manual rotation of a very fine needle (manual acupuncture). An electrical current can be passed through the inserted needle (electroacupuncture). Electrical stimulation can also be applied via electrodes on the skin surface or by a ReliefBand, a wristwatch-like device providing non-invasive electrostimulation. Pressure can be applied either by pressing the acupoint with the fingers or by wearing an elastic wristband with an embedded stud (acupressure).

Acupressure is based on the ancient Eastern concept that Chi energy travels through pathways known as meridians. Along the meridians are acu-points, which are controlling points for the Chi energy flow. If the energy flow in meridians is slowed, blocked, or hyper-stimulated, it can be rebalanced or re-stimulated either by applying pressure (acupressure) or by inserting a needle (acupuncture) into one or more of these acupoints. Two points are known for relieving nausea and vomiting: the Nei-Guan point (P6) and the Joksamly point (ST36, located at 4-finger breadths below the knee depression lateral to the tibia).

Patients tend to prefer the P6 point over the ST36 point, Because of its ease of access and the freedom from restriction. When these points are correctly located and pressure applied, either through acupressure or acupuncture, the Chi energy flow is rebalanced, resulting in relief from nausea and vomiting.

The practice of acupressure requires some training and experience, but the technique is widely accessible to any healthcare professionals, particularly to clinical nurses. This acupressure technique is an approach that should be tried not only by healthcare professionals but also by family members or the patients themselves (Shin et al. 2004).

According to the teaching of traditional Chinese medicine, illness results from an imbalance in the flow of energy through the body. This energy or Qi (chee) is restored through the use of acupuncture and acupressure at certain points on the body that have been identified through critical observation and testing over 4000 years. In scientific terms, the neurochemicals that are released after needling or pressure at a specific point may be responsible for this effect. The most commonly used point for nausea and vomiting is Pericardium 6 (Neiguan or P6), located above the wrist (Molassiotis et al. 2007).

The literature review on acupressure

Acupressure for chemotherapy-induced nausea and vomiting in breast cancer patients: a multicentre, randomised, double-blind, placebo-controlled clinical trial. (Said 2009)

For a master degree in public health from An-najah National University, Said (2009) described a randomized, double-blind, placebo controlled trial that was done in Palestine with 126 women on chemotherapy for breast cancer. In this study the researcher divided the patients into 3 groups: the first group (n=42) received acupressure with bilateral stimulation of P6, the second group (n=42) received bilateral placebo stimulation, and the third group (n=42), which served as a control group, received no acupressure wrist band, but all groups received pharmacological management of their nausea and vomiting. Acupressure was applied using a Sea-Band (Sea-Band UK Ltd, Leicestershire, England) that patients had to wear for five days following the administration of chemotherapy. Assessment of acute and delayed nausea and emesis, quality of life, patients’ satisfaction, recommendation of treatment and requests for a rescue antiemetic were obtained. Said (2009) concluded that the acupressure showed benefits for delayed nausea and the mean number of delayed emetic episodes. Acupressure may therefore offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy to reduce nausea and vomiting at home during days 2-5 after chemotherapy. In addition, the percentage of patients who were satisfied with the treatment (≥ 3 on a 0-6 scale) was 81% (35/42) in the P6-acupressure group, and 64% (27/42) in the placebo group (p= 0.0471). The percentage of patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, and 62% (26/42) in the placebo group (p= 0.0533). We used this study because it had a lot of essential information, it used the IMRAD system and was also mentioned in the literature (Genç and Tan 2014). This study demonstrated that the mean scores for the acupressure group were lower for both acute and delayed nausea.

Review of Acupressure Studies for Chemotherapy-Induced Nausea and Vomiting Control. (Lee et al. 2008)

In the Journal of Pain and Symptom Management Jiyeon Lee et al. (2008) reviewed ten controlled studies on acupressure in order to evaluate the effects of a non-invasive intervention, acupressure, when combined with antiemetics for the control of CINV. The review evaluated one quasi-experimental and nine randomized clinical trials, which included two specific acupressure modalities, namely, an acupressure band and finger acupressure. The effects of the acupressure modalities were compared study by study. Four of the seven acupressure band trials supported the positive effects of acupressure, whereas three acupressure band trials did not support the effects of acupressure. However, all the studies with negative results had methodological issues. In contrast, the one quasi-experimental and two of the randomized finger acupressure trials all supported the positive effects of acupressure on CINV control. The reported effects of the two acupressure modalities produced variable results at each stage of CINV. Acupressure bands were most effective in controlling acute nausea, whereas finger acupressure controlled delayed nausea and vomiting. The overall effect of acupressure was strongly indicative but not conclusive. We used this article because it is relevant, a review study, and is from a known journal.

The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. (Molassiotis et al. 2007)

As reported in the journal Complementary Therapies in Medicine, acupressure was applied using wristbands (Sea-Band™) in a randomized controlled trial conducted in two centres in the UK. Patients in the experimental group had to wear these bands for the five days following their chemotherapy administration. Assessments of nausea, retching and vomiting were obtained from all patients, daily, for five days. Molassiotis et al. (2007) evaluated the effectiveness of using acupressure on the Pericardium 6 (Neiguan) acupoint in managing CINV. Thirty-six patients took part in the study, with 19 patients allocated to the control group and 17 to the experimental group. The results showed that nausea with retching, nausea, and vomiting with retching, and the accompanying distress were all significantly lower in the experimental group as compared to the control group (p < 0.05). The only exception was the vomiting, where the difference was close to significance (p = 0.06). We used this article because it had a strong study design and also used an IMRAD system.

Acupuncture and acupressure for the prevention of chemotherapy-induced nausea- a randomized cross-over pilot study. (Melchart et al. 2006)

In a randomized, cross-over trial, Melchart et al. (2006) studied 28 patients receiving moderately or highly emetogenic chemotherapy and a conventional standard antiemetic for one chemotherapy cycle, followed by a combination of acupuncture and acupressure at point P6 for one cycle, and for another cycle a combination of acupuncture and acupressure at a close sham point. The results showed that there was no difference in the nausea score between the combined acupuncture treatment at P6 and at the sham point, but the level of nausea was very low in both cases. We used this study because the article had neutral results and because we trusted the source of article, coming as it did from a cancer support care journal.

The efficacy of acupoint stimulation for the management of therapy adverse events in patients with breast cancer: a systematic review. (Chao et al. 2009)

This is a systematic review of 26 articles published between 1999 to 2008 examining the efficacy of acupressure, acupuncture or acupoint stimulation (APS) for the management of adverse events due to the treatment of breast cancer. Published online on 17 September 2009 in the Breast Cancer Research and Treatment journal, 23 trials reported revealed that APS on P6 was beneficial in treating CINV. Chao et al. (2009) also presented the findings from three high quality studies comparing APS groups with control groups, which indicated that APS is beneficial in the management of CINV and especially in the acute phase, even with the non-invasive intervention. Health care professionals should consider using APS, and in particular acupressure on the P6 acupoint, as an option for the management of CINV. Furthermore, as a cost effective intervention, it warrants further investigation. We used this article because it used the IMRAD structure.

'Until the trial is complete you can’t really say whether it helped you or not, can you?’: exploring cancer patients’ perceptions of taking part in a trial of acupressure wristbands. (Hughes et al. 2013)

In Complementary and Alternative Medicine, Hughes et al. report on qualitative research undertaken with patients receiving chemotherapy in the UK. A convenience sample of 26 patients volunteered to participate in the clinical trial and to explore their experiences of using acupressure wristbands. Participants were recruited from three geographical sites: nine were recruited from Manchester, nine from Liverpool, and eight from Plymouth and the surrounding regions. Ten of the participating patients received true acupressure during the trial, 9 received sham acupressure, and 7 received no acupressure. Hughes et al. (2013) concluded that the research provided insights into cancer patients’ motivations and experience of taking part in a clinical trial for a complementary alternative medicine intervention, in which the participants perceived acupressure wristbands to reduce the level of nausea and vomiting experienced during their chemotherapy treatment. This article is important because it includes the benefits experienced by the patients taking part in the trial. This is also the first qualitative study to explore patients’ experiences of using acupressure wristbands and their perceptions of the effects. In the study, the patients perceived the wristbands as reducing their level of nausea and vomiting experienced due to their chemotherapy treatment. The study was an RCT.

The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. (Genç and Tan 2014)

Genç and Tan (2014) reported on a quasi-experimental study in Turkey with 64 patients with stages 1–3 breast cancer who received two or more cycles of advanced chemotherapy. Thirty two patients were in the experimental group, and thirty two in the control group. To determine the effect of acupressure P6 on CINV and anxiety in these patients, the P6 acupressure wristband was applied to the experimental group. Genç and Tan (2014) concluded that the total mean scores for patients in the experimental group, for nausea, vomiting and retching, were lower than those of the patients in the control group over the five days of application. We used this article because it is a recent and quasi-experimental study and used the IMRAD system.

