#Skin Treatment in Malvern

[plusscalpandskin]

Skin Treatment in Malvern: Get Your Glow On!

Hey there, beautiful! Feeling blah about your skin? Well, no worries - Plus Scalp and Skin Clinic in Malvern's got you covered! So, let's chat about how we can help you rock that gorgeous skin you've always wanted.

Why Us for Your Skin Treatment in Malvern?

Okay, so here's the deal. First off, we know your skin's as unique as you are. That's why we don't do cookie-cutter treatments. Instead, we're all about that personalized touch. Zits giving you grief? Or maybe fine lines making you frown? Whatever's bugging you, we're all ears. And guess what? On top of that, we've got some pretty nifty tricks to make your skin do a happy dance.

Our Skin-tactic Treatments

We've got a whole bag of goodies to make your skin look fab. For instance, if acne's acting up, we'll show those spots who's boss. Additionally, if you're feeling a bit meh about aging, our treatments can smooth things out and give you that "I woke up like this" glow. Moreover, those pesky dark spots and scars? We'll tackle those too. Cool, right?

Chill Vibes for Your Skin Care

Now, I know what you're thinking. "Ouch, is this going to hurt?" Chill, my friend! We're all about keeping things comfy here. In fact, there's no scary stuff, just gentle TLC for your skin. Plus, our team? Total sweethearts. So, if you've got questions, fire away - we love a good skin care chat!

What's the Deal When You Visit?

Pop in, and we'll roll out the red carpet (okay, maybe not literally, but you get the idea). First up, we'll have a good old natter about your skin dreams. Then, we'll cook up a plan that's just your flavor. While we work our magic, you just kick back and relax. Afterwards, we'll spill the tea on keeping your skin looking awesome at home.

Come On Down!

So, if you're hunting for the best skin treatment in Malvern, why not give us a bell? We're here to help you get that healthy, glowing skin you've been crushing on. Therefore, don't be shy - book a visit today and let's get this skin party started!

Wanna know more? Well then, check out our website at Plus Scalp and Skin Clinic. Can't wait to see your gorgeous face!

[diorclinic]

Reputed Skin Rejuvenation Clinic in Pascoe Vale Are you tired of looking in the mirror and seeing dull and lifeless skin staring back at you? Di-Or Medical and Skin Rejuvenation Clinic is here to rescue you from your beauty woes. As your trusted skin specialist in Pascoe Vale, we offer a wide range of cosmetic and beauty services to help you achieve that radiant and glowing skin you’ve been dreaming of. Our expert team of skin therapists understands that everyone’s skin is different and requires a personalized approach. That’s why we provide FREE consultations to discuss your skin goals and create a customized treatment plan just for you. Our skin rejuvenation clinic offers various treatments such as microdermabrasion, photorejuvenation, and chemical peels, among others in Pascoe Vale.  Book an appointment today with us via https://www.diorclinic.com.au/ and say goodbye to dull skin forever.

[purifyskinclinic]

HIFU Treatment Melbourne

HIFU is an advanced non-invasive lunchtime facelift treatment that can help with wrinkles, fine lines, sagging skin on the neck and body. It is suitable for most skin types and there’s no recovery period needed.

HIFU uses ultrasound energy to target a tissue site below the surface of your skin, causing no damage to the upper layers. It’s also TGA listed and backed by multiple peer review clinical papers.

How Does HIFU Work?

A HIFU treatment Melbourne works by targeting collagen beneath the skin. This causes the skin to contract and tighten, giving it a rejuvenated appearance. The treatment can also help reduce the appearance of fine lines and wrinkles.

HIFU uses sound waves to target tissue without damaging the surrounding cells. Its ultrasound machine narrows beams of energy to a specific spot, up to 4.5mm under the skin’s surface. These beams are heated to a temperature that destroys (ablates) the tissue.

The HIFU procedure doesn’t require anesthetic or downtime. Some patients experience mild discomfort during the treatment, but over-the-counter pain relievers can prevent this.

A HIFU session lasts up to 2 hours, depending on the area treated. The dermal therapist will clean the skin before starting the procedure. Then, they will apply a gel to the targeted area of the face. A topical numbing cream may be used, too. Patients should avoid consuming alcohol or caffeine before their HIFU treatment.

What Are the Benefits of HIFU?

HIFU has been shown to stimulate collagen production and tighten skin. It is ideal for body sculpting (post pregnancy tummy, abdomen fat, bingo wings, thighs) as well as improving 'crepey' arms and knees. HIFU also works to reduce unwanted facial fats by targeting the 'double chin' area and cheeks. It can also be used to lift the eyebrows, eliminating the 'hooding' appearance and giving a fresher, lifted look.

HIFU facial treatments work as a non-invasive facelift, ironing out fine lines, shrinks pores, targets the 'V' line formation and jowl lines and improves overall skin tone and texture. It may be a good first treatment for those with moderate ageing and loose skin, especially if it is paired with fillers to help replace lost volume.

Some people experience slight discomfort during the HIFU treatment, but most describe it as a light prickly sensation. We recommend taking acetaminophen or an NSAID (such as ibuprofen) prior to the treatment to help with any pain you may have.

What Can I Expect from HIFU?

HIFU uses ultrasound technology to stimulate your body’s natural healing process and collagen production. The results are naturally occurring, long-lasting and extremely safe. HIFU can treat several skin concerns, such as pore size and appearance, skin texture and tone and fine lines and wrinkles. It can also help with contouring and slimming the chin and jaw line, as well as restoring firmness to the neck and face.

During the treatment, an acoustic lens concentrates multiple intersecting beams of ultrasound energy to a single point deep in the tissue. This creates a concentrated thermal (heating) effect at the target area. You might feel a slight discomfort during the procedure, but this usually only lasts during the treatment. You can take an over-the-counter pain reliever, such as acetaminophen or ibuprofen, if needed.

If you’re looking for a clinic that provides quality, professional and honest guidance to achieve genuine skin results, visit us at SkinCarely within Somatic Healthcare in Melbourne. We are a short drive away from Malvern, Doncaster, Caufield and South Yarra.

What Are the Side Effects of HIFU?

The ultrasound energy targets the fat layer below the skin and destroys the tissue. It leaves the upper layers of the skin unharmed. The heat of the ultrasound damage encourages your body to create more collagen, a protein that provides structure to the skin. The resulting tighter, firmer skin reduces the appearance of wrinkles and sagging.

The treatment is considered safe for most people. It may cause some redness and swelling afterward, but this should fade quickly. You may also experience some fatigue in the days following your treatment.

This type of treatment is not recommended for people who have a swollen prostate or an infection in the area. It can also cause a long-lasting urinary problem if it damages the nerves that control your bladder (urinary incontinence). It can also cause problems with the tubes that carry sperm from your testicles (erectile dysfunction). This is not likely, but if it does happen, you will need to use a catheter until the problem resolves.

[careproviders8]

Know Everything About Skin Needling Melbourne | Malvernskinstudio

Skin Needling, otherwise called Dermal Rolling, has been all the rage in the most recent couple of years and keeps on acquiring fame. Healthy skin and magnificence lovers the same depend on it. In any case, how does Skin Needling Melbourne respond, and what would it be able to treat?

What can Skin Needling treat?

Skin Needling is the one-stop hostile to maturing skin treatment! It animates the creation of your collagen to make smoother, better skin. Skin Needling benefits incorporate lessening the presence of:

• Acne scarring

• Fine lines

• Pigmentation

• Enlarged pores

• Scarring

• Stretch marks

The outcomes are further developed skin surface, all the more even complexion and an overall sound shine.

How frequently would it be advisable for me to seek Skin Needling medicines?

This relies upon your singular treatment plan and your treatment objectives. Overall, we suggest 3-6 medicines with every treatment divided 4 a month and a half separated. Note, every individual will fluctuate somewhat, and our skin advisor will inform you of the suggested number regarding medicines at your free meeting.

How does skin needling work?

As each fine needle penetrates the skin, it makes a channel or miniature injury. The microchannels made precipitously close following 10 minutes with the goal that epidermal boundary honesty stays flawless.

The needles harm shallow dermal collagen strands and little veins setting off a controlled course of irritation, including the arrival of platelet-inferred development factors changing development factor-alpha and beta (TGF β-3), connective tissue enacting protein, connective tissue development factor, and fibroblast development factor. These lead to the creation of new collagen, elastin, and vessels.

Neovascularisation and neocollagenesis lead to thickened skin and decreased scars, with the further developed skin surface, immovability, and hydration.

Advantages of skin needling

Skin needling's advantages are recorded beneath.

• It is utilized to limit scars from skin break out, medical procedures, warm consumption, chickenpox, or injury.

• Skin needling is utilized for facial revival, less discernible differences and kinks, and further developing complexion, surface, and pigmentation.

• There is a decreased danger of hyperpigmentation and scarring with skin needling contrasted with more intrusive strategies, and accordingly, it is more secure on the ethnic or brown complexion.

• It is reasonable for slender and touchy skin.

• The treatment can be acted in an office setting and needn't bother with any broad extraordinary preparing or costly instruments.

• The method is very much endured and all around acknowledged by patients.

• It is practical and should be possible on spaces of skin that are not reasonable for stripping or laser reemerging, for example, close to eyes.

• As went against ablative laser restoring, the epidermis stays flawless and isn't harmed. Thus, the activity can be securely rehashed if necessary.

• Treatment doesn't bring about a boundary line between treated and untreated skin, as ordinarily happens with other reemerging systems. This considers explicit spaces of scarring to be treated without the need to 'mix' or 'quill' at the treatment edges.

• The patient can continue normal exercises within a couple of days, contingent upon the profundity of infiltration of the needles. Led Light Therapy Malvern Treatment alternatives like laser reemerging or dermabrasion are regularly connected with impressive horribleness and vacation from day by day exercises of the patient in the post-treatment time frame.

[malvernsmilestudioaus]

Why do Every Expert Dentist Recommend Laser Dentistry in Malvern ?

Every professional dentist in Malvern often resorts to laser dentistry for carrying out many dental procedures. The procedure owes its popularity to its preciseness and effectiveness. However, success rate of the process typically depends on the dentists’ dexterity to contain exposure duration on the tissue and power output. It is only a highly skilled professional who can treat a highly specific area of focus without affecting any surrounding tissues adversely. 

Laser Dentistry — A Brief Introduction 

Professionals practising at Malvern east dental clinics often propagate that the process deploys usage of high-powered beams of light energy to make dental procedures more comfortable, easier and faster. In laser dentistry, each laser has its own wavelength of light that enables professionals to carry out multiple procedures. It aids in a plethora of oral treatments. 

Elimination and shaping of soft tissues, augmenting specific chemical reactions, and cutting through hard tissues, such as tooth enamel are some of the processes that are commonly carried out deploying this technology. It also facilitates enamel and dentin processes, whitening treatments, filling cavities, eliminating caries and much more. 

Lasers cauterise as it cuts through the skin, resulting in less bleeding during both the procedure and throughout the recovery period. They also disinfect, decreasing all risk of bacterial infection, post treatment. Moreover, the laser state-of-art prospects allow professionals to carry out treatments frequently with nominal anaesthetics or drills. 

Conclusion 

The unique abilities of laser technology eliminates all requirements of sutures or stitches to heal. With laser dentistry, healing occurs much quicker and aids in more effective regeneration of tissues. It results in lower recovery time, enabling you to return to your daily routine faster. Thus, it also demands lesser official visits to the clinic. 

Laser treatments extend better accuracy with lesser disturbance to the tissue, which, in turn, decreases discomfort and pain. There is no denying dental processes carried out with lasers offer numerous benefits. 

Contact your nearest clinic for the  best service.

[waxedau]

Laser treatment is a proven way to remove your hair, know how?

In case you’re not content with shaving, tweezing, or waxing to eliminate unwanted hair, laser hair removal may be a choice worth considering. Laser hair evacuation is quite possibly the most generally done corrective method. laser hair removal Malvern radiates profoundly focused light into hair follicles. Color in the follicles assimilates the light.

That annihilates the hair.

Speed. Each beat of the laser takes a negligible portion of a second and can treat numerous hairs simultaneously. If we are talking about hair removal & we can’t include laser removal- it’s unbelievable. Little zones, for example, the upper lip can be treated in under a moment, and huge territories, for example, the back or legs, may take up to an hour.

