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PubMed2003

Retrospective case series of therapeutic applications of a lotrafilcon A silicone hydrogel soft contact lens.

PURPOSE: To report a series of consecutive cases for which a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications. METHODS: Three practitioners in Spain, Denmark, and Germany supplied 41 consecutive case reports on 39 patients for whom a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications for erosion or recurrent erosion, bullous keratopathy, corneal edema, corneal dystrophy, neurotrophic corneal ulcer, entropion, and after corneal surgeries. Practitioners reported their judgements of pain relief, change in corneal signs by slitlamp evaluation, additional complications, and success of therapeutic lens treatment. Twenty cases that had completed treatment and 21 that remained under ongoing treatment were reported. RESULTS: Complete pain relief was reported for 78% of cases with 94% reporting pain relief of 50% or more. Corneal signs were restored to normal for 74% of cases with 100% showing at least partial improvement. No additional complications were reported in 83% of cases. Therapeutic contact lens application was judged fully successful for 71% of cases with 93% showing at least partial success. CONCLUSION: The high-Dk lotrafilcon A lens met or exceeded the outcomes reported from historic reports of therapeutic applications of low-Dk soft contact lenses. Whereas the case reporting conditions may vary among the historic studies and from the current study, there is the indication that success may be improved with the lotrafilcon A high-Dk lens.

Biocompatible Materials↗
PubMed2003

The effects of various therapeutic measures on shoulder strength and muscle soreness after baseball pitching.

AIM: This study was intended as an investigation of the effects of various therapeutic measures on the shoulder strength and muscle soreness after baseball pitching. METHODS EXPERIMENTAL DESIGN: participants threw 98 pitches in a simulated single game. The mode of the therapeutic measures after pitching were classified into 4 groups; the control group (CON), the ice treatment group (IT), the light shoulder exercise group (LSE) and the ice treatment with LSE group (ILSE). Each therapeutic measure was applied to the dominant shoulder immediately after pitching. PARTICIPANTS: 7 healthy, skilled baseball pitchers. MEASURES: both shoulder strength and muscle soreness were measured before pitching, immediately after pitching (Post-P), at the time of the therapeutic measure (Post-TM), and 24 hours after pitching (Post-24 h). RESULTS: All 4 groups showed shoulder strength losses in shoulder abduction, internal/external rotation with no shoulder abduction or with the shoulder abducted to 90 degrees immediately after pitching. ILSE had greater recovery from Post-P values at Post-TM or Post-24 h than the other methods in all 5 shoulder strengths. On the other hand, the soreness in shoulder internal rotation was increased significantly from Post-P and continued by Post-24 h. Both IT and ILSE had beneficial effects on reducing the shoulder muscle soreness at Post-TM or Post-24 h. CONCLUSION: The findings of this study suggested that ILSE was the optimal therapeutic measure against decreased shoulder strength or increased shoulder muscle soreness resulting from the repetitive baseball pitching.

Adult↗
PubMedDate not supplied

[The therapeutic prospects of patients with bronchopulmonary cancer].

By means of a retrospective analysis on 405 cases found out as having bronchopulmonary cancer, the therapeutical possibilities on fixing the diagnosis were evaluated. The therapeutical attitude indicated by pre-established criteria and the therapeutical line adopted were also analysed. The low percentage (25%) of cases with favourable therapeutical perspectives at case finding, as well as the high percentage (75%) of cases found out in stages therapeutically beyond treatment are pointed out. Several non-concordances between recommended and applied therapies are discussed.

Adult↗
PubMed2003

STI571 enhances the therapeutic index of epothilone B by a tumor-selective increase of drug uptake.

