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Iqra Mazhar

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Ismail Munir

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Laughter Is Indeed The Best Medicine – Here's How

Introduction

You probably would have laughed it off when someone mentioned laughter as the best therapy because it&#39;s too hard to believe, right?&nbsp; But, guess what? There is now a plethora of evidence and research to back the claim that a good laugh can do wonders.&nbsp;

&nbsp;

As we go along this article, you will learn more about the power of humor and what staying happy does to a person, especially if they&rsquo;ve been sick for a long time. The theory suggests humor promotes healing through staying happy. Let&rsquo;s see how it achieves that. 
&nbsp;

Understanding the Benefits of Humor Therapy

Humor therapy, also known as therapeutic humor or laughter therapy, refers to the art of using humor to relieve stress and pain, and to improve your overall sense of well-being<a href="#accordion">[1]</a>. Humor therapy uses the power of giggles and smiles to help you heal and escape the worries of life<a href="#accordion">[2]</a>.&nbsp;

&nbsp;

Scientists have proven that laughter can alter the brain chemistry, by reducing<a href="merisehat.pk/disease/stress"> stress</a> and promoting the release of happiness hormones, namely serotonin and dopamine. Humor therapy would help you to feel confident and in control of your life. Additionally, it would liberate you from the negative emotions that are pooling inside, helping you to let go of added stress and worries concerning your health condition or about life events in general<a href="#accordion">[3]</a>.

&nbsp;

Research has proven that patients who received humor therapy showed a significant improvement in their health. Among the health benefits observed in these patients was reduction in blood pressure, a boost in the activity of the immune system, reduction in stress hormone levels, and a rise in the levels of endorphins (a chemical produced in the body that brings about feelings of euphoria)<a href="#accordion">[3]</a>.

&nbsp;

In fact, upon realizing the importance of humor therapy, many hospitals have now either installed humor carts or have set up rooms where comic material is provided to people of all ages<a href="#accordion">[2]</a>. The funny material consists of comic recordings, audios, humorous films, books, or games. In certain hospitals, there are volunteers whose sole job is to make the patients laugh. Humor therapy has also become a part of the standard treatment plan for cancer patients at some hospitals<a href="#accordion">[3]</a>. 
&nbsp;

<h5>How Did Humor Therapy Come to Light?&nbsp;</h5>

It was in 1930 when humor therapy was used for the first time at a children&#39;s hospital by bringing in clowns to cheer up the children affected with polio. Later in 1979, Norman Cousins, a physician, in his book Anatomy of an Illness mentioned the benefits of humor therapy to educate the masses. He mentioned how humor therapy had a pivotal role in managing his pain while he was getting treated for rheumatoid arthritis of the spine, which is a very painful condition affecting the joints. According to Cousins, laughter eased the pain for him, as is proven by multiple researchers how having a good laugh can decrease stress and alleviate pain<a href="#accordion">[4]</a>.

&nbsp;

It was not until 1998, however, when the movie Patch Adams starring Robin Williams was released that people started appreciating the importance of laughter in treating individuals who are sick. According to the movie, &#39;Being happy is the most revolutionary act one can commit&#39;, and rightly so since happiness is associated with a myriad of health benefits<a href="#accordion">[4]</a>.&nbsp; 
&nbsp;

Laughter is a great medicine &ndash; one that has insurmountable benefits &ndash; and it&rsquo;s free! It&#39;s surprising, isn&rsquo;t it, how you laugh all day long as kids at one silly thing or the other but as you grow older, the natural tendency to enjoy life and laugh at petty moments drifts somewhere in the background. Responsibilities take over. However, if you try seeking humor, you can still fill your life with so much positivity that you&rsquo;ll be surprised.&nbsp;

&nbsp;

Humor and a good laugh can improve your emotional, physical, and psychological health. Moreover, humor is said to strengthen relationships, keep you happy, and also results in longevity<a href="#accordion">[5]</a>. 
&nbsp;

Here&#39;s a list of health benefits of a good laugh<a href="#accordion">[5]</a>:

<ul>
	<li>Helps the body to relax and dissipates the tension building in muscles. Your muscles stay relaxed for about 45 minutes after you have laughed.</li>
	<li>Promotes the release of endorphins, which is a substance that promotes feeling of wellbeing and relieves pain for some time.&nbsp;</li>
	<li>Improves heart health by increasing the blood flow within the heart. Staying happy can even reduce your risk of heart attack and other cardiovascular diseases. Now, isn&#39;t that huge?&nbsp;</li>
	<li>Helps burn calories if you&rsquo;re laughing for a good 10-15 minutes every day. While it is no substitute for gym, it can help you lose 3-4 pounds in a year.&nbsp;</li>
	<li>Lifts off the load of anger. You start looking at the funny side of the problem and this helps to resolve conflict and prevents negative feelings from developing in relationships.&nbsp;</li>
	<li>Add years to your life. A study in Norway conducted on people battling with cancer revealed that those who had a good sense of humor lived longer than their counterparts who didn&#39;t laugh often.&nbsp;</li>
	<li>Brings people together and strengthens relationships. Laughing together creates a strong, positive, and emotional bond between people.&nbsp;</li>
	<li>Relieves stress and improves mood. It helps you look at things from a different perspective so that you don&#39;t feel overwhelmed. 
	&nbsp;</li>
</ul>

Laughter or humor therapy is a non-traditional and non-pharmacological treatment approach that is mainly considered for old individuals in nursing homes, people with chronic diseases, and for patients battling with cancer. Humor therapy is offered alongside conservative treatment and has a tremendous effect on their mental health and immune function<a href="#accordion">[6]</a>.

&nbsp;

Additionally, laughter therapy does not require extra facilities or any specialized preparation, hence, it is easily available for all. Therapeutic humor is merely the use of the innate ability of humans to laugh at gleeful circumstances. But, to be able to laugh heartily after an extremely exhausting day can be extremely rewarding, too. Similarly, for patients dealing with chronic pain, a good laugh can momentarily take away their pain and it provides them an opportunity to enjoy life. Humor therapy is not just an inexpensive treatment option, it is also devoid of any adverse effects<a href="#accordion">[6]</a>.&nbsp;

&nbsp;

The elderly people in our society are already prone to mental health problems due to the natural process of aging; loneliness, pain, and discomfort in daily activities means they&rsquo;re likely to suffer from depression. A study found that older individuals endure pain considering it a normal part of the process of aging and are hesitant to request for pain relief because they don&#39;t wish to be labeled as &#39;complainers&#39;<a href="#accordion">[7]</a>. As heart wrenching as it sounds, it is true that most elderly individuals are not heard and this adds to their psychological and physical stresses<a href="#accordion">[6]</a>. Humor therapy can be a breath of fresh air in their lives, a chance to live life and laugh out loud.

&nbsp;

A study was conducted to evaluate the effectiveness of laughter therapy in relieving chronic pain, alleviating loneliness, promoting life satisfaction, and enhancing happiness in older patients who were living with chronic pain. Chronic pain is defined as pain ongoing for more than 3 months. In this study, 36 old people from a nursing home were invited for an 8-week long humor therapy program while 34 old people were taken as a control who did receive humor therapy. Upon completion of the program, the individuals who were introduced to humor therapy reported remarkable reduction in their perception of loneliness, decreased pain, and a profound feeling of happiness accompanied with life satisfaction. However, the control group reported no significant changes. Consequently, this study proves that therapeutic humor is an effective intervention in the elderly population<a href="#accordion">[7]</a>.

&nbsp;

Chronic disease patients usually have a negative attitude towards life and it worsens their physical and mental health. Incorporating humor therapy in their treatment plan will significantly improve their outlook on life.&nbsp; 
&nbsp;

There is no denying that caregiving is no easy job and it can take a significant toll on the healthcare providers. Long working hours and little rest adds on to the stress and it is believed that sharing a good laugh can benefit the doctors as it does the patients. Roughly 40-70% healthcare providers show signs of clinical depression, which is a worrying figure<a href="#accordion">[8]</a>. Humor therapy can be provided to tackle the situation because cracking jokes and sharing hearty laughs over funny movies might be all that they need to instill positive feelings<a href="#accordion">[8]</a>. Saving people is a tough job already; laughing often would renew the stamina of the caregivers and build positive energy!&nbsp; 
&nbsp;

Conclusion

Whether young or old, sick or healthy, everyone needs a bit of humor to feel alive. Whether they realize this or not is a different debate, but finding reasons to laugh and giggle at even the silliest of things helps to have a positive outlook on life. People who are battling with chronic diseases or older individuals fighting loneliness have all greatly benefited from humor therapy. So, grab a comic book, watch a sitcom or do anything that makes for a good laughter experience!&nbsp;