Treatments Don’t Take Long

Laser hair expulsion medicines are a lot speedier than you may anticipate. It takes around 20 minutes to perform treatment on underarms or the two-piece region and just about an hour for territories like arms and legs. Try not to hope to go throughout the day in the spa while having laser hair evacuation done – you’ll be done instantly.

Dispense with Ingrown Hairs

You can forestall and take out ingrown hairs with laser hair evacuation. It is the best answer to ensure you don’t experience the ill effects of a bothersome ingrown hair and hazard needing it eliminated. eyelash extension Bentleigh is likewise an extraordinary alternative for individuals who have touchy skin and have skin disturbance in the wake of shaving or waxing.

Saves Time

As we see that it’s not a time-consuming process, so it makes save your valuable time with considering safety factors in our mind. With laser hair expulsion, you at this point don’t need to invest energy shaving or going to arrangements to get the hair waxed. In short, you don’t have to take tension about your hair removal process- because Laser treatment makes it easier. You will have clean-cut skin without the issue of shaving or waxing. So, indeed time-saving in Hair removal treatment is really helpful.

Exact

Laser hair removal process explicitly targets hairs that had filicides & other issues. This is a specific advantage over exceptional beat light (IPL) hair expulsion as the utilization of the laser makes it more fit to treating individuals with brown complexion tones. The exactness additionally implies you ought to get results sooner. The finishing you’ll get is such tremendous. It may fulfill your requirement as it works with ease & saves up money as well.

Conclude everything, Laser hair expulsion is one of the quickest developing strategies for freeing the group of undesirable hair. The allure of laser hair expulsion comes from its adequacy, effectiveness, and comfort. laser hair removal Malvern very well may be performed basically anyplace on the body where you experience undesirable hair development. Another justification for its ubiquity is that laser hair expulsion can bring about a perpetual decrease of the hair.

[plusscalpandskin]

Discover Amazing Skin Treatments in Malvern

Hey there! Dreaming of glowing skin? Well, you're in luck! Let's chat about the fantastic skin treatments Malvern offers at Plus Scalp And Skin Clinic. Trust me, your skin is in for a real treat!

Personalized Skin Treatments Malvern: Show Your Skin Some Love!

First off, our skin is incredibly important. In fact, it's like our body's personal bodyguard. That's why we need to give it lots of love and care. At our clinic, we understand that everyone's skin is unique. Therefore, we offer a variety of skin treatments in Malvern tailored just for you.

 Microdermabrasion: Your Ticket to Smooth Skin

Have you heard of microdermabrasion? It's basically a super-powered face scrub. This amazing treatment whisks away dead skin cells, unclogs those pesky pores, and even boosts collagen production. As a result, you'll get skin that's smoother than silk and brighter than ever. Plus, it works wonders for all skin types!

 Chemical Peels: Don't Let the Name Scare You!

Now, don't run away when you hear "chemical peel." Surprisingly, these treatments are quite gentle. They work by removing dull outer skin layers, thus revealing the fresh, youthful skin hiding underneath. Moreover, if you're dealing with sun damage or uneven skin tone, a chemical peel might be your new best friend.

Laser Treatments: High-Tech Solutions for Stubborn Issues

For those tough skin problems that just won't budge, we've got laser treatments up our sleeve. These high-tech procedures are like skin superheroes, targeting specific issues with incredible precision. Whether you're battling acne, visible blood vessels, or unwanted hair, our lasers are ready to come to your rescue.

Beautiful Skin Starts from Within

Here's a little secret - great skin isn't just about what you put on it. Instead, it's also about how you treat it from the inside out. That's why we're not just about treatments. We're here to be your skin's BFF, giving you all the tips and tricks you need. From finding the perfect products to advising on sun protection and hydration, we've got your back.

So, there you have it! If you're on the hunt for top-notch skin treatments in Malvern, Plus Scalp And Skin Clinic is the place to be. We're not just about fancy treatments - we're about making you feel fantastic in your own skin. Why not pop in for a chat? Your skin will thank you!

Remember, while great skin doesn't happen overnight, with a little patience and the right care, you'll be glowing in no time. So, what are you waiting for? Let's get this skin party started!

[facialacupuncture-blog]

Maintain Body Posture by Energizing session of Massage in Malvern

In the current era of hectic or busy corporate life, every individual feels rejuvenated by relaxing massage in Malvern. It ensures to improve physical performance and mobility. The therapist of these wellness centers use a variety of techniques to achieve desired outcome, based on their experience and proven results may be, but are not limited to trigger point therapy; they also treat patients by fascial release, joint mobilization, dry needling, muscle energy techniques and deep tissue massage and cupping.

Highly skilled massage therapist employs a wide range of techniques for stretching tissues, stimulating and relaxing the nervous system, lymphatic drainage and increasing circulation, breaking down knots in muscles. Massage is one of the effective treatments for correcting and maintaining correct posture. It is also very effective or useful in dealing with an injury. The massage therapist applies long flowing massage strokes in the direction of muscle fibers.

Sports therapist also heals the body by remedial massage. They work with you to move towards physical therapy goals and optimize your sports performance. All practitioners and staff members of these wellness centers are hired for their expertise in remedial massage therapy as their friendly personalities. Attain balanced body goals and better long term health by treatment of acupuncturist in Malvern.

All professionals of these wellness centers are well versed in acupuncture theory and practice, including techniques for facial acupuncture for skin rejuvenation. The range of modalities healing technique includes acupuncture and massage. They also assist in increasing the energy flow throughout the body and calm the nervous system. Acupuncture is apt for treating depression as it relaxes the body and aids in the release of endorphins, giving the nervous system a nice rest and lifting the mood. When an individual is confronting with anxiety; it gets hard to switch off the parade of thoughts in your mind.

While going for treatment of acupuncture during situation helps by aiding the flow of energy between the brain and body for greater balance. Acupuncture is also impactful in muscular skeletal issues such as lower back pain, sciatica, tennis elbow and shoulder pain as well as neck pain. Fertility problems or complications can also be resolved by acupuncture treatment. Source:https://sportfacial.blogspot.com/2019/12/maintain-body-posture-by-energizing-session-of-massage-in-malvern.html

[flaircareskincare-blog]

Did you know we also have an in-clinic professional skin treatment range?@flaircare skincare Malvern⠀⠀⠀⠀⠀⠀⠀⠀⠀ Our selected stockists will tailor a treatment based on your skin type and skin concerns. We recommend the use of our skincare range at home daily to continue the great work achieved by your in-clinic treatment. To find your nearest stockist visit our website. Link in bio ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ #realresults #facialserum #dermatology #rejuvenation #exfoliant #cosmeceutical #instaskincare #plasticsurgeon #australianmade #youthfulskin #activeingredients #dermalclinician #nonsurgical #retinol #cosmeceuticals #skintips #sensationalskin #medicalaesthetics #dermaltherapy #cosmetics #skincarejunkie #realskincare #skinspecialist #skincareroutine #freshface #skincareblogger #skincareaddict #dermalroller #serum (at Flaircare Skincare Rejuvenation Clinic) https://www.instagram.com/p/BvKtBQ9Aq0b/?utm_source=ig_tumblr_share&igshid=1kgxv8337zgpp

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Best Microdermabrasion Clinics in Malvern East –Malvernskinstudio

Microdermabrasion is a treatment that utilizes a cautiously rough interaction to delicately buff away the top layer of the skin, further developing your complexion and surface. Individuals pick dermabrasion for various reasons; however, for the most part, it's utilized for working on the vibe of your skin, handling sun harm, maturing, skin break-out scarring, and some other skin concerns.

 What is Microdermabrasion?

 Microdermabrasion Malvern East is an expert skin treatment. First, a specific tool is utilized to scratch away the exceptionally top layer of skin tenderly. Then, another microdermabrasion procedure utilizes a splash containing either aluminum oxide or sodium bicarbonate to do the same thing. It's generally viewed as protected and appropriate for most skin types and skin tones.

 Microdermabrasion isn't intrusive, yet it utilizes expert abilities and devices. In that capacity, you need to have it finished by a certified proficient. You are generally in a leaned back position or resting, and the professional will work utilizing the picked apparatuses on the designated region. Generally, the treatment gets done with the utilization of a calming cream and sunscreen.

 There are three primary sorts of dermabrasion:

 • diamond-tip handpiece: This is an exceptionally planned instrument that at the same time swamps off dead cells while suctioning them away from the skin. The profundity of the Microdermabrasion is controlled by the specialist's applied pressing factor and the period on a space of skin. It's ordinarily utilized on the face, especially near the eyes, because of its exactness.

 • Crystal: Crystal Microdermabrasion shows fine gems onto the skin, focusing on the dead skin cells and the external layer. Once more, there is an in-assembled pull to eliminate the skin and utilized gems right away.

 • Hydra dermabrasion: This is a more up-to-date microdermabrasion strategy and utilizations water and oxygen to shed the skin, rather than the gems portrayed previously.

 The Procedure

 A microdermabrasion treatment is done by a dermatologist or Beauty Therapist Malvern East utilizing a handheld gadget that tenderly eliminates the top layer of skin.

 There are two distinct sorts of methods. With one, the gadget discharges small shedding gems across your skin, while a vacuum gadget attraction the gems back into the machine, alongside the dead or extricated skin.1

 The specialist moves a jewel tip wand delicately across your skin with the other sort of treatment to shed it.

 Advantages

 Since it profoundly sheds, Microdermabrasion can work on the tone and surface of your skin. On the off chance that you have a progression of medicines done (which is the thing that is suggested), you should see your complexion evening out. On the other hand, you might see conditioning of scarcely discernible differences and shallow wrinkles. Microdermabrasion can likewise assist with battling sun harm and make maturing creams more viable.

 Even though Microdermabrasion isn't suggested for those with serious or provocative skin break out, a progression of medicines can assist with lessening the arrangement of comedones and work on gentle acne.3 It can likewise assist with decreasing sleekness and make huge pores seem more modest.

 For certain individuals, Microdermabrasion can assist with easing up post-incendiary hyperpigmentation or dull skin break-out marks that stay after a pimple has recuperated.

 The vast majority get a progression of microdermabrasion medicines. Therefore, contingent upon the justification of the medicines, a normal routine incorporates five to 16 medicines, divided up to seven days separated.

[herbalbeautysalon]

Eyebrow Threading In Malverne To Make Your Eyes Completely Beautiful

Your eyes say a lot and therefore you should treat them in a better way to make beautiful and impressive. Eyebrow is the first thing comes in mind whenever it comes about the beauty of eyes. Are you looking for the best platform to have your eyebrows done nicely? Go with Herbal Beauty Salonny to have the best Eyebrow Threading In Malverne treatment at the best prices.

It is needless to say that threading is quite an old way of removing hair and it has been using in India for a long time. Threading is pretty much popular among the women to get their eye brows in the desired shape so that they would look beautiful. There would be many of you might not know about the great benefits of threading. This is a kind of hair removal procedure that does not need any chemicals. The only thing is used to do threading is a soft cotton thread. Apart from it, there are not artificial products or ingredients used in that procedure.

It means you will not have any sorts of skin irritation. If your skin is prone to redness or itchiness, do consult with the expert going to do your eyebrow threading. They will follow the sophisticated procedure in order to make you have quality based treatment. Eyebrow Threading In Malverne by Herbal Beauty Salonny is the best option to choose if you wish to have the best eyebrow treatment. So, what are you waiting for? Do visit the official site in order to get to know more about it.  The expert staff is here to assist you in a great way.

