In this study, the potential role of homocysteine in diabetes and vitamin B12 and folate deficiency was reviewed along with the impact of folate and vitamin B12 in regulation of homocysteine level (1). Deficiency of vitamin B12 and folate is rare in developed countries and the countries which adopted fortification programs, but deficiency of these vitamins is found to be highly prevalent in developing world, particularly in Pakistan. This review discusses how several studies have found an association of high homocysteine levels and diabetes, but a few studies found contrary results. The authors conclude that further epidemiological studies are recommended for homocysteine involvement in diabetes and vitamin B12 and folate deficiency, so that an urgent action can be taken to control the high homocysteine and consequently the ever increasing burden of disease and specifically diabetes.

This study investigated the effects of locally injected vitamin C in the treatment of persistent gingival inflammation (1). Twenty adult patients with persistent chronic gingival inflammation were included in this study. The same dose of sterile vitamin C was injected in gingival tissues after the completion of phase I therapy. Gingival biopsies were taken after total resolution of inflammation. The results showed that there was great improvement of the injected sites with recall visits. The authors conclude that Vitamin C is an effective adjunctive treatment in reducing various degrees of chronic gingival inflammation.

This study examined the effects of long term vitamin D administration on the regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1) (1). This randomized, double-blind, placebo-controlled trial was performed among 58 women diagnosed with CIN1. CIN1 diagnosis was performed based on specific diagnostic procedures of biopsy, pathological diagnosis, and colposcopy. Patients were randomly allocated into two groups to take 50,000 IU vitamin D3 supplements (n = 29) or placebo (n = 29) every 2 weeks for 6 months. The results showed that Vitamin D intake led to significant decreases in serum insulin levels, and an increase in total antioxidant capacity. The authors conclude that vitamin D3 administration for 6 months among women with CIN1 resulted in its regression and had beneficial effects on markers of insulin metabolism and other health markers.

In this article, various oils in aroma therapy were studied to see if they facilitate sleep in cancer patients (1). Essential oils may be inhaled by means of an aromastick (a personal inhaler device containing essential oils) as a means of improving sleep. A prospective audit of aromasticks given to help facilitate sleep. Sixty-five aromasticks were given out over a 13 week period. Bergamot (Citrus bergamia) and sandalwood (Santalum austrocaladonicum); and frankincense (Boswellia carterii), mandarin (Citrus reticulata) and lavender (Lavandulaangustifolia) were the essential oils used in the two blends chosen by patients. The authors conclude that 94% of patients reported that they did use their aromastick to help them sleep and 92% reported that they would continue to do so. An improvement of at least one point on a scale measuring sleep quality was shown by 64% of patients following the use of an aromastick.

In this article, the authors of this systematic review discuss chinese herbal medicine (CHM) in subfertile women with polycystic ovarian syndrome (1). PCOS is one of the most common reproductive endocrinology abnormalities, and affects 5% to 10% of women of reproductive age. Western medicines, such as oral contraceptives, insulin sensitizers and laparoscopic ovarian drilling (LOD), have been used to treat PCOS. The authors conclude that there is insufficient evidence to support the use of CHM for women with PCOS and subfertility. No data are available on live birth, and there is no consistent evidence to indicate that CHM influences fertility outcomes. However there is very limited low quality evidence to suggest that the addition of CHM to clomiphene may improve pregnancy rates. There is insufficient evidence on adverse effects to indicate whether CHM is safe.

In this review, the authors investigate vitamin B12 (1). Vitamin B12 is an essential micronutrient, as humans have no capacity to produce the vitamin and it needs to be ingested from animal proteins. The ingested Vitamin B12 undergoes a complex process of absorption and assimilation. Vitamin B12 is essential for cellular function. Deficiency affects 15% of patients older than 65 and results in haematological and neurological disorders. Low levels of Vitamin B12 may also be an independent risk factor for coronary artery disease. High levels of Vitamin B12 are associated with inflammation and represent a poor outlook for critically ill patients. Treatment of Vitamin B12 deficiency is simple, but may be lifelong. The review goes through this information in greater detail.

This Cochrane review focused on vitamin A supplementation (1). Reduced vitamin A concentration increases the risk of blindness in children infected with the measles virus. Promoting vitamin A supplementation in children with measles contributes to the control of blindness in children, which is a high priority within the World Health Organization (WHO) VISION 2020 The Right to Sight Program. The authors assessed the efficacy of vitamin A in preventing blindness in children with measles without prior clinical features of vitamin A deficiency. The authors conclude that there were no trials assessing whether or not vitamin A supplementation in children with measles prevents blindness, as neither study reported blindness or other ocular morbidities as end points. Although it may seem silly to report on such findings, it is exactly this type of inquisitive process that moves science and medicine forward.