Key Points

<ul><li>Humor therapy is the art of using humor to heal, to relieve pain, and to reduce stress.&nbsp;</li><li>Humor therapy creates a healthy brain environment and releases happy hormones.&nbsp;</li><li>Laughter therapy improves the physical, psychological, and emotional health of an individual.&nbsp;</li><li>Humor therapy greatly benefits individuals who are old, dealing with chronic diseases, or those battling with cancer.&nbsp;</li><li>Caregivers can also benefit from humor therapy.&nbsp;</li></ul>

[1] NCI Dictionary of Cancer Terms. National Cancer Institute.

[2] Humor Therapy – Health Information Library | PeaceHealth. Peacehealth.org.

[3] Therapeutic Humor - Therapedia. Theravive.com.

[4] Encyclopedia. Humor Therapy.

[5] Laughter is the Best Medicine - HelpGuide.org.

[6] Yim J. Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review. Tohoku J Exp Med. 2016;239(3):243-249. doi:10.1620/tjem.239.243

[7] Tse M, Lo A, Cheng T, Chan E, Chan A, Chung H. Humor Therapy: Relieving Chronic Pain and Enhancing Happiness for Older Adults. J Aging Res. 2010;2010:1-9. doi:10.4061/2010/343574

[8] How Humor Can Improve your Health | Silver Creek Retirement. Silver Creek.

Nawal Adnan

Medilink Consultant clinic

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Medicine For The Soul: Music Therapy

As Leo Tolstoy once said, &ldquo;Music is the shorthand of emotion&rdquo;. Music has the ability to make you smile or cry and sometimes one after another! It makes you think, makes you wonder; it can even make you regret. Doesn&rsquo;t it embody the entire life? Surely the song &ldquo;Can&rsquo;t help falling in love with you&rdquo; by Elvis wouldn&rsquo;t exist if there was no one to love.

&nbsp;

Music therapy was discovered and used by the United States&rsquo; war department in 1945. The therapy yielded encouraging results in the patients who were recovering in army hospitals.&nbsp;

&nbsp;

Music could be one of the best ways to get positive results, if you are&nbsp; a student overwhelmed by academic stress, OR an autistic individual who has to feel calm yet focused during their occupational therapy, Or a patient dealing with physical deconditioning. 
&nbsp;

Understanding the Benefits of Music Therapy

Music therapy is recognized as a form of treatment. It refers to the clinical use of music to achieve a certain level of satisfaction and contentment in case of <a href="https://merisehat.pk/disease/stress">stress.&nbsp;</a>

&nbsp;

Furthermore, music therapy improves self-expression and elevates the mood. Whether the person is equipped with musical skills or talents or not, music therapy &ndash; singing, listening, composing and playing instruments &ndash; plays a huge role in psychological and emotional stability of an individual.

&nbsp;

Other than improving the cognitive and social abilities of a person, their spirituality, and emotional stability, music plays a vital role in the following as well:

<ul>
	<li>It helps in lowering the blood pressure and improving the memory.</li>
	<li>It boosts communication and social skills.</li>
	<li>It helps release muscle tension and lets you ponder over your thoughts and emotions.</li>
	<li>It increases motivation and morale of a person.</li>
	<li>It assists in self-regulation, which is developing healthy coping skills to deal with your emotions and thoughts.</li>
	<li>It helps with pain management to some extent. 
	&nbsp;</li>
</ul>

According to a study, music is integral to psychedelic therapy because it involves self-exploration and imagery experiences associated with certain meaningful emotions.&nbsp;

&nbsp;

Music embodies different emotions for different people and it changes with time. As such, it&rsquo;s a great tool to relieve stress.&nbsp;

&nbsp;

Moreover, it&rsquo;s quite powerful in that it inspires and motivates listeners, compelling them, transforming them. It influences how a person thinks. And since music is what&rsquo;s driving their actions, it ensures optimal results.

&nbsp;

A study was conducted to check the results of music therapy and its impact on the quality of life of hospice patients who were diagnosed with terminal cancer and were undergoing treatment. The study evaluated the effect of music on&nbsp; the prognosis of disease,&nbsp; and the impact it had on the patients who would see their ward fellows dying.&nbsp;

&nbsp;

Results were compiled from the 2 visits that were made to get in touch with the patients. A significant difference between groups was noted when the researcher compared the self-reported quality of life scores i.e., patients in the control group had a lower quality of life compared to those in the experimental group who were receiving music therapy. Also, with an increasing number of music therapy sessions, the quality of life seemed to be increasing as well.

