Breastfeeding has been shown to benefit both maternal and child immune status. The impact of exclusive breastfeeding in the presence of HIV infection on maternal and child health is still unclear. Socio-economic factors make breast-feeding an important source of nutrition for an infant 6 months and under in the developing world. A prospective study was conducted to examine the impact of feeding mode on various maternal indices including anthropometry; body composition indicators (using FTIR); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. In infants we examined the impact on growth, development and morbidity. AFASS criteria (affordable, feasible, accessible, sustainable and safe) were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (P = 0.043). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (P = 0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development scores and growth parameters. Breastfeeding is not harmful to the mother in the presence of HIV infection. Mothers are still choosing formula feeding inappropriately despite counselling about the AFASS criteria. Breastfeeding is beneficial to the infants especially in the first 3 months of life.

The worldwide prevalence of childhood asthma has been increasing considerably, and the protection afforded by breastfeeding in its development has been the subject of controversy for more than 80 years. Previous systematic reviews have generally found a protective effect of breastfeeding on allergic outcomes, although many studies have methodological limitations. Although breastfeeding is protective against lower respiratory tract infection during infancy, such protection has not been demonstrated for asthma in all studies. Breastfeeding has health benefits for the mother and child. Exclusive breastfeeding for the first 6 months of an infant's life, with continued breastfeeding for up to 2 years or longer, is recognized as the"gold"standard for infant feeding because human milk is uniquely suited to the human infant, and its nutritional content and bioactivity promote a healthy development. There is increasing concern that the practice of delaying complementary foods until 6 months may exacerbate the risk of allergic disease. Breast milk contains immunological components that protect against infections and allergic disease in infancy. The composition of human breast milk is complex, containing factors that interact with the infant immune system and intestinal milieu including allergens, cytokines, immunoglobulins, polyunsaturated fatty acids, and chemokines. Transforming growth factorβ is a cytokine in human milk involved in maintaining intestinal homeostasis, inflammation regulation, and oral tolerance development. Modern day society, with increased standards of hygiene, has changed the gut flora of Western infants, potentially impacting the risk of developing immune-mediateddiseases including allergic disease and asthma. Microbial diversity is intrinsic to healthy immune maturation and function. Compared to breastfed infants, formula-fed infants had lower bacterial diversity and an altered intestinal microbiota in the first few weeks of life associated with an increased risk of eczema and asthma. Favorable gut colonization through continued breastfeeding may promote tolerance as well as protection when complementary feeding is initiated.

Anxiety and trauma-related disorders are psychiatric diseases with a lifetime prevalence of up to 25%. Phobias and post-traumatic stress disorder (PTSD) are characterized by abnormal and persistent memories of fear-related contexts and cues. The effects of psychological treatments such as exposure therapy are often only temporary and medications can be ineffective and have adverse side effects. Growing evidence from human and animal studies indicates that cannabidiol, the main non-psychotomimetic phytocannabinoid present in Cannabis sativa, alleviates anxiety in paradigms assessing innate fear. More recently, the effects of cannabidiol on learned fear have been investigated in preclinical studies with translational relevance for phobias and PTSD. Here we review the findings from these studies, with an emphasis on cannabidiol regulation of contextual fear. The evidence indicates that cannabidiol reduces learned fear in different ways: (1) cannabidiol decreases fear expression acutely, (2) cannabidiol disrupts memory reconsolidation, leading to sustained fear attenuation upon memory retrieval, and (3) cannabidiol enhances extinction, the psychological process by which exposure therapy inhibits learned fear. We also present novel data on cannabidiol regulation of learned fear related to explicit cues, which indicates that auditory fear expression is also reduced acutely by cannabidiol. We conclude by outlining future directions for research to elucidate the neural circuit, psychological, cellular, and molecular mechanisms underlying the regulation of fear memory processing by cannabidiol. This line of investigation may lead to the development of cannabidiol as a novel therapeutic approach for treating anxiety and trauma-related disorders such as phobias and PTSD in the future.