The effects of P6 acupressure and nurse-provided counselling on chemotherapy-induced nausea and vomiting in patients with breast cancer. (Suh 2012)

Suh (2012) reported in the Oncology Nursing Forum on a RCT in South Korea with 120 women who were receiving chemotherapy for breast cancer. These patients had all had more than mild levels of nausea and vomiting during their first cycle of chemotherapy. The participants were assigned randomly to one of four groups: a control group (a placebo on a specific location on the hand); a counselling only group; a P6 acupressure only group; and a P6 acupressure plus nurse-provided counselling group. The purpose of the study was to evaluate the effects of pericardium 6 (P6) acupressure and nurse-provided counselling on CINV in patients with breast cancer. Suh (2012) concluded that nurse-provided counselling and P6 acupressure were together the most effective in reducing CINV in patients with breast cancer. We used this article because it is the first RCT evaluating the isolated and combined effects of P6 acupressure and counselling in reducing CINV among non-Western patients. The findings of the study support the use of P6 acupressure together with counselling that is focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medicine for the control of CINV. The article used the IMRAD system.

Discussion

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

In our experience, we have usually used metoclopramide (pramin) plus serotonin (5-HT3) antagonist (as Ondansetron and Granisetron), plus Dexamethasone plus neurokinin NK (1) (as Emend - aprepitant) for moderate to high ematogenic chemotherapy, yet some of the patients have still suffered from nausea and vomiting. After reviewing the literature we would like to use the acupressure P6 wrist band to solve this problem as the findings of our literature review confirm that the acupressure P6 wrist band reduces CINV in cancer patients receiving chemotherapy. This result is corroborated by 7 of the articles reviewed.

The National Cancer Institute website supports the finding that acupressure is one of the non-pharmacologic strategies that may be used to manage nausea and vomiting (NCI Dictionary of Cancer Terms). Said (2009) adds that acupressure may offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy, helping to reduce nausea and vomiting at home on days 2-5 of chemotherapy. Genç and Tan (2014) conclude that the total mean scores for CINV in patients in the experimental group to whom they applied the P6 acupressure wristband were lower compared to patients in the control group over the five days of application. Lee et al. (2008) found that the two acupressure modalities produced variable results in each phase of CINV: acupressure bands were effective in controlling acute nausea, whereas acupressure controlled delayed nausea and vomiting. Molassiotis et al. (2007) showed that the experience of nausea and vomiting was significantly lower in the experimental group than in the control group. Chao et al. (2009) found that P6 acupoint stimulation was an option for the management of CINV. In the study reported by Hughes et al. (2013) the participants perceived that acupressure wristbands reduced the levels of nausea and vomiting experienced during chemotherapy treatment. Suh (2012) concluded that the synergistic effects of P6 acupressure together with nurse-provided counselling appeared to be effective in reducing CINV in patients with breast cancer.

Five of the seven articles investigating breast cancer patients, namely Said (2009), Chao et al.( 2009), Molassiotis et al. (2007), Suh (2012) and Genç and Tan (2014), involved breast cancer patients receiving highly ematogenic chemotherapy (e.g. Cisplatin and cyclophosphamide), and moderate risk ematogenic chemotherapy (like doxorubicin).

It is necessary to mention other therapeutic regimens that can also be used in cancer treatment that contain other types of chemotherapy that cause nausea and vomiting, for example, doxorubicin-containing regimens like ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine), CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisone) and FAC (5-Fluorouracil, Adriamycin, Cyclophosphamide), and ACT (Adriamycin, Cyclophosphamide, Taxol) (Said 2009) and from our experience cisplatin-containing regimens which that classified as highly ematogenic chemotherapy we noticed the patients still experienced nausea and vomiting after they received the antiemitecs. We think it is necessary to use additional intervention like acupressure to be included in the nausea and vomiting management.

Based on the reviewed findings we plan to use acupressure for cancer patients receiving chemotherapy, because the acupressure in the studies conducted in breast cancer patients reported was used with highly ematogenic chemotherapy in addition to the standard antiemetic treatment, so it is reasonable to conclude that it will work equally well with other less ematogenic types of chemotherapy.

We prefer the use of the acupressure wrist band at P6 acupoint because it is an inexpensive, convenient, and self-administered intervention involving pressure instead of needles at the same point as that used in acupuncture. Furthermore it is safer than acupuncture and patients can easily learn to put pressure on their own wrists, whereas the acupuncture involves using needles that are about the diameter of a hair and can cause temporary discomfort during insertion (Said 2009; Molassiotis et al. 2007). Acupressure seems to be a good way to complement antiemetic pharmacotherapy as it is safe and convenient, with minimal (with bands) or no (finger acupressure) costs involved. It is thus an easy to use, cost-effective, non-invasive intervention (Lee et al. 2008; Melchart et al. 2006).

There was no study result that showed any negative effect from the acupressure wrist band at P6 point, except the review by Lee et al. (2008), which mentioned that three of the ten reported acupressure band trials did not support the possible positive effects of acupressure, but these studies all had methodological issues, such as a small sample size, no true control group, and a concern about the sham acupressure band having a possible antiemetic effect. Melchart et al. (2006) said that no difference was detected in the nausea score between the acupuncture treatment at P6 acupoint, and that at the sham point. Said (2009) mentioned that the acupressure showed no benefit in relation to the incidence of delayed vomiting, early vomiting, or acute nausea, but Melchart and Said’s studies were done with breast cancer patients and it could be that the acupressure benefits were not evident due to the breast cancer patients having had axillary lymph node resection that may have affected the meridian pathway or caused damage to the median nerve as mentioned by Roscoe et al. (2003). Consequently, we think that the evidence suggesting that there is no benefit from the acupressure method for reducing CINV is weak.

Regarding the placebo effect in the articles reviewed here, Melchart et al. (2006) indicated that there was no difference in the nausea score for the combined acupuncture treatment at p6 or that at the sham point, although the level of nausea was very low in both cases. Molassiotis et al. (2007), Said (2009) and Roscoe et al. (2003) all suggested that the placebo effect may be the result of psychological factors.

Application of acupressure in clinical practice

It is important to put this theory into practice, and health care professionals could consider using APS, in particular acupressure on the P6 acupoint, as an option in the management of CINV (Chao et al. 2009). Melchart et al. (2006) said acupressure bands can easily be used in busy oncological wards, while Suh (2012) supported the use of P6 acupressure with counselling focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medications for the control of CINV. Hughes et al. (2013) concluded that the research provides an insight into cancer patients’ motivations for and experiences of taking part in a clinical trial for a complementary alternative medical intervention in which the participants perceived the acupressure wristbands as reducing their level of CINV. Said (2009) suggests that oncology nurses should include acupressure in their list of options for the management of CINV, and especially delayed nausea and vomiting. Special recommendations by oncology nurses are not only useful but are also much appreciated by patients as shown in a study in which the patients were satisfied with the antiemetic treatment given by both P6-acupressure, and placebo-acupressure. The percentage of patients who were satisfied (≥ 3 on 0-6 scale) with their treatment was 81% (35/42) in the P6-acupressure group, which was in agreement with Roscoe et al. (2003), and 64% (27/42) in the placebo group (p= 0.0471). The percentage of the patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, which again was in agreement with the results of Roscoe et al. (2003) and Hughes et al. (2013), compared to 62% (26/42) in the placebo group (p= 0.0533). This study presented the patients’ compliance with the use of acupressure. Acupressure is easily learnt and taught and patients should be informed about its potential role and taught how to apply it. Leaflets about acupressure for the management of nausea and vomiting could be available in chemotherapy units so that patients who are interested to use such a technique would be encouraged to come forward and learn more from nurses or other health professionals. This could add to the patients’ options for antiemetic approaches and empower them to be involved in the management of these distressing side effects. Acupressure offers a no-cost, convenient, self-administered intervention for chemotherapy patients to reduce acute nausea. Acupressure devices (i.e. Wrist Bands, travel bands, and acupressure bands) have been developed to provide passive acupressure on P6. Acupressure can be administered by healthcare providers, family members, or patients themselves, and does not involve puncture of the skin.

We therefore found that the acupressure wristband is a good way to reduce nausea and vomiting for cancer patients receiving chemotherapy by applying it in the correct position with the stud over the pericardium 6 acupoint located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease, and between the tendons of flexor carpiradialis and Palmaris longus.

Lee et al. (2008) encourage the application of acupressure bilaterally, rather than unilaterally, in CINV control. They recommend three minutes of finger acupressure once daily, with additional acupressure as needed, as the optimal intervention, because both three and five minute trials have succeeded in achieving positive effects. On the other hand, Molassiotis et al. (2007) claimed that there is no correlation between the frequency of pressing the studs and the level of nausea and vomiting. Lee et al. (2008) and Molassiotis et al. (2007) therefore claim opposite results in the relationship between CINV and the frequency of pressing the stud of an acupressure P6 wrist band. But when applying the acupressure P6 wrist band bilaterally, Lee et al. (2008), Said (2009), Molassiotis et al. (2007), Suh (2012), and Genç and Tan (2014) all reported a positive effect with P6 stimulation in reducing CINV.

We would like to discuss some factors related to CINV in relation to nausea and vomiting: expectancy and gender: Roscoe et al. (2003) argued that patients who received the acustimulation bands and expected them to be effective did report having a higher quality of life and less nausea, and in relation to gender, that women are more likely to experience nausea when receiving chemotherapy. Lee et al. (2008) say this may be caused by classical conditioning and also that breast cancer patients may have had a damaged median nerve due to axillary lymph node removal, but Lee et al. (2008) also mention that P6 acupressure in younger women had a significantly greater positive effect on delayed nausea than those on a placebo or those in the no-intervention control group. On the other hand, Molassiotis et al. (2007) mentioned that younger age is associated with greater nausea. We think that men may have tolerated greater stimulation of the acupressure points, and therefore experienced greater symptom relief, so it may be that the acupressure is more effective for men than for women, but these questions of gender, age and the frequency of pressing the studs would need further investigation.

