History of cupping (Hijama): a narrative review of literature / 中西医结合学报

Cupping (Hijama in Arabic) is an ancient, holistic method for the treatment of a variety of diseases. Though the exact origin of cupping therapy is a matter of controversy, its use has been documented in early Egyptian and Chinese medical practices. Diverse human civilizations have contributed to the historical development and continuation of cupping therapy. This narrative review describes the history of cupping, historical definitions, cupping instruments and uses of cupping therapy. Electronic searches of relevant databases (PubMed, Google Scholar and OvidSP) were conducted using keywords and Boolean operators. Manual searches and references of published articles and books were also conducted. A number of articles (N = 625) were retained for extensive review, and finally 83 articles were included in this paper. The historical descriptions of cupping therapy were found in ancient human civilizations of the Eastern and Western world. There were inconsistent data concerning the origin of cupping, definitions, instruments, procedures, definite advancements and research in Hijama over centuries. Cupping therapy fell out of favor in 17th and mid-18th centuries but recovered popularity in modern medicine. Currently, cupping therapy is used for health promotion, prophylaxis and treatment of a variety of diseases around the world. Cupping therapy with a good safety profile has a checkered history and is a well-recognized traditional method for managing medical conditions. Currently, the scope of cupping therapy is expanding, and a growing body of research is providing additional evidence-based data for the further advancement of cupping therapy in the treatment of a variety of diseases.

Knowledge, attitude and practice of patients with type 2 diabetes mellitus towards complementary and alternative medicine / 中西医结合学报

<p><b>OBJECTIVE</b>The use of complementary and alternative medicine (CAM) is relatively common among patients with type 2 diabetes mellitus (T2DM) around the world. Like many other countries, Saudi Arabia has a high incidence of T2DM, and incorporates the use of CAM in its treatment. This study explores the knowledge, attitude and practice (KAP) of CAM therapies among patients with T2DM and explores the relationships between sociodemographics and the KAP of CAM modalities.</p><p><b>METHODS</b>This is a hospital-based, observational, cross-sectional study that selected 302 outpatients with T2DM, from Diabetic Center of King Salman bin Abdul-Aziz Hospital, in Riyadh city, in May 2014. Patients were interviewed using a predesigned questionnaire.</p><p><b>RESULTS</b>The mean age of patients was (51.6 ± 10.6) years and 43.4% of them were males. The prevalence of CAM practices was 30.5%; 30.39% of them used herbs, 20.58% used wet cupping and 17.64% used nutritional supplements and other therapies. The factors found to predict the use of CAM therapies among patients with T2DM were: age above 51 years, unemployment and the participants± knowledge about the effectiveness of CAM products.</p><p><b>CONCLUSION</b>This preliminary study estimated the prevalence of CAM use, revealed positive attitude towards CAM and found three significant predictors of CAM use among patients with T2DM, which is consistent with regional data. A community-based research with a larger sample that targets T2DM population is needed in Saudi Arabia.</p>

FDG-PET scan detection of axillary lymph node metastases of papillary thyroid carcinoma

Plasma thyroglobulin and radio-iodine whole body scintigraphy, well established techniques for the assessment of differentiated papillary thyroid cancer and its recurrence and metastases, may not always identify the site of tumour recurrence among patients with iodine-negative tumour recurrence or metastases. From this particular perspective, fluorine-18-fluo-rodeoxyglucose position emission tomography [FDG-PET] is specifically reported to localize not only the recurrence of thyroid cancer but also the site of its metastases. A case of papillary thyroid carcinoma with axillary lymph node metastases identified by FDG-PET scan is reported in order to highlight the diagnostic importance of this new technique that could also provide therapeutic interventional guide to concerned clinicians. Patients with differentiated papillary thyroid cancer revealing negative 131I results should be investigated by FDG-PET for localizing its recurrence sites and metastases that would help in curtailing high mortality coupled with occult thyroid cancers

Trihexyphenidyl [Artane] dependence: a controlled investigation between users and abusers