ABSTRACT: Celiac Disease (CD) occurs in patients with Type 1 Diabetes (T1D) ranging the prevalence of 4.4-11.1% versus 0.5% of the general population. The mechanism of association of these two diseases involves a shared genetic background: HLA genotype DR3-DQ2 and DR4-DQ8 are strongly associated with T1D, DR3-DQ2 with CD. The classical severe presentation of CD rarely occurs in T1D patients, but more often patients have few/mild symptoms of CD or are completely asymptomatic (silent CD). In fact diagnosis of CD is regularly performed by means of the screening in T1D patients. The effects of gluten-free diet (GFD) on the growth and T1D metabolic control in CD/T1D patient are controversial. Regarding of the GFD composition, there is a debate on the higher glycaemic index of gluten-free foods respect to gluten-containing foods; furthermore GFD could be poorer of fibers and richer of fat. The adherence to GFD by children with CD-T1D has been reported generally below 50%, lower respect to the 73% of CD patients, a lower compliance being more frequent among asymptomatic patients. The more severe problems of GFD adherence usually occur during adolescence when in GFD non compliant subjects the lowest quality of life is reported. A psychological and educational support should be provided for these patients.

In this study, the structure characteristic of the Hericium erinaceus polysaccharide (HEP) was investigated using Fourier transformed infrared spectrometry (FT-IR), gas chromatography-mass spectrometry (GC-MS), gel permeation chromatography (GPC), methylation and nuclear magnetic resonance (NMR). The results showed that HEP, with a molecular weight of 43 KDa, was mainly composed of glucose and rhamnose. The linkages of the sugar residues of HEP were → 6) β-d-Glcp-(1 → and → 2) -α-l-Rhap-(1 → residue at the end of the branches. The Fusarium toxin deoxynivalenol (DON)-induced cellular injury model for IPEC-J2 cells was established and used to investigate the protective effects of HEP against the oxidative stress. The results suggest that HEP could significantly protect IPEC-J2 cells from DON-induced oxidative stress, inhibit DON-induced apoptosis and reduce the production of reactive oxygen species (ROS). Overall, this study suggested that HEP could be explored as potential antioxidant agents for DON-induced intestinal mucosa injury.

Macrophagic myofasciitis has been almost exclusively detected in adults only. We describe six children of Arab Moslem origin with this disorder. Three presented with hypotonia, developmental delay and seizures and were evaluated for a mitochondrial disorder. The other three children had hypotonia and predominantly motor delay. Five of the six families were consanguineous. A massive collection of macrophages was present in the fascia and adjacent epimysium in all biopsies. The macrophages were periodic-acid-Schiff positive and immunoreactive for CD68. One biopsy which was evaluated by electron microscopy and energy-dispersive X-ray microanalysis showed crystalline structures containing aluminum in macrophages. Two children with motor delay and hypotonia were treated with oral prednisone for 3 months with no clinical improvement. Genetic predisposition probably accounts for the variability in the prevalence of macrophagic myofasciitis in different populations. At least in childhood, there seems to be no connection between macrophagic myofasciitis as a pathological entity and the clinical symptoms and signs.

OBJECTIVE:To compare the difference in the clinical efficacy on infantile Tourette syndrome between the integrated therapy of acupuncture and pingganjianpi decoction and haloperidol tablets.

METHODS:Forty-seven children were randomized into an observation group (25 cases) and a control group (22 cases). In the observation group, acupuncture was applied to Taichong (LR 3), Baihui (GV 20), Zhongwan (CV 12), Zusanli (ST 36), etc. The needles were retained for 30 min. Acupuncture was given once a day and there were 5 days at intervals after 10 times of acupuncture. Additionally, pinggan jianpi decoction was prescribed. In the control group, haloperidol tablets were prescribed, starting from the small dose, 0. 05 mg/kg per day, twice a day. The treatment of 30 days made one session and 3 sessions were required. Yale global tic severity scale (YGTSS) was adopted to observe tic time, tic frequency and tic severity score before treatment and in 30 days, 60 days and 90 days after treatment in the two groups. The efficacy and adverse reactions were compared between the two groups.