PURPOSE: The purpose is to investigate whether STI571, through platelet-derived growth factor receptor inhibition, enhances the therapeutic response to the chemotherapeutic drug epothilone B (EPO906) and, if so, to analyze the mechanism(s) underlying the effect. EXPERIMENTAL DESIGN: SCID mice with s.c. human anaplastic thyroid carcinomas were treated with different doses of EPO906 alone or in combination with STI571 and with different timing of STI571 and EPO906 administration. Tumor growth, tumor interstitial fluid pressure (IFP), and uptake of EPO906 in tumors and normal organs were monitored. RESULTS: STI571 potentiated the therapeutic effect of EPO906. Tumors subjected to combination treatment were >40% smaller than those subjected to monotreatment with EPO906. The improved efficacy was matched by reduced tumor IFP and a 3-fold increase in the tumor levels of EPO906. No significant increase of EPO906 levels was seen in liver, kidney, or the intestinal tract. Cotreatment did not reduce the tolerability of EPO906, as determined by measuring body weight throughout treatment. STI571-induced reduction in tumor IFP and increase in tumor uptake required a minimum of three daily doses of STI571 and was not observed 3 days after last treatment with STI571. The enhancement of EPO906 therapeutic efficacy was only observed when STI571 was scheduled in a manner associated with reduced tumor IFP and increased tumor uptake of EPO906. CONCLUSIONS: We conclude that STI571 increases the therapeutic index of EPO906 by selectively increasing the EPO906 uptake in tumors. The correlations between STI571 effects on tumor IFP and tumor drug uptake of EPO906 suggest a causal relationship between these phenomena. The study thus validates STI571 for combination treatment to enhance the therapeutic index of EPO906 in particular and, possibly, of chemotherapeutics in general.

Animals↗
PubMed2003

Therapeutic efficacy of anti-malarials in Plasmodium falciparum malaria in an Indo-Myanmar border area of Arunachal Pradesh.

BACKGROUND & OBJECTIVES: Malaria is one of the major public health problems in the north eastern region of India. Antimalarial drug resistance is widespread and one of the important causes of recent resurgence of falciparum malaria in this region. Antimalarial drugs are seen to be used sequentially one after another in many areas of the region, when therapeutic failure is observed with a drug. In view of this, the present study was undertaken to assess the therapeutic efficacy of common antimalarial drugs viz., chloroquine, sulfadoxine+pyrimethamine (S-P) and quinine, administered sequentially to the patients with Plasmodium falciparum infection in a Myanmar bordering area of Arunachal Pradesh. METHODS: A hospital based in vivo study was carried out with 53 patients with uncomplicated falciparum malaria. All patients were first treated with chloroquine and therapeutic efficacy assessed. In case of therapeutic failure of chloroquine combination drug (S-P) was given and those showing failure with S-P combination, oral quinine was administered and followed up for 28 days to assess both clinical and parasitological responses. RESULTS: Therapeutic failure was observed with chloroquine in 83.1 per cent (44 of 53) and to both chloroquine and S-P combination drug in 44.1 per cent (19/43) patients. Further, 15.8 per cent patients (3 of 19) failed to respond even to quinine. Overall, 5.7 per cent patients (3 of 53) showed unresponsiveness to all the three drugs i.e., chloroquine, S-P combination and quinine. Asexual parasite clearance and also fever clearance was slowest with chloroquine and fastest with quinine. INTERPRETATION & CONCLUSION: The findings of this study show the presence of multi drug failure P. falciparum in Jairampur-Nampong, a western Myanmar bordering area of Arunachal Pradesh. Anti malarial drug resistance is increasing in Indo-Myanmar border areas and systematic studies need to be done to review the situation.

Adolescent↗
PubMed1992

[Prognosis of myocardial infarction in women. Effect of the therapeutic effort and the socioeconomic status].

The causes of the high mortality of acute myocardial infarction in women as compared with men are controversial. The objective of this study is to assess the role of the therapeutic effort and socioeconomic factors on the genesis of this excess of mortality. We studied, using a retrospective cohort design, 491 men and 124 women admitted with the diagnosis of acute myocardial infarction. As a group, women were older (69 versus 61 years of age, p < 0.00001), showed a higher prevalence of cardiac failure on admission (44% versus 26%; p = 0.00008) and a higher mortality in the coronary care unit (29.3% versus 12.9%; p = 0.00002). In addition, the women showed an unfavorable socioeconomic profile and received a lower relative therapeutic effort, as assessed by the Therapeutic Intervention Scoring System. There was statistical interaction between gender and marital status, with a higher mortality in the unmarried male, comparable to that of women. Within the married group, the excess of mortality in women persisted after adjusting for age and Killip group (adjusted odds ratio = 2.48, 95% confidence interval between 1.26 and 4.89). None of the studied socioeconomic variables was independently associated to mortality, once age, Killip group and marital status were taken into account. After adjusting for therapeutic effort, the differences between men and women increased. Women admitted with acute myocardial infarction show a poor short-term prognosis that is not explained by their socioeconomic profile nor by the differences in therapeutic effort.

