Effect of Hijama (wet cupping), Dalk (massage) and Bukhur (medicated steam) in amelioration of Waja al-Zahr (non-specific low back pain) - an open prospective clinical trial.

OBJECTIVES: Low back pain is the most widespread musculoskeletal ailment and a common cause of disability worldwide. Conventional medicine typically treats low back pain with a combination of physical therapy; activity modification and rest; pain-relieving and anti-inflammatory medications which are associated with huge socioeconomic implications and adverse drug reactions. In contrast Hijama, Dalk and Bukhur are ancient medical techniques recommended in the management of musculoskeletal disorders with little or no adverse effects. To evaluate the safety and effectiveness of Hijama bi'l Shart (wet cupping), followed by Dalk (Massage) with Roghan Dafli and Bukhur (medicated steam) with Tukhm Soya (Anethum graveolens Linn) in patients of Waja al-Zahr (Non-specific Low back pain). METHODS: Patients of either gender in the age group of 18-50 years with low back pain persisting for four weeks or more as chief complaint were recruited in the trial. The study was GCP compliant. The duration of the protocol therapy carried out was 14 days. RESULTS: Ninty two patients of NSLBP were screened, of which 34 who fulfilled the inclusion criteria and were willing to participate in the study were recruited. Three participants were lost to follow-ups due to personal reasons and 31 patients completed the trial during the study period. Overall therapeutic response observed in this study was 97% while 3% of the patients did not respond to intervention. CONCLUSIONS: The study findings imply that there is a credible evidence to ensure that the regimens intervened are safe and effective in ameliorating the symptoms of Waja al-Zahr.

Effect of dry cupping versus soft and prolonged massage in the management of knee osteoarthritis - a randomized controlled clinical trial.

OBJECTIVES: Osteoarthritis is one of the most common musculoskeletal diseases which leads to functional decline and loss of quality of life. Knee osteoarthritis is considered as highly burdensome disease as well as highest contributor to global disability. Hijamah (Cupping Therapy) and Dalk (Massage) are claimed effective in the treatment of Waja'ul Mafasil (osteoarthritis). Present study was framed to compare the efficacy of Hijamah bila Shart (Dry Cupping) and Dalk-i-Layyin Kathir (soft and prolonged massage) with Roghan-i-Babuna (chamomile oil) in the management of Waja' ur Rukbah (knee osteoarthritis). METHODS: In present randomised controlled clinical trial, a total of 48 diagnosed patients of knee osteoarthritis were allocated randomly into group A (n=24) and group B (n=24). Group A was treated with soft and prolonged massage with Roghan-i-Babuna while group B was managed with dry cupping on alternate day for 15 min. Visual Analog Scale (VAS) and Knee osteoarthritis outcome score (KOOS) were used for the assessment of efficacy. A total of 40 patients, group A (n=20) and group B (n=20), were completed the allocated duration of protocol therapy and were restricted to statistical analysis. RESULTS: Statistically highly significant improvement was observed in objective parameters using both paired and unpaired t-tests. VAS and all KOOS subscales were found to be strongly significant at 20th day when compared with baseline (p<0.001). In intergroup comparison significant change (p>0.05) was not observed. Safety parameters were in their normal range after treatment. CONCLUSIONS: Dalk-i-Layyin Kathir with Roghan-i-Babuna and Hijamah bila Shart both were found safe and effective in the management of Waja'ur Rukbah. Hence, it may be concluded that both regimenal therapies are safe, effective and almost equal in their efficacy in the management of Knee Osteoarthritis.

The Effect of a Persian Medicine Massage (Dalk and Ghamz) on Neck Pain and Disability in Nonspecific Chronic Neck Pain.

BACKGROUND: This study was conducted to investigate the effect of Dalk and Ghamz on pain and disability in patients with nonspecific chronic neck pain. PATIENTS AND METHODS: This study was conducted on 37 patients with nonspecific chronic neck pain. Dalk and Ghamz massage were performed once a week for four sessions and the neck pain was evaluated by visual analog scale (VAS). In addition, the neck disability index (NDI) was used to assess the disability related to neck disorder. Data were analyzed with the SPSS software. RESULTS: Among 37 patients, 85.5% were female and 13.5% were male. A significant decrease in VAS score was observed during the study (F = 57.77, p < 0.001). The NDI score decreased from 27.27 ± 5.83 to 19.08 ± 7.71 (p < 0.001). CONCLUSION: Dalk and Ghamz massage in patients with nonspecific neck pain could reduce pain and disability.

Management of dislocated nucleus with corneal opacity by combined deep anterior lamellar keratoplasty, pars- plana vitrectomy and phaco-fragmentation.

A 32-year-old man presented with bilateral diminution of vision for 10 years. Visual acuity was light perception in both eyes with inaccurate projection in the oculus dextrus(OD) and accurate projection in the in oculus sinister (OS). Intraocular pressure was 6 and 12 mm Hg in the OD and OS, respectively. Slit-lamp examination revealed the presence of leucomatous corneal opacification with microcornea in oculus uterque (OU). Both eyes had a dislocated nucleus in the vitreous cavity on ultrasound B-scan with advanced cupping in the right eye. Ultrasound biomicroscopy revealed ciliary body atrophy in the OD and preserved ciliary processes (two quadrants) in the OS. In view of a partially preserved ciliary body function and a potential for gaining useful vision, we planned surgical intervention in the left eye. Deep anterior lamellar keratoplasty with pars planavitrectomy (PPV) and phacofragmentation of the nucleus was done. Donor lamellar graft was sutured after completion of PPV and nucleus fragmentation. The patient regained useful ambulatory vision postoperatively with clear corneal graft.