RESULTS:The total effective rates were 40. 0% (10/25), 64.0% (16/25) and 76.0% (19/25) in the observation group and were 59.1% (13/22), 68.2% (15/22) and 77.3% (17/22) in the control group in 30 days, 60 days and 90 days after treatment respectively. The effect in 30 days after treatment in the control group was better than that in the observation group (P<0. 05). The differences at the other time points were not significant between the two groups (all P>0. 05). The tic time, tic frequency and tic severity score at the each time point after treatment were reduced obviously as compared with those before treatment (all P<0. 05). Each item score in the control group was reduced obviously as compared with that in the observation group in 30 days after treatment (all P<0. 05). The differences at the other time points were not significant between the two groups (all P>0.05). The probability of adverse reaction in the observation group was less than that in the control group.

CONCLUSION:The integrated therapy of acupuncture and medicine achieves the similar effect on infantile Tourette syndrome to haloperidol tablets and the side effects of it are less.

OBJECTIVE:To compare the difference in the clinical efficacy on infantile Tourette syndrome between the integrated therapy of acupuncture and pingganjianpi decoction and haloperidol tablets.

METHODS:Forty-seven children were randomized into an observation group (25 cases) and a control group (22 cases). In the observation group, acupuncture was applied to Taichong (LR 3), Baihui (GV 20), Zhongwan (CV 12), Zusanli (ST 36), etc. The needles were retained for 30 min. Acupuncture was given once a day and there were 5 days at intervals after 10 times of acupuncture. Additionally, pinggan jianpi decoction was prescribed. In the control group, haloperidol tablets were prescribed, starting from the small dose, 0. 05 mg/kg per day, twice a day. The treatment of 30 days made one session and 3 sessions were required. Yale global tic severity scale (YGTSS) was adopted to observe tic time, tic frequency and tic severity score before treatment and in 30 days, 60 days and 90 days after treatment in the two groups. The efficacy and adverse reactions were compared between the two groups.

RESULTS:The total effective rates were 40. 0% (10/25), 64.0% (16/25) and 76.0% (19/25) in the observation group and were 59.1% (13/22), 68.2% (15/22) and 77.3% (17/22) in the control group in 30 days, 60 days and 90 days after treatment respectively. The effect in 30 days after treatment in the control group was better than that in the observation group (P<0. 05). The differences at the other time points were not significant between the two groups (all P>0. 05). The tic time, tic frequency and tic severity score at the each time point after treatment were reduced obviously as compared with those before treatment (all P<0. 05). Each item score in the control group was reduced obviously as compared with that in the observation group in 30 days after treatment (all P<0. 05). The differences at the other time points were not significant between the two groups (all P>0.05). The probability of adverse reaction in the observation group was less than that in the control group.

CONCLUSION:The integrated therapy of acupuncture and medicine achieves the similar effect on infantile Tourette syndrome to haloperidol tablets and the side effects of it are less.

BACKGROUND:Studies on alternative medicines for generalized anxiety disorder (GAD) are few. Manasamitra Vataka (an Ayurveda preparation) is explored for its efficacy in patients with GAD with comorbid generalized social phobia.

MATERIALS AND METHODS:Seventy-two (72) patients with GAD with comorbid social phobia meeting DSM IV TR criteria, and who were between the ages of 20 and 55 of either sex, participated in the study. They were randomly divided into three treatment groups: Group 1 (n=24) and Group II (n=24) received Manasamitra Vataka tablets (100 mg twice daily for 30 days). Group II, in addition to Manasamitra Vataka, underwent Shirodhara (therapy involving dripping of medicated oil [Brahmi tail] over the forehead) treatment for the first 7 days. Group III (n=24) received clonazepam 0.75 mg daily in divided dose for 30 days. The assessment of the study was done using the Hamilton Anxiety Rating Scale, Beck Anxiety Inventory, Beck Depression Inventory, Epworth Sleepiness Scale (ESS), World Health Organization Quality of Life BREF, and Clinical Global Impression scales (Improvement and Efficacy).