Aged↗
PubMed2004

Representative case series from public hospital admissions 1998 I: drug and related therapeutic adverse events.

AIMS: To examine a representative case series of drug and related therapeutic adverse events in New Zealand public hospitals with a view to assessing their occurrence, causation, patient impact and preventability. METHODS: An analysis was carried out on 192 drug and related therapeutic adverse events classified by reviewing physicians. These were identified from among 850 adverse events determined by two-stage retrospective review of a representative sample of 6579 medical records drawn from 13 public hospitals in 1998. RESULTS: One fifth of all adverse events were in the combined group, comprising drug (15.4%) and related therapeutic (7.3%) incidents. In comparison with other adverse events these incidents appeared to be more common among older patients, were less likely to have occurred in hospital, and had slightly less impact on patients. Cardiovascular drugs accounted for nearly half of drug events; poor infection management, by contrast, was the dominant factor among related therapeutic events, with problems in cardiovascular management also important. Inadequate monitoring and follow up of medication was identified as the most common reason for failure to prevent both drug and related therapeutic adverse events. CONCLUSIONS: This study shows that morbidity related to medications is extensive. Drug-related adverse events are frequent and many are preventable. Better monitoring and more appropriate medication choice for individuals are the most common prevention strategies identified.

Adult↗
PubMed2004

Appropriateness of requests for therapeutic drug monitoring of antiepileptic drugs: the experience in southwestern Saudi Arabia.

The purpose of this study was to evaluate request forms of therapeutic drug monitoring of antiepileptic drugs for appropriateness criteria according to published data. Request forms received by the laboratory were sampled as all requests in one day per week on an alternating basis. Drugs monitored were phenytoin (PHT), phenobarbital (PB), carbamazepine (CBZ) and valproic acid (VPA). A total of 420 request forms were collected. Age, gender and weight were provided in 95.5%, 97.1% and 56.9% of request forms, respectively. The diagnosis, seizure type and the indication for therapeutic drug monitoring were provided in 81.6%, 3.2% and 55.5%, respectively. Sampling times were provided in 45% and were considered appropriate in 25.2% of the request forms. The indications for therapeutic drug-monitoring were considered appropriate in 28.6% of the request forms, and only 19.2% of these were appropriately sampled. Only 37.9% of all samples were drawn at steady-state. Serum albumin and creatinine concentrations were lacking in 93.6% and 53.3% of requests, respectively. The potential for drug-drug interactions was detected in 28.6% of all requests. Thus, the information needed for the proper interpretation of therapeutic drug monitoring results and that was provided in the request forms was surprisingly scarce. Most of the appropriateness criteria for therapeutic drug monitoring were not met.

Adolescent↗
PubMed2004

Therapeutic foster care for the prevention of violence: a report on recommendations of the Task Force on Community Preventive Services.

In therapeutic foster care programs, youths who cannot live at home are placed in homes with foster parents who have been trained to provide a structured environment that supports their learning social and emotional skills. To assess the effectiveness of such programs in preventing violent behavior among participating youths, the Task Force on Community Preventive Services conducted a systematic review of the scientific literature regarding these programs. Reported and observed violence, including violent crime, were direct measures. Proxy measures were externalizing behavior (i.e., behavior in which psychological problems are acted out), conduct disorder, and arrests, convictions, or delinquency, as ascertained from official records, for acts that might have included violence. Reviewed studies assessed two similar interventions, distinguished by the ages and underlying problems of the target populations. Therapeutic foster care for reduction of violence by children with severe emotional disturbance (hereafter referred to as cluster therapeutic foster care) involved programs (average duration: 18 months) in which clusters of foster-parent families cooperated in the care of children (aged 5-13 years) with severe emotional disturbance. The Task Force found insufficient evidence to determine the effectiveness of this intervention in preventing violence. Therapeutic foster care for the reduction of violence by chronically delinquent adolescents (hereafter referred to as program-intensive therapeutic foster care) involved short-term programs (average duration: 6-7 months) in which program personnel collaborated closely and daily with foster families caring for adolescents (aged 12-18 years) with a history of chronic delinquency. On the basis of sufficient evidence of effectiveness, the Task Force recommends this intervention for prevention of violence among adolescents with a history of chronic delinquency. This report briefly describes how the reviews were conducted, provides additional information about the findings, and provides information that might help communities in applying the intervention locally.

