Efficacy of the myofascial approach as a manual therapy technique in patients with clinical anxiety: A randomized controlled clinical trial

BackgroundTo analyze the efficacy of the myofascial approach in patients with clinical anxiety and to study its relationship with associated symptoms.MethodsRandomized placebo-controlled clinical trial. Thirty-six adult patients with clinical anxiety were randomized to receive the myofascial treatment (n = 18) or placebo (n = 18). The patients and the evaluators were blinded to this assignation. The treatment consisted of four myofascial sessions of 40 min each for four weeks. The placebo intervention consisted of four sessions of simulated myofascial intervention of the same duration and frequency as the treatment. Follow-up was at one, three and six months. The primary outcome was clinical anxiety measured using the STAI (State-Trait Anxiety Inventory). Secondary outcomes were central sensitization, general health, somatization, depression, and pain.ResultsThere were significant differences in the behavior of the groups over time for clinical anxiety (STAI Trait-Anxiety) (p < 0.001), central sensitization (p = 0.005) and somatization (p = 0.008) in favor of the myofascial group, with a large effect size for anxiety and a medium effect size for central sensitization and somatization. Regarding clinical anxiety, after the intervention a mean difference was observed with respect to the baseline of 19.98 points in the myofascial group (p < 0.001) and 5.95 in the placebo group (p = 0.22). The intention-to-treat principle was used. There were no adverse events or side effects in either group.ConclusionsThe myofascial approach is effective in improving anxiety levels and associated central sensitization processes in patients with clinical anxiety and this improvement is maintained over time.Clinical Trial RegistrationNCT04826302.     

Effectiveness and safety of kamikihito,a traditional Japanese medicine,in managing anxiety among female patients with intractable chronic constipation

Background and purposeThe prevalence of anxiety in patients with chronic constipation is particularly high and these individuals are not necessarily satisfied by normal treatments targeting the gastrointestinal tract. Kamikihito, a traditional Japanese Kampo medicine, has been widely used to date in treating anxiety and neurosis in Japan. We conducted a single-arm, open-label pilot study of female patients with intractable chronic constipation and anxiety who took kamikihito by mouth for 12 weeks.Materials and methodsValidated symptom questionnaires on anxiety and gastrointestinal symptoms [the Profile of Mood States, second edition (POMS2); the State–Trait Anxiety Inventory (STAI); and the Gastrointestinal Symptom Rating Scale (GSRS)] were completed at each study visit. Plasma, salivary, and stool samples were also assessed to evaluate levels of clinical bioactive substances linked to stress and inflammation, oxidative levels, the metabolome profile, and gut microbiota.ResultsTwenty-four patients completed this study. Anxiety was significantly reduced at four and 12 weeks (Tension–Anxiety subscale of the POMS2, p = 0.006 and p = 0.039; Trait anxiety score of the STAI, p < 0.001 and p = 0.034), while the total GSRS score was improved at 12 weeks (p = 0.039). Targeted metabolomics in plasma showed significant alterations in some metabolites associated with psychological symptoms, such as O-phosphoethanolamine. No significant differences were found between pre- and posttreatment levels of clinical bioactive substances related to stress and inflammation, oxidative levels, and the gut microbiota in this cohort. No serious adverse events occurred.ConclusionKamikihito ameliorated psychological and gastrointestinal symptoms in patients with chronic constipation. In parallel with the onset of efficacy, kamikihito modulated some anxiety-related metabolites. Kamikihito was safe and well-tolerated.     

Evaluating the efficacy of lavender aromatherapy on peripheral venous cannulation pain and anxiety: A prospective,randomized study

ObjectiveThis study was designed to evaluate the effectiveness of lavender aromatherapy on pain, anxiety, and level of satisfaction associated with the peripheral venous cannulation (PVC) in patients undergoing surgery.MethodOne hundred and six patients undergoing surgery were randomized to receive aromatherapy with lavender essential oil (the lavender group) or a placebo (the control group) during PVC. The patients' pain, anxiety, and satisfaction scores were measured.ResultsThere was no statistically significantly difference between the groups in terms of demographic data. After cannulation, the pain and anxiety scores (anxiety 2) of the patients in the lavender group were significantly lower than the control group (for p = 0.01 for pain scores; p < 0.001 for anxiety 2 scores). In addition, patient satisfaction was significantly higher in the lavender group than in the control group (p = 0.003).ConclusionLavender aromatherapy had beneficial effects on PVC pain, anxiety, and satisfaction level of patients undergoing surgery.     