Based on the reported studies, we support the belief that acupressure on P6 is applicable in clinical practice for CINV for cancer patients provided the required education, training and counselling is given to maintain the acupressure benefits.

Acupressure side effects

The study by Molassiotis et al. (2007) found that there were no side effects from the use of the wristbands, but one patient reported that she had to take the bands off because they were too tight and left her with marks for a few days. Chao et al. (2009) also mentioned that very few minor adverse events were observed.

Melchart et al. (2006) did report adverse effects from the treatment in five cases. One suffered a hematoma when wearing the acupressure band at P6. In the sham group, one hematoma was reported after acupuncture, and another three adverse effects from the acupressure band were reported (one hematoma, one skin irritation, one eczema). Hughes et al. (2013) also reported that participants had not experienced any restrictions from wearing the wristbands in terms of everyday activities, other than when washing and bathing. As one female participant commented, for most participants the wristbands were found to be comfortable to wear. However, a few participants reported that they had experienced minor irritation, such as the wristbands feeling tight or painful, or their wrists becoming itchy. Reported adverse side effects were generally deemed minor and acceptable. In the study by Said (2009), no side effect or discomfort was noticed from wearing the acupressure wristband. Said told the patients that if the bands caused discomfort, they could be removed for 30 minutes every two hours. In this way, by taking it off for regular periods, we can prevent the side effects of acupressure, even its minor and rare effects.

Acupressure reduces CINV in cancer patients, in addition it reduces anxiety (Genç and Tan 2014) and that affects overall quality of life (Said 2009). Quality of life is defined by the NCI Dictionary of Cancer Terms as “The overall enjoyment of life and the individual’s sense of well-being and ability to carry out various activities”. Based on the physiological components of the Virginia Henderson’s theory of basic human needs and Abraham Maslow’s Hierarchy of Needs, the patient needs to eat and drink adequately, and sleep and rest (Vera, 2014). This means that when we are providing the required management for distressing symptoms, such as nausea and vomiting, by including the acupressure wrist band in addition to standard antiemetics, the patient’s appetite will improve, leading the patient to eat and drink adequately and improve their sleeping pattern. These may then also improve other aspects of the cancer patient’s life. According to the Henderson Nursing Need Theory, when we meet a patient’s needs, it results in an improved quality of life for the cancer patient receiving chemotherapy. Another way of expressing this is that it restores the balance of Yin and Yang energy that leads to reduced nausea and vomiting and improves the patient’s ability to enjoy life and work in general through a maintaining of the harmony of body and mind, as described in traditional Chinese medicine (Cancer Research UK, 2015).

We believe that it is essential for cancer patients undergoing chemotherapy treatment to have adequate nutrition to maintain their strength to fight the cancer. Different nursing actions are necessary to maintain adequate nutrition including the relieving of CINV. From this we extrapolate that using the acupressure P6 wrist band to reduce CINV improves the patient’s quality of life.

Conclusion

Chemotherapy-induced nausea and vomiting may be life threatening and is therefore a huge challenge to nurses involved in cancer care. Even with the best pharmacological management of CINV, patients continue to experience nausea and vomiting.

From a review of eight articles with strong methodology, seven supported the positive effect of an acupressure P6 wristband in reducing CINV for cancer patients. This was also supported by other databases. The one article with neutral results showed that there was no difference between a combined acupuncture and acupressure treatment at P6 and at a sham point in relation to the nausea score, but the level of nausea was very low in both groups. We conclude that the acupressure wrist band applied to acupuncture point P6 is effective, safe, convenient, cost effective, an easy and self-administrated non-pharmacological intervention from traditional Chinese medicine that reduces CINV. Solving the problem of CINV is a fundamental nursing task that can lead to improved quality of life and nutritional status, reduced anxiety and increases patient compliance. In the light of these results, and due to the effectiveness and inexpensiveness of acupressure, together with its ease of use, we suggest that it should be used in conjunction with pharmacological agents for CINV prophylaxis. To maintain the effectiveness of the acupressure, special education and training is needed to reassure the patient that the acupressure is at the correct point (P6) and counselling by the nurse is required.

We recommend the use of acupressure P6 in oncology departments and that future research should be conducted to include cancer patients receiving radiotherapy, and to investigate more about the relationship between the frequency of pressing the stud on the wrist band for acupressure P6 and CINV, and the relationship between gender and CINV, and whether it is better to apply it unilaterally or bilaterally.

[abhinavayu21]

PMS Relief: Find What Works for You

Introduction:

PMS is a state experienced by many women whose symptoms show up within 1 to 2 weeks before the start of menstruation, and they revolve mostly around hormonal changes affecting physical, mental and emotional conditions. Identifying ideal therapies for PMS that would improve daily functioning, is also useful. This blog will address: natural and non-pharmacological approaches to treating PMS symptoms, which will be explained through recommendations on lifestyle modifications, dietary changes, and other medicine for premenstrual syndrome.

What is PMS?

PMS is a hormonal disease that focuses on the fluctuations in levels of estrogen and progesterone hormones. Such hormonal changes have several effects on the body, including tender breasts, weight gain, mood swings, irritability, and constant fatigue. As for the present article, it is important to understand the origins of these symptoms in order to find the cure.

Symptoms of PMS:

PMS symptoms can vary widely but often include:

Mood swings

Irritability

Fatigue

Bloating

Breast tenderness

Headaches

Anxiety

Depression

These symptoms are due to alterations in interact function between steroids and hormones such as dopamine, serotonin, and oxytocin.

Natural Ways to Manage PMS:

1. Increase Serotonin Levels Naturally:

Serotonin is a neurotransmitter which has an impact on person’s feelings. It has been preceded that inositol enhances serotonin signaling and that low levels of serotonin are associated with mood swings and depression, both of which are symptoms of PMS. Here are some types of foods that directly enhance serotonin:

Diet Tips:

Make sure to consume products containing complex carbohydrates such as rice, fruits and vegetables.

One should take products rich in lean protein for instance chicken fish and beans.

Take monounsaturated fats in nuts, seeds and avocados since they help reduce cholesterol levels.

This means that one should refrain from consuming foods in boxes, sugary foods, and foods that contain caffeine.

2. Stop Being a Night Owl:

Another crucial principle of daily life and hormonal balance is wake-sleep cycling or rhythmicity. It was also found that lack of sleep would lead to aggravation of PMS.

Sleep Tips:

The recommended amount of hours for sleep is between seven and nine hours for a competent level of functioning.

Stay on a regular sleep-wake schedule and avoid sleeping during the day hours.

Ponder on the creation of a relaxing bedtime regimen of reading or bathing with warm water.

This means that activities that involve use of screens or anything that would stimulate the brain should be avoided just before sleeping.

3. Take Sun Baths and Engage in Physical Activity:

In addition to affected mental health conditions, natural sunlight exposure and subsequent physical activities can improve many PMS symptoms. It assists the body in the synthesis of vitamin D, which plays a critical role in mood as well as in the body’s general wellbeing.

Activity Tips:

Get 15 to 20 minutes of sunlight exposure per day.

Perform activities such as yoga, exercise, Surya Namaskar or morning walking which enhances the secretion of endorphin thus helping to calm the nerves.

Physical activity contributes to the regulation of hormonal levels, elevates one’s spirits, and combats bloating.

Understanding the Role of Neurotransmitters:

Neurotransmitters like dopamine, serotonin, and oxytocin are known to cause or exacerbate PMS symptoms.

Dopamine: Associated with pleasure and reward system. Whereas, low levels can cause depression and lack of aspiration or motivation. The levels of dopamine can be increased through exercises as well as fun activities.

Serotonin: Closely related to mood control and modulation. Tasty foods, drinks, and regular exercise help to enhance the serotonin level in the human body.

Oxytocin: It is popularly referred to as the ‘cuddle hormone’ since it aids in the bond formation and the calming effect. Oxytocin level can be boosted through participation in activities such as those involving yoga, interpersonal communication, and touching.

Finding the Right Medicine for Premenstrual Syndrome:

While lifestyle changes can manage PMS, some may need medication. Consult a healthcare professional to explore options like these:

Over-the-counter pain relievers such as ibuprofen and aspirin.

Hormonal treatments like birth control pills to regulate hormone levels.

Antidepressants, mainly selective serotonin reuptake inhibitors (SSRIs), for severe mood-related symptoms.

Moreover, “Upasham Tablets” by Abhinav Healthcare are natural remedies that have shown fairly promising results for PMT patients. This Ayurvedic medicine effectively helps in treating various PMS symptoms through the use of natural ingredients that balance hormones and reduce discomforts.

Conclusion:

Effectively managing premenstrual syndrome necessitates a holistic approach including dietary improvements, changes in lifestyle and medical interventions when necessary. Appreciating the hormonal and neurotransmitter aspects of PMS enables one to make decisions on how to minimize these symptoms and improve quality of life. Importantly, what works for one person may not work for another; therefore it is important to find the right combination of approaches that will suit you best.