Adolescent↗
PubMed1992

[Augmentation of LAK cell-accumulation in tumor tissue and its therapeutic effect after chemotherapy].

We investigated the therapeutic effects of a combination of chemotherapy with adoptive immunotherapy on BMT-11 fibrosarcoma in C57BL/6 mice. Although no significant therapeutic effects were brought about by CY alone or LAK.rIL-2 alone, CY plus LAK/rIL-2 brought about significant therapeutic effects such as a reduced proportion of dead mice (63%) and prolongation of the mean survival times of dead mice (64.4 days). We transferred radioactive 111In-labeled effector cells into untreated and CY-treated tumor bearing mice. LAK cell-accumulation (% dose/g) at the tumor site was only 2.7% in untreated mice and 19.7 in CY-treated mice. On the other hand, CTL.rIL-2 therapy exhibited significant therapeutic effects by itself. The accumulation of CTL was 9.1% in untreated tumors and only slightly enhanced by CY-chemotherapy. These results suggest that the therapeutic effects of adoptive immunotherapy depend on the accumulation of transferred effector cells at the tumor site and are augmented by the enhanced accumulation of effector cells after chemotherapy.

Animals↗
PubMed2005

[Thinking on the assessment of clinical therapeutic effectiveness of TCM].

How to assess the therapeutic effectiveness of TCM is the focus of this paper, the trend of study on standard for therapeutic effectiveness assessment and application of standard for disease combined with symptom diagnosis and treatment were described. Taking the study on standard for TCM syndrome of Gan as an example, the basic principle and existing problem in standard formulation were pointed out. The possibility in establishing the therapeutic effectiveness assessment system of TCM by using the quantified scale for therapeutic effectiveness assessment as a tool, i.e., the theoretical design of the scale formation should be in accord with the theories of TCM, and followed with scientific measuring principle, based on the sample investigation to establish the database of quantified scale, to make sure the scale that having corresponding checking process and scoring criteria so as to make the scale meeting the need of reliability and validity. It was also pointed owt that the scale should be used in combination with the standard for syndrome differentiation, thus, the scientific, practical therapeutic effectiveness assessment system of TCM could be built up.

Diagnosis, Differential↗
PubMed2005

Ottawa panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis.

BACKGROUND AND PURPOSE: Osteoarthritis (OA) affects a large and growing proportion of the population. The purpose of this project was to create guidelines for the use of therapeutic exercises and manual therapy in the management of adult patients (>18 years of age) with a diagnosis of OA. All stages of the disease were included in the analysis, and studies of patients who had recent surgery or other rheumatologic, musculoskeletal, or spinal problems or of subjects without known pathology or impairments were excluded. METHODS: The Ottawa Methods Group used Cochrane Collaboration methods to find and synthesize evidence from comparative controlled trials and then asked stakeholder groups to nominate representatives to serve on a panel of experts. The Ottawa Panel agreed on criteria for grading the strength of the recommendations and their supporting evidence. Of the 609 potential articles on therapeutic exercises for OA that were identified, 113 were considered potentially relevant, and 26 randomized controlled trials and controlled clinical trials were ultimately used. RESULTS: Sixteen positive recommendations of clinical benefit were developed for therapeutic exercises, especially strengthening exercises and general physical activity, particularly for the management of pain and improvement of functional status. Manual therapy combined with exercises also is recommended in the management of patients with OA. DISCUSSION AND CONCLUSION: The Ottawa Panel recommends the use of therapeutic exercises alone, or combined with manual therapy, for managing patients with OA. There were a total of 16 positive recommendations: 13 grade A and 3 grade C+. The Ottawa Panel recommends the use of therapeutic exercises because of the strong evidence (grades A, B, and C+) in the literature.

Clinical Trials as Topic↗
PubMed2005

Representing the Patient's Therapeutic History in Medical Records and in Guideline Recommendations for Chronic Diseases Using a Unique Model.