Effectiveness of acupuncture on pregnancy success rates for women undergoing in vitro fertilization: A randomized controlled trial

ObjectiveTo investigate the effect of acupuncture on pregnancy success rates applied before and after embryo transfer (ET) among women undergoing in vitro fertilization (IVF).Materials and methodsIn this randomized controlled trial, 72 infertile women undergoing IVF were randomized to acupuncture (AG; n = 36) and control group (CG; n = 36). Three sessions of acupuncture were applied to AG, the first was one week before ET, the second was 30 min before ET, and the third was 30 min after ET. CG received no acupuncture. The primary outcome was pregnancy success rate (Beta-HCG level, clinical pregnancy, ongoing pregnancy, live birth). Secondary outcome was anxiety level (STAI-1 state anxiety scale). Beta-HCG levels were assessed for conception 12 days after ET. Additionally, STAI-1 state anxiety scale was administered 30 min before and after ET to measure anxiety levels in both groups.ResultsThe mean age was 30.9 ± 3.7 years. Positive Beta HCG was detected in 63.9% (n = 23) of the AG and 33.3% (n = 12) of CG (p = 0.009). Clinical pregnancy, ongoing pregnancy, and live birth rates were higher in AG (p < 0.05). There was no difference between the groups concerning anxiety scores before ET (p > 0.05). The mean STAI-1 score was decreasing from 57.3 ± 9.8 to 28.8 ± 3.3 in AG, while it was decreasing from 57.0 ± 8.0 to 41,1 ± 6,8 in CG after ET (p < 0.000).ConclusionsIt was observed that three sessions of acupuncture before and after ET significantly increased the pregnancy rates in women with unexplained infertility. It was also found that acupuncture significantly reduced anxiety levels that occurred before ET.     

Biochemical and psychometric evaluation of Self-Healing Qigong as a stress reduction tool among first year nursing and midwifery students

BackgroundQigong, a traditional Chinese exercise, has a potential role in the management of stress.ObjectiveTo examine the influence of Qigong training on depression, anxiety and stress.DesignA randomised control trial among first year student participants.MethodsQigong was practised twice a week by the study group (n = 18) while a control group (n = 16) had no intervention. The Depression, Anxiety and Stress (DASS-21) and Patient Health Questionnaires (PHQ) were administered. Salivary biomarkers were also measured over a 10-week period.ResultsAfter 10 weeks, only the Qigong group showed a statistically significant improvement in their depression, anxiety and stress scores. Similarly, increases in secretion rates of salivary immunoglobulin-A, and decreases in salivary cortisol concentrations were seen only in the Qigong group.ConclusionsThe practice of Qigong improves psychological states and mucosal immunity; as indicated by psychometric tests and biochemical markers of stress.     

Effects of baduanjin exercise on blood glucose,depression and anxiety among patients with type II diabetes and emotional disorders: A meta-analysis

BackgroundDiabetes mellitus (DM) is a group of metabolic disorders reflected by high blood glucose levels and lack of hormone insulin. Notably, T2DM patients are three times more likely to report depression than the general population. Conventional exercise training programs have been shown to be beneficial for T2DM, but less is known regarding the effects of Baduanjin exercise on hemoglobin A1c (HbA1c) and psychological measures among this unique group. Therefore, this systematic review and meta-analysis aimed to investigate the effects of Baduanjin exercise on HbA1c, depression, and anxiety among type 2 diabetes mellitus (T2DM) patients with emotional disorders.MethodsThe potential literature was searched from six electronic databases (PubMed, MEDLINE, CINAHL, Scopus, Wanfang, and CNKI) from their inception to July 2022. The randomized controlled studies that investigated the effects of Baduanjin on HbA1c, depression , and anxiety in T2DM with emotional disorders were included. The effect sizes were calculated using the random-effect models with a 95% confidence interval (CI). The Physiotherapy Evidence Database (PEDro) scale was employed to assess the study quality.ResultsEleven studies involving 755 T2DM participants with emotional disorders were analyzed in this study. The pooled results showed that Baduanjin had significant improvements in HbA1c (SMD = 0.75, 95% CI 0.46 to 1.04, p < 0.001), depression (SMD = 0.69, 95% CI 0.30 to 1.08, p < 0.01) and anxiety (SMD = 0.98, 95% CI 0.44 to 1.53, p < 0.01) compared to the control group.ConclusionFindings suggest that Baduanjin exercise may effectively alleviate HbA1c, depression, and anxiety among T2DM patients with emotional disorders. However, more well-designed studies are required to further substantiate the promising findings.     