Read More:- Say No To Skin Irritation and Go With Waxing Option

[journalofsportsmedicine]

Juniper Publishers- Journal of Physical Fitness, Medicine & Treatment in Sports Complementary and Alternative Medicine: Evaluation of the impact of Biofield Energy Treatment on L-Cysteine-Juniper Publishers Introduction L-Cysteine is a semi-essential amino acid for the human body where it is available in the extracellular space in the form of L-cystine, mainly. It is classified as semi-essential as it could be biosynthesized by the body in some amount in the presence of normal conditions. The process of biosynthesis requires methionine, through which it gets the sulfur that is necessary for this process of making the amino acid. Therefore, it also makes the sulphur under the classification of an essential nutrient for the human body [1]. A transport system helps the transfer of extracellular L-cystine within the cells across the plasma membrane where it gets reduced in the form of L-cysteine by the help of thioredoxin and reduced glutathione. The role of intracellular L-cysteine is quite evident in the process of cellular homeostasis. It also acts as a precursor for the synthesis of protein as well as the production of GSH, hydrogen sulfide, and taurine [2,3]. The use of L-cysteine is also evident in the alternative medicine as a natural treatment for cardiovascular disease, inflammation, angina, chronic bronchitis, diabetes, osteoarthritis, flu, and inflammatory bowel disease, etc. [4-7]. It is also used in improving the health of lungs in chronic obstructive pulmonary disease (COPD) patients, which is considered as the third most common cause of death in the United States [8]. The natural food resources that contain L-cysteine are dairy products, meat, eggs, legumes, oats, and vegetables such as, broccoli, garlic, Brussels sprouts, granola, onions, sprouted lentils, and peppers. Some studies also reported the use of L-cysteine in the prevention of colon cancer, promoting the detox, and boosting sports performance. The main health benefits of L-cysteine are supposed to occur from its antioxidant properties that also support the ability of the body in managing the blood sugar, digestive health, and the skin’s appearance [9-11]. L-cysteine is also used widely for breaking up the mucus caused by the pulmonary and respiratory conditions and it also helps in regulating the level of glutamate within the body that ultimately affects the neurons taking part in the central nervous system [12,13]. The L-cysteine deficiency might occur in the elderly and infant’s population that are unable to biosynthesize it within the body. Besides, the people having metabolic syndrome and some malabsorption issues may also have the deficiency of L-cysteine. Its deficiency can cause a slow recovery from injury and other diseases due to the compromised immune system resulted from insufficient L-cysteine in the body [14,15]. Thus, it is provided by the healthcare professionals in the form of pharmaceutical/nutraceutical formulations to supplement the bodily need. The amino acids, such as L-cysteine, are highly affected by their physicochemical properties in terms of their biological performance. Therefore, various researchers were working in this field to enhance the performance of amino acids in the body by altering the physicochemical and thermal profile, such as the particle size, surface area, crystalline structure, and melting point, etc. [16,17]. In recent days, the Biofield Energy Treatment is also used by various researchers to enhance the performance of various compounds due to its significant impact on the living and non-living objects [18,19]. The Biofield Energy is a type of energy medicine that is used as the Complementary and Alternative Medicine (CAM) and includes the traditional as well as the contemporary models and approach to fight against various diseases [20-22]. The living organisms are known to have unique energy surrounding their body, which is known as the Biofield Energy that is an infinite and para-dimensional electromagnetic field. The Trivedi Effect® is a natural and methodically proven phenomenon in which an individual can harness this inherently intelligent energy and transfer it anywhere on the planet via the possible mediation of neutrinos [23]. The Consciousness Energy Healing Treatment has been reported for its remarkable effects in the field of biotechnology [24,25], agriculture science [26,27], human health and wellness [28-30], microbiology [31-33], livestock [34], and metals and ceramics [35,36]. The significant impact of the Trivedi Effect® is also established scientifically on the physicochemical and thermal properties of various pharmaceutical/nutraceutical and organic compounds [37-39]. Thus, this study was executed to determine the effect of the Consciousness Energy Healing Treatment on the physicochemical and thermal properties of L-cysteine by using the analytical techniques such as particle size analysis (PSA), powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA)/differential thermogravimetric analysis (DTG). Materials and Methods Chemicals and Reagents L-cysteine was purchased from Alfa Aesar, USA. Other chemicals which used during the experiments were of analytical grade purchased in India. Consciousness Energy Healing Treatment Strategies In this study, the L-cysteine was used as the test compound that was divided into the control and Biofield Energy Treated parts. The control sample was not given any treatment; whereas, the treated part remotely received the Consciousness Energy Healing Treatment by the well-known Biofield Energy Healer, Dahryn Trivedi (USA). The treatment process involves keeping the sample under the standard laboratory conditions followed by providing the Trivedi Effect® - Consciousness Energy Healing Treatment by the Biofield Energy Healer for 3 minutes through the Unique Energy Transmission process. Besides, the control sample was subjected to a “sham” healer under similar laboratory conditions, who did not have any knowledge about the Biofield Energy Treatment. After the treatment, the control and the Biofield Energy Treated samples were kept in similar sealed conditions and further characterized by using modern analytical techniques. Characterization The physicochemical and thermal analysis of L-cysteine was performed. The PSA was performed using Malvern Mastersizer 2000, from the UK using the wet method [40,41]. The PXRD analysis of the L-cysteine powder sample was performed with the help of Rigaku MiniFlex-II Desktop X-ray diffractometer (Japan) [42,43]. The average size of crystallites was calculated from PXRD data using the Scherrer’s formula (1): [Click here to view Large Eq 1] Where G is the crystallite size in nm, k is the equipment constant, λ is the radiation wavelength, β is the full-width at half maximum, and θ is the Bragg angle [44]. Similarly, the DSC analysis of L-cysteine was performed with the help of DSC Q200, TA instruments. The TGA/DTG thermograms of L-cysteine were obtained with the help of TGA Q50 TA instruments [40,41]. The % change in specific surface area, particle size, crystallite size, peak intensity, melting point, latent heat, weight loss and the maximum thermal degradation temperature of the Biofield Energy Treated L-cysteine was calculated compared with the control sample using the following equation 2: [Click here to view Large Eq 2] Results and Discussion Particle Size Analysis (PSA) The particle size analysis helps in determining the impact of the Biofield Energy treatment on the particle size distribution of the treated L-cysteine samples in comparison to the control sample. The results revealed that the particle size distribution corresponding to d10, d50, d90, and D (4, 3) of the Biofield Energy Treated L-cysteine sample was significantly decreased by 10.18%, 12.97%, 16.83%, and 14.36%, respectively in comparison to the control sample (Table 1). d10, d50, d90: particle diameter corresponding to 10%, 50%, and 90% of the cumulative distribution, D (4,3): the average mass-volume diameter, and SSA: the specific surface area. The study also showed a significant change in the specific surface area of the Biofield Energy Treated sample that might result due to the reduction in the particle sizes after the Biofield Energy Treatment. It was observed that the specific surface area of the Biofield Energy Treated sample was significantly increased by 14.29% compared to the control L-cysteine sample. The significant correlation between the surface area and the solubility profile has been established by various scientific studies [45,46]. It was suggested that the reduced particle size of the compounds ultimately increases the effective surface area available for salvation that further enhances the solubility and dissolution of the compound and thereby the bioavailability within the body [47]. Thus, the Biofield Energy Treated L-cysteine was supposed to possess better dissolution and bioavailability profile within the body after the Biofield Energy Treatment compared with the control sample. The diffractograms corresponding to the powder XRD analysis of the control and Biofield Energy Treated samples were presented in Figure 1. Both the diffractograms showed the presence of sharp and intense peaks, which revealed the crystalline nature of the Biofield Energy Treated sample as that of the control sample. The data of both the diffractograms indicated the missing of some of the characteristic’s peaks in the Biofield Energy Treated sample along with significant alterations in the Bragg’s angle of the other peaks compared to the control sample. The diffractogram of the Biofield Energy Treated sample showed the highest peak intensity at 2θ equal to 23.05°; while it was observed at 2θ equal to 24.67° in the control sample. Besides, the peaks observed at 2θ equal to 13.24°, 33.84°, and 40.04° in the diffractogram of the control sample were not found in the Biofield Energy Treated sample. Instead, the Biofield Energy Treated sample’s diffractogram showed new peaks at 2θ equal to 23.05°, 43.42°, and 49.81°, compared to the control sample. The significant changes were also found in the peak intensities and the crystallite sizes corresponding to the characteristic peaks of the Biofield Treated sample ranging from -47.62% to 110.11% and -17.74% to -74.57%, respectively, compared to the control sample. The significant changes observed in the positioning of the characteristic diffraction peaks as well as their corresponding intensities and crystallite sizes of the Biofield Energy Treated sample compared to the control sample indicated the possible alterations in their crystalline properties after the Biofield Energy Treatment (Table 2). The treated sample also showed a significant change in the average crystallite size (450.75 nm) that was found to be decreased significantly by 49.81% in comparison to the control sample (898 nm). The crystalline properties of the compound could be altered after the Biofield Energy Treatment as studied previously by various researchers [23,35,36,38]. The basis of such alterations was established depending on the changes observed in the peak intensities of the characteristic peaks of the Biofield Energy Treated compounds and their corresponding crystallite sizes [48,49]. In this study, the results indicated the presence of some new peaks in the treated sample’s diffractogram along with the absence of some characteristic peaks compared to the control sample that might indicate the formation of new polymorphs of L-cysteine after the Biofield Energy Treatment. There are various scientific studies which reported that the physical modifications in the crystalline structure of compounds such as, altering the crystal habits may alter the bioavailability and efficacy of the drug [50]. Thus, it is presumed that the Biofield Energy Treated sample might be more bioavailable and effective in comparison to the control L-cysteine sample. The DSC thermograms of the control and the Biofield Energy Treated samples (Figure 2) help in determining the difference in their melting temperature and latent heat [51] that may arise due to the Biofield Energy Treatment. The scientific studies previously done on L-cysteine reported the decomposition of the sample during heating instead of its sublimation as the peaks observed in the DSC thermogram coincides with the drop in the TGA thermogram. Thus, the same temperature indicated the decomposition process of L-cysteine during the thermal heating instead of melting process [51,52]. The thermograms of both the samples showed two endothermic peaks during the thermal heating process. The results indicated the minor changes in the peak temperature of both the peaks of the Biofield Energy Treated sample; however, the latent heat (ΔHdecomposition) corresponding to both peaks were significantly altered compared with the control sample. The treated sample showed a slight reduction in the peak temperature corresponding to 1st and 2nd peak by 0.20% and 0.40%; while the ΔHdecomposition was significantly altered by 11.45% and 20.79%, respectively compared to the control sample (Table 3). The DSC results revealed that the decomposition temperatures of the treated sample were similar as that of the control sample, whereas the latent heat corresponding to those temperatures was significantly increased that may occur due to some alterations in the crystal structure and molecular pattern of the L-cysteine [51,53] after the Biofield Energy Treatment. Hence, the thermal decomposition pattern of the Biofield Energy Treated was altered with respect to its latent heat compared to the control L-cysteine sample. Thermal Gravimetric Analysis (TGA)/ Differential Thermogravimetric Analysis (DTG) The TGA thermograms of the control and treated samples showed a significant weight loss of L-cysteine during the thermal degradation (Figure 3) and the pattern of degradation of both the samples during the heating was found similar as reported in the previous scientific studies [52]. Further data of the thermograms revealed a significant reduction in the weight loss of the treated sample compared to the control sample. The treated sample showed a 93.94% weight loss during the thermal heating that was found to be reduced by 5.59% in comparison to the total weight loss of the control sample (99.50%). Hence, the resultant residue weight of the treated sample was increased significantly by 1111.20% compared to the control L-cysteine sample (Figure 4). Moreover, the DTG analysis (Table 4) of the control and the treated sample indicated a slight alteration in the maximum thermal degradation temperature (Tmax) of the Biofield Energy Treated L-cysteine in comparison with the control sample. The Tmax of the control sample was observed as 221.06ºC; while it was slightly reduced by 0.50% in the treated sample and found as 219.96 °C. Hence, the overall TGA/DTG studies indicated the increased thermal stability of the Biofield Energy Treated sample after the Biofield Energy Treatment in comparison with the control L-cysteine sample. [Click here to view Large Figure 3]. Conclusion This scientific study was performed to analyze the alterations in the physicochemical and thermal properties of L-cysteine that may arise due to the impact of the Trivedi Effect®-Consciousness Energy Healing Treatment in comparison to the control sample. The Biofield Energy Treated sample showed significant changes in the particle size distribution pattern that was observed to be reduced at d10, d50, d90, and D (4, 3) by 10.18%, 12.97%, 16.83%, and 14.36%, respectively, compared with the particle size values of the control L-cysteine sample. The resultant impact was also seen on the specific surface area of the Biofield Energy Treated sample after the Biofield Energy Treatment as it was significantly increased by 14.29% compared with the control L-cysteine sample. The PXRD data of both the samples revealed significant changes in the positioning of characteristics peaks of the Biofield Energy Treated sample along with the highest peak intensity compared with the peaks of the control L-cysteine’s diffractogram. The peaks having similar Bragg’s angles of the Biofield Energy Treated sample as that of the control sample also showed alterations in their peak intensities ranging from -47.62% to 110.11% and in crystallite sizes ranging from -17.74% to -74.57% in comparison to the control sample. The average crystallite size of the Biofield Energy Treated L-cysteine was also found to be significantly reduced by 49.81% compared with the control sample. The presence of two endothermic peaks in the DSC thermograms of the control and Biofield Energy Treated sample, which denoted their thermal decomposition. The ΔHdecomposition of the 1st and 2nd endothermic peaks were significantly increased by 11.45% and 20.79%, respectively, compared with the control L-cysteine sample. The Biofield Energy Treated sample indicated the increased thermal stability after the Biofield Energy Treatment as the total weight loss during the thermal heating was reduced by 5.59% in comparison to the control sample, which therefore causes a remarkable increase in the residue weight by 1111.20% compared with the control L-cysteine sample. The overall analysis on the L-cysteine sample revealed the impact of the Biofield Energy Treatment on the sample that causes the decrease in particle sizes and increased specific surface area, which might help in increasing the solubility, absorption, and bioavailability of the Biofield Energy Treated sample. The impact of the Trivedi Effect® was also found on the crystalline and thermal properties of L-cysteine as the Biofield Energy Treated sample showed altered crystallinity that might form a novel polymorph with improved thermal stability of the sample, compared to the control sample. Thus, the Biofield Energy Treated L-cysteine could be useful in formulations (i.e., food, cosmetics, pharmaceuticals, etc.) which might improve the bioavailability and more efficacious in the treatment against cardiovascular disease, inflammation, angina, chronic bronchitis, chronic obstructive pulmonary disease (COPD), diabetes, osteoarthritis, flu, inflammatory bowel disease, etc. For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.com For more articles in Journal of Physical Fitness, Medicine & Treatment in Sports please click on: https://juniperpublishers.com/jpfmts/index.php For more Open Access Journals please click on: https://juniperpublishers.com

