Temporal Trends and Factors Associated with Bisphosphonate Discontinuation and Restart

Adverse events related to long-term use of bisphosphonates have raised interest in temporary drug discontinuation. Trends in bisphosphonate discontinuation and restart, as well factors associated with these decisions, are not fully understood at a population level. We investigated temporal trends of bisphosphonate discontinuation from 2010 to 2015 and identified factors associated with discontinuation and restart of osteoporosis therapy. Our cohort consisted of long-term bisphosphonate users identified from 2010 to 2015 Medicare data. We defined discontinuation as 6512\u2009months without bisphosphonate prescription claims. We used conditional logistic regression to compare factors associated with alendronate discontinuation or osteoporosis therapy restart in the 120-day period preceding discontinuation or restart referent to the 120-day preceding control periods. Among 73,800 long-term bisphosphonate users, 59,251 (80.3%) used alendronate, 6806 (9.2%) risedronate, and 7743 (10.5%) zoledronic acid, exclusively. Overall, 26,281 (35.6%) discontinued bisphosphonates for at least 12\u2009months. Discontinuation of bisphosphonates increased from 1.7% in 2010, reaching a peak of 14% in 2012 with levels plateauing through 2015. The factors most strongly associated with discontinuation of alendronate were: benzodiazepine prescription (adjusted odds ratio [aOR] = 2.5; 95% confidence interval [CI] 2.1, 3.0), having a dual-energy X-ray absorptiometry (DXA) scan (aOR = 1.8; 95% CI 1.7, 2.0), and skilled nursing facility care utilization (aOR = 1.8; 95% CI 1.6, 2.1). The factors most strongly associated with restart of osteoporosis therapy were: having a DXA scan (aOR = 9.9; 95% CI 7.7, 12.6), sustaining a fragility fracture (aOR = 2.8; 95% CI 1.8, 4.5), and an osteoporosis or osteopenia diagnosis (aOR = 2.5; 95% CI 2.0, 3.1). Our national evaluation of bisphosphonate discontinuation showed that an increasing proportion of patients on long-term bisphosphonate therapy discontinue medications. The factors associated with discontinuation of alendronate were primarily related to worsening of overall health status, whereas traditional factors associated with worsening bone health were associated with restarting osteoporosis medication. \ua9 2019 American Society for Bone and Mineral Research

Proximate composition and mineral content of spices increasingly employed in the Mediterranean diet

The present study aimed to investigate the nutritional constituents of common market available spices in the United Arab Emirates. Seven commonly consumed spices namely, ginger (Zingiber officinale), cinnamon (Cinnamomum verum), black seed (Nigella sativa), fenugreek (Trigonella foenum-graecum), cardamom (Elettaria cardamomum), cloves (Syzygium aromaticum) and saffron (Crocus sativus) were obtained from local markets. Proximate analyses were performed according to AOAC procedures. Assessment of major (Ca, K, Mg, Na, P and S) and minor (Co, Cu, Fe, Mn and Zn) elements was conducted using inductively coupled plasma optical emission spectrometry (ICP-OES). Findings revealed varying macronutrient, micronutrient and mineral contents which are highly valuable for dietary purposes. The present study demonstrates that these edible spices could be used for nutritional support, due to their micro and macronutrient contents

Efficacy of Hijamah Bishshurtin Releasing Functional Backache

Back pain is the most frequent complaints in office working adults.  Back pain may have a sudden onset or can be a chronic pain, it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may radiate into the arms and hands as well as the legs or feet, and may include symptoms other than pain. These symptoms may include tingling, weakness or numbness.  It is the fifth most common reason for physician visits, about nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year. Low back pain causes 40% of missed days of work as well it is the single leading cause of disability worldwide.In the present study effect of wet Hijamah has been studied in patients of backache 40 male 20-60year patients were included in the study. Wet Hijamah was done on Sunnah point monthly on 17th lunar date for three months. Patients who were having degeneration and disc prolapse were excluded and only patients having functional backache included in the study. Pain is measured by pain scale before during and after the study.It was found that wet cupping therapy was associated with clinically significant pain relief within 3-month follow-up. It can be concluded that Present study concluded that wet Hijamah on Sunnah points Relieves the FUNCTIONAL BACKACHE and further studies need to be conducted which will further supports the outcomes of this therapy