Effect of yoga on cognitive functions and anxiety among female school children with low academic performance: A randomized control trial

BackgroundTo achieve better academic performance, students should improve their cognitive faculties and overcome anxiety. Therefore, the present research was conducted to assess the effect of yoga on the cognitive functions of female adolescents with low academic performance.MethodsThe present study is a randomized control trial (RCT). Eighty-nine female students in the age range of 12–14 years were randomly assigned into two groups [yoga (n = 45); physical exercise (n = 44)] at a school setting. Both groups were assessed before and after on Raven's standard progressive matrices (RSPM), Corsi Block Tapping Test (CBTT), Six Letter Cancellation Test (SLCT), Digit Letter Substitution Test (DLST), Stroop Color and Word Test (SCWT), and State-Trait Anxiety Inventory for Children (STAIC).ResultsFindings of the present study showed significant (p < .05) differences in scores of forward CBTT, SWCT, and SLCT in group × time interaction. Both the groups showed significant (p < .05) improvement in SLCT, backward scores of CBTT, and STAIC-T. All outcomes measured were significantly (p < .05) improved in the yoga group except STAIC-S.ConclusionYoga improves general intelligence, visuospatial working memory, and attention, as well as reduces the anxiety of students with low academic performance. Similarly, physical exercise was also found to be improving visuospatial working memory, sustained attention, and reduce trait anxiety. However, the finding of the present study indicated yoga to be more effective compared to physical exercise in regards to students' fluid intelligence and executive function. Improvement in general intelligence, visuospatial working memory, and attention is expected to positively influence students’ academic performance.     

The effect of ylang oil and lemon oil inhalation on labor pain and anxiety pregnant women: A randomized controlled trial

Backgroundand purpose: To date, there has been very limited experimental research on the impact of ylang ylang oil and lemon oil inhalation labor pain. This study was conducted to investigate the effects of aromatherapy, one of the non-pharmacological pain methods, on anxiety and labor pain in the active phase in primiparous pregnant women.MethodsA randomized controlled trial design was used in the study, which was conducted with 45 primiparous pregnant women. Volunteers were randomized into the lemon oil group (n = 15), ylang-ylang oil group (n = 15), and control group (n = 15) by using the sealed envelope method. The visual analog scale (VAS) and the state anxiety inventory were applied to the intervention and control groups before the application. After the application, the VAS and the state anxiety inventory were applied at 5–7 cm dilatation and the VAS was applied alone at 8–10 cm dilatation. The trait anxiety inventory was applied to the volunteers after delivery.ResultsThe mean pain scores at 5–7 cm dilatation in the intervention groups (lemon oil 6.90, ylang ylang oil, 7.30) were significantly lower than in the control group (9.20) (p = 0.005). There was no significant difference between the groups in terms of their mean pre-intervention and 5-7-cm-dilatation anxiety scores (p = 0.750; p = 0.663), mean trait anxiety scores (p = 0.094), and mean first-and fifth-minute Apgar scores (p = 0.051; p = 0.051).ConclusionIt was found that aromatherapy applied by inhalation at labor reduced the perception of labor pain but had no effect on anxiety.     