RESULTS:Patients from all the groups showed significant reduction in clinical parameters evaluated. However, improvement in ESS was observed only in Group II. The treatment outcome was comparable between the three groups.

CONCLUSIONS:This is the first study conducted on the efficacy of Manasamitra Vataka in anxiety disorders. The results suggest that Manasamitra Vataka is effective in the management GAD with comorbid generalized social phobia. Add-on effect of Shirodhara reduced the daytime sleepiness. Further studies on Manasamitra Vataka need to be carried out to judge its potential as a first-line treatment modality.

BACKGROUND:Celiac disease (CD) is an autoimmune disorder, characterized by the presence of gastrointestinal and multisystem symptoms, which occasionally mimic those of Irritable Bowel Syndrome (IBS) and Fibromyalgia Syndrome (FMS). To assess the effectiveness of a Gluten-Free Diet (GFD) in seven adult female screening-detected CD subjects, categorized as severe IBS and FMS patients.

METHODS:All subjects showed villous atrophy in duodenal biopsies, were HLA-DQ2/DQ8-positive, and fulfilled the Rome III and ACR 1990 criteria respectively for IBS and FMS classification. GFD effectiveness was assessed at baseline and after 1 year, examining the score changes in the Tender Points (TPs) test, Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Visual Analogue Scales (VAS) for gastrointestinal complaints, pain and tiredness, drug prescriptions and tissue-Trans-Glutaminase (tTG) serum levels.

RESULTS:At baseline, all patients had poor Quality of Life and VAS scores, a high number of TPs and drug prescriptions, and increased tTG levels. After 1 year of GFD, all outcome measures significantly improved, with a decrease of 51-60% in TPs, FIQ, HAQ, and VAS scales, and in the number of prescribed drugs, accompanied by an increase of 48-60% in SF-36 Physical and Mental Component Summary scores, and a decrease of tTG to normal values.

CONCLUSION:Results of this pilot study show that the adherence to a GFD by CD-related IBS/FMS patients can simultaneously improve CD and IBS/FMS symptoms, and indicate the merit of further research on a larger cohort.

OBJECTIVE:To observe the clinical effect of acupuncture for depression and to discuss its impact on the content of 5-HT in patients with depression.

METHODS:Eighty patients with depression were randomly divided into an acupuncture group and a western medication group,40 cases in each one. Acupuncture was applied in the acupuncture group,Siman(KI 14),Shenshu(BL 23),Guanyuan(CV 4),Dazhui(GV 14),Yinlingquan(SP 9), Zusanli(ST 36),Taichong(LR 3),Yanglingquan(GB 34) and Jingming(BL 1) were selected, the intensive moxibustion was applied at G(uanyuan(CV 4). Fluoxetine was treated with oral administration in the western medication group. The treatments of six weeks were required in each group. The Hamilton depression rating scale (HAMD) was applied to evaluate efficacy and serum 5-HT was detected before and after treatment in the two groups.

RESULTS:After treatment,the scores of HAMD were decreased obviously in the two groups compared with those before treatment (scores in the acupuncture group: 24. 48± 0. 28 vs 8. 95 ± 2. 24; scores in the western medication group: 24. 14±0. 24 vs 10. 29±1. 30),and the differences were statistically significant (both P<0. 05). Between the two groups,the scores of HAMD in the acupuncture group at the end of the lst,2nd,4th,6th weeks were superior to those in the western medication group (all P<0. 05). The content of serum 5-HT after treatment was increased markedly compared with that before treatment [the content in the acupuncture group: (26. 21 2. 36)pg/mL vs (52. 07± 0. 56)pg/mL, the content in the western medication group:(26. 26±2. 31)pg/mL vs (51. 70±0. 52)pg/ mL, both P<0. 05]. But there was no statistic significance between the two groups(P>0.05).