Marz Akyas Khusyatur Rehm (Polycystic Ovary Syndrome): An Overview

The MARZ AKYAS KHUSYATUR REHM (polycystic ovary syndrome) (PCOS)is a common with an incidence varying from 5% to 10% and 9.13%.  inindian population.It is a “multispeciality” disorder suspected in patients with irregular menses and clinical signs of hyperandrogenism,often associated with psychological impairments, including depression and other mood disorders and metabolic derangements, chiefly insulin resistance and compensatory hyperinsulinemia, which is recognized as a major factor responsible for altered androgen production and metabolism.In Unani system of Medicine PCOS is mentioned under the headings of Amenorrhea, Obesity and other phlegmatic disorders. This disease is common in Balghami mizaj patients of reproductive age.On the basis of consistency one type is Balgham Mayi which is responsible for causing the Marz AkyasKhusyaturRehm (Polycystic Ovarian Syndrome). So it can be concluded that PCOS arise due to predominance of Balgham in the body which leads to the cyst formation in the ovaries, amenorrhea and obesity. Hirsutism has been mentioned as a complication of ehtebas tams associated with virilism, and other masculine features, like hoarseness of voice, male body contour, acne and clitoromegaly due to sue mizaj barid. Clinically, PCOS is made up of three characteristics: hyperandrogenic state, anovulation and insulin resistance.We can prevent or limit the complications from which PCOS patients suffer, such as cardiovascular disease, diabetes mellitus, and increased risk for unopposed estrogen, with using unani formulation having properties of antispasmodic and analgesic,emmenogogue (Mudir-e-haiz), diuretics (Mudir-e-boul), vasodialator (Mufatehsudad), specific drugs for liver to correct Ehtebase tams (amenorrhea) caused by liver disorders and Munzig Balgham and mushile balgham advia in single and compound form,  along with ilajbittadbeerwatytaghziya

Knowledge of Neural Tube Defects and Prevention Through Folic Acid Use Among Women in Faisalabad, Punjab, Pakistan:A Cross-Sectional Survey

OBJECTIVE: Neural tube defects (NTDs) are one of the most common congenital abnormalities of the central nervous system and are associated with significant mortality, morbidity, and major life-long disability. Periconceptional folic acid reduces the risk of NTDs by up to 70%; however, in Pakistan, no public information program exists concerning the risks of NTDs or promoting folic acid use. As such, the aim of this study was to assess levels of knowledge about NTDs and folic acid use among women attending the gynaecology department of DHQ Hospital, Faisalabad, Pakistan. DESIGN: A cross-sectional survey. SETTING: The gynaecology department of the District Head Quarter (DHQ) Hospital in Faisalabad, Pakistan. PARTICIPANTS: Three hundred and fifty-five married women. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measures included knowledge of NTDs and knowledge of folic acid use. RESULTS: About 85.4% of participants had no knowledge of neural tube defects and 76.7% reported no knowledge about folic acid use. The majority of participants (86.2%) were unaware that folic acid protects against NTDs. Lack of knowledge of NTDs was significantly associated with education (P = 0.001), husband’s education (P = 0.002), planned pregnancy (P = 0.002), sources of antenatal care (P = 0.003), knowledge of folic acid (P = 003), knowledge that folic acid protects against NTDs (P = 0.002), and health decision-making (P = 0.003). Knowledge of folic acid use was significantly associated with age (P = 0.000), education (P = 0.004), husband’s education (P = 0.002), monthly income (P = 0.003), planned pregnancy (P = 0.003), pregnancy trimester (P < 0.001), sources of antenatal care (P < 0.001), knowledge of NTDs (P = 0.002), knowledge that folic acid protects against NTDs (P < 0.001), use of folic acid (P < 0.001), sources of vitamin information (P < 0.001), and health decision-making (P = 0.002). CONCLUSION: These findings highlight extremely low levels of knowledge about NTDs and folic acid use of women in Pakistan. There is an urgent need to increase knowledge and awareness of the risks of NTDs and preventative approaches, through health education programs delivered by trusted health professionals

Physical Exercise (Riyazat) a Boon for Expecting Mothers

Creation has endowed the female of the species with the gift of pro-creation. Therefore this unique gift is the greatest happiness for a woman, who is aware that she and her kind are the ones who have brought mankind in this world. But biologically considering, along with the thought that she would be a mother, the female also has to face the greatest and gravest challenges during pregnancy, so much so that it may also become a matter of life and death. During pregnancy there are progressive anatomical and physiological changes not only confined to the genital organs but also to all systems of the body. Maternal physiological changes are the normal adaptations that a woman undergoes during pregnancy to better accommodate the embryo or fetus. Various ailments among pregnant women are likely the outcome of these physiological changes. These ailments may include backache,leg cramps,ankle oedema, acidity, varicose vein, insomnia and haemorrhoids, while some may develop gestational diabetes. As a precautionary as well as preventive step, women are advised to consume minimum but safe drugs during pregnancy, so as to avoid teratogenic effect, as a result of most drugs crossing the placental barrier. Hence alternative method in which medicines are not used internally would be beneficial for expecting mothers.Ilaj-biltadbeer (Regimenal therapy) of Unani system of medicine is a unique way of treatment ,in which ailments are cured without or with least use of drugs, hence is the best way to relieve pregnancy related discomfort. Exercise( Riyazat) is one of the methods of Ilaj-bil-tadbeer (Regimenal therapy) and is found to be very safe and effective during pregnancy and postpartum period. Exercise ( Riyazat)is a series of voluntary movements which produce deep and rapid respiration. These movements of different parts of body are needed for maintaining health, hence in recent years the need for physical exercise has gained greater importance during pregnancy as well as in postpartumperiod.A daily exercise programme is an important part of healthy pregnancy. Recent studies have proved that prenatal and postnatal exercises can prevent pregnancy related discomfort. So for maintaining better maternal health as well as psychological well being,various exercises like fitness walking, jogging (mild), swimming, aquanatal classes,yoga and stretching, pilatesand low-impact aerobics are recommended during pregnancy and postpartum period