In this article, the authors ask which treatments are the best for vitiligo ^[1]. Combination therapies, specifically those using light (narrowband UV-B) are associated with more improved repigmentation than single therapies. There is limited evidence to support the association of UV-A alone and UV-B alone with repigmentation for vitiligo. There was moderate evidence to support the association of UV-A and UV-B, when used in combination with psoralens, topical corticosteroids, vitamin D analogues, fluorouracil, azathioprine, and oral prednisolone with improved outcomes for vitiligo. However, combination therapies were associated with more adverse effects.

Vitamin D plays an important role in the immune system. This study looked at vitamin D status and tuberculosis risk (1). Eight trials examined whether vitamin D as a therapy during tuberculosis treatment was useful. The studies varied substantially in a number of ways. One carefully performed study in which moderately large vitamin D doses were given to those who were vitamin D deficient and found a benefit sufficient to shortening treatment from 6 to 4 months, although other studies did not show this. Vitamin D is thought to have anti-inflammatory effects. A couple of studies reported some paradoxical inflammatory reactions. Future studies in patients with specific genetic backgrounds must monitor these events to discover underlying mechanisms.

In this study, the authors evaluated the effect of a supplement containing alpha-lipoic acid and of a placebo on glyco-metabolic control and on oxidative stress markers in type 2 diabetics (1). They randomized 105 diabetics to either a supplement containing 600mg of alpha-lipoic acid, 165mg of L-carnosin, 7.5mg of zinc, and vitamins of group B, or placebo, for 3 months. They evaluated numerous measures. They found a reduction of blood glucose and sugar markers in the group who took the alpha-lipoic acid compared with at baseline. They found a reduction in LDL and triglycerides with the supplement. The authors conclude that the supplement containing alpha-lipoic acid, L-carnosin, zinc, and vitamins of group B improved glycemic control, lipid profile, and anti-oxidative stress markers.

In this study, the authors investigated the association between sleep apnea and risk of dementia based on a study on the use of Vitamin E and Selenium (1). Participants were assessed at 128 local clinical study sites during the clinical trial phase and followed-up. The results of the study showed that self-reported sleep apnea on dementia risk depended on APOE 4 status. When the allele was absent, baseline self-reported sleep apnea was associated with a 66% higher risk of developing dementia, whereas self-reported sleep apnea caused no additional risk. The authors conclude that sleep apnea may increase risk of dementia in the absence of APOE4. This may help prevention strategies for dementia or Alzheimer's disease in older men with sleep apnea.

This study aimed to detail the pattern of complementary and alternative medicine (CAM) used by women with cyclic perimenstrual pain and discomfort (1). The study used a survey of over 7000 women with various female health conditions and looked at how frequently they saw their CAM practitioners. The results showed that endometriosis was 3.7%, PMS was at 41.2%, irregular bleeding was at 22.2%, heavy periods at 29.8% and severe period pain at 24.1%. Women with endometriosis were more likely to consult a massage therapist or acupuncturist and to have used vitamins, yoga, or Chinese medicine. PMS were more likely to consult osteopaths, massage therapists, naturopathic doctors or herbalists. The authors conclude that there's a high prevalence of perimenstrual pain among women in the mid-thirties age group. Women used CAM differentially when they had specific symptoms. Use of CAM needs to be properly assessed to ensure safe and effective use.

Evidence-based practice (EBP) is an approach to clinical practice that includes using the best evidence to make decisions (1). EBP is a patient-centered approach. It can facilitate consistency across professional boundaries. An over-emphasis on research trials as the ultimate standard is a limitation in clinical practice. Complementary and alternative medicine therapies often do not do well in these studies due to the lack of research and changes in the ways studies are done. Naturopathy is unique because it uses both traditional and scientific evidence. There is no conflict with it and EBP. However, the authors of the paper argue that Naturopathic Doctors need to reconcile tensions between those two fields to benefit the patient and must maintain their emphasis on clinical practice as well as patient preferences.

Adhesive capsulitis causes pain and reduced range of motion. Acetaminophen and nonsteroidal anti-inflammatory drugs are first-line options. This study investigated the effectiveness of acupuncture in the treatment of frozen shoulder (1). In a controlled clinical trial, patients with should pain and frozen shoulder received acupuncture and were analyzed 3 months after. The results showed that acupuncture achieved improved shoulder motion and greater improvement in visual analog scale after 3 months compared to the control group. The authors conclude that acupuncture improves flexion and adduction of the shoulder and pain.

Threatened miscarriage is a common complication of early pregnancy and increases the risk of miscarriage or premature labour. This study examined the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage (1). This was a mixed methods study involving a randomized controlled trial and semi structured interviews. The results showed that for women receiving acupuncture, there was a reduction with threatened miscarriage symptoms including bleeding, cramping and back pain compared with the control. An overarching theme emerged from the data of 'finding something you can do.' This encompassed the themes: 'they said there was nothing they could do,' 'feeling the benefits' and 'managing while marking time.' The authors conclude that acupuncture was feasible and reduced threatened miscarriage symptoms.