CONCLUSION:The efficacy of acupuncture for depression is superior to that of western medication with fluoxetine.

OBJECTIVE:To observe the clinical effect of acupuncture for depression and to discuss its impact on the content of 5-HT in patients with depression.

METHODS:Eighty patients with depression were randomly divided into an acupuncture group and a western medication group,40 cases in each one. Acupuncture was applied in the acupuncture group,Siman(KI 14),Shenshu(BL 23),Guanyuan(CV 4),Dazhui(GV 14),Yinlingquan(SP 9), Zusanli(ST 36),Taichong(LR 3),Yanglingquan(GB 34) and Jingming(BL 1) were selected, the intensive moxibustion was applied at G(uanyuan(CV 4). Fluoxetine was treated with oral administration in the western medication group. The treatments of six weeks were required in each group. The Hamilton depression rating scale (HAMD) was applied to evaluate efficacy and serum 5-HT was detected before and after treatment in the two groups.

RESULTS:After treatment,the scores of HAMD were decreased obviously in the two groups compared with those before treatment (scores in the acupuncture group: 24. 48± 0. 28 vs 8. 95 ± 2. 24; scores in the western medication group: 24. 14±0. 24 vs 10. 29±1. 30),and the differences were statistically significant (both P<0. 05). Between the two groups,the scores of HAMD in the acupuncture group at the end of the lst,2nd,4th,6th weeks were superior to those in the western medication group (all P<0. 05). The content of serum 5-HT after treatment was increased markedly compared with that before treatment [the content in the acupuncture group: (26. 21 2. 36)pg/mL vs (52. 07± 0. 56)pg/mL, the content in the western medication group:(26. 26±2. 31)pg/mL vs (51. 70±0. 52)pg/ mL, both P<0. 05]. But there was no statistic significance between the two groups(P>0.05).

CONCLUSION:The efficacy of acupuncture for depression is superior to that of western medication with fluoxetine.

OBJECTIVE:To compare the differences in the clinical efficacy on Alzheimer's disease between acupuncture and medicine.

METHODS:One hundred and forty-one patients were randomized into an acupuncture group (72 cases) and a medicine group (69 cases). In the acupuncture group, the needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence was used at Shenting (GV 24), Baihui (GV 20), Fengchi (GB 20), Wangu (GB 12), Danzhong (CV 17), Zhangwan (CV 12), Qihai (CV 6), Xuehai (SP 10) and Zusanli (ST 36). The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was given once a day and 6 treatments were required for a week. In the medicine group, the choline sterase inhibitor, donepezil (aricept) was prescribed for oral administration, 1 tablet (5 mg) each time, once every night. Four weeks later, the dose was increased to 2 tablets (10 mg) each time. In the two groups, the treatment of 4 weeks made one session and 4 sessions were required. The changes of scores before and after treatment in the minimum mental state examination (MMSE), the activity of daily living scale (ADL), Alzheimer's disease assessment scale-cognition (ADAS-cog) and the digit span (DS) were observed.

RESULTS:After treatment, scores of MMSE and DS were increased as compared with those before treatment (both P<0.05) and scores of ADL and ADAS-cog were reduced as compared with those before treatment. The score differences in MMSE, ADL, ADAS-cog and DS before and after treatment were significant in the two groups (all P<0.01).

CONCLUSION:The needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence significantly improves the overall function, cognition and activity of daily life in the patients of Alzheimer's disease and the efficacy is better than donepezil.

OBJECTIVE:To compare the differences in the clinical efficacy on Alzheimer's disease between acupuncture and medicine.