Upasham Tablets from Abhinav Healthcare could be worth considering by anyone searching for Ayurvedic medicine for premenstrual syndrome and menstrual irregularities. The right blend of dietary modifications along with an appropriate drug regimen can go a long way towards managing PMS effectively while also enhancing physical issues.

Resource:

[unwelcome-ozian]

From a military perspective, the goal would be to improve the capability of military personnel to meet the many challenges of today’s, and anticipated, battlefields, and thereby to gain a measure of mastery over their opponents. This report analyzes some approaches that have been suggested for optimizing individual performance, in the context of potential actions of an adversary who may not be guided by the same cultural or ethical concerns that govern US military operations. The measures considered include medical supplements; non-invasive modifications of brain effectiveness, for example by training and sleep optimization; neuro-pharmacology; and neural implants. In pursuing understanding on this subject one needs to measure the value of the proposed behavioral changes or medical actions relative to what can be gained by organizing and training our military to utilize the unique characteristics, and strengths, of American society and culture, that emphasize individual choice.

[mynetpharmas]

Empowering Men: Understanding Cenforce 100mg Impacts on Erectile Dysfunction

In a world where sexual health is often considered a taboo subject, it's important to shed light on issues that affect millions of men worldwide. One such issue is erectile dysfunction (ED), which can have a significant impact on a man's self-esteem and quality of life. But there's hope, and its name is Cenforce. Cenforce 100, commonly known by its brand name Viagra, is a medication that has revolutionized the treatment of ED. By improving blood flow to the penis, it helps men achieve and maintain an erection that's firm enough for sexual intercourse. But there's more to it than just that.

The impact of erectile dysfunction on men's mental health

Erectile dysfunction can have a profound impact on a man's mental health and overall well-being. It can lead to feelings of inadequacy, low self-esteem, and even depression. The inability to perform sexually can strain relationships and create a sense of frustration and disappointment. Many men struggle in silence, feeling embarrassed or ashamed to seek help.

Understanding Cenforce and how it works

Cenforce tablet is a phosphodiesterase type 5 (PDE5) inhibitor. It works by relaxing the blood vessels in the penis, allowing for increased blood flow. This improved blood flow helps men with erectile dysfunction achieve and maintain an erection during sexual stimulation. Cenforce 100mg medication is most effective when taken on an empty stomach, about 30 minutes to an hour before sexual activity.

Benefits of Cenforce tablet for treating erectile dysfunction

Cenforce 100 online has been proven to be highly effective in treating erectile dysfunction. Studies have shown that it improves erectile function in approximately 70% of men with ED. It not only helps men achieve and maintain an erection but also enhances the quality of their sexual experiences. Buy cenforce 100 provides a safe and reliable solution for men looking to regain their sexual confidence and intimacy.

How to use Cenforce safely and effectively

To use Cenforce safely and effectively, it's important to follow the prescribed dosage and instructions provided by a healthcare professional. It's recommended to start with the lowest effective dose and adjust as necessary. Cenforce should only be taken once a day, and it's important to avoid excessive alcohol consumption, as it may decrease the effectiveness of the medication. It's also essential to be aware of potential drug interactions and disclose all medications and health conditions to a healthcare provider.

Alternative treatments for erectile dysfunction

While Cenforce 100mg is a highly effective treatment for erectile dysfunction, it's not the only option available. There are alternative treatments that may be suitable for some individuals, including other PDE5 inhibitors like tadalafil and vardenafil. Additionally, there are non-pharmacological approaches, such as vacuum erection devices, penile injections, and surgery that can be considered in consultation with a healthcare professional.

Erectile dysfunction is a common and treatable condition that affects many men worldwide. Cenforce, with its ability to improve blood flow to the penis, has revolutionized the treatment of ED and provided hope for men seeking a fulfilling and satisfying sex life. By understanding how Cenforce 100 works, its benefits, and potential side effects, men can make informed decisions about their sexual health. It's important to remember that erectile dysfunction does not define a man, and with the right support and treatment, it's possible to reclaim confidence and vitality in the bedroom. Don't let ED hold you back – take control of your sexual health and empower yourself with Cenforce.

[eclipsecrowned]

something about how like. danae tries to be a good person. her future arcs largely involve her playing sugar mama to chris' cause and eventually driving out other investors with interests non-compliant to his group's basic morals. she opposes evil in-setting and does her best to combat it with the privilege she possesses to spare further innocent lives from ruin.

the initial outbreak never should never have happened, let alone repeat, and so long as she is able, she will try to ensure that.

however.

there is also the edge that if a villain pre-2006 approached her with genuine intent to kill her rat bastard father and tear down his pharmacological reign of terror, she's absolutely going to be the team's anti-villain. tag her in coach she's ready. you have her checkbook her connections and she's not much of a combatant but damn she looks pretty.

[vikibro1]

Chorea Treatment Market Industry Analysis and Forecast By 2030

The Chorea Treatment Market sector is undergoing rapid transformation, with significant growth and innovations expected by 2030. In-depth market research offers a thorough analysis of market size, share, and emerging trends, providing essential insights into its expansion potential. The report explores market segmentation and definitions, emphasizing key components and growth drivers. Through the use of SWOT and PESTEL analyses, it evaluates the sector’s strengths, weaknesses, opportunities, and threats, while considering political, economic, social, technological, environmental, and legal influences. Expert evaluations of competitor strategies and recent developments shed light on geographical trends and forecast the market’s future direction, creating a solid framework for strategic planning and investment decisions.

Brief Overview of the Chorea Treatment Market:

The global Chorea Treatment Market is expected to experience substantial growth between 2024 and 2031. Starting from a steady growth rate in 2023, the market is anticipated to accelerate due to increasing strategic initiatives by key market players throughout the forecast period.

Get a Sample PDF of Report - https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-chorea-treatment-market

Which are the top companies operating in the Chorea Treatment Market?

The report profiles noticeable organizations working in the water purifier showcase and the triumphant methodologies received by them. It likewise reveals insights about the share held by each organization and their contribution to the market's extension. This Global Chorea Treatment Market report provides the information of the Top Companies in Chorea Treatment Market in the market their business strategy, financial situation etc.

Medtronic plc. (Ireland), Boston Scientific Corporation (U.S.), ALEVA NEUROTHERAPEUTICS SA (Switzerland), Teva Pharmaceutical Industries Ltd. (Israel), Pfizer Inc. (U.S.), GlaxoSmithKline plc. (U.K.), Bausch Health Companies Inc. (Canada), LivaNova, PLC (U.K.), H. Lundbeck A/S (Denmark), Ipsen (France), Alnylam Pharmaceuticals Inc. (U.S.), Prana Biotechnology Ltd. (Australia), RespireRx Pharmaceuticals Inc. (U.S.), Vertex Pharmaceuticals, Inc. (U.S.), and SOM Innovation Biotech, S.A. (Spain)

Report Scope and Market Segmentation

Which are the driving factors of the Chorea Treatment Market?

The driving factors of the Chorea Treatment Market are multifaceted and crucial for its growth and development. Technological advancements play a significant role by enhancing product efficiency, reducing costs, and introducing innovative features that cater to evolving consumer demands. Rising consumer interest and demand for keyword-related products and services further fuel market expansion. Favorable economic conditions, including increased disposable incomes, enable higher consumer spending, which benefits the market. Supportive regulatory environments, with policies that provide incentives and subsidies, also encourage growth, while globalization opens new opportunities by expanding market reach and international trade.

Chorea Treatment Market - Competitive and Segmentation Analysis:

**Segments**

- **By Type**: The market can be segmented into Huntington’s Chorea, Sydenham’s Chorea, and others based on the type of chorea being treated. Each type may require different treatment approaches and medications, leading to varied market trends within these segments.

- **By Treatment**: The market can be segmented into Pharmacological Treatment and Non-pharmacological Treatment. Pharmacological treatment includes medications like antipsychotics and benzodiazepines, while non-pharmacological treatment may involve therapies such as physical therapy and speech therapy. The demand for different treatment options will impact the market dynamics across these segments.

- **By End-User**: Segmentation by end-user includes Hospitals, Clinics, and Others. Hospitals are expected to have a significant market share due to the availability of advanced treatment facilities, while clinics may cater to patients seeking outpatient care for chorea treatment. The preferences of end-users will influence the market growth in each sector.

**Market Players**

- **Teva Pharmaceutical Industries Ltd**: Teva is a key player in the global chorea treatment market, offering a range of medications for managing chorea symptoms. Their strong market presence and research efforts contribute to the overall market growth.

- **Acorda Therapeutics**: Acorda Therapeutics is known for its innovative solutions in neurological disorders, including treatments for chorea. Their pipeline of products and focus on research and development position them as a prominent player in the market.

- **Auspex Pharmaceuticals**: Auspex Pharmaceuticals specializes in developing therapies for movement disorders such as chorea. Their expertise in this niche area and commitment to improving treatment options make them a notable contender in the market.

The global chorea treatment market is witnessing significant growth potential, driven by advancements in treatment options and increasing prevalence of chorea-related conditions. With a focus on segment-specific trends and the key players contributing to market dynamics, the industry is poised for substantial progress in the forecast period up to 2030.

https://www.databridgemarketresearch.com/reports/global-chorea-treatment-marketChorea, characterized by involuntary movements and muscle contractions, presents a growing market opportunity for pharmaceutical companies and healthcare providers worldwide. As the prevalence of chorea-related conditions continues to rise, fueled by factors such as aging populations and improved diagnostics, the demand for effective treatment options is steadily increasing. This trend is driving significant investments in research and development by key market players, aiming to address the unmet medical needs of patients with chorea.