Anxiety as a factor influencing physiological effects of acupuncture

PurposeThis study investigated the influence of manual acupuncture on heart rate variability and the role which anxiety can play in modifying physiological outcomes.MethodAnalysis of heart rate variability (HRV) was used as a sensitive and a reliable indicator of the balance between sympathetic and parasympathetic regulation of the heartbeat. Two groups of healthy female subjects were recruited into the study. The control group (n = 30) attended one experimental session where no acupuncture treatment was used. The experimental group (n = 30) attended three sessions in which unilateral manual stimulation of acupuncture points LU7 and KD6 was performed.ResultsThe stimulation of the acupuncture points LU7 and KD6 was not associated with significant changes in HRV. Previous familiarity with acupuncture did not influence the outcomes but level of anxiety had a strong impact on physiological outcomes. Stimulation of LU7 acupuncture point counterbalanced naturally occurring sympathetic increase over time and had relaxing and harmonizing effect on the heart rhythm without influencing subjective perception of increased anxiety. Stimulation of KD6 acupuncture point had sympathetic influence on HRV in subjects with low “trait” anxiety and this influence was nullified by simultaneous stimulation of LU7 acupuncture point.ConclusionsIt seems likely that the level of anxiety can modify HRV during acupuncture treatment and up to 40 min after the treatment. Psychological factors such as anxiety level should be considered as having important influence on physiological response to acupuncture.     

Acupuncture effects on in-vitro fertilization pregnancy outcomes: A meta-analysis

BackgroundThe effects of acupuncture on in-vitro fertilization outcomes remain controversial. This study aimed to perform a meta-analysis to assess the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization.MethodsA systematic literature search up to January 2021 was performed and 29 studies included 6623 individuals undergoing in-vitro fertilization at the baseline of the study; 3091 of them were using acupuncture as an adjuvant therapy to embryo transfer, 1559 of them were using sham-controls, and 1441 of them were using no adjuvant therapy controls. They reported a comparison between the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls using the dichotomous method with a random or fixed-effect model.ResultsSignificantly higher outcomes with acupuncture were observed in biochemical pregnancy (OR, 1.98; 95% CI, 1.55–2.53, p < 0.001); clinical pregnancy (OR, 1.70; 95% CI, 1.46–1.98, p < 0.001); ongoing pregnancy (OR, 1.78; 95% CI, 1.41–2.26, p < 0.001); and live birth (OR, 1.58; 95% CI, 1.15–2.18, p = 0.005) compared to no adjuvant therapy controls. However, no significant difference were found between acupuncture and no adjuvant therapy controls in miscarriage (OR, 0.96; 95% CI, 0.48–1.92, p = 0.91).No significant difference was observed with acupuncture in biochemical pregnancy (OR, 1.16; 95% CI, 0.65–2.08, p = 0.62); clinical pregnancy (OR, 1.13; 95% CI, 0.83–1.54, p = 0.43); ongoing pregnancy (OR, 1.04; 95% CI, 0.66–1.62, p = 0.87); live birth (OR, 1.02; 95% CI, 0.73–1.42, p = 0.90), and miscarriage (OR, 1.16; 95% CI, 0.86–1.55, p = 0.34) compared to sham-controls.ConclusionsUsing acupuncture as an adjuvant therapy to embryo transfer may improve the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth outcomes compared to no adjuvant therapy controls. However, no significant difference was found between acupuncture as an adjuvant therapy to embryo transfer and sham-controls in any of the measured outcomes. This relationship forces us to recommend the use of acupuncture as adjuvant therapy in women undergoing in-vitro fertilization and inquire further studies comparing acupuncture and sham-controls to reach the best procedure.     

SIRTI and cortisol in unexplained infertile females; a cross sectional study,in Karachi Pakistan

ObjectiveTo explore a disparity in anti-oxidants (SIRT1) and pro-oxidants (cortisol) levels as a plausible cause of unexplained infertility in females.MethodologyIt was a cross sectional study in which 342 females with unexplained infertility were recruited from ACIMC outpatient clinic: 135 infertile cases and 207 fertile controls. Biochemical estimation of serum cortisol and SIRT1 was performed using Enzyme Linked Immuno Sorbent Assay. Statistical comparisons were performed using Student-t test and Mann-Whitney U test. Associations between circulating hormone levels and infertility were determined using Spearman's rank correlation. Associations were considered significant where value of p was less than 0.05.ResultsThe stress hormones profile of case and control demonstrated that the antioxidant SIRT1 was significantly lower in infertile females when compared with the fertile (p =< 0.001) while (the oxidant) Cortisol showed a contrast of results with higher values of in infertile females when compared with fertile counterparts (p =< 0.01). There was a strong negative association observed between SIRT1 and cortisol serum level (r = 0.244, p < 0.001).ConclusionChronic stress causes oxidative stress that is depicted by a decrease in antioxidant levels in infertile females.     