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Characterization of the Physicochemical and Thermal properties of the Biofield Energy Treated Flutamide Using PSA, PXRD, TGA/DTG, and DSC Analytical Techniques- Juniper Publishers

Abstract

Flutamide is an antiandrogen drug that blocks the action of testosterone by binding to the androgen receptor. This study was designed to determine the impact of the Trivedi Effect®-Energy of Consciousness Healing Treatment on the physicochemical and thermal properties of flutamide. The test sample was divided into two parts, i.e., control and treated sample. The control part was known as untreated sample, while the treated part remotely received the Biofield Energy Healing Treatment by a renowned Biofield Energy Healer, Alice Branton. The study showed that the particle size values were significantly increased by 15.82%(d10), 16.36%(d50), 1.05%(d90), and 5.10% {D (4, 3)}; thus, the specific surface area was significantly decreased by 14.56% in the treated sample compared with the control sample. The PXRD peak intensities and crystallite sizes were significantly altered ranging from 7.02% to 29.41% and -9.17% to 17.86%, along with 2.84% increase in the average crystallite size in the treated flutamide compared to the control sample. The residue weight was significantly decreased by 64.16%; however, the maximum thermal degradation temperature was increased by 10.16% in the treated sample compared to the control sample. The latent heat of the treated sample reduced by 9.37% compared with the control sample. The results revealed the significant alteration in the crystallinity, particle size and thermal stability of the treated sample as compared to the untreated sample. Thus, the Biofield Energy Treated flutamide might improve the flowability, and compatibility compared with the untreated sample, that may help in designing a better pharmaceutical formulation in terms of its performance against various diseases.

Keywords: Flutamide, The trivedi effect®, Energy of consciousness haling treatment, Complementary and alternative medicine, PSA, PXRD, TGA, DSC

    Introduction

Flutamide is a nonsteroidal pure antiandrogen drug (toluidine derivative, structurally associated to bicalutamide and nilutamide), which perform its action by inhibiting the uptake and/or binding of dihydrotestosterone to the target cell receptor that leads to alter the interfering with the androgen action. It blocks the action of both endogenous and exogenous testosterone by binding to the androgen receptor, thus flutamide administration results in elevations of plasma testosterone and estradiol [1]. However, it was reported that it is a potent inhibitor of testosterone-stimulated prostatic DNA synthesis. 2-Hydroxyflutamide, an active metabolite of flutamide competitively blocks the dihydrotestosterone binding at androgen receptors, which results in the formation of inactive complexes that could not be translocate into the cell nucleus. This property is significantly useful to arrest the growth of tumour cell or transient tumour regression [2]. Absorption, distribution, and excretion of flutamide is very rapid and absorbed completely. In addition, it is rapidly and extensively metabolized with only 2.5% of plasma radioactivity of 1 hour after administration. The biological half-life of the alpha-hydroxylated metabolite of flutamide is approximately 6 hours. Flutamide, as an anti-androgens action used to treat prostate cancer in men, by blocking the effects of testosterone that helps prostate cancer to grow and also significantly used with other medications for radiation treatments [3]. Flutamide is administered and preferred orally, while it is 95% plasma protein-bound and seems to concentrate in the prostate. The data suggested that flutamide undergoes rapid metabolism to a variety of compounds. However, 95% of an oral dose is excreted by the kidneys. Hemodialysis cannot remove it due to its high protein binding. It might have some side effects because this is commonly used with other medications, such as hot flashes, diarrhoea and nausea, loss of sexual interest/ability, vomiting, and enlargement of male breasts. However, drowsiness is one of the less common side effects, while diarrhoea is a common side effect. The rate of absorption and mechanism of action depends upon various factors of drugs such as its solubility, stability, pharmacokinetics and bioavailability [4,5]. However, physicochemical properties of any pharmaceuticals are very important in the different role for its biological profile. Therefore, in order to improve the physiochemical profile such as such as particle size, crystalline structure, crystallite size, surface area, etc., research has been carried to alter the physicochemical properties.

The Biofield Energy Treatment is considered as an emerging field as it is an integral healthcare approach including the increasing beneficial effects of Complementary and Alternative Medicine (CAM) therapies, against various health conditions [6,7]. National Institute of Health (NIH) recommend and included various Energy Healing therapies such as natural products, yoga, deep breathing, meditation, homeopathy, progressive relaxation, acupressure, acupuncture, hypnotherapy, relaxation techniques, healing touch, pilates, Ayurvedic medicine, traditional Chinese herbs and medicines, Reiki, cranial sacral therapy, etc. under CAM category and these are accepted by most of the U.S. population with several advantages [8,9]. Similarly, the Biofield Energy Healing (the Trivedi Effect®) has also been popular worldwide due to its remarkable impact on the nonliving materials as well as the living organisms. The Trivedi Effect®-Consciousness Energy Healing Treatment has been reported for its significant impact on the physicochemical and thermal properties of various pharmaceutical/nutraceutical compounds [10-12], plants [13,14], altered characteristics in microbiology [15-17], metals, ceramics, and polymers [18,19], livestock [20], biotechnology [21], and skin health [22]. Thus, this study was aimed to determine the effect of the Biofield Energy Treatment (Trivedi Effect®) on the physicochemical and thermal properties of flutamide by using various analytical techniques such as, particle size analysis (PSA), powder X-ray diffraction (PXRD), thermogravimetric analysis (TGA), and differential scanning calorimetry (DSC).

    Materials and Methods

Chemicals and reagents

Flutamide was purchased from Tokyo Chemical Industry Co. Ltd. All other chemicals used during the experiments were of analytical grade available in India.

Consciousness energy healing treatment strategies

Flutamide, i.e., the test compound was divided into two parts. Among both parts, one portion was denoted as control sample that did not receive the Biofield Energy Treatment. Besides, the other part of flutamide was considered as the treated part that received the Energy of Consciousness Healing Treatment by the renowned Biofield Energy Healer, Alice Branton (USA), and named as the Biofield Energy Treated sample. In the process of Biofield Energy Treatment, the sample was kept under the standard laboratory conditions, and the Biofield Energy Healer provided the Trivedi Effect® - Energy of Consciousness Healing Treatment to the sample, remotely, for 3 minutes through the Unique Energy Transmission process. On the other hand, the control flutamide was subjected to a “sham” healer under the similar laboratory conditions, who did not have any knowledge about the Biofield Energy Healing Treatment. Consequently, the control as well as Biofield Energy Treated flutamide samples were kept in similar sealed conditions and further characterized by using modern analytical techniques.

Characterization

The PSA, PXRD, TGA/DTG, and DSC analysis of pyridoxine were performed. The PSA was performed using Malvern Mastersizer 2000, from the UK with a detection range between 0.01μm to 3000μm using the wet method [23,24]. The PXRD analysis of pyridoxine powder sample was performed with the help of Rigaku MiniFlex-II Desktop X-ray diffractometer (Japan) [25,26]. The average size of crystallites was calculated from PXRD data using the Scherrer’s formula (1)

Where G is the crystallite size in nm, k is the equipment constant (0.94), λ is the radiation wavelength (0.154056nm for K α 1 emission), β is the full-width at half maximum, and θ is the Bragg angle [27]. Similarly, The TGA/DTG thermograms of pyridoxine were obtained with the help of TGA Q50 TA instruments. The DSC analysis of pyridoxine was performed with the help of DSC Q200, TA instruments [23,24]. The % change in particle size, specific surface area (SSA), peak intensity, crystallite size, melting point, latent heat, weight loss and the maximum thermal degradation temperature (Tmax) of the Biofield Energy Treated sample was calculated compared with the control sample using the following equation 2:

    Results and Discussion

Particle size analysis (PSA)

The particle size analysis of the control and Biofield Energy Treated samples were presented in Table 1. The particle size distribution of the control sample was found at d10 = 44.31μm, d50 = 179.98μm, d90 = 653.57μm, and D (4, 3) = 276.60μm. However, the particle size distribution of the Biofield Energy Treated flutamide sample was observed at d10 = 51.32μm, d50 = 209.43μm, d90 = 660.45μm, and D (4, 3) = 290.70μm. The result analysis revealed that the particle size values at d10, d50, d90, and D (4, 3) in the Biofield Energy Treated sample were significantly increased by 15.82%, 16.36%, 1.05%, and 5.10%, respectively, compared to the control sample.

On the other hand, the specific surface area of the Biofield Energy Treated flutamide (0.088m2/Kg) was decreased by 14.56% as compared with the control sample (0.103m2/Kg). The literature reported the impact of particle size distribution of drug on the formulation development in terms of its blend uniformity, compactibility, and flowability, etc., which further affected the safety, efficacy, and the quality of the formulation [28,29]. Hence, the Biofield Energy Treated flutamide sample might help in better formulation development by improving its uniformity, flowability, and compactibility.

d10, d50 and d90: particle diameter corresponding to 10%, 50%, and 90% of the cumulative distribution, D (4,3): the average mass-volume diameter, and SSA: the specific surface area. *denotes the percentage change in the Particle size distribution of the Biofield Energy Treated sample with respect to the control sample.

Powder X-ray Diffraction (PXRD) Analysis

The PXRD diffractograms of the control and Biofield Energy Treated flutamide samples are shown in Figure 1. There was the presence of sharp and intense peaks in the diffractograms of both the samples which indicated that both the samples are crystalline in nature. Besides, the peak intensities and the crystallite size corresponding to each characteristic peak was done for both the control and the Biofield Energy Treated sample (Table 2).

a: Denotes the percentage change in the peak intensity of Biofield Energy Treated sample with respect to the control sample.

b: Denotes the percentage change in the crystallite size of Biofield Energy Treated sample with respect to the control sample.

The highest peak intensity (100%) was observed at 2θ equal to 8.85° (Table 2, entry 1) in the PXRD diffractogram of the control sample, while at 8.72° in the Biofield Energy Treated sample; however, the Bragg’s angle of all the characteristic peaks of the Biofield Energy Treated sample were observed to differ from the control sample. Also, the peak intensities corresponding to these characteristic diffraction peaks in the Biofield Energy Treated sample were found to be significantly increased ranging from 7.02% to 29.41% compared to the control sample. Such alterations in the peak intensities of the peaks indicated the change in the crystallinity of the Biofield Energy Treated sample as compared to the control flutamide sample.

Besides, the crystallite sizes of the Biofield Energy Treated sample corresponding to those peaks were also observed to be significantly altered ranging from -9.17% to 17.86% as compared to the control sample. Also, the Biofield Energy Treated sample showed an increase in the average crystallite size (158.5nm) by 2.84% as compared to the control sample (154.12nm). The literature reported that the alterations in the peak intensity of the crystalline compound changes based on its crystal morphology [30]. Moreover, the alterations in the complete PXRD pattern may be considered as the proof of polymorphic transitions taken place in treated flutamide sample [31,32]. Thus, the overall results indicated the alterations in the crystallinity, crystallite size, and polymorphic form of the Biofield Energy Treated flutamide sample when compared with the control sample. Such changes might ensure its better drug performance in the formulation development than the untreated flutamide.