Computer-interpretable guidelines (CIGs) are more likely to affect the clinician's behavior when they deliver patient-specific and just-in-time clinical advice. CIGs must take into account the data stored in the patient's electronic medical records (EMR). For chronic diseases, the outcome of past and ongoing treatments (therapeutic history) is used in the clinical guidelines. We propose a model for the conceptualization of therapeutic history, facilitating data sharing between EMRs and CIGs and the representation of therapeutic history and recommended treatments in clinical guidelines.Based on medical literature review and an existing treatment model, a core structure is first defined taking into account drug and non-drug treatment components and treatment type (e.g. bitherapy). These elements together with additional concepts obtained by analyzing a sample guideline relating to diabetes, are then organized into an object-oriented model, using UML formalism.We show how this model can be used to store the patient's therapeutic history in the EMR, together with other attributes such as treatment efficacy and tolerance. We also explain how this model can efficiently code guidelines therapeutic rules.We evaluated this model, using additional guidelines hypercholesterolemia and asthma. We found it capable for representing guideline recommendations in several domains of chronic diseases.

Chronic Disease↗
PubMed2005

Therapeutic uses of Ocimum sanctum Linn (Tulsi) with a note on eugenol and its pharmacological actions: a short review.

The medicinal plants are widely used by the traditional medical practitioners for curing various diseases in their day to day practice. In traditional systems of medicine, different parts (leaves, stem, flower, root, seeds and even whole plant) of Ocimum sanctum Linn (known as Tulsi in Hindi), a small herb seen throughout India, have been recommended for the treatment of bronchitis, bronchial asthma, malaria, diarrhea, dysentery, skin diseases, arthritis, painful eye diseases, chronic fever, insect bite etc. The Ocimum sanctum L. has also been suggested to possess antifertility, anticancer, antidiabetic, antifungal, antimicrobial, hepatoprotective, cardioprotective, antiemetic, antispasmodic, analgesic, adaptogenic and diaphoretic actions. Eugenol (1-hydroxy-2-methoxy-4-allylbenzene), the active constituent present in Ocimum sanctum L., has been found to be largely responsible for the therapeutic potentials of Tulsi. Although because of its great therapeutic potentials and wide occurrence in India the practitioners of traditional systems of medicine have been using Ocimum sanctum L. for curing various ailments, a rational approach to this traditional medical practice with modern system of medicine is, however, not much available. In order to establish the therapeutic uses of Ocimum sanctum L. in modern medicine, in last few decades several Indian scientists and researchers have studied the pharmacological effects of steam distilled, petroleum ether and benzene extracts of various parts of Tulsi plant and eugenol on immune system, reproductive system, central nervous system, cardiovascular system, gastric system, urinary system and blood biochemistry and have described the therapeutic significance of Tulsi in management of various ailments. These pharmacological studies have established a scientific basis for therapeutic uses of this plant.

Animals↗
PubMed2006

[Observation on therapeutic effect of acupuncture on late sudden deafness].

OBJECTIVE: To observe therapeutic effect of acupuncture on late sudden deafness of different types. METHODS: According to the principles of TCM syndrome differentiation treatment, 63 cases were treated with acupuncture, once very other day, 7 days constituting one course with a interval of 3 days between two courses. Changes of the hearing threshold, and the difference of therapeutic effects between different states of illness and different types were investigated. RESULTS: Four cases (6.3%) were cured, 17 cases (27.0%) were markedly effective, 19 cases (30.2%) were effective, and 23 cases (36.5%) were ineffective, the total effective rate being 63.5%; there was a significant difference in the mean hearing threshold before and after treatment (P < 0.05). CONCLUSION: The milder the state of illness, the better the therapeutic effect of the acupuncture; in addition, acupuncture has the best therapeutic effect for the type with decrease of the curve of audition, and better therapeutic effects for the types of upward invasion of phlegm-heat, and the type of stagnation of turbid phlegm in the middle-jiao.

Acupuncture Therapy↗
PubMed1991

[Therapeutic indications of low molecular weight heparins].