&nbsp;

Last but not the least, music therapy has proved to be efficient in treating people with dementia. It provides a more active environment and engages them so that they are able to express their emotions. 
&nbsp;

No matter what the background, age, culture, and tradition of the patient is, they respond to music therapy. According to therapists, it&rsquo;s mostly:

&nbsp;

<ul>
	<li>Veterans And Military Service Members. Music therapy helps them to get over their trauma and manage their&nbsp;PTSD.</li>
	<li>People With Autism Spectrum Disorder (ASD). People on the spectrum learn best when there is structure, consistency, predictability, and familiarity in the learning material.</li>
	<li>People With Alzheimer&rsquo;s Disease. As music enhances familiarity and predictability, patients with Alzheimer&rsquo;s disease benefit from the stimulation of memory and the mind. This also provides them with a feeling of security.</li>
	<li>People In Correctional Settings. When a person is working in a mental health facility and/ or taking care of a patient, music can help&nbsp; with communication. It can also be used to calm down and relax.</li>
	<li>Victims Of Trauma And Crisis. If someone lives through trauma, they&rsquo;ll probably also be suffering with associated stress, pain, and anxiety,and music can be cathartic for them.</li>
	<li>Those Who Are Physically Ill. People with a terminal illness or those who have a poor prognosis are usually depressed. For example, patients with cardiac conditions, diabetes, chronic pain, or those who&rsquo;ve had surgery recently. They&rsquo;re not hopeful about the future; it is important to keep them cheered up, and one way to do so could be through music.&nbsp;</li>
	<li>Individuals With Mental Health Disorders. For patients dealing with mental health disorders, music therapy gives them a medium to channel their energies positively. Music can help a patient to articulate feelings and thoughts, and improve concentration and mood by developing coping skills.</li>
	<li>People With Chronic Pain. Music can help distract a patient in extreme pain. It can also help manage depression, fatigue, and anxiety.</li>
	<li>Substance Abusers. Music can help addicts quit because it increases self-esteem and motivation. Furthermore , it releases muscular stress and tension, and decreases anxiety. 
	&nbsp;</li>
</ul>

Besides psychological influence, music therapy has proved to be effective in 5 more domains: emotional, physical, spiritual, cognitive, and social.

&nbsp;

<h5>Emotional</h5>

<ul>
	<li>
	It helps release bottled-up emotions that eventually harm the individual.
	</li>
	<li>Music helps reduce feelings of loneliness and isolation.</li>
	<li>It elevates mood and decreases depression.</li>
	<li>It helps deal with anxiety.</li>
	<li>Self-expression is another advantage.</li>
	<li>It also helps with stress management. 
	&nbsp;</li>
</ul>

<h5>Physical</h5>

<ul>
	<li>
	It lowers blood pressure and respiration rate.
	</li>
	<li>It controls the heart rate by calming the nerves.</li>
	<li>Music helps with sleep and relaxation.</li>
	<li>Music improves gait and large body movements.</li>
	<li>It improves speech.</li>
	<li>It distracts the patient from pain.</li>
	<li>Asthma episodes can also be managed with the right music therapy.</li>
	<li>Premature infants having problems with weight gain and sleep can also be treated with music therapy.</li>
	<li>It improves motor functions in people with Parkinson&rsquo;s disease. 
	&nbsp;</li>
</ul>

<h5>Spiritual</h5>

<ul>
	<li>
	Exploration of spiritual beliefs is possible through music therapy.
	</li>
</ul>

&nbsp;

<h5>Cognitive</h5>

<ul>
	<li>
	It provides a control over emotions.
	</li>
	<li>It enhances coping skills.&nbsp;</li>
	<li>The effects of dementia can be greatly reduced by using music therapy. 
	&nbsp;</li>
</ul>

<h5>Social</h5>

<ul>
	<li>
	It brings people together both for gatherings such as funerals, weddings, and parties, as well as intimate meetings.
	</li>
	<li>It also helps patients with autism to have better communication with others.</li>
</ul>

&nbsp;