Thermal gravimetric analysis (TGA)/ Differential thermogravimetric analysis (DTG)

The TGA thermograms of the control and Biofield Energy Treated flutamide samples displayed one step of thermal degradation (Figure 2). The results revealed 2.21% increase in the total weight loss of the Biofield Energy Treated flutamide as compared with the control sample (Table 3). Also, the residue amount of the treated flutamide sample was reduced significantly by 64.16% when compared to the control sample (Table 3).

*denotes the percentage change of the Biofield Energy Treated sample with respect to the control sample,

Tmax = the temperature at which maximum weight loss takes place in TG or peak temperature in DTG.

The DTG thermograms of the control and Biofield Energy Treated sample showed a single peak (Figure 3). The results revealed that the onset of thermal degradation taken place at 134.68°C in the control flutamide sample, while it started earlier in the Biofield Energy Treated sample i.e., at 103.41°C. However, the maximum thermal degradation temperature (Tmax) of the treated flutamide sample was significantly increased by 10.16% as compared with the control sample (Table 3). Thus, the overall, TGA/DTG results showed that the thermal stability of the Biofield Energy Treated sample was significantly decreased as compared with the control flutamide sample.

Differential scanning calorimetry (DSC) analysis

The DSC thermograms of both the control and the Biofield Energy Treated flutamide samples were shown in Figure 4 and the results were used to determine the melting and other thermal behaviours of the flutamide sample [33]. A sharp endothermic peak was evident in the thermograms of both the samples which are considered as the melting temperature of the samples. The peak was observed in the control sample at 113.23°C; while it was slightly decreased to 112.58°C in the Biofield Energy Treated flutamide sample. Moreover, the latent heat of fusion (ΔH) of the con trol sample was found as 107.2 J/g; whereas it was decreased to 97.15J/g in the Biofield Energy Treated sample. Hence, the results revealed a reduction in the melting point and the ΔHfusion of the Biofield Energy Treated flutamide by 0.57% and 9.37%, respectively as compared to the control sample (Table 4). It is presumed that there was might be some alterations in the molecular chains and the crystallization structure of the flutamide [33] due to the Biofield Energy Treatment that may cause the changes in the melting temperature and ΔH of the treated flutamide.

ΔH: Latent heat of fusion, *denotes the percentage change of the Biofield Energy Treated sample with respect to the control sample.

    Conclusion

The study revealed that the Trivedi Effect®-Consciousness Energy Healing Treatment showed a significant impact on the particle size distribution, crystallite sizes, peak intensities, and the thermal properties of flutamide. The particle size values of the Alice’s Biofield Energy Treated flutamide were increased significantly by 15.82%, 16.36%, 1.05%, and 5.10% at d10, d50, d90, and D (4, 3), respectively compared to the control sample. The specific surface area of the Biofield Energy Treated sample was found to be decreased by 14.56% compared to the untreated flutamide sample. The increase in particle size might be helpful in providing the better compactibility, uniformity, and flowability to the treated flutamide sample. The PXRD results showed alterations in the Bragg’s angle of the highest intensity peak as well as the other peaks of the treated sample. Also, the peak intensities and crystallite sizes corresponding to those peaks of the treated flutamide sample showed alterations ranging of 7.02% to 29.41% and -9.17% to 17.86%, respectively as compared to the untreated sample. Similarly, the average crystallite size of the Biofield Energy Treated flutamide sample was also increased by 2.84% compared to the control sample. Besides, the total weight loss of the Biofield Energy Treated sample was increased by 2.21% in TGA; whereas, the residue amount was significantly reduced by 64.16% as compared with the control sample. The DTG study showed that the Tmax of the Biofield Energy Treated flutamide sample was significantly improved by 10.16% compared with the control sample. The Biofield Energy Treated sample revealed that the melting temperature and ΔHfusion were decreased by 0.57% and 9.37%, respectively as compared to the untreated flutamide sample. Thus, the thermal analysis indicated the less thermal stability of the Biofield Energy Treated sample as compared to the control sample. Overall, the Trivedi Effect®- Consciousness Energy Healing Treatment poses its impact on the flutamide sample, which might generate its new polymorphic form with altered crystallinity, particle size, and thermal stability. Such alterations in the Trivedi Effect® Treated flutamide may confirm its better designing in the form of nutraceutical and pharmaceutical formulations by providing better compactibility, flowability, and content uniformity, which might be used to offer better therapeutic response against prostate cancer, androgendependent skin and hair conditions including acne, seborrhea, hirsutism, and scalp hair loss, hyperandrogenism, as well useful for feminizing hormone therapy aimed at transgender women.

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Diagnostic tests for common STDs and HSV-2.

c. the cause of trachoma Sensitivity of serologic tests. The sensitivity of both nontreponemal and treponemal tests varies with stage of infection. The sensitivity of nontreponemal tests increases with duration of infection, and ranges from approximately 75% to 85% in the primary stage to virtually 100% in the secondary stage. (10) Humoral antibodies typically are detectable one to four weeks after chancre formation. Since the sensitivity of nontreponemal tests is lower in the primary stage, a negative nontreponemal test in an individual with a genital lesion cannot exclude primary syphilis. In such patients, direct laboratory examination of suspicious lesions should be sought. 2. Primary stage of infection with syphilis is a. most commonly reported STD Direct testing of clinical specimens. TP may be detected using specimens collected noninvasively from skin and mucosal lesions suspicious for P & S syphilis using dark-field microscopy, with sensitivity of 75% to 80%, depending on specimen adequacy. (7)