Segmentation of the chorea treatment market by type allows for a more targeted approach to address the specific requirements of different types of chorea, such as Huntington's Chorea and Sydenham's Chorea. Each type may necessitate unique therapeutic interventions, leading to diverse market dynamics within these segments. For instance, the management of Huntington's Chorea, a genetic disorder, may involve a different treatment approach compared to acquired forms of chorea like Sydenham's Chorea. Understanding these nuances is crucial for pharmaceutical companies to develop tailored treatment strategies and medications.

The segmentation of the market by treatment into Pharmacological and Non-pharmacological options reflects the varying approaches to managing chorea symptoms. Pharmacological treatments, including antipsychotics and benzodiazepines, remain standard practice for many patients. On the other hand, non-pharmacological interventions like physical and speech therapy play a complementary role in enhancing patient outcomes. The market dynamics within these segments are influenced by factors such as treatment efficacy, safety profiles, and patient preferences, driving the need for diversified treatment options in chorea management.

End-user segmentation, including Hospitals, Clinics, and Others, sheds light on the healthcare delivery landscape for chorea treatment. Hospitals, equipped with advanced facilities and specialist physicians, are pivotal in managing complex chorea cases and providing comprehensive care to patients. Clinics, on the other hand, cater to individuals seeking outpatient services, offering convenience and accessibility for routine monitoring and follow-up care. Understanding the preferences and requirements of different end-users is essential for market players to tailor their strategies and offerings effectively.

Key market players such as Teva Pharmaceutical Industries Ltd, Acorda Therapeutics, and Auspex Pharmaceuticals play a crucial role in driving innovation and advancements in chorea treatment. These companies are at the forefront of research and development, continuously striving to enhance treatment options and improve patient outcomes in the chorea space. With a focus on disease-specific therapies and collaboration with healthcare providers, these market players are poised to shape the future landscape of chorea treatment.

In conclusion, the chorea treatment market presents significant growth opportunities fueled by evolving treatment paradigms, increasing disease prevalence, and the dedication of key market players to address unmet medical needs. By understanding the market segments, key players, and emerging trends, pharmaceutical companies and healthcare providers can navigate the dynamic landscape of chorea treatment and contribute to the improved quality of life for patients affected by this neurological condition.**Segments**

Global Chorea Treatment Market:

- By Type: The segmentation of the global chorea treatment market includes Sydenham's Chorea and Chorea-Acanthocytosis, reflecting the specific types of chorea that require distinct treatment approaches and medications. Understanding the nuances of each type is essential for pharmaceutical companies to tailor their strategies effectively to address the diverse needs of patients.

- Treatment: The market is segmented into Medication, Surgeries, and Others, representing the various approaches to managing chorea symptoms. Medication options typically include antipsychotic drugs and benzodiazepines, while surgeries may be considered for severe cases. The availability of different treatment modalities influences market trends and patient outcomes.

- Drugs Class: Within the treatment segment, the market can also be segmented by Drugs Class, with categories such as Antipsychotic Drugs and Benzodiazepines Drugs. These classifications highlight the specific types of medications commonly used in chorea management, each with its unique mechanism of action and therapeutic benefits.

- Symptoms: Segmenting the market by Symptoms, such as Involuntary Muscle Movements, Milkmaids Grip, Speech Problems, and Seizures, provides insights into the diverse clinical presentations of chorea. Understanding the constellation of symptoms associated with this condition is crucial for developing targeted treatment approaches.

- End-Users: End-user segmentation includes Clinics, Hospitals, Ambulatory Surgical Centres, and Others, delineating the various healthcare settings where chorea treatment is provided. Different end-users cater to different patient needs, with clinics offering outpatient services and hospitals managing complex cases with advanced facilities.

- Distribution Channel: The market can also be segmented by Distribution Channel, with options like Direct Tender, Hospital Pharmacy, Retail Pharmacy, Online Pharmacy, and Others. This segmentation reflects the diverse channels through which chorea medications and treatment services are distributed to patients, highlighting the importance of accessibility and convenience in healthcare delivery.

Industry Trends and Forecast to 2030:

- The global chorea treatment market is projected to witness significant growth in the forecast period, driven by evolving treatment paradigms, increasing disease prevalence, and advancements in pharmaceutical research and development.

- Emerging trends such as personalized medicine, precision therapies, and digital health solutions are expected to shape the future landscape of chorea treatment, offering new opportunities for market players to innovate and improve patient care.

- Key industry drivers include an aging population, rising awareness about neurological disorders, and collaborations between pharmaceutical companies and healthcare providers to enhance treatment outcomes and quality of life for chorea patients.

**Market Players**

- Medtronic plc. (Ireland) - Boston Scientific Corporation (U.S.) - ALEVA NEUROTHERAPEUTICS SA (Switzerland) - Teva Pharmaceutical Industries Ltd. (Israel) - Pfizer Inc. (U.S.) - GlaxoSmithKline plc. (U.K.) - Bausch Health Companies Inc. (Canada) - LivaNova, PLC (U.K.) - H. Lundbeck A/S (Denmark) - Ipsen (France) - Alnylam Pharmaceuticals Inc. (U.S.) - Prana Biotechnology Ltd. (Australia) - RespireRx Pharmaceuticals Inc. (U.S.) - Vertex Pharmaceuticals, Inc. (U.S.) - SOM Innovation Biotech, S.A. (Spain)

These market players are at the forefront of driving innovation and advancements in chorea treatment, with a focus on research and development, collaboration with healthcare providers, and the introduction of novel therapies to address unmet medical needs. Their contributions are crucial in shaping the future trajectory of the chorea treatment market and improving outcomes for patients worldwide.

North America, particularly the United States, will continue to exert significant influence that cannot be overlooked. Any shifts in the United States could impact the development trajectory of the Chorea Treatment Market. The North American market is poised for substantial growth over the forecast period. The region benefits from widespread adoption of advanced technologies and the presence of major industry players, creating abundant growth opportunities.

Similarly, Europe plays a crucial role in the global Chorea Treatment Market, expected to exhibit impressive growth in CAGR from 2024 to 2030.

Explore Further Details about This Research Chorea Treatment Market Report https://www.databridgemarketresearch.com/reports/global-chorea-treatment-market

Key Benefits for Industry Participants and Stakeholders: –

Industry drivers, trends, restraints, and opportunities are covered in the study.

Neutral perspective on the Chorea Treatment Market scenario

Recent industry growth and new developments

Competitive landscape and strategies of key companies

The Historical, current, and estimated Chorea Treatment Market size in terms of value and size

In-depth, comprehensive analysis and forecasting of the Chorea Treatment Market

Geographically, the detailed analysis of consumption, revenue, market share and growth rate, historical data and forecast (2024-2031) of the following regions are covered in Chapters

The countries covered in the Chorea Treatment Market report are U.S., Canada and Mexico in North America, Brazil, Argentina and Rest of South America as part of South America, Germany, Italy, U.K., France, Spain, Netherlands, Belgium, Switzerland, Turkey, Russia, Rest of Europe in Europe, Japan, China, India, South Korea, Australia, Singapore, Malaysia, Thailand, Indonesia, Philippines, Rest of Asia-Pacific (APAC)  in the Asia-Pacific (APAC), Saudi Arabia, U.A.E, South Africa, Egypt, Israel, Rest of Middle East and Africa (MEA) as a part of Middle East and Africa (MEA

Detailed TOC of Chorea Treatment Market Insights and Forecast to 2030

Part 01: Executive Summary

Part 02: Scope Of The Report

Part 03: Research Methodology

Part 04: Chorea Treatment Market Landscape

Part 05: Pipeline Analysis

Part 06: Chorea Treatment Market Sizing

Part 07: Five Forces Analysis

Part 08: Chorea Treatment Market Segmentation

Part 09: Customer Landscape

Part 10: Regional Landscape

Part 11: Decision Framework

Part 12: Drivers And Challenges

Part 13: Chorea Treatment Market Trends

Part 14: Vendor Landscape

Part 15: Vendor Analysis

Part 16: Appendix

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Data Bridge Market Research:

Today's trends are a great way to predict future events!

Data Bridge Market Research is a market research and consulting company that stands out for its innovative and distinctive approach, as well as its unmatched resilience and integrated methods. We are dedicated to identifying the best market opportunities, and providing insightful information that will help your business thrive in the marketplace. Data Bridge offers tailored solutions to complex business challenges. This facilitates a smooth decision-making process. Data Bridge was founded in Pune in 2015. It is the product of deep wisdom and experience.

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[amitshahneuro]

Parkinson's Disease Specialist in Mumbai: Advanced Treatments

Parkinson's disease, a progressive neurological disorder, affects millions worldwide and requires specialized care. Finding a Parkinson's Disease Specialist in Mumbai, like Dr. Amit Shah, ensures access to advanced treatments and comprehensive care. The condition is marked by tremors, rigidity, bradykinesia (slowed movement), and postural instability, necessitating a tailored approach for effective management.

Understanding Parkinson's Disease

Parkinson's disease impacts the brain's basal ganglia, critical for movement regulation. It stems from the degeneration of dopamine-producing neurons, causing a neurotransmitter deficit. While its exact cause is unknown, genetics, environmental factors, and aging contribute to its onset.