Effect of the Mindfulness-Based Stress Reduction program on stress,anxiety, and childbirth fear in pregnant women diagnosed with COVID-19

ObjectiveThis study aims to examine the effectiveness of a live online Mindfulness-Based Stress Reduction (MBSR) program in preventing distress, anxiety and childbirth fear in pregnant women diagnosed with COVID-19.Material and methodsDesigned as a randomized-controlled trial, this study was performed with the participation of pregnant women who were diagnosed with COVID-19. The sample comprised 84 pregnant women, including 42 in the experimental group and 42 in the control group. The online MBSR program composed of eight sessions and lasting four weeks was provided to the pregnant women in the experimental group, whereas such an initiative was not provided to the control group. The data were collected via the Revised Prenatal Distress Questionnaire (NuPDQ), the Beck Anxiety Inventory (BAI), and the Childbirth Attitudes Questionnaire (CAQ).ResultsAfter the MBSR program, the mean NuPDQ, BAI and CAQ scores of the pregnant women in the experimental group were significantly lower than the mean scores of those in the control group (p < 0.001).ConclusionThe online MBSR program may be utilized to reduce the distress, anxiety and childbirth fear levels of pregnant women diagnosed with COVID-19. By using the MBSR program, health professionals might improve the psychological well-being of pregnant women diagnosed with COVID-19.     

Is There a Relationship between Mood Disorders and Dysmenorrhea?

ObjectiveMenstrual problems are common among adolescent females. Mood changes are related to menstrual problems (menorrhagia, dysmenorrhea, and abnormal menstrual cycle length). The aim of this study was to determine the relationship between depressive symptoms, anxiety, and premenstrual syndrome (PMS) with dysmenorrhea in adolescent girls.MethodsA total of 159 adolescent girls (aged 13-19 y) with regular menstrual cycles presenting to the gynecology clinic with any complaints were included in the study during April-May 2013. All of the participants filled up the sociodemographic data collection form, FACES Pain Rating Scale, Beck anxiety inventory (BAI), Beck depression inventory (BDI), and a questionnaire form on criteria for PMS. Mann-Whitney U and chi-square tests were used to analyze the data.ResultsThe prevalence of dysmenorrhea was 67.9%. The mean BAI and BDI scores of the patients were 13.64 ± 12.81 and 11.88 ± 10.83, respectively. Statistically significant differences were observed between patients and control groups on the BAI and BDI scoring (P < .05). At least 1 of the symptoms of the PMS was detected in all of the participants and 29 (18.2%) of them were diagnosed as premenstrual dysphoric disorder (PMDD). The mean BAI score of the patients with PMS and PMDD were 9.65 ± 9.28 and 21.31 ± 15.75, respectively. The mean BDI score of the patients with PMS and PMDD were 8.39 ± 8.62 and 19.1 ± 11.85, respectively. Statistically significant differences were observed between PMS/PMDD and BAI/BDI scoring (P = .00).ConclusionAdolescent girls with dysmenorrhea have an increased risk of depression and anxiety. These results of our study are significant in emphasizing the importance of a multidisciplinary approach to primary dysmenorrhea follow-up and treatment.     

Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial

ObjectiveThe present study was conducted to determine the effect of massage on post-cesarean pain and anxiety.MethodsThe present single-blind clinical trial was conducted on 156 primiparous women undergone elective cesarean section. The participants were randomly divided into three groups, including a hand and foot massage group, a foot massage group and a control group (n = 52 per group). The patients' intensity of pain, vital signs and anxiety level were measured before, immediately after and 90 min after the massage.ResultsA significant reduction was observed in the intensity of pain immediately and 90 min after massage (P < 0.001). Moreover, changes in some of the physiological parameters, including blood pressure and respiration rate, were significant after massage (P < 0.001); however, this change was not significant for pulse rate. A significant reduction was also observed in the level of anxiety (P < 0.001) and a significant increase in the frequency of breastfeeding (P < 0.001) after massage.ConclusionAs an effective nursing intervention presenting no side-effects, hand and foot massage can be helpful in the management of postoperative pain and stress.     

Effect of integrated yoga on anxiety,depression & well being in normal pregnancy

ObjectiveTo study the effect of integrated yoga on Pregnancy experience, anxiety, and depression in normal pregnancy.MethodsThis Prospective Randomized control study recruited 96 women in 20th week of normal pregnancy. Yoga group (n = 51) practiced integrated yoga and control group (n = 45) did standard antenatal exercises, one hour daily, from 20th to 36th week of gestation. Mann–Whitney and Wilcoxon's tests were used for statistical analysis.ResultsThere was significant difference between groups (Mann–Whitney p < 0.001) in all variables. There were significant changes within groups (Wilcoxon's p < 0.001) in both groups. Pregnancy related experience (PEQ) reduced in yoga by 26.86%, State (STAI I) anxiety (decreased 15.65% in yoga, increased 13.76% in control), Trait (STAI II) anxiety (decreased 8.97% in yoga, increased 5.02% in control) and Depression (HADS) (decreased 30.67% in yoga, increased 3.57% in control).ConclusionYoga reduces anxiety, depression and pregnancy related uncomfortable experiences.     

Music for anxiety reduction in patients undergoing cardiac catheterization: A systematic review and meta-analysis of randomized controlled trials

BackgroundMedical diagnostic procedures, such as cardiac catheterization, can cause significant patient anxiety. Patient anxiety can have negative implications for compliance with healthcare visits, medical tests, and treatments. Music interventions may have a role in reducing anxiety related to cardiac catheterization procedures.ObjectiveTo perform a comprehensive systematic review and meta-analysis evaluating whether musical interventions reduce anxiety in patients undergoing cardiac catheterization.Data sourcesMEDLINE, EMBASE, CENTRAL, AMED, and PsychINFO from inception to May 2015. Reference lists of included articles were further hand searched for additional eligible studies.Study selectionRandomized controlled trials evaluating the effectiveness of music interventions for anxiety reduction in patients undergoing cardiac catheterization.Data extraction and synthesisData on trial design, baseline characteristics and outcomes was extracted using a data extraction table. Study quality and risk of bias were assessed using the JADAD scale.Main outcomes and measuresThe main outcome was the effectiveness of music interventions in reducing anxiety in this patient population. Meta-analysis was pursued using data from studies that had used the Spielberger state anxiety inventory (STAI-S) to measure anxiety reduction. Other outcomes qualitatively reported include the use of anxiolytic medications and effect on physiological parameters such as blood pressure and heart rate.ResultsA total of 15 studies were found to be eligible for inclusion (14 published trials and one conference abstract) in this review. Two-thirds of these studies showed statistically significant reduction in measures of patient anxiety or well-being with musical interventions. Meta-analysis included six studies (n = 695) and showed statistically significant reduction in mean STAI-S scores with music (−3.95 points; 95% confidence −5.53 and −2.37; p value less than 0.005).Conclusion and relevanceIn conclusion, music is a safe and easily administered intervention that can be used for anxiety reduction among patients undergoing cardiac catheterization. Further research is needed to better evaluate the clinical implications associated with the anxiolytic effects of music interventions during cardiac catheterization.     