TP-specific staining of histologic specimens may also be performed, but sensitivity is diminished if concentration of treponemes is low. In clinical settings equipped with a dark-field microscope, the clinician may scrape the suspected syphilis lesion with a glass slide to prepare a wet mount for immediate examination. Identification of motile, corkscrew-shaped organisms appearing fluorescent green supports the diagnosis of syphilis. Specimens from oral lesions should not be examined using dark-field microscopy, as saprophytic, nonpathogenic treponemes may cause a false-positive result for TP. The FTA-Abs CSF test is also available for testing CSF specimens, though it lacks the specificity of the VDRL-CSF test. A nonreactive result, however, carries a high negative predictive value and is recommended by some experts to exclude neurosyphilis in VDRL-CSF-negative cases in which minimal abnormalities in WBCs and/or protein raise suspicion for active neurosyphilis. 18. HSV is c. endocervical specimens 4. Holmes KK, Sparling PF, Mardh P, et al. Sexually Transmitted Diseases. 3rd ed. 1999:1454. New York, NY: McGraw-Hill. Conclusion Neisseria gonorrhoeae (NG) is a Gram-negative diplococcus that commonly infects the mucosa of the urethra, cervix, rectum, and throat. It frequently presents as an uncomplicated, symptomatic infection at one or more of these sites. In women, untreated lower genital tract infection, which more often may be asymptomatic, may progress to pelvic inflammatory disease (PID). Repeated cases of PID increase the risk for chronic pelvic pain, ectopic pregnancy, and infertility. 3. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75(1):3-17. c. an obsolete test The role of type-specific serologic testing for HSV. Clinical diagnosis of genital HSV is insensitive and nonspecific. (34) The diagnosis of HSV-2 infection has been aided by the availability of serologic tests for type-specific antibody to the virus, supplanting crude antigen testing. Use of these tests necessitates appropriate patient-centered counseling about transmission risk, prevention steps, and treatment, especially since herpes infection continues to carry significant stigma in the general population. The tests cannot differentiate recent infection from that acquired remotely. In many instances, patients diagnosed with HSV-2 can recall symptoms consistent with the infection. Diagnosis of HSV infection may facilitate interventions aimed at minimizing secondary transmission. For instance, a recent clinical trial showed daily antiviral therapy reduced the risk of HSV-2 transmission to uninfected partners. (35) 15. World Health Organization. Laboratory-based evaluation of rapid syphilis diagnostics. The Sexually Transmitted Diseases Diagnostics Initiative (SDI). Geneva, Switzerland. World Health Organization Special Programme for Research and Training in Tropical Diseases. 2003. Chlamydia trachomatis 10. NG can be detected by: a. True b. EIA 7. A multiplex polymerase chain reaction test detects a. urine Table 1: Performance of standard serologic tests for syphilis* Stage of untreated syphilis Specificity % sensitivity (range) % (range) Nontreponemal test Primary Secondary Latent Nonsyphilis RPR card 86 (77-99) 100 98 (95-100) 98 (93-99) VDRL slide 78 (74-87) 100 96 (88-100) 98 (96-99) Nontreponemal test FTA-Abs 84 (70-100) 100 100 87 (84-100) TPPA ** 90-100 50-100 * Modified from Larsen. S.A., V. Pope, R.E. Johnson, et al., A Manual of tests for syphilis. 9th ed. 1999. Washington, DC: American Public Health Association, except as indicated. Indicated percentage ranges based on CDC studies. (Citation 8 in references.) ** Fujirebio Diagnostics Inc., Serodia--TP-PA [package insert, p.4]. Malvern, PA, 2002, comparing TPPA with MHA-TP in population of patients suspected of syphilis by symptoms and history, as well as population of normal controls. (Not cited in references.) Table 2: Performance of selected tests for Neisseria gonorrhoeae* Sensitivity Specificity (%; range) (%; range) Culture 85-95 100 Nucleic acid amplification test ([double dagger]) Urine specimens, LCR 94.3-100 98.2-100 Nucleic acid hybridization (nonamplified) test ([dagger]) Endocervical swab specimens 85.4-100 93.5-99.6 Male urethral swab specimens 91.5-100 82.2-98.9 Performance of selected tests for Chlamydia trachomatis** Cell culture (male and female) 30-86 100 Nucleic acid amplification test ([double dagger]) Endocervical specimens PCR 85.0-100 99.0-100 SDA 92.8-100 98.2-99.3 TMA 82.5-100 99.4-100 Urine specimens PCR 86.7-100 97.0-100 SDA 92.8-100 93.8-99.3 TMA 82.5-100 98.7-100 Nucleic acid hybridization (nonamplified) test ([dagger]) Male and female swab specimens 75.3-91.7 99.0-100 * Koumans EH, Johnson RE, Knapp JS, St Louis ME. Laboratory testing for Neisseria gonorrhoeae by recently introduced nonculture tests: a performance review with clinical and public health considerations. Clin Infect Dis. 1998 Nov; 27(5): 1171-1180. (Not cited in references.) ** Evaluation of Diagnostic Tests for Detection of Genitourinary Chlamydia Infections, 2001 California Department of Health Services STD Control Branch and the Department of Epidemiology and Biostatistics: Berkeley, CA. (http://www.ucsf.edu/castd/std_publications.html) ([dagger]) Gen-Probe PACE 2, compared to culture as reference standard ([double dagger]) NAATs include polymerase chain reaction (PCR, e.g., Roche AMPLICOR), strand displacement amplification (SDA, e.g., BDProbeTec), and transcription-mediated amplification (TMA, e.g. Gen-Probe APTIMA) tests; ligase chain reaction (LCR, e.g., Abbott LCx NG Assay) no longer commercially available in the U.S. b. rashes on palms and soles Acknowledgement: The authors wish to thank Gail Bolan for her contributions in the preparation of this manuscript. c. 12 Herpes capsid images courtesy of Hong Zhou, Ph.D., University of Texas Health Science Center, Department of Pathology and Laboratory Medicine b. conventional serologic d. 6 a. direct examination of suspicious lesion material only Bacterial culture is the gold standard for diagnosis of gonorrhea. Growth of NG is selected using Thayer-Martin medium and 5% C[O.sub.2] incubation at 35[degrees]C to 36.5[degrees]C. Plates are examined at 24-hour intervals through 72 hours' incubation. A candle-extinction jar may be used at field sites where C[O.sub.2] incubation is unavailable. Self-contained transport systems, such as the GasPak C[O.sub.2] iPouch (BD, Franklin Lakes, NJ), are available to substitute for incubation. Presumptive diagnosis of culture isolates requires a Gram stain and oxidase test. Carbohydrate-degradation tests are used to differentiate nonNG species and related organisms. NG-specific tests, such as the nucleic acid probe test may be used to confirm isolates. In general, the sensitivity of culture is affected by a host of factors including specimen-collection technique, condition of medium prior to use, and handling issues (e.g., timing of plate inoculation, transit time, and storage of plates). (16) a. serology techniques A multiplex polymerase chain reaction (PCR) test for genital ulcer disease, or GUD, has been developed that simultaneously detects TP, Haemophilus ducreyi (the etiologic agent of chancroid), and herpes simplex virus (HSV) in ulcer material (Roche Diagnostics Corp., Basel, Switzerland). While its sensitivity for TP is excellent, approximating 95%, there are no plans to market this test in the United States. (9) c. both a and b a. uses a fluorescein isothiocyanate-labeled globulin Herpes simplex virus Gram stain and culture for NG. Gram staining of clinical specimens allows direct visualization of Gram-negative diplococci within polymorphonuclear leukocytes, supporting the diagnosis of gonorrhea. In symptomatic male urethritis, the sensitivity and specificity of Gram stain approximate that of culture; the utility of Gram stain in asymptomatic urethritis is not as well validated. Gram staining of endocervical smears should not be undertaken unless a skilled microscopist is available. Since saprophytic nonpathogenic Neisseria species colonize the pharynx and rectum, Gram staining of such specimens may lead to false-positive results and should not be done routinely. (16) 13. NG-specific NAAT test can be used for: a. TP only d. all of the above [ILLUSTRATION OMITTED] Infection with herpes simplex virus is among the most common STDs in the world, affecting more than one in five adults in the United States alone. (32) Most genital herpes is caused by HSV type 2. Initial, or primary, episodes may cause severely painful vesicles and ulcers, with or without lymph-node tenderness and enlargement. Less often, primary herpes involves systemic symptoms and causes "aseptic" meningitis. A chronic state of infection then ensues, in which recurrent symptoms vary in tempo and severity. Irrespective of symptoms, intermittent shedding of virus is ongoing, as is the risk of transmitting the virus to sex partners. (33) The infection cannot be cured. Use of nucleic acid amplification technology for testing of specimens from the oropharynx, rectum, and vagina is subject to limited FDA clearance. In January 2004, the FDA cleared the Gen-Probe APTIMA COMBO 2 for testing self-collected vaginal swabs. While research studies have validated the use of NAATs in certain anatomic sites (18-20), compliance with the Clinical Laboratory Improvement Amendments (CLIA) of 1988 requires clinical laboratories to conduct internal evaluations prior to testing specimens using collection methods not cleared by the FDA. Also, the assays are subject to factors that inhibit enzymatic amplification, which may be associated with false-negative results, although internal control procedures instituted by manufacturers have minimized this problem. Finally, a predictable rate of false-positive results using NAATs, as has been observed, may appreciably lower the positive predictive value of these tests when employed in populations with a low-prevalence of NG. (21) a. Gram stain 6. U.S. Department of Health and Human Services. Sexually transmitted diseases treatment guidelines:2002. Atlanta, GA: Centers for Disease Control and Prevention; 2002. MMWR 2002;51(No. RR-6):1-82. Tertiary syphilis describes disease presenting with late manifestations, encompassing cardiovascular features such as aortitis with aneurysm formation, late neurologic sequelae, and formation of gummas (indolent, destructive lesions occurring in any organ but chiefly involving skin, bone, and liver). Late-stage manifestations may occur in one-third of untreated cases, and as long as 10 to 20 years after infection. Neurosyphilis, or central nervous system involvement by TP, is not a stage but rather a site of infection, where symptoms may manifest either earlier or later in the course of infection and may involve the visual and auditory systems prominently. a. a rare STD Nucleic acid amplification testing for CT. NAATs available for CT screening include the Roche AMPLICOR, BDProbeTec ET, and Gen-Probe APTIMA assays. A particular advantage of these tests is the ability to test urine samples, in addition to swabs of the endocervix and urethra. Since the sensitivity of these tests exceeds culture, the precise estimation of sensitivity and specificity is difficult and depends on the test used and the specimen tested, though most experts agree that sensitivity of NAATs exceeds that of other tests, especially rapid tests. (16) Use of NAATs identify up to 30% of CT infections that would be missed by other methods. (25) As mentioned previously, in January 2004, the FDA cleared the Gen-Probe APTIMA COMBO 2 for testing self-collected vaginal swab for CT. d. A and b 29. Miller GA, Klausner JD, Coates TJ, et al. Assessment of a rapid antigen detection system for Trichomonas vaginalis infection. Clin Diagn Lab Immunol. 2003;10(6):1157-1158. Rapid point-of-care tests for CT. Rapid point-of-care tests for CT include QuickVue Chlamydia (Quidel Corp., San Diego, CA), Clearview Chlamydia (Unipath Limited, Bedford, U.K.), Biostar Chlamydia OIA (Thermo Electron Corp.), and Abbott Testpack (Abbott Laboratories, Abbott Park, IL). These tests offer rapid results, but entail higher cost and decreased sensitivity compared to other testing modalities, such as NAATs. Reliance on these rapid tests may slow adoption of NAATs, especially given logistical and practical considerations in some laboratories, such as lack of staff and loss of revenue from samples redirected to larger labs. In Seattle, for instance, a survey of laboratory directors revealed continued reliance on lower-sensitivity tests for CT six years after the advent of NAATs. (28) While use of rapid tests for CT may be justified in settings where follow-up is extremely unlikely, their utility must be weighed against the benefit of more accurate, less costly, laboratory-based NAATs now in wide use. 27. California STD/HIV Prevention Training Center and the California Chlamydia Action Coalition. Sexually Transmitted Chlamydial Infections: Continuing Education for Primary Care Clinicians. Berkeley, CA. 2002. b. must be transported to the lab within 48 hours Recent years have witnessed steady levels of most sexually transmitted diseases (STDs), along with a significant resurgence in syphilis cases. (1,2) At the same time, diagnostic tests for STDs have increased in number and diversity. This article summarizes the most important standard tests for common sexually transmitted infections in adults, highlighting newer tests designed to address challenges in management and control of these infections. 13. Joyanes P, Borobio MV, Arquez JM, et al. The association of false-positive rapid plasma reagin results and HIV infection. Sex Transm Dis. 1998;25(10):569-571. Cell/tissue culture for CT. A variety of methods is available to culture CT directly. Usually, a susceptible cell line is inoculated by a patient specimen, and within 72 hours of incubation, characteristic inclusions of CT elementary and reticulate bodies can be visualized using a CT-specific fluorescein-conjugated antibody. The process is labor intensive, costly, and subject to diminished sensitivity if specimens are handled improperly. Given interlaboratory variation in culture routines, performance of this method is variable. Since the advent of noninvasive nucleic acid tests, the role of CT culture has diminished. Yet given its absolute specificity, in most situations, culture remains the test of choice for legal purposes in sexual abuse cases. 17. The InPouch TV culture system 16. Johnson RE, Newhall WJ, Papp JR, et al. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections:2002. MMWR Recomm Rep. 2002;51(RR-15):1-38; quiz CE1-4. 3. CDC defines early latent syphilis as infection in less than ______ months' duration. a. True d. by routine culture 15. In sexual abuse cases, the preferred test for CT is Infection caused by the spirochete Treponema pallidum (TP) is diagnosed by direct examination of suspicious lesion material and conventional serologic tests for syphilis. The organism cannot be cultured routinely, and the gold-standard rabbit infectivity test is impractical to perform. The selection and timing of serologic tests is integral to recognition and appropriate management of syphilis and necessitates an understanding of the natural history of the disease. The emergence of rapid tests for syphilis offers promise for timelier identification, treatment, and interrupted spread of this infection, which is a significant cofactor in human immunodeficiency virus (HIV) susceptibility and transmission. (3) Since infection with one STD is a marker of risk for contracting others, familiarity with the diagnostic modalities available for all such infections is important. Diagnostic testing is a critical tool for stemming spread of new infections. The invasiveness of diagnostic tests, their ease of use, ability to conduct them in alternative clinical and nonclinical settings, timing of results, and cost are important test factors that contribute to effective disease control. In some instances, newer diagnostic tests have replaced more labor-intensive and/or costlier techniques, such as bacterial culture and older assays necessitating daily preparation of reagents, nondisposable hardware, and intensively skilled staff for results interpretation. Increasingly, testing for STDs is conducted when and where the patient presents, such as in pre-natal and STD clinics. Such point-of-care testing minimizes mistreatment based on clinical diagnosis alone and addresses public health imperatives to recognize and treat STDs early, blunting further disease transmission. c. more severe in men than women Additional tests for TV. A variety of immunoassays, latex agglutination assays, and nucleic acid-based tests have been developed for use on serum and genital samples. Recently, the Xenostrip TV Trichomonas Test (Xenotope Diagnostics Inc., San Antonio, TX), a qualitative immunochromatographic assay, was FDA cleared for use on clinician-collected vaginal swab specimens. (29) The test provides results within 10 minutes and has a relative sensitivity compared to culture of 99% to 100% and specificity of > 98%. A PCR-based test has not been cleared for use in the United States, though local laboratories may develop and evaluate such assays. A recent evaluation of five PCR primers using self-collected vaginal swabs, with comparison to culture and/or EIA, demonstrated only 60% to 90% sensitivity of PCR. (30) Prior investigators reported sensitivity and specificity of TV PCR using vaginal swabs of 97 and 98%, respectively, compared to sensitivity of culture and wet prep of 70 and 36%. (31) [ILLUSTRATION OMITTED] Diagnosis of gonorrhea has undergone dramatic change with the advent and widespread use of NG-specific NAATs for urine, urethral, and endocervical specimens, first available in 1993. While different amplification techniques and nucleic acid targets underlie the variety of available NAATs, from a practical clinical perspective, the noninvasiveness and portability of test collection has increased the potential for more widespread screening. Furthermore, features translating into enhanced clinical practice and public health efforts include: comparable sensitivity to reference-standard tests, such as culture; noninvasiveness of specimen collection; ease of transport; the accurate performance of these tests with a variety of specimen sources; and the ability to detect nonviable organism. (17) b. bacterial culture d. all of the above b. asymptomic References Type-specific antibody tests. The Western blot assay is the gold standard technique for HSV antibody detection and can differentiate between type 1 and 2 antibodies. Limitations include high cost and labor intensity, such that tests have not been developed commercially. (36) Type-specific protein glycoprotein G2 antibody tests for HSV-2 include the HerpeSelect-2 ELISA IgG and HerpeSelect 2 Immunoblot IgG tests (Focus Technologies Inc., Herndon, VA). Sensitivities of these tests vary from 80% to 98%, with specificities [greater than or equal to]96%. (6,35) Since this is a serologic assay measuring IgG, the sensitivity relies on the time since infection, with median positivity occurring within two weeks. Rarely, HSV-2 can be gG2 deficient, resulting in a false-negative result. a. the gold-standard technique for HSV 1. Identify the most important standard test for common sexually transmitted infections. d. a and b 37. Turner KR, Wong EH, Kent CK, et al. Serologic herpes testing in the real world: validation of new type-specific serologic herpes simplex virus tests in a public health laboratory. Sex Transm Dis. 2002;29(7):422-425. 23. Morre, SA, Meijer CJ, Munk C, et al. Pooling of urine specimens for detection of asymptomatic Chlamydia trachomatis infections by PCR in a low-prevalence population: cost-saving strategy for epidemiological studies and screening programs. J Clin Microbiol. 2000;38(4):1679-1680. CE test on DIAGNOSTIC TESTS FOR COMMON STDs and HSV-2 a. NAAT All feature articles published in MLO are peer-reviewed. 16. Trichomoniasis is New rapid tests for syphilis. Given multiple incentives to accurately diagnose syphilis at the point of care, including the need to identify those infected and initiate treatment of the index case and partners early, numerous rapid treponemal tests have been developed for field-based use. None of these is yet cleared for use in the United States. A recent review of six such tests by the World Health Organization demonstrated a range of sensitivities from 84.5% to 97.7% and specificities from 92.8% to 98.0%. (15) A recent evaluation of three rapid tests by the San Francisco Department of Public Health showed that the Abbott Determine Syphilis TP test (Abbott Laboratories, South Pasadena, CA) had the highest sensitivity, 88% (95% CI 0.81 to 0.96), using whole-blood venipuncture samples, with both 100% sensitivity and specificity on 99 whole-blood fingerstick specimens. The test typically takes 15 minutes to perform, does not require sophisticated laboratory equipment, and costs approximately $2 per test. 3. Discuss the use of these tests to address management and control of these infections. Roughly one-third of individuals sexually exposed to a person with syphilis will become infected. (4) After exposure and incubation, the primary stage ensues with one or more typically painless ulcers (chancres) developing at the site of exposure, usually on the genitals or anus, with or without regional lymph-node enlargement. Such symptoms may appear within several days of exposure (mean, 21 days; range, 14 to 90 days). The chancre then resolves, even without treatment, in one to five weeks. (4,5) In the secondary stage, symptoms typically include mucosal lesions and rashes that may cover the palms and soles. Constitutional symptoms (e.g., sore throat, low-grade fever, malaise, muscle and joint aches, enlarged lymph nodes) also may be present. Less common symptoms and signs include oral mucous patches, condylomata lata (moist, wart-like papules occurring mostly in skin folds), and hair loss. In latent syphilis, serologic evidence of infection is found despite absence of symptoms and signs of the primary and secondary (P & S) stages. Early latent syphilis is defined by the Centers for Disease Control and Prevention (CDC) as infection less than 12 months in duration. (6) Without evidence of acquisition in the prior year, infection is referred to as syphilis of unknown duration. During the early latent phase, relapses with secondary stage symptoms may occur. 14. Rompalo AM, Cannon RO, Quinn TC, et al. Association of biologic false-positive reactions for syphilis with human immunodeficiency virus infection. J Infect Dis. 1992;165(6):1124-1126. Many clinics do not have dark-field microscopes and/or adequately trained staff to operate them. In these instances, smears from suspected syphilis lesions may be collected and submitted to the laboratory for fixation and immunostaining by the direct fluorescent antibody to TP (DFA-TP) method, which uses a fluorescein isothiocyanate-labeled globulin to detect TP antigen. Unlike direct dark-field examination, the DFA-TP employs a TP-specific conjugate; thus, specimens collected from oral lesions may be tested by this method. Sensitivity and specificity of DFA-TP approximate 100% using properly prepared specimens. (8) 34. Langenberg AG, Corey L, Ashley RL, et al. A prospective study of new infections with herpes simplex virus type 1 and type 2. Chiron HSV Vaccine Study Group. N Engl J Med. 1999;341(19):1432-1438. 36. Ashley RL, Wald A. Genital herpes: review of the epidemic and potential use of type-specific serology. Clin Microbiol Rev. 1999; 12(1):1-8. b. can differentiate between type 1 or 2 antibodies To earn CEUs, see test on page 22. c. can be used to test oral lesions [ILLUSTRATION OMITTED] 24. Morre SA, Van Dijk R, Meijer CJ, et al. Pooling cervical swabs for detection of Chlamydia trachomatis by PCR: sensitivity, dilution, inhibition, and cost-saving aspects. J Clin Microbiol. 2001;39(6):2375-2376. 17. Marrazzo JM. Impact of New Sexually Transmitted Disease Diagnostics on Clinical Practice and Public Health Policy. Curr Infect Dis Rep. 2001;3(2):147-151. c. painless ulcers (chancre) Detection of HSV in genital ulcer material. In addition to serologic testing, direct laboratory evaluation of suspicious genital lesions remains important to clinical management of genital ulcer disease. In the United States, HSV and TP cause most such ulcers. While direct laboratory evaluation of genital lesions to rule in syphilis is often most pressing, depending on clinical circumstances lesions suspicious for HSV should be evaluated by collecting a specimen for culture or DFA. Cell culture is the preferred test for laboratory evaluation of suspicious mucocutaneous lesions. The sensitivity of culture is higher for primary vs. recurrent lesions and declines as lesions heal, often several days after onset. HSV culture requires live virus, infected cells, special care in sampling and transport to a virology laboratory; it is time-consuming and expensive. Of note, the enzyme-linked virus-inducible ELVIS HSV system is a 24-hour culture system (Diagnostic Hybrids Inc., Athens, OH) that is commonly used but less sensitive than traditional culture. LEARNING OBJECTIVES