METHODS:One hundred and forty-one patients were randomized into an acupuncture group (72 cases) and a medicine group (69 cases). In the acupuncture group, the needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence was used at Shenting (GV 24), Baihui (GV 20), Fengchi (GB 20), Wangu (GB 12), Danzhong (CV 17), Zhangwan (CV 12), Qihai (CV 6), Xuehai (SP 10) and Zusanli (ST 36). The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was given once a day and 6 treatments were required for a week. In the medicine group, the choline sterase inhibitor, donepezil (aricept) was prescribed for oral administration, 1 tablet (5 mg) each time, once every night. Four weeks later, the dose was increased to 2 tablets (10 mg) each time. In the two groups, the treatment of 4 weeks made one session and 4 sessions were required. The changes of scores before and after treatment in the minimum mental state examination (MMSE), the activity of daily living scale (ADL), Alzheimer's disease assessment scale-cognition (ADAS-cog) and the digit span (DS) were observed.

RESULTS:After treatment, scores of MMSE and DS were increased as compared with those before treatment (both P<0.05) and scores of ADL and ADAS-cog were reduced as compared with those before treatment. The score differences in MMSE, ADL, ADAS-cog and DS before and after treatment were significant in the two groups (all P<0.01).

CONCLUSION:The needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence significantly improves the overall function, cognition and activity of daily life in the patients of Alzheimer's disease and the efficacy is better than donepezil.

OBJECTIVE:To observe the clinical effect of acupuncture therapy combined with Lipitor in the treatment of primary hyperlipidemia (spleen deficiency and food stagnation type).

METHODS:Sixty primary hyperlipidemia patients (spleen deficiency and food stagnation type) were equally randomized into medication group and acupuncture plus medication group. Patients of both groups were treated by oral administration of Lipitor (20 mg/tablet, one tablet per day) for 6 weeks. Manual acupuncture stimulation was applied to Baihui (GV 20), Zhongwan (CV 12), and bilateral Zusanli (ST 36), Sanyinjiao (SP 6), Yin-lingquan (SP 9) and Fenglong (ST 40) for 40 min, twice daily for 6 weeks except the weekends. Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) were detected by using a full-automatic biochemistry analyzer before and after the treatment. The therapeutic effect was assessed according to the standards described in"Guide Principles for Clinical Researches of New Chinese Herbal Drugs".

RESULTS:After the treatment, the levels of serum TC, TG of the two groups were significantly decreased in comparison with pre-treatment in the same one group (P<0.05), and the therapeutic effect of the acupuncture+medication group was significantly superior to that of simple medication group in lowering serum TC, TG and LDL-C levels and heightening HDL-C levels (P<0.05). Of the two 30 cases in the medication and acupuncture+medication groups, 2 (6.7%) and 7 (23.3%) were basically controlled in their blood-lipid levels, 10 (33.3%) and 15 (50.0%) had a marked improvement, 10 (33.3%) and 6 (20.0%) were improved, and 8 (26.7%) and 2 (6.7%) were invalid, with the effective rates being 73.3% and 93.3%, respectively.

CONCLUSION:Acupuncture combined with administration of Lipitor is effective in improving primary hyperlipidemia in patients, which is superior to administration of simple Lipitor.

OBJECTIVE:To observe the clinical effect of acupuncture therapy combined with Lipitor in the treatment of primary hyperlipidemia (spleen deficiency and food stagnation type).

METHODS:Sixty primary hyperlipidemia patients (spleen deficiency and food stagnation type) were equally randomized into medication group and acupuncture plus medication group. Patients of both groups were treated by oral administration of Lipitor (20 mg/tablet, one tablet per day) for 6 weeks. Manual acupuncture stimulation was applied to Baihui (GV 20), Zhongwan (CV 12), and bilateral Zusanli (ST 36), Sanyinjiao (SP 6), Yin-lingquan (SP 9) and Fenglong (ST 40) for 40 min, twice daily for 6 weeks except the weekends. Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) were detected by using a full-automatic biochemistry analyzer before and after the treatment. The therapeutic effect was assessed according to the standards described in"Guide Principles for Clinical Researches of New Chinese Herbal Drugs".