The depolymerisation of the various chains of unfractionated heparin (UFH) by chemical or enzymatic reactions provides so-called low molecular weight heparin (LMWH), with an average molecular weight of approximately 5000 daltons. The specific biological and pharmacokinetic properties of LMWH with greater inhibition of factor Xa than of thrombin activity, less interaction with platelets, better bioavailability and a longer half life of anti-Xa activity, suggest possible new therapeutic applications. The hypothesis of reducing the risk of haemorrhage related to the antithrombin activity and the incidence of heparin-induced thrombocytopenia whilst preserving effective antithrombotic action has stimulated clinical and biological research. Clinical trials of prophylaxis of venous thrombo-embolism have been undertaken mainly in surgical patients. The results have shown identical if not better efficacy of LMWH compared to UFH in general surgical and above all orthopedic patients in whom subcutaneous heparin is only effective with a strict protocol which is difficult to adhere to in routine practice (adaptation of dosage to activated partial thromboplastin time). The risk of bleeding was not significantly lower using LMWH at the specified dosage, which in the latter indication, is twice that used in general surgery. There are many indications of prophylaxis of thromboembolism in the medical specialties but, paradoxically, LMWH has not been widely studied because of the difficulties in performing the therapeutic trials. Except in rare cases (extreme body weights, renal failure, haemorrhagic disease, thrombotic or haemorrhagic complications) the evaluation of amidolytic anti-Xa activity does not seem to be necessary. More recently, LMWH has been studied in a small number of trials for the treatment of deep venous thrombosis (DVT). The therapeutic efficacy is identical if not better than that of UFH without increasing the risk of bleeding. Biological monitoring seems to be necessary in this indication for evaluating amidolytic anti-Xa activity, which, though not a true marker of antithrombotic activity is a relatively sensitive investigation. The therapeutic values are 0.5 IU/ml to 1.0 IU/ml, 3 to 4 hours after subcutaneous injection. The conclusions of all these trials are: LMWH is relatively simple to use and, compared with UFH, has a more stable anticoagulant effect due to its pharmacokinetic properties; the therapeutic efficacy is as good as, if not better, than that of UFH; the risk of bleeding remains, therefore, the specified dosages should be respected and treatment should be monitored by anti-Xa activity when indicated; the decreased interaction with platelet function should not mask the risk of thrombocytopoenia.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical Protocols↗
PubMed2001

Outcomes of therapeutic selective nerve root blocks for whiplash induced cervical radicular pain.

This study was designed to investigate the clinical efficacy of fluoroscopically guided therapeutic cervical selective nerve root blocks (SNRBs) in patients with whiplash induced cervical radicular pain. Study design was restrospective with independent clinical review. Twenty two patients were included. Each patient met specific physical examination criteria and failed to improve clinically after at least four weeks of physical therapy and the use of oral analgesics. Each patient demonstrated a positive response to a fluoroscopically guided diagnostic cervical SNRB. Patients were excluded for radiographic evidence of a focal disc protrusion or foraminal stenosis at the symptomatic level. Therapeutic cervical SNRBs were administered in conjunction with physical therapy. Data collection and analysis were performed by an independent clinical reviewer. Outcome measures included VAS pain scores, work status, medication usage, and Oswestry disability scores. Results showed the patients' symptom duration prior to diagnostic injection averaged 6 months. An average of 2.1 therapeutic injections was administered. Follow up data collection transpired at an average of 33.3 weeks following the final therapeutic injection. Good or excellent results were observed in 14% of patients. In higher functioning individuals a significantly greater (F=.0427) improvement in pain of 48.9% was observed. In these initial findings suggest that fluoroscopically guided therapeutic SNRBs, except possibly for higher functioning individuals, are not effective in the treatment of whiplash induced cervical radicular pain.

Journal Article↗
PubMed2006

[Observation on therapeutic effects of centro-square needling and triple needling on ankylosing spondylitis].

OBJECTIVE: To probe therapeutic effects of centro-square needling and triple needling on ankylosing spondylitis. METHODS: Sixty cases of spondylitis were randomly divided into a treatment group and a control group. The treatment group were treated with centro-square needling and triple needling, and the control group with routine acupuncture therapy, with motortherapy combined in the two groups. RESULTS: Both the therapeutic methods were effective, but the therapeutic effect in the treatment group was significantly better than that in the control group (P < 0.05). CONCLUSION: Acupuncture combined with motortherapy has definite therapeutic effect on ankylosing spondylitis, with centro-square needling and triple needling having better therapeutic effect.

Acupuncture Therapy↗