32. Fleming DT, McQuillan GM, Johnson RE, et al. Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med. 1997;337(16):1105-1111. b. False Improved methods for diagnosing neurosyphilis are needed. Use of PCR for identification of TP in CSF has been disappointing, due to inadequate sensitivity and the inability to distinguish between pathogenic and nonviable treponemes. 11. Carbohydrate-degradation tests are used to differentiate nonNG species and related organisms. MLO and Northern Illinois University (NIU), DeKalb, IL, are co-sponsors in offering continuing education units (CEUs) for this issue's article on DIAGNOSTIC TESTS FOR COMMON STDs and HSV-2. CEUs or contact hours are granted by the College of Health and Human Sciences at NIU, which has been approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.[R] program (Provider No. 0001) and by the American Medical Technologists Institute for Education (Provider No. 121019; Registry No. 0061). Approval as a provider of continuing education programs has been granted by the state of Florida (Provider No. JP0000496), and for licensed clinical laboratory scientists and personnel in the state of California (Provider No. 351). Continuing education credits awarded for successful completion of this test are acceptable for the ASCP Board of Registry Continuing Competence Recognition Program. After reading the article on page 10, answer the following test questions and send your completed test form to NIU along with the nominal fee of $20. Readers who pass the test successfully (scoring 70 percent or higher) will receive a certificate for 1 contact hour of P.A.C.E.[R] credit. Participants should allow four to six weeks for receipt of certificates. c. labor intensive By Christopher S. Hall, MD, MS, and Jeffrey D. Klausner, MD, MPH 2. U.S. Department of Health and Human Services. Primary and Secondary Syphilis--United States:2002. Atlanta, GA: Centers for Disease Control and Prevention; 2003. MMWR 2003;52:1117-1120. [ILLUSTRATION OMITTED] b. dependent upon concentration of treponema for accuracy results a. cardiolipin 4. Disease presenting with late manifestations, encompassing cardiovascular features and formation of gummas is defined as d. neurological syphilis Serologic testing for syphilis. Routinely employed to diagnose and monitor treated syphilis are nontreponemal assays that use cardiolipin-, lecithin-, and cholesterol-containing antigen to measure antilipoidal IgM and IgG antibodies. The two most common such tests are the rapid plasma reagin (RPR) card and venereal disease research laboratory (VDRL) slide tests. By contrast, treponemal tests utilize antigen from TP or its components and often are used to confirm the results of nontreponemal tests in a two-step, reflex process. Treponemal tests include the fluorescent treponemal antibody absorption (FTA-Abs) test, the Serodia TP particle agglutination (TP-PA) test (Fujirebio America Inc., Fairfield, NJ), and its manufacturer's predecessor test, the microhemagglutination assay for antibodies to TP, or MHA-TP. The FTA-Abs requires a fluorescent microscope to detect adherence of the patient's serum antibody to TP antigen fixed to a slide. By contrast, the TP-PA is an agglutination assay using colored gelatin particle carriers sensitized with TP antigen. Trichomonas vaginalis 8. Nontreponemal assays use b. False c. culture 18. Shafer MA, Moncada J, Boyer CB, et al. Comparing first-void urine specimens, self-collected vaginal swabs, and endocervical specimens to detect Chlamydia trachomatis and Neisseria gonorrhoeae by a nucleic acid amplification test. J Clin Microbiol. 2003;41(9):4395-4399. False-positive treponemal test results also occur in the general population, though at a lower rate than that seen with nontreponemal tests. In these instances, techniques are available to help resolve the treponemal test status, involving processing of patient serum and/or use of an investigational Western blot assay specific for TP antibodies. (8) Rarely, false-positive treponemal tests may be due to infection with other nonvenereal treponemal infections like yaws, bejel, or pinta, particularly in persons from endemic areas. d. all of the above The sensitivity of treponemal tests continues to approximate 100% in late syphilis, in contrast to nontreponemal tests, which are more practical and cost-effective for initial screening but have diminished sensitivity in late syphilis. Despite the higher sensitivity of treponemal tests, data supporting their use for initial screening are limited. Nonetheless, it may be useful to employ both a nontreponemal and (nonreflexed) treponemal test to identify newly infected persons with suspicious lesions. For instance, in a recent evaluation of 39 dark-field confirmed syphilis cases, VDRL was reactive in 30 (77%) whereas TP-PA was positive in 37 (95%). Using a strategy of initially obtaining both VDRL and TP-PA would have identified 100% of cases, compared to only 72% of cases using a conventional reflex strategy. (11) 31. Madico G, Quinn TC, Rompalo A, et al. Diagnosis of Trichomonas vaginalis infection by PCR using vaginal swab samples. J Clin Microbiol. 1998;36(11):3205-3210. c. tertiary syphilis d. None of the above d. none of the above b. urethral specimens The most prevalent nonviral sexually transmitted infection worldwide, trichomoniasis is caused by the protozoan Trichomonas vaginalis (TV). Infection is often asymptomatic, especially in men. In women, trichomoniasis may cause a malodorous yellow-green discharge, along with vulvo-vaginal irritation. Since infection is often asymptomatic or mild in men, affected women are often re-exposed to TV from untreated male partners. Trichomoniasis is a risk marker for other STDs, inflammation from the infection may potentiate HIV transmission, and infection during pregnancy may contribute to poor birth outcomes. (3,4) The fee for each continuing education test will be $20. d. DFA a. a highly sensitive test d. highly recommended b. primary syphilis [ILLUSTRATION OMITTED] 20. Richardson E, Sellors JW, Mackinnon S, et al. Prevalence of Chlamydia trachomatis infections and specimen collection preference among women, using self-collected vaginal swabs in community settings. Sex Transm Dis. 2003;30(12):880-885. d. not a risk marker for other STDs a. mucosal lesions d. all of the above 28. Battle TJ, Golden MR, Suchland KL, et al. Evaluation of laboratory testing methods for Chlamydia trachomatis infection in the era of nucleic acid amplification. J Clin Microbiol. 2001;39(8):2924-2927. 2. Identify new tests for common sexually transmitted infections. c. an STD that can be cured Infection with Chlamydia trachomatis (CT) is the most commonly reported STD in the United States. It is an obligate intracellular bacterium with a complex life cycle that infects mucosa of the lower genital tract, rectum, and throat. It is also the cause of trachoma and lymphogranuloma venereum, rarely seen in this country. Most infection with CT is asymptomatic, more so in women, in whom untreated infection can lead to PID, ectopic pregnancy, and infertility. b. hybridization technology Nucleic acid amplification testing for NG. Available nucleic acid tests are based on probe hybridization technology, as well as amplification methods. Two such hybridization assays are FDA cleared, including the PACE 2 (Gen-Probe) and Hybrid Capture II (Digene Corp., Gaithersburg, MD) tests, both of which detect NG and C. trachomatis in the same specimen. A version of these two tests identifies the presence of either bacterium and, when positive, must be followed up by the more specific test. A particular advantage of these tests is the ability to store and transport specimens for one week. Sensitivity of these tests is somewhat lower than that of NAATs. b. False The mainstays of NG detection have been direct visualization by Gram-stain using light microscopy, as well as bacterial culture. In recent years, testing for NG has been reshaped by the emergence of widely available nucleic acid amplification tests (NAATs), often supplanting the need for invasive and uncomfortable collection of genital specimens. Nucleic acid probe hybridization assays remain available. Serologic tests for NG are not available, and although enzyme immunoassay (EIA) tests are available, their test performance is inferior to standard methods. A 20-minute rapid assay, based on an optical immunoassay (OIA) technology (Thermo Electron Corp., Waltham, MA), was recently cleared by the Food and Drug Administration (FDA) for testing of endocervical and male urine specimens in symptomatic persons. Its role in clinical care remains to be determined. a. True In general, serologic tests for HSV-2 should be available to those who request them, especially those who are partners to HSV-2-infected persons. Most authorities, however, recommend use of such tests for screening only in high-risk populations, such as persons with other STDs and those with or at risk for HIV infection. Screening the general population, including pregnant women, is not recommended. (33) In particular, serologic tests may be most useful for diagnosing genital herpes on the first presentation of genital symptoms when culture and antigen detection tests are not available, when a recurrent lesion is repeatedly culture-negative, or when a patient's history of symptoms is consistent with genital herpes. A "window period" of six to 12 weeks, during which time antibodies have yet to form after primary infection, however, complicates the use of HSV serology in these instances. (32) This test was prepared by Shirley A. Richmond, PhD, Dean, College of Health and Human Sciences, MT, ASCP, CLS, NCA, Northern Illinois University, DeKalb, IL. 35. Corey L, Wald A, Patel R, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004;350(1):11-20. Despite the advantages of NAATs for NG, a significant benefit of culture is the capacity to determine antibiotic susceptibility of derived isolates. Such monitoring has become increasingly important given the recent emergence of drug-resistant gonococcal species, such as fluoroquinolone-resistant NG. (25) http://www.thefreelibrary.com/DiagnostictestsforcommonSTDsandHSV-2.-a0114339159 b. 18 Upon completion of this article the reader will be able to: The laboratory plays a crucial role in providing the tools necessary to effectively diagnose and control the spread of sexually transmitted infections. Numerous well-established assays continue to be used in the diagnosis of some STDs. Newer tests, however--some based on advances in molecular diagnostics--have radically improved the efficiency and accuracy of STD diagnosis. Rapid tests, point-of-care testing, and nucleic acid amplification technology represent advances addressing long-standing barriers in STD diagnosis, while meeting with patient acceptance given noninvasiveness, ease of collection, and quick turnaround of many such tests. By working closely with laboratorians, clinicians and public health officials are realizing new opportunities for the early recognition, treatment, and control of STDs. c. serology test 25. Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii, 1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri: 1999. MMWR Morb Mortal Wkly Rep. 2000;49(37):833-837. c. IgM antigen d. b and c 6. The DFA-TP The availability of such technology also allows testing of pooled patient specimens. Pooling permits substantial cost savings of reagents and technicians' time, especially when testing in low-prevalence populations. Numerous published studies have demonstrated pooling does not significantly compromise sensitivity or specificity. (21-23) Pooled testing, however, is not cleared by the FDA. Local laboratories must perform validation studies to comply with regulations under CLIA. Turnaround time is increased if positive specimens are not retested the same day, and care in specimen processing is required to avoid laboratory error. Laboratories planning to implement pooling protocols should review CDC recommendations. (16) Christopher S. Hall, MD, MS, and is Fellow at California STD/HIV Prevention Training Center, and the Division of Infectious Diseases, Department of Medicine, University of California, San Francisco. Jeffrey D. Klausner, MD, MPH, is director, STD Services, San Francisco Department of Public Health, and assistant professor of Medicine, Divisions of Infectious Diseases and AIDS & Oncology, Department of Medicine, University of California, San Francisco. [GRAPHIC OMITTED] 33. Guerry S, Allen B, Branagan B, et al. Guidelines for the Use of Herpes Simplex Virus Type 2 Serologies: Recommendations from the California Sexually Transmitted Diseases (STD) Controllers Association and the California Department of Health Services (CA DHS). Sacramento, CA. California Sexually Transmitted Diseases (STD) Controllers Association and the California Department of Health Services (CA DHS). 2003. a. 24 b. detects TP antigen CONTINUING EDUCATION 26. Schachter J. DFA, EIA, PCR, LCR and other technologies: what tests should be used for diagnosis of chlamydia infections? Immunol Invest. 1997;26(1-2):157-161. 12. Nucleic acid test are based on: Neisseria gonorrhoeae Specificity of serologic tests. Syphilis test specificity is a function of the test used and the population tested. False-positive nontreponemal results are known to occur in the setting of coexisting infection, autoimmune disease, and drug use, among other conditions. In the general population, false-positive results may occur at a rate of 1% to 2%. (8) In HIV-infected persons, nonspecific polyclonal B-cell activation may lead to false-positive nontreponemal results or higher test titers than in those uninfected with HIV. (13,14) While many have observed that biologic false-positive nontreponemal test titers typically are less than 1:8, such low titers may also occur in latent syphilis. From a public health perspective, positive nontreponemal tests, particularly with titers greater than 1:8, should be interpreted as indicating active infection, with interval testing to assess delayed seroreactivity of the confirmatory test. a. early latent syphilis 7. Romanowski B, Forsey E, Prasad E, et al. Detection of Treponema pallidum by a fluorescent monoclonal antibody test. Sex Transm Dis. 1987;14(3):156-159. b. lecithin 30. Crucitti T, Van Dyck E, Tehe A, et al. Comparison of culture and different PCR assays for detection of Trichomonas vaginalis in self collected vaginal swab specimens. Sex Transm Infect. 2003;79(5):393-398. d. all of the above 14. Chlamydia trachomatis is Wet mount and culture for TV. Using light microscopy, examination of saline wet-mount specimens obtained from pelvic examinations allows direct visualization of motile trichomonads, though sensitivity is operator-dependent and rarely exceeds 70%. (6) Sensitivity of TV detection is increased by culture under microaerophilic conditions. A variety of culture media is commercially available for diagnosis of TV. Also available is the InPouch TV Culture System (Biomed Inc., San Jose, CA). The test involves simultaneous performance of wet mount and can detect presence of a single organism. Viable organisms are required, and inoculated pouches must be transported to the lab within 48 hours, incubated at 37[degrees]C, and read over five to seven days. Nontreponemal tests may be performed qualitatively or quantitatively, the latter enabling the clinician to follow serologic response to treatment. For quantitative tests, serum is diluted in a serial twofold fashion, and the last dilution in which the specimen is fully reactive is reported. Of significance to the laboratorian, the VDRL test requires daily preparation of an antigen suspension and use of reusable slides, whereas the RPR card test utilizes disposable plastic-coated cards. (8) Given variation in antigen preparation among the commonly available nontreponemal tests, reactivity level is variable and, therefore, the tests cannot be interchanged in monitoring response to treatment. 22. Clark AM, Steece R, Crouse K, et al. Multisite pooling study using ligase chain reaction in screening for genital Chlamydia trachomatis infections. Sex Transm Dis. 2001;28(10):565-568. b. always symptomatic Testing for CT has undergone dramatic change with the widespread use of NAATs. Compared to NG testing, alternatives to nucleic acid tests for CT diagnosis are more numerous and include cell culture, EIA- and DFA-based tests, and rapid tests. Serologic testing for acute CT is neither sensitive nor specific and should not be used. Despite a broad array of test alternatives, as well as statistical challenges in comparing accuracy of competing modalities, growing evidence supports use of NAATs for routine CT diagnosis, utilizing a variety of specimen types. 20. Cell culture is the preferred test for laboratory evaluation of suspicious mucocutaneous lesions caused by HSV. a. caused by a protozoan 9. The FTA-Abs requires a fluorescent microscope to detect adherence of the patient's serum antibody to TP antigen fixed to a slide. b. an obligate intracellular bacterium 9. Liu H, Rodes B, Chen CY, et al. New tests for syphilis: rational design of a PCR method for detection of Treponema pallidum in clinical specimens using unique regions of the DNA polymerase I gene. J Clin Microbiol. 2001;39(5):1941-1946. a. requires viable organisms d. temperature Laboratory diagnosis of neurosyphilis. Laboratory diagnosis of neurosyphilis is based primarily on a reactive VDRL-CSF. When the VDRL is negative, the diagnosis is suggested by elevated white blood cells (WBC), with or without elevated protein concentration, in the absence of other known causes of these abnormalities. Use of secondary criteria is problematic, since CSF WBCs and/or protein may be elevated in the natural history of HIV infection and other diseases. Syphilis Other techniques for direct examination are available. DFA tests, such as the Light Diagnostics HSV 1/2 Typing DFA Kit (Chemicon International Inc., Temecula, CA) and MicroTrak DFA test (Wampole Laboratories, Princeton, NJ), approximate the sensitivity of culture and can distinguish HSV-2 from HSV-1. Compared to other available techniques, cytologic detection of HSV infection, such as by Tzanck prep, is insensitive and nonspecific and thus not recommended. PCR assays for HSV, including multiplex assays, are highly sensitive but are not FDA cleared and thus not readily available. If herpes dating info culture and antigen detection tests are not available or if a recurrent lesion is repeatedly culture-negative, a serologic test for HSV-2 should be considered. Of special significance in the laboratory, the prozone phenomenon may lead to false-negative serologic test results, more often during the secondary stage. This reaction occurs when a high concentration of treponemal antigen does not permit detectable antigen-antibody complex formation. It may be overcome by dilution of the specimen. Clinicians should be reminded of the need to request specimen dilution in highly suspicious cases in which serologic tests are nonreactive. Finally, temperature of the laboratory (<73[degrees]F) may also contribute to false-negative nontreponemal test results. (12) 12. El-Zaatari MM, Martens MG. False-negative syphilis screening due to change in temperature. Sex Transm Dis. 1994;21(5):243-246. 10. Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev. 1995;8(1):1-21. 21. Katz, AR, Effler, PV, Ohye, RG, et al., False-positive gonorrhea test results with a nucleic acid amplification test: the impact of low prevalence on positive predictive value. Clin Infect Dis. In press. 1. U.S. Department of Health and Human Services. Sexually Transmitted Disease Surveillance:2002. Atlanta, GA: Centers for Disease Control and Prevention; 2003. 19. Western blot assay is 1. Infection caused by the spirochete Treponema pallidum is diagnosed by Available NAATs include: the PCR-based Roche AMPLICOR; the BDProbeTec ET, using strand displacement amplification; and the Gen-Probe APTIMA and APTIMA COMBO 2, using transcription-mediated amplification of ribosomal RNA targets. Institutional and laboratory selection among candidate assays requires a review of clinical service goals, population characteristics, and laboratory issues--such as physical space constraints, including segregation of sample processing and amplification areas, technician resources, and other economic and logistical factors. 5. Golden MR, Marra CM, Holmes KK. Update on syphilis: resurgence of an old problem. JAMA. 2003;290(11):1510-1514. c. Herpes simplex virus only 19. Schachter J, McCormack WM, Chernesky MA, et al. Vaginal swabs are appropriate specimens for diagnosis of genital tract infection with Chlamydia trachomatis. J Clin Microbiol. 2003;41(8):3784-3789. c. is incubated at 37[degrees]C 8. Larsen SA, Pope V, Johnson RE, et al. A manual of tests for syphilis. 9th ed. Washington, DC. American Public Health Association. 1999. [ILLUSTRATION OMITTED] 5. TP-specific staining of histologic specimens is c. amplification methods b. Haemophilus ducreyi only 11. Creegan L, Bauer HM, Klausner JD, et al. An evaluation of the relative sensitivities of VDRL and TP-PA among patients with darkfield-confirmed primary syphilis [Abstract 0641]. In: 15th Biennial Congress of the International Society for Sexually Transmitted Diseases Research. 2003. Ottawa, Canada. Other testing methods. Nucleic acid tests utilizing probe hybridization technology also are available. As discussed earlier, these tests facilitate testing for both CT and GC, simultaneously, are automated and cheap, and do not require refrigeration of transported specimen containers. They cannot be used, however, to test urine and are not as sensitive as NAATs. EIA- and DFA-based tests for CT antigen detection have similar disadvantages and are more technically difficult to perform. (27)