For some, music therapy will be a waste of time; for some it serves an escape. Your parents might express their concern if you prefer your headphones more than general interaction. Explain to them that you need it; that the resonating lyrics make you feel less lonely and that the calming music takes away your anxiety.&nbsp;

<ul><li>Music therapy refers to the clinical use of music to achieve a certain level of satisfaction and contentment in case of stress. It improves self-expression and elevates the mood to allow individual relief.</li><li>Music therapy involving singing, listening, composing and playing instruments plays a huge role in psychological and emotional stability.</li><li>For any patient who is going through education, occupational therapy, physical deconditioning, and recreation, it is one of the best ways to bring about positive results.</li><li>Music is an integral part of psychedelic therapy because it takes part in the self-exploration and imagery experiences associated with certain meaningful emotions.</li><li>Since music changes with time and carries different meanings for different people, it can be used to influence people in multiple ways, in all sorts of settings.</li><li>It inspires and motivates the listener, compelling them to transform and grow as an individual who has more elaborate control over their emotions and innate drives.</li><li>According to a study that involved patients who had terminal cancer and were undergoing treatment; patients in the control group had a lower quality of life, compared to the experimental&nbsp; group receiving music therapy.&nbsp;</li><li>Besides psychological influence, music therapy has proved to be effective in 5 domains – emotional, spiritual, cognitive, social, and physical. </li></ul>

[1] Russell E. Hilliard, PhD, LCSW, MT-BC, The Effects of Music Therapy on the Quality and Length of Life of People Diagnosed with Terminal Cancer, Journal of Music Therapy, Volume 40, Issue 2, Summer 2003, Pages 113–137,

[2] Rebecca Dahms, MA, Cornelia Eicher, PhD, Marten Haesner, PhD, Ursula Mueller-Werdan, PhD, MD, Influence of Music Therapy and Music-Based Interventions on Dementia: A Pilot Study, Journal of Music Therapy, Volume 58, Issue 3, Fall 2021, Pages e12–e36,

[3] Music therapy: What is it, types &amp; treatment. Cleveland Clinic.

Arbaz Ansari

Is The Cup Half Full Or Half Empty?

Cupping therapy was first documented on Eber&rsquo;s papyrus in 1550 BCE, in North Africa. It was the time when a cup was actually an Egyptian glyph used to refer to a physician.&nbsp;

&nbsp;

In Asia, during the Jin dynasty, Ge Hong (281-341 CE) mentioned the use of animal horns to drain the fluids from the body, a practice he thought was helpful in case of emergencies.&nbsp;

&nbsp;

According to Chinese medicine, cupping and other treatments essentially follow the Daoist model of holism. Holism is basically the philosophy in which systems and their properties must be viewed in totality, and not just as a collection of parts. Daoists believed that humans couldn&rsquo;t exist unless they are closely related to nature. 
&nbsp;

Understanding Medical Cupping

Cupping is a technique in which cups are placed over the skin and negative pressure is generated through suction.&nbsp;

&nbsp;

It&rsquo;s usually done in 2 ways: dry method and wet method. Dry cupping is noninvasive; hence, there&rsquo;s no blood loss. On the other hand, wet cupping is an invasive type and is subdivided into traditional wet cupping and Al-hijamah.&nbsp;

&nbsp;

Al-hijamah is derived from an Arabic word &ldquo;hajam&rdquo;, which means sucking, expansion, and bloodletting. The traditional wet cupping is commonly practiced in China, Korea, and Germany, while Al-hijamah is popular in the Middle East and North Africa.&nbsp;

&nbsp;

The method of cupping, how it relieves pain and promotes healing is still being studied. A large number of people believe in healing through cupping and get this treatment quite often. 
&nbsp;

Cups are placed on the skin and, through suction, they manage to draw fluid into the focused areas. These areas are carefully marked and decided according to the importance of blood flow. It breaks tiny blood vessels under the skin thus causing a fake injury in that area. As the negative pressure increases, the suction makes the small blood capillaries rupture and release blood but the blood loss in this case is harmless if done with the right technique.&nbsp;

&nbsp;

Your body automatically sends more blood to the injured area to fasten the healing process. In this way, blood circulation is increased, giving a signal to the blood cells to mature and multiply faster. It also signals the erythropoietin system to enhance the process of maturation and release of new blood cells. According to some people, it clears pores and releases toxins produced in your body. 
&nbsp;