Acupuncture for the treatment of trigeminal neuralgia: A systematic review and meta-analysis

Background and purposeFew systematic reviews have examined the effects of acupuncture on trigeminal neuralgia. This review aims to provide up-to-date evidence on the efficacy of acupuncture for managing pain in patients with trigeminal neuralgia.MethodsEleven databases were searched from inception until November 2022 for relevant articles Two researchers independently conducted study selection, data extraction, and evaluation. The present review solely targeted randomized controlled trials (RCTs). The Cochrane risk of bias assessment tool 2.0 was employed to assess the risk of bias. Data were compiled using RevMan 5.4.1 software, and the quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.ResultsThirty studies involving 2295 patients were included in this review. Compared with carbamazepine, acupuncture led to improvements in pain scores (15 RCTs, mean difference (MD) - 1.40, 95% confidence interval (CI)-1.82 to −0.98 [95% prediction interval, −3.137,0.343], p < 0.00001, low certainty of evidence (CoE)), response rates (29 RCTs, risk ratio (RR) 1.20, 95% CI 1.15 to 1.25 [95% prediction interval, 1.067, 1.346], p < 0.00001, low CoE), frequency of pain attacks (2 RCTs, MD -2.53, 95% CI -4.11 to −0.96, P = 0.002, low CoE), and adverse effects (13 RCTs, risk difference (RD) −0.15, 95% CI -0.19 to −0.11 [95% prediction interval, −0.193, −0.108], P < 0.00001, very low CoE).ConclusionAlthough the quality of evidence is low, compared with carbamazepine, acupuncture may improve trigeminal neuralgia-related pain. Further rigorously designed studies are warranted to confirm the effects of acupuncture on patients with trigeminal neuralgia.     

Self-Concept,Depression, and Anxiety Levels of Adolescents with Polycystic Ovary Syndrome

Study ObjectiveIn this study we explored the level and severity of issues related to self-concept, depression, and anxiety in adolescents with polycystic ovary syndrome (PCOS).DesignCross-sectional and case-control study.SettingThe research was conducted in the outpatient Pediatric Endocrinology Clinic of Adiyaman University School of Medicine in Turkey.ParticipantsThe study population comprised 153 patients with PCOS and 161 healthy adolescents.Interventions and Main Outcome Measures: The Personal Information Form, State-Trait Anxiety Inventory for Children, Children's Depression Inventory, and Piers-Harris Children's Self-Concept Scale were administered to all of the participants who took part in the study.ResultsThe Piers-Harris Children's Self-Concept Scale scores were lower in the PCOS group than in the control group (P < .001). In addition, the scores for the Children's Depression Inventory were also significantly higher in the PCOS group (P < .001). The State-Trait Anxiety Inventory for Children scores showed statistically significant higher levels of state anxiety and trait anxiety in the PCOS group (P < .001).ConclusionAdolescents with PCOS had lower self-concept scores, greater anxiety levels, and increased depressive symptoms than the healthy controls. Future studies are needed to examine the psychiatric problems in adolescents with PCOS.     

Efficacy of add-on Ayurveda and Yoga intervention in health care workers of tertiary care hospital during COVID-19: Randomized controlled trial

BackgroundThe present study aimed to evaluate the safety and prophylactic efficacy of add-on Comprehensive Ayurveda and mindfulness-based Yoga (CAY) regimen to standard care among HealthCare Workers (HCWs) against COVID-19.Materials and methodsThis prospective single-blind (outcome assessor-blinded) RCT was conducted in tertiary care hospital in Delhi during July 2020–April 2021. HCWs of both sexes were randomized to add-on CAY intervention or control group. The primary outcomes were the incidence of confirmed COVID-19 positive cases and influenza-like illness events (ILI). Secondary outcomes were anxiety (GAD-7), depression (PHQ-9), and quality of life (SF-36) at the end of 12 weeks.ResultsThree hundred fifty-six participants (181 in intervention and 175 in the control group) were randomized. With the modified intention to treat approach, we analyzed 309 participants. The mean age for the intervention and control group was 39.3 ± 10.1 and 36.6 ± 10 years, respectively. Incidence of COVID-19 event was higher in control group compared to CAY group (16 of 164 [9.8%] vs. 11 of 145 [7.6%]; P = 0.50). The incidence of ILI events was also higher in the control group as compared to the CAY group (14 of 164 [8.5%] vs 9 of 145 [6.2%]). The health change domain of the SF-36 questionnaire showed statistically significant improvement in the CAY group as compared to the control group (P < 0.01).ConclusionIncidence of COVID-19 and ILI events was lower in the CAY group compared with the contr ol group, though the difference is not statistically significant.