Leucorrhoea (Sailanur Raham): A Unani Literature Review

Sailanur Raham (Leucorrhoea) is excessive vaginal discharge. It is a frequent gyenaecological complaint that accounts for more then 1/4th gynaec .According to classical unani reference books sailanur raham is a discharge of fluid from the vagina .This fluid is produced in uterus due to weakness of absorptive faculty in the uterus also due to the natural evacuation or istifraghe-tabiee, where tabiyat diverts all the wastes of body to the natural manafiz, so these wastes comes in uterus to be evacuated. there is a classification made by the authors for sailanur raham, based on types of wastes upon colour and consistency of fluid it was demonstrated by hukma by asking patients to keep tampon is having blackish red colour, then the waste of sanguinic humour is there, orange red for bilious wastes, milky white of phlegmatic wasted and black colour indicates melancholic wastes.&nbsp

A comparative study of Hematological profile of Cupping (Hijamah) versus venous blood

The Unani system of Medicine - one of the ancient systems is now gaining popularity. This system includes threebasic methods of treatments; these are Regimenal therapy, diet-o-therapy and pharmacotherapy. Regimenal therapyincludes Hijamah (dry &amp; wet cupping), massage, venesection, leeching and cauterization. “Hijamah” has originatedfrom the Arabic word “Hajm” meaning “sucking”. It is of two types, Hijamah-bila-shurt (dry cupping) and Hijamahbi's-shurt (wet cupping). In the Wet cupping blood is sucked after applying cups to specific areas of the body. Thecupping therapy has also been used in Chinese System of Medicine as a preventive, promotive, curative andrestorative therapy. Hence this therapy needs a more convincing scientific base. Thus the aim of this study was tocompare hematological profile of cupping blood with venous blood.Method: Hematological investigations were done on 40 blood samples taken from normal, healthy individuals (20paired samples of Hijamah blood and venous blood of each subject). Consent form was filled and permission wastaken from the ethics committee.Result: Data was collected according to prestructured questionnaire and statistical analysis was done using SPSSsoftware. Analysis of the data showed significant differences in many of the hematological factors between thecupping blood and venous blood.Conclusion: As per the result we can allege that Hijamah is not just a simple mechanical technique of withdrawingblood, but is a comprehensive, curative Regimenal therapy

Lifestyle Age Related Ophthalmic Diseases: Preventive Strategies from Unani System of Medicine

The vision is of great importance in day-to-day life. Currently ICMR data shows more than 60% of blindness is due to lifestyle diseases. As longevity of population increases the blindness due to cataract and retinopathy is also increasing.Hence correct diagnosis, advice &amp; treatment in early stage may save money as well as valuable time. Unani system of medicine is found to possess vivid information about the lifestyle leading to healthy living and also the preventive strategies in ophthalmic disease. The lines of treatment with diet, regimen and suitable modifications of lifestyle are promoted as high-end measures for the maintenance of eye health. The detail explanation is in full paper

Efficacy of Unani Compoud Formulation (UCF) “ZHS-1” in Case of Nephrolithiasis (HISSAT-UL-KULIYAH)

Nephrolithiasis (Hissat-ul-Kulliyah) is on the rise worldwide, with highest growth projected in Asia and other geographical region with hot, dry climates resulting from super saturation of urine in respect to the stone forming materials. It is estimated that at least 10% of the population in the industrialized part of the world is affected by nephrolithiasis. The epidemiology of nephrolithiasis differs according to geographical area in terms of prevalence and incidence, age and sex distribution, stone composition and stone location. According to one estimates there are about 5-7 million patients suffering from urinary calculus disease in India. According to Unani literaturekhilt-e-ghaleez,qarah-e-kulliyah, Suddah in the lumen and ghiza-e-ghaleez which cause weakness of quwwat-e-hazima are the causes of stone formation. Despite the major technical achievement in the last three decades, the problem of recurrent stone formation remains as before. The Unani system of medicine claim to offer a vast scope for the successful management of Nephrolithiasis. An open perspective trail was conducted in M.I.J.T.U.C and Kalsekar Hospital Mumbai to evaluate the efficacy and safety of Unani compound formulation (UCF) “ZHS-1”, to manage nephrolithiasis. Therapeutic responses were evaluated through follow up observations at weekly interval. The results were analyzed on the basis of symptoms and USG –KUB reports. In conclusion, the study revealed that UCF“ZHS-1”is safe and effective and have promising results in the management of nephrolithiasis