RESULTS:After the treatment, the levels of serum TC, TG of the two groups were significantly decreased in comparison with pre-treatment in the same one group (P<0.05), and the therapeutic effect of the acupuncture+medication group was significantly superior to that of simple medication group in lowering serum TC, TG and LDL-C levels and heightening HDL-C levels (P<0.05). Of the two 30 cases in the medication and acupuncture+medication groups, 2 (6.7%) and 7 (23.3%) were basically controlled in their blood-lipid levels, 10 (33.3%) and 15 (50.0%) had a marked improvement, 10 (33.3%) and 6 (20.0%) were improved, and 8 (26.7%) and 2 (6.7%) were invalid, with the effective rates being 73.3% and 93.3%, respectively.

CONCLUSION:Acupuncture combined with administration of Lipitor is effective in improving primary hyperlipidemia in patients, which is superior to administration of simple Lipitor.

Coeliac disease, epilepsy and cerebral calcifications (CEC) syndrome is a rare clinical condition. One hundred and seventy-one patients have been reported in the literature. Patients are mostly from Italy, Spain, and Argentina, suggesting a geographically restricted condition. Epilepsy is more frequently characterized by occipital seizures. It may be benign or drug-resistant, sometime evolving into severe epileptic encephalopathy. Gluten free diet (GFD) efficacy seems to be inversely related to the duration of epilepsy and the young age of the patient. Patients with cerebral calcifications (CC) and coeliac disease (CD) without epilepsy are considered as having an incomplete form of CEC syndrome. Some patients with epilepsy and CC without CD are supposed to have a CEC syndrome with silent or latent CD. Whether CEC syndrome is a genetic condition, or whether epilepsy and/or CC are a consequence of an untreated CD is unknown yet. Since histopathological findings seem to be the expression of vascular calcified malformation, CEC syndrome may be considered a genetically determined entity, such as a type of Sturge-Weber-like phacomatosis. Moreover, CEC, as well as CD, is associated with HLA-DQ2 and HLA-DQ8 phenotype and genotype. The progressive growth and late occurrence of CC before beginning a GFD, the demonstration of anti-gliadin antibodies in the cerebro-spinal fluid and the association with HLA class II genes, suggest that an immune reaction originating from the jejunal mucosa, triggered by gliadin in gluten intolerance predisposed subjects (HLA phenotype) may be responsible for seizures and CC. Moreover, a long-lasting untreated CD folic acid deficiency may cause calcifications. Probably, CEC is considered a genetic, non-inherited, ethnically and geographically restricted syndrome associated with environmental factors.

Migraine is a painful condition in which patients suffer from recurrent episodes of disabling pain, which could be very severe and can lead to grave psychological disturbances. There is no curative treatment for migraine, but there are various treatment modalities, though, with conflicting reports on their efficacy. This study was conducted to compare the effectiveness of electro acupuncture therapy and the conventional drug therapy on the psychological profile of migraneurs based on the assessment of quality of life and disability parameters. Migraneurs (n = 60) were recruited from the Psychiatry and Neurology OPD, Guru Tegh Bahadur Hospital, Delhi. Following a written consent, migraneurs were randomly allocated into 2 study groups--Group A received 10 sittings of electro acupuncture on selected acupuncture points over a period of 30 days, while for the same duration the Group D received a conventional drug therapy in the form of oral flunarizine 20 mg OD along with paracetamol 500 mg SOS. The patients were assessed twice, before and after completion of the treatment programme (30 days). The quality of life was assessed with WHOQOL BREF (WHO Quality of Life Biomedical Research and Education Foundation) questionnaire and the disability was assessed with MIDAS (Migraine Disability Assessment) questionnaire. Statistical analysis was performed using repeated measure's ANOVA with Tukey's test. Migraneurs were found to have lower quality of life and higher disability scores but following the treatment regimes, the 2 study groups showed a significant improvement in both the parameters studied. It was however observed, that the acupuncture group showed a better response and was thus found to be more effective as compared to the drug group (P = 0.005 to 0.000). We thus conclude that acupuncture is a better treatment option than the conventional drug therapy in not only relieving the pain of migraine but in also improving the psychological profile in migraneurs. Hence its use should be encouraged as an alternative/adjunct treatment for migraine.