This controlled study aims to identify the socioclinical factors predisposing psychiatric patients to abuse trihexyphenidyI [artane] and to document the extrapyramidal symptoms in artane abusers and users. Thirty patients [n=30], with mainly two major functional psychoses and who were abusing trihexypenidyI, were compared with 90 artane user patients [n=90], who were mmatched for both the diagnosis and treatment. Besides a detailed clinical interview, ach patient was assessed by using DSM-IIIR criteria, Brief Psychiatric Rating Scale, Simpson and Angus Scale, and Abnormal Involubatry Movement Scale. The analysis of data showed that, compared with users, trihexyphenidyI abusers were significantly characterized by being unmarried, unemployed, smokers and having past and concurrent history of multiple drug abuse, and genetic loading of mental disorders. Both groups of patients were prescribed antipsychotic drugs and trihexyphenidyl on a longer basis. Besides other socioclinical parameters, premorbid personalities, stressful life vents and extrapyramidals, including tardive dyskinesias, we did not differentiate between the two groups. Artane abusers, when compared with users, were significantly characterized by less negative psychopathology. However, other psychopathological domains, in particular, the positive symptoms and depression, did not differentiate between abusers and users. In conclusion, patients having these soicoclinical profile tend to develop trihexyphenidyI abuse. The mental health pofessioals should not prescribe trihexyphenidyI indiscriminately or for a long time to such patients, who indeed require long-term antipsychotic maintenance medications

Curriculum framework for a master's degree in community medicine: some reflections with reference to Saudi Arabia

This paper describes a skeleton of a new curriculum intended for the teaching of community medicine leading to a recognized master's degree. The curriculum should have a detailed course framework and a distinctive rationale and justification with aims and specific objectives, contents, teaching methods, proper evaluation, available resources, and a well defined time framework. It is a prerequisite to develop a comprehensive curriculum before any postgraduate course is started. This curriculum must address all the relevant issues outlined in this paper. The authors recommend that the semitheoretical construction of the curriculum could be utilized in Saudi Arabia or possibly elsewhere with appropriate modifications

Erythema multiforme revisited: a follow-up report of two patients with bipolar disorder

The hypersensitivity mucocutaneous disorders within the spectrum of erythema multiforme [EM] are characterized by salient features, caused by multiple etiologies, and associated with 1% to 50% mortality. The objective of this paper is to describe the follow-up course of two bipolar patients who had previous episodes of carbamazepine-induced EM. During their in-patient treatment it was observed that once again these two patients developed spectrum of EM in case 1 erythema multiforme major [EMM] temporally induced by chlorpromazine [CPZ] while in case 2, EMM and toxic epidermal necrolysis [TEN] for which the etiological factor remained questionably identified. Besides, discussing the most relevant points including comparative phenomenology, possible etiological agents, complications, and histopathological findings in relation to hese cases, it was tentatively concluded that the drugs known to cause EM should be avoided to the maximum extent in those patients who had previous history of EM

Neuroleptic Malignant Syndrome: a comprehensive review and update

Objective; neuroleptic malignant syndrome [NMS] is a life-threatening psychomedical emergency arising as a complication of neuroleptic therapy. This paper critically reviews this syndrome update the data and also identifies the areas where knowledge is deficient. an extensive online search through the years 1974 to 1995 was made and several related books and relevant papers published in different peer-reviewed national and international journals were located. the presentation of NMS in developing countries is like that of the developed nations, however, the specific pharmacotherapy and the guidelines recommended there are sparingly used to treat this syndrome in developing world where there is dearth of data on this syndrome. Conclusions: comparatively NMS is coupled with high morbidity and mortality in developing nations as it often underdiagnosed and undertreated. From this perspective there is a crucial need to launch a NMS awareness campaign among medical community in rapidly developing countries, however, at international level multicenter studies are needed to clarify many different facets of this syndrome

Neuroleptic Malignant Syndrome: a report of nine suspected cases

Neuroleptic malignant syndrome [nms], one of the most devastating complications of neuroleptics in psychiatric population, is characterized by hyperthermia, muscular rigidity, altered consciousness, autonomic dysfunctions, leucocytosis and elevated creatine phosphokinase. This article presents nine suspected cases of NMS which were encountered over a period of decade [1984-1994] in buraidah mental health hospital. The predefined operational criteria for diagnosing NMS were used retrospectively and prospectively in those patients with fatal / non fatal outcome who developed probable features of NMS in the background of neuroleptic therapy. out of nine patients, 34% [n=3] died without being identified having this syndrome, another 34% [n=3] were diagnosed initially and treated conservatively with rest of the patients [n=3 34%] who also survived but recognized during progression of and recovery from this syndrome. Conclusions: it is concluded that patients receiving neuroleptics or other psychotropic drugs blocking or interfering directly or indirectly with the functioning of central nervous system dopamine receptors developing sudden rise in temperature should be investigated on priority basis from the point of view of NMS. This condition therefore could be identified early and immediately thereafter proper therapy could be instituted in order to avoid the high morbidity and mortality coupled with this syndrome