Médecine alternative et intégrative

Introduction: The new focused antenatal care model recognizes that every pregnant woman is at risk for complications and four antenatal care visits are recommended for most pregnant women; the first one being early in the first trimester. When pregnant women attend antenatal care late they miss the cares being provided in the first 16 weeks. Therefore it is important to assess timing of first antenatal care visit and identify associated factors for late coming for the sake of intervention. Methods: Institutional based cross-sectional study was conducted among 362 randomly selected pregnant women from April to June 2014 in Dilla town, Southern Ethiopia. The data had been entered in to Epi Info version 7 and analyzed through SPSS version 20. Bivariate analysis was run to look for the association between dependent and explanatory variables; and using variables which have p-value ≤ 0.25 binary logistic regressions was fitted. Association presented in odds ratio with 95% confidence interval and significance determined at P-value less than 0.05. Results: The mean time of first antenatal care visit was found to be 15.9 (SD 3.7) weeks and the proportion of women who visit their first antenatal care within the recommended time (before or at 16 weeks of gestation) was 49.7%; nearly equal to late presentation. Rural residence (AOR=3.6, 95% CI (1.72, 6.62)), low monthly income (AOR=3.20, 95% CI (1.5, 6.74)), illiteracy (AOR=1.48, 95% CI (1.12, 3.04)), not being advised on timing of visit (AOR=4.64, 95% CI (2.32, 8.17) and unplanned pregnancy (AOR=5.02, 95% CI (2.21, 8.95)) were independent predictors of late presentation for first antenatal care. Conclusion: Even though, half of pregnant women started antenatal care attendance during the first trimester the finding was not satisfactory. Hence, further activities are needed through health education and promotion.

Background: Menorrhagia i.e., excessive menstrual blood loss is a common problem that interferes with women’s physical, emotional, social and material quality of life. Unani physicians have mentioned so many herbal formulations to treat menorrhagia. This study was aimed to compare the efficacy of polyherbal unani formulation and tranexamic acid on menorrhagia. Materials & Methods: This prospective randomized single blind standard controlled trial was conducted in Department of Niswan wa Qabala, National Institute of Unani Medicine. 40 patients were assigned to test (20) and control (20) groups. Both the test as well as control was given orally for five days from first day of menstrual cycle for two consecutive cycles. Assessment of efficacy was based on pictorial blood loss assessment chart (PBAC) to assess the amount of blood loss. Hb% and quality of life were also assessed as secondary outcome. Chi-square/ Fisher Exact test has been used to find the significance of study parameters on categorical scale between groups. Results: There was no significant difference found between the groups on all parameters assessed which shows that the test drug can be an alternative for tranexamic acid after clinical trial on large sample size and for longer duration. Conclusion: Test drug has been found having equal effect with tranexamic acid. There is need for further study on large sample size.

Objectives: Using survey data, this study produces estimates of the cost, effectiveness, and cost-effectiveness of complementary and alternative medicine combined with traditional therapies (pharmacotherapy and/or psychotherapy) in the treatment of anxiety disorders. Unlike past cost-effectiveness analyses that use a narrow definition or randomized controlled trials, this study uses a broad definition of complementary and alternative medicines and survey data to assess the cost-effectiveness. Study Desi and Outcome Measures: This analysis uses the Medical Expenditure Panel Survey (MEPS), an overlapping panel survey of medical use, expenditure, and health status for the civilian non-institutionalized U.S. population to identity economic costs and effects for individuals with anxiety disorders. The primary measure of effect is based on self-perceived mental health status. Cost-effectiveness is determined by estimation of incremental net benefit method. Potential self-selection bias is investigated using observable characteristics and inverse propensity score weighting. Results: Complementary and alternative medicine users with an anxiety disorder showed a statistically insignificant decrease in costs compared to nonusers ($458.95 versus $467.03; p-value 0.920). Complementary and alternative medicine expenditures were offset by a statistically significant decrease in office-based and pharmaceutical costs. Complementary and alternative medicine users showed an increase in the probability of steady or improved mental health compared to nonusers (0.7549 versus 0.6912; p-value 0.190) resulting in an incremental cost-effectiveness ratio of -$12.70 per 10% increase in the probability of steady or increased mental health. The evidence suggests a high probability that complementary and alternative medicine is cost-effective for large values of effect for anxiety disorders (p-value 0.080 for WTP of $5000). Conclusions: This survey data indicates complementary and alternative medicine users with anxiety disorders had slightly lower costs and improved outcomes. Limitations are considered.