There are several ways through which cupping can be done. Some practitioners leave the cups in the same position for several minutes; others choose to slightly move the cups to produce tension and massage the area. The number of cups used in the treatment can also vary.&nbsp;

&nbsp;

Some of the methods through which cupping can be done include:

<ul>
	<li>&nbsp;Dry Method: The inside of the cup is heated mostly with the help of alcohol-soaked cotton balls set on fire. Heat makes the cup oxygen-free; in other words, it produces a vacuum in the cup. Some use suction machines to produce vacuum in the cups. Once the cups are placed on the skin, the vacuum pulls the skin into the cup. It draws more blood to the concerned area as the suction starts to work.</li>
	<li>Wet Method: The skin is punctured by your <a href="https://merisehat.pk/article/accessing-quality-healthcare-online-doctors-in-pakistan">healthcare</a> provider with the help of a needle. It can be done either before cupping or after the cupping step. Puncturing releases toxins during cupping. It is one of the most common methods used to relieve pains, muscle stiffness, and to relax the body.</li>
	<li>Running Cupping Method: Suctioned cups are moved across the body. Oil is applied to the desired parts of the body to massage and also because it aids in the smooth motion of the cups. This method increases circulation in different parts of the body where the cup moves. The practitioner is well aware of all the pressure points and, therefore, applies the suction accordingly.</li>
	<li>Flash Cupping Method: It involves rapid, repeated suction and release of cups. It needs great expertise and skill for optimized results and to ensure there is no harm to the person. 
	&nbsp;</li>
</ul>

&nbsp;Mostly cups of glass and plastic are used, but other materials like bamboo, ceramic metal, and silicone can also be used. The cup material depends upon the choice of the practitioner or the person receiving the cupping treatment. 
&nbsp;

Cupping is sometimes done along with acupuncture treatment.&nbsp;

&nbsp;

Also, for best results, professionals recommend either to fast or to eat light meals approximately 2 hours before each session.

&nbsp;

During your cupping session you can experience the following things:

<ul>
	<li>The practitioner begins by taking a detailed medical history. They ask you many questions, like what symptoms you are experiencing and where you feel pain in your body.</li>
	<li>Cups are placed directly on your skin. Some people might find it uncomfortable at first but it&rsquo;s nothing for you to worry about; the body gets used to it after a while.</li>
	<li>It&rsquo;s normal to feel a sucking sensation and pressure on your body. Once the session is underway, this sensation becomes quite tolerable and relaxing.</li>
	<li>The practitioner may leave you to rest for a few minutes before they remove the cups. It depends upon the procedure you signed up for.</li>
	<li>Your skin might turn red and slight bruises might appear on your skin after the session. This is normal and it all heals within a few days.&nbsp; 
	&nbsp;</li>
</ul>

A study in 2017 showed the clinical effects of cupping. According to it, cupping increases our blood flow, initiating a healing process in compromised areas of the body. It also stretches the underlying tissues.&nbsp;

&nbsp;

Heme oxygenase-1 is a gene that prevents vascular inflammation. According to a study, cupping therapy activates this gene, thus, proving to be beneficial for local as well as systemic health.&nbsp;

&nbsp;

In 2010, a study revealed that cupping therapy is quite effective in treating medical conditions, like herpes zoster and associated pain, facial paralysis, and cervical spondylosis. It helps in reducing blood pressure and preventing cardiovascular diseases in healthy people.&nbsp;

&nbsp;

Studies have proven that wet cupping especially is very helpful in treating musculoskeletal pains, back pain in low areas, neck pain, fibromyalgia, and other conditions. It is, moreover, quite effective in treating the pain and other symptoms of carpal tunnel syndrome.

&nbsp;

Also, it plays a major role in relaxing the body and activating the healing system so that the body is prepared for any upcoming disease or infection. 
&nbsp;

Cupping is an ancient technique and has been used by different communities. It has proved efficient in relieving pain in patients with long standing diseases such as fibromyalgia. It should be kept in mind that sometimes non-conventional treatments which have logical mechanisms of action are not that bad to try. After all, it’s up to you if you think the cup is half full or not.

<ul>
	<li>Cupping is a technique in which cups are placed over the skin and negative pressure is generated through suction.</li>
	<li>Cupping technique can be done by 2 methods: dry method and wet method. In dry cupping no invasion is done and, hence, there&rsquo;s no blood loss. The wet method is invasive and is further categorized into traditional wet