Symptoms include motor issues like tremors, rigidity, and balance problems, alongside non-motor symptoms such as depression, anxiety, and cognitive decline. Early diagnosis and intervention are essential for managing the disease effectively.

The Role of a Parkinson's Disease Specialist

A specialist in Parkinson's disease, typically a neurologist with expertise in movement disorders, plays a vital role in diagnosis and treatment. Experts like Dr. Amit Shah in Mumbai adopt a multidisciplinary approach, combining medical, surgical, and therapeutic interventions for better outcomes.

Diagnosis and Evaluation

Accurate diagnosis is key to effective management. Specialists use detailed assessments, including:

Medical History: Reviewing symptom onset, family history, and environmental exposures.

Neurological Examination: Evaluating motor and non-motor symptoms, reflexes, and gait.

Imaging and Tests: Utilizing MRI and DaTscan to confirm the diagnosis and rule out other conditions.

Comprehensive Treatment Options

Managing Parkinson's disease requires personalized care plans. Dr. Amit Shah offers a range of treatments, including:

1. Medications

Pharmacological treatments aim to restore dopamine levels or mimic its effects. Common medications include:

Levodopa: The gold standard, often combined with carbidopa.

Dopamine Agonists: Effective in early stages.

MAO-B Inhibitors: Prolong dopamine action.

COMT Inhibitors: Enhance Levodopa efficacy.

Anticholinergics: Address tremors and rigidity.

2. Surgical Interventions

For advanced cases, Deep Brain Stimulation (DBS) offers relief by implanting electrodes to regulate abnormal brain activity. Dr. Amit Shah’s expertise ensures precision and minimal complications.

3. Therapies

Physical and Occupational Therapy: Tailored exercises improve mobility and prevent falls.

Speech and Swallowing Therapy: Enhances communication and addresses dysphagia.

Psychological Support: Counseling and support groups alleviate emotional distress and improve coping mechanisms.

Innovative Approaches in Parkinson’s Care

Dr. Amit Shah incorporates advanced therapies and technologies:

Personalized Medicine: Treatment plans based on genetic profiling.

Neuroprotective Therapies: Strategies to slow disease progression.

Wearable Devices: Real-time symptom monitoring.

Telemedicine: Accessibility for remote patients.

Early Intervention and Support

Timely diagnosis and early intervention improve outcomes. Awareness, regular health check-ups, and consulting specialists like Dr. Amit Shah in Mumbai ensure proactive care. Support for caregivers through workshops and community resources fosters a comprehensive support system.

Clinic Location:

26/204, Shalimar Building, Above McDonald’s, Goregaon West, Mumbai – 400104.

Easy Ways to Reach the Clinic:

For Patients Using the Western Line:

Take a Western Line train and alight at Goregaon Station.

The clinic is a 5-minute walk or a short auto-rickshaw ride from the station.

For Patients Using the Central Line:

Board a Central Line train and get off at Dadar Station.

Change to the Western Line at Dadar and proceed to Goregaon Station.

For Patients Coming from Outside Mumbai:

By Train: Travel to Mumbai Central or Bandra Terminus and switch to the Western Line to Goregaon Station.

By Air: From Mumbai Airport, take a taxi or app-based service for a 30-45 minute drive to the clinic.

[sevayu1]

Exploring Natural Approaches to ADHD Management

ADHD is a childhood disorder that affects how a child behaves and pays attention. Instead, Ayurveda provides comprehensive preventions and treatments for the conditions as it diagnoses through dosha balancing, theologizing, and organizing therapeutic procedures. 

Now is the time to look for natural methods of Indian origin to deal with ADHD treatment efficiently.

Ayurvedic Perspective on ADHD:

According to Ayurveda, ADHD symptoms can be rated as the doshic state of Vata, which tends to impair mental functioning and cause restlessness. 

Pitta and Kapha have disturbed emotions and cognition functions as well. 

Balancing dosha forms is a natural approach to ADHD treatment, but the American medical approach only focuses on the physical aspect.

➧ You can check it out here from the American Gov. website: 

Attention-Deficit / Hyperactivity Disorder (ADHD) 

Ayurvedic Remedies for ADHD:

Dietary Adjustments: Avoid processed foods and excess sugar; favor warm, grounding foods like lentils, ghee, and whole grains.

Herbal Formulations: Brahmi, Ashwagandha, Vacha, and Tagara are herbs known to enhance focus, reduce hyperactivity, and promote calmness.

Lifestyle Practices: Establish consistent routines, practice yoga, and engage in mindfulness techniques.

Natural Treatment Options:

Brahmi Tablets: Enhance memory and focus.

Ashwagandha Tablets: Reduce stress and anxiety and help stabilize the participant’s mood.

Dep-end Tablets: Develop speech and voice. 

Tagar Tablets: Insomnia and hyperactivity should be discouraged through encouragement to go to bed early enough.

Tip: 

Always consult an Ayurveda expert or professional before taking/consuming a tablet.

Natural therapy for ADHD​:

Abhyanga (Body Massage): A full-body oil massage to calm the Vata dosha, reduce restlessness, and improve relaxation.

Shirodhara: A soothing stream of warm oil on the forehead to reduce stress, stabilize the mind, and enhance focus.

Wind up:

Ayurveda could be an effective non-pharmacological for ADHD treatment, it works with doshas, uses herbs, and promotes various kinds of therapies. Come to Sevayu-Ayurvedic Treatment Center to get individualized advice and begin improving your focus and quality of life today.

[gastroenterologyugc]

 Hepatology’s New Horizons: Insights from the 15th World Conference

The liver, a powerhouse organ, plays an essential role in maintaining overall health. From detoxifying the body to aiding digestion, its importance is unparalleled. With increasing global health challenges like liver diseases, hepatitis, and fatty liver disorders, the field of hepatology has become more critical than ever.

At the 15th World Gastroenterology, IBD & Hepatology Conference, the spotlight was on the groundbreaking advancements and collaborative solutions redefining hepatology. This year’s conference brought together global experts, researchers, and clinicians to discuss the latest innovations and future directions in liver health.

Key Insights from the Conference

1.      Advancements in Hepatitis Management Chronic hepatitis, particularly hepatitis B and C, remains a leading cause of liver-related morbidity worldwide. Discussions at the conference emphasized:

Direct-Acting Antivirals (DAAs): These therapies have transformed hepatitis C treatment with high cure rates.

Vaccination Strategies: Progress in hepatitis B vaccines offers hope for global eradication efforts.

Long-Term Management: Approaches to reduce complications and improve the quality of life for chronic hepatitis patients.

2.      The Rising Challenge of Fatty Liver Disease Non-Alcoholic Fatty Liver Disease (NAFLD) is now the most common liver disorder globally. Insights shared included:

The role of lifestyle interventions, such as diet and exercise, in managing NAFLD.

Pharmacological Advances: Trials of new drugs targeting fatty liver and its complications, like NASH (non-alcoholic steatohepatitis).

The need for early diagnosis using non-invasive biomarkers and imaging techniques like FibroScan.

3.      Liver Cancer: Hope Through Innovation Liver cancer, particularly hepatocellular carcinoma (HCC), poses a significant challenge in hepatology. The conference unveiled:

Immunotherapy Advances: Therapies like immune checkpoint inhibitors are showing promise in improving survival rates.

Early Detection Tools: Enhanced imaging and blood tests for early-stage liver cancer.

Personalized Medicine: Tailoring treatments based on genetic and molecular profiling.

4.      Liver Transplantation: Improving Outcomes With demand for liver transplants increasing, innovative solutions were discussed, including:

Expanding the donor pool through living donor transplants and organ preservation techniques.

Reducing complications through better pre- and post-transplant care.

Exploring artificial liver support devices as a bridge to transplantation.

5.      The Gut-Liver Axis: An Emerging Frontier The interplay between the gut microbiome and liver health continues to reveal therapeutic potential:

Probiotics and Prebiotics: Their role in managing conditions like cirrhosis and fatty liver disease.

Microbiome-Based Therapies: Fecal microbiota transplantation (FMT) as a promising treatment avenue.

Opportunities for Collaboration and Learning

The conference was more than just a platform for sharing research—it fostered global collaboration:

·         Abstract Presentations: Researchers showcased groundbreaking studies, sparking ideas for future innovations. If you have research to share, consider submitting it for the next event: https://gastroenterology.utilitarianconferences.com/submit-abstract-abstarct

·         Interactive Workshops: Hands-on sessions in advanced diagnostic and therapeutic techniques provided practical skills for hepatology professionals.

·         Keynote Speeches: Renowned experts discussed the pressing issues and solutions shaping hepatology’s future.

Join the Next Step in Hepatology

As hepatology continues to evolve, staying informed and engaged with global advancements is crucial. The 15th World Gastroenterology, IBD & Hepatology Conference not only highlighted the challenges but also celebrated the progress being made in liver health.

·         Be part of the conversation and innovation by attending the next event. https://gastroenterology.utilitarianconferences.com/registration

·         Learn more about the conference and its impact on the future of gastroenterology and hepatology: https://gastroenterology.utilitarianconferences.com/

Looking Ahead

The future of hepatology is brighter than ever, with technology, research, and collaboration driving transformative change. From personalized medicine to regenerative therapies, the next frontier in liver health is here.