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Get Safe from Diseases by Chinese Herbal Medicine in Caulfield

Natural and organic products prove to be highly effective in many health problems. There are health care and wellness firms that treat patients through great and effective Chinese herbal medicine in Caulfield. It has unbroken tradition of treating people going back to 4000 years, it involves the practitioner prescribing a carefully designed herbal formula composed of around 12 to 16 herbal medicines tailored each patient.

It is also known by the acronym of CHM. As the causes of illness that afflict mankind have evolved in time, CHM has undergone developments continuously. Along with modern medicine, hospitals use herbal medicine for various ailments and diseases. Depending upon the severity of the disease the duration of medication is expanded to get the best results and cure. Allergies, digestive disorders, respiratory conditions pertaining to respiratory tracks, problems due to psychological problems can be treated effectively treated using Chinese herbal medicines.

People of all ages and backgrounds can take Chinese herbal medical treatment. Symptoms of current illness and history are taken into consideration by the practitioner before prescribing the medicine. Traditional and modern versions of Chinese herbal medicines are available in many formats. It is clinically proven to be safe and effective treatment for a wide range of disorders.

Whenever an individual thinks about massage then they think about relaxation and healing. The remedial massage in Malvern is blended with healing and relaxing therapy which eliminates stiffness from body and stress from mind. Remedial massage is a deep massage that benefits the body in more ways than one. It produces many good effects on the body. Remedial massage enables to stimulate the flow of blood all over the body. Skin also receives good benefits and makes it glowing and refreshed. Healthy and glowing skin is also attributed by proper body fluid circulation. Get rid of muscular pain by remedial massage of skilled therapists. Source:https://sportfacial.blogspot.com/2019/10/get-safe-from-diseases-by-chinese-herbal-medicine-in-caulfield.html