Stay ahead in the field by engaging with global experts, sharing your research, and adopting the latest advancements. Together, we can reshape the future of hepatology and improve lives worldwide.

#Hepatology2024 #LiverHealth #HepatitisCare #LiverCancerInnovation #HepatologyTrends #GIConference2024 #GlobalHepatology

[cailynnjohnson]

Alzheimer’s Disease and Its Treatment

Alzheimer's disease (AD) is a common neurodegenerative encephalopathy which occurs in pre- and post-elderly conditions with a gradual loss of cognitive and memory functions. As the population aging intensifies, the number of AD patients worldwide is growing rapidly, resulting in a heavy social burden. Thus, how to treat Alzheimer's disease is the focus of the whole society.

In fact, the treatment of AD is a comprehensive management, which not only requires individuals, families, and even the whole society to participate. The treatment of AD mainly includes three aspects: drug treatment, non-drug treatment and life care.

First of all, the current anti-dementia, cognitive improvement drugs can improve the patient's symptoms, delay the development and deterioration of the disease, but there is no drug that can fundamentally reverse or cure the disease.

However, scientists are working on finding the reason and effective medicine. As is proved for many years, AD is related to amyloid beta aggregations, neurofibrillary tangles (NFTs), prominent neuroinflammation, and a series of physiological cascades including complement cascade initiated in response to the increased A? deposition. As a consequence, interference with neuroinflammation as a new therapeutic approach for AD treatment has gained great interest recently.

Currently, various complement components are known to be upregulated in AD brain, including C1q, C1r, C1s, and C2, C3, C4, C5, C6, C7, C8, C9. Recent research also showed that the pro-inflammatory complement factor C5a and its receptor C5aR are up-regulated in different mouse models of AD. Studies reported that blocking of C5aR with this inhibitor resulted in improved memory skills and reduced amyloid plaque formation, which may provide a new method for anti-AD drugs.

Apart from the medical treatment, non-pharmacological treatment, including cognitive rehabilitation training, vocational training, music therapy, and psychotherapy are also reported to be effective.

For memory-losing patients, some training about instantaneous memory, short-term memory and long-term memory can be of great use. These can be some games of children’s cognitive training that are simple and can be conducted by family members. For those patients with mood and behavior changes who become irritable even with violent conduct, professional psychotherapy should be considered.

Last but not least, life care is necessary to be conducted by family members or professional nurses. In the first stage, the patient should be encouraged to do things independently, participate in a variety of social activities, and walk around accompanied by someone. In the second stage, family members or caregivers need to assist patients with some simple self-care, such as assisting patients to do something at their own pace, and appropriately encourage and comfort patients in the process to make them feel involved and delightful. In the third stage, patients have lost their ability to take care of themselves, so professional nurses are required to take care of the patients to eat, dress, clean, and exercise properly.

[codeconnectx]

Neurosarcoidosis Treatment Market: Progress in Neurological Care

"Neurosarcoidosis Treatment Market Size And Forecast by 2031

The Neurosarcoidosis Treatment Market is an evolving industry that holds significant potential across various sectors, driven by advancements in technology, shifting consumer preferences, and growing demand for innovative solutions. With a robust ecosystem of players and a dynamic competitive landscape, the market offers ample opportunities for growth and value creation. This report delves into the size, share, and scope of the Neurosarcoidosis Treatment Market, providing a detailed analysis of its current state and future outlook.

Data Bridge Market Research analyses that the Global Neurosarcoidosis Treatment Market which was USD 55.96 Billion in 2023 is expected to reach USD 77.77 Million by 2031 and is expected to undergo a CAGR of 4.20% during the forecast period of 2023 to 2031

The global Neurosarcoidosis Treatment Market study presents a comprehensive analysis of the industry's landscape, focusing on evolving market dynamics, emerging trends, and the competitive framework. At the core of this analysis lies a detailed examination of the leading companies that play a pivotal role in shaping the market. These organizations not only define industry standards but also drive innovation, catering to consumer demands and aligning with global trends. The report highlights their contributions, offering a clear view of the competitive intensity within the market.

Get a Sample PDF of Report - https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-neurosarcoidosis-treatment-market

Which are the top companies operating in the Neurosarcoidosis Treatment Market?

The Top 10 Companies in Neurosarcoidosis Treatment Market include leading industry players that have established a strong presence through innovation, quality products, and strategic partnerships. These companies dominate the market by leveraging advanced technologies, extensive distribution networks, and a deep understanding of consumer needs. Their market leadership is often driven by significant investments in research and development, as well as their ability to adapt to changing market trends and consumer demands.

**Segments**

- **Treatment Type**: The neurosarcoidosis treatment market can be segmented based on the type of treatments available. This includes medications such as corticosteroids, immunosuppressants, and tumor necrosis factor-alpha inhibitors. Additionally, non-pharmacological approaches like physical therapy, speech therapy, and occupational therapy can also be considered as treatment segments within this market.

- **Distribution Channel**: Another important segment in the neurosarcoidosis treatment market is the distribution channel. This can include hospital pharmacies, retail pharmacies, online pharmacies, and specialty clinics. The ease of access to these distribution channels plays a significant role in determining the overall market penetration of neurosarcoidosis treatments.

- **End-User**: End-user segmentation is crucial in understanding the demand for neurosarcoidosis treatments. End-users of these treatments can include hospitals, specialty clinics, research institutes, and ambulatory surgical centers. The preferences and requirements of each end user segment can greatly impact the market dynamics and growth potential of neurosarcoidosis treatment products.

**Market Players**

- **F. Hoffmann-La Roche Ltd**: F. Hoffmann-La Roche Ltd is a prominent player in the neurosarcoidosis treatment market, offering a range of medications and therapies for this condition. Their strong global presence and research-driven approach make them a key player in the market.

- **AbbVie Inc.**: AbbVie Inc. is another major market player known for its innovative treatments for neurosarcoidosis. With a focus on developing targeted therapies and personalized medicine, AbbVie Inc. has established itself as a leading provider in this space.

- **Pfizer Inc.**: Pfizer Inc. is a well-known pharmaceutical company that also has a significant presence in the neurosarcoidosis treatment market. Their diverse portfolio of medications and strong distribution network contribute to their competitiveness in this market segment.

- **Novartis AG**: Novartis AG is aNovartis AG is a key player in the neurosarcoidosis treatment market, known for its innovative research and development efforts in the pharmaceutical industry. The company has a diverse portfolio of medications that cater to various therapeutic areas, including neurosarcoidosis. Novartis AG's strong emphasis on R&D investments allows them to continuously introduce new treatments and therapies to address unmet medical needs in the market. Their global presence and strategic partnerships enable them to reach a wide range of patients and healthcare providers, ensuring access to their neurosarcoidosis treatment offerings.

One of the critical strategies adopted by Novartis AG in the neurosarcoidosis treatment market is the focus on personalized medicine. By tailoring treatments to individual patients' needs and genetic profiles, Novartis AG aims to improve treatment efficacy and patient outcomes. This personalized approach also helps in reducing the potential side effects of medications, enhancing patient compliance and satisfaction. Through ongoing clinical trials and research collaborations, Novartis AG remains at the forefront of innovation in neurosarcoidosis treatment, striving to bring novel therapies to the market.

Moreover, Novartis AG's commitment to sustainability and corporate social responsibility further strengthens its position in the neurosarcoidosis treatment market. By promoting access to healthcare in underserved regions and investing in community health programs, Novartis AG demonstrates its dedication to improving global health outcomes. This positive brand image and ethical business practices contribute to building trust among healthcare professionals, patients, and stakeholders in the neurosarcoidosis treatment market.

Furthermore, Novartis AG's comprehensive market knowledge and strategic decision-making capabilities allow them to adapt to changing market trends and regulatory requirements effectively. By staying abreast of emerging technologies and treatment modalities, Novartis AG can continually enhance its product offerings and expand its market presence. Their investment in digital health solutions and data analytics also positions them as a forward-thinking player in the neurosarcoidosis treatment market, enabling them to deliver innovative and efficient healthcare**Market Players:**

- Hikma Pharmaceuticals PLC (U.K.) - Mylan N.V. (U.S.) - Amneal Pharmaceuticals LLC. (U.S.) - Mallinckrodt (U.K.) - AbbVie Inc. (U.S.) - Pfizer Inc. (U.S.) - Sandoz International GmbH (Switzerland) - Teva Pharmaceuticals USA, INC. (U.S.) - F. Hoffmann-La Roche Ltd (Switzerland) - Fresenius Kabi USA (U.S.) - Merck & Co., Inc. (U.S.) - Vintage Labs (India) - Taro Pharmaceutical Industries Ltd (U.S.) - Jubilant Cadista Pharmaceuticals Inc (U.S.) - Horizon Therapeutics plc (Ireland)

In the neurosarcoidosis treatment market, the presence of diverse market players offers a wide range of treatment options and competitive dynamics. Each player brings its unique strengths and strategies to address the evolving needs of patients and healthcare providers. The market is characterized by continuous research and development efforts to introduce innovative therapies, personalized medicine approaches, and enhanced distribution networks to ensure broader accessibility to treatments. Collaborations, strategic partnerships, and investments in digital health solutions play a crucial role in shaping the competitive landscape of the neurosarcoidosis treatment market.

As competition intensifies in the neurosarcoidosis treatment market, market players focus on differentiation strategies to maintain market share and drive growth. Key factors such as pricing strategies

Explore Further Details about This Research Neurosarcoidosis Treatment Market Report https://www.databridgemarketresearch.com/reports/global-neurosarcoidosis-treatment-market

Key Insights from the Global Neurosarcoidosis Treatment Market :

Comprehensive Market Overview: The Neurosarcoidosis Treatment Market is witnessing strong growth driven by increasing demand and technological advancements.

Industry Trends and Projections: Key trends include automation, sustainability, and a shift towards digital solutions, with a projected CAGR of X%.

Emerging Opportunities: Opportunities are emerging in green technologies, personalized services, and untapped geographical regions.

Focus on R&D: Companies are heavily investing in R&D to drive innovation, especially in AI, IoT, and sustainable solutions.

Leading Player Profiles: Dominant players like Company A and Company B lead the market with robust portfolios and global reach.

Market Composition: The market is fragmented, with a mix of established companies and innovative startups.

Revenue Growth: Revenue in the Neurosarcoidosis Treatment Market is steadily increasing, fueled by rising consumer demand and expanding commercial applications.

Commercial Opportunities: Commercial opportunities lie in entering emerging markets, digital expansion, and forming strategic partnerships.

 Get More Reports:

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Email:- corporatesales@databridgemarketresearch.com"

[virtued12]

Top Challenges for New Diabetology Fellows

Fellowship in Diabetology: Advancing Global Diabetes Management

The Fellowship in Diabetology, offered by Virtued Academy International in collaboration with the International Association of Therapists (IAOTH), UK, is a groundbreaking program designed to empower healthcare professionals with specialized knowledge and skills in diabetes management.  Fellowship in Diabetology As diabetes continues to pose a significant challenge to global health, this fellowship aims to equip practitioners with the tools necessary to address this epidemic effectively.

Program Overview

The Fellowship in Diabetology is a comprehensive program that combines theoretical knowledge with practical applications. It is tailored for healthcare professionals, including doctors, nurses, dietitians, and other allied health practitioners, Diabetes Management Course  who seek to deepen their understanding of diabetes and enhance their clinical expertise. The program covers the latest advancements in diabetes research, diagnosis, treatment, and prevention strategies.

Key Features of the Program

Collaborative Excellence: The fellowship is a joint initiative by Virtued Academy International and the IAOTH, UK, ensuring global standards of education and certification.

Comprehensive Curriculum: The program encompasses a wide range of topics, including:

Pathophysiology and types of diabetes

Latest diagnostic tools and techniques

Advanced pharmacological and non-pharmacological treatments

Lifestyle interventions, including nutrition and physical activity

Diabetes-related complications and their management

Patient education and psychological support

Practical Training: Participants engage in hands-on training, case studies, and real-world scenarios to apply their knowledge effectively.

Global Recognition: Graduates of the program receive a certification recognized internationally, enhancing their professional credibility and career prospects.

Flexible Learning: The fellowship offers both online and offline learning options, allowing participants to balance their professional commitments while pursuing the program.

Program Modules

The fellowship is structured into several well-defined modules, ensuring a step-by-step approach to mastering diabetology:

Fundamentals of Diabetes: Covering the basics of diabetes, including its types, causes, and epidemiology.

Diagnostics in Diabetes: Understanding laboratory tests, glucose monitoring, and innovative diagnostic tools.

Treatment Modalities: Analyzing pharmacological therapies such as insulin, oral hypoglycemic agents, and emerging treatment options.

Lifestyle and Nutrition: Emphasizing the role of diet, exercise, and lifestyle changes in managing and preventing diabetes.

Special Populations: Addressing diabetes care in children, pregnant women, and the elderly.

Complication Management: Exploring strategies for managing complications such as neuropathy, nephropathy, and retinopathy.

Patient-Centered Care: Focusing on communication, counseling, and psychological support for patients.

Why Choose This Fellowship?

Addressing a Global Challenge: With over 537 million adults living with diabetes worldwide (as of recent data), the need for skilled professionals in diabetes management is more critical than ever.

Expert Faculty: Learn from leading experts and practitioners in the field of diabetology, gaining insights into cutting-edge practices and research.

Career Advancement: Enhance your credentials and open doors to new opportunities in clinical practice, research, and education.

Holistic Approach: The program emphasizes a patient-centered approach, integrating medical, psychological, and lifestyle aspects to ensure comprehensive care.

Research Opportunities: Participants are encouraged to engage in research projects and contribute to the growing body of knowledge in diabetes management.

Networking: Join a global community of healthcare professionals, fostering collaboration and sharing best practices in diabetology.

Testimonials from Graduates

Participants of the Fellowship in Diabetology have shared their experiences:

"This program transformed my approach to diabetes care. The practical insights and case studies were invaluable."

"I feel more confident in managing complex diabetes cases, thanks to the expert faculty and comprehensive curriculum."

"The flexibility of online learning allowed me to pursue the fellowship without interrupting my practice."

Future Prospects

Graduates of the fellowship can explore a variety of career paths, including:

Specialist roles in diabetes clinics and hospitals

Diabetes education and counseling

Research and academic positions

Leadership roles in public health initiatives focused on diabetes prevention and care

How to Enroll

Enrollment in the Fellowship in Diabetology is straightforward. Interested candidates can visit the Virtued Academy International website to learn more about eligibility criteria, program fees, and the application process. Early registration is recommended due to the limited number of seats.

Conclusion

The Fellowship in Diabetology offered by Virtued Academy International in collaboration with the IAOTH, UK, represents a significant step forward in combating the diabetes epidemic. By equipping healthcare professionals with advanced knowledge and skills, this program not only enhances individual careers but also contributes to improving global health outcomes. Enroll today to become a leader in the fight against diabetes and make a lasting impact in the field of healthcare.

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Early Stage Diabetic Foot Ulcers: A Call to Action for Early Diagnosis and Management

Diabetes mellitus is a chronic metabolic condition that affects millions worldwide, with India bearing a significant burden. One of the most concerning complications of diabetes is diabetic foot ulcers (DFUs), which pose a severe threat to mobility and overall quality of life. Early-stage diabetic foot ulcers (DFUs) are a critical yet often overlooked phase of this condition. Addressing them at the earliest stage can significantly reduce complications, improve patient outcomes, and lower healthcare costs.

Understanding Early-Stage Diabetic Foot Ulcers

Early-stage diabetic foot ulcers are superficial, non-infected wounds primarily affecting the skin’s outermost layers. They are often the result of repetitive trauma, poor glycemic control, and underlying neuropathy or vascular compromise. Identifying and addressing these ulcers early can prevent progression to deeper, infected, or gangrenous wounds that may require invasive interventions.

Key Features of Early-Stage DFUs:

Redness or discoloration of the affected area.

Superficial breaks in the skin with minimal discharge.

Absence of systemic infection or deep tissue involvement.

Associated neuropathy leading to reduced pain perception.

Risk Factors for Early-Stage DFUs

Peripheral Neuropathy: Reduced sensation increases the likelihood of unnoticed trauma.

Peripheral Arterial Disease (PAD): Compromised blood flow delays wound healing.

Hyperglycemia: Prolonged high blood sugar levels impair immune function and tissue repair.

Improper Footwear: Shoes that cause pressure points or friction.

Poor Foot Hygiene: Increased risk of infection and skin breakdown.

Importance of Early Diagnosis

Timely identification of early-stage DFUs is essential to prevent complications. Screening for neuropathy, vascular insufficiency, and skin integrity should be a routine practice for individuals with diabetes. Vascular specialists play a pivotal role in assessing arterial health through non-invasive techniques like ankle-brachial index (ABI) and Doppler studies.

Management Strategies for Early-Stage DFUs

Glycemic Control: Maintaining blood sugar levels within target ranges promotes effective wound healing and reduces the risk of infection.

Wound Care:

Regular cleansing with sterile solutions.

Application of non-adherent, moist wound dressings.

Debridement of calluses and necrotic tissue as needed.

Pressure Offloading: Using custom orthotics or offloading devices to reduce pressure on the ulcerated area.

Infection Prevention:

Use of topical antibiotics for superficial infections.

Close monitoring for signs of systemic infection.

Vascular Health Optimization:

Addressing PAD with pharmacological or interventional treatments.

Ensuring adequate circulation to promote healing.

Preventive Measures

Routine Foot Exams: Patients with diabetes should inspect their feet daily and undergo regular professional foot evaluations.

Education on Foot Care:

Proper cleaning and moisturizing of feet.

Avoiding barefoot walking.

Appropriate Footwear: Shoes should provide cushioning and prevent pressure points.

Regular Vascular Assessments: Periodic evaluation of arterial health, especially for those with a history of PAD or ulcers.

The Role of Multidisciplinary Care

Managing early-stage diabetic foot ulcers requires a coordinated approach involving diabetologists, vascular surgeons, podiatrists, and wound care specialists. Early referral to vascular specialists is crucial for patients with signs of compromised circulation or non-healing wounds.

Conclusion

Early-stage diabetic foot ulcers present an opportunity for intervention before complications arise. Proactive measures, including education, regular screenings, and timely treatment, are essential to curb the progression of DFUs. The Vascular Society of India is uniquely positioned to lead efforts in raising awareness, promoting research, and developing clinical guidelines to improve the lives of patients living with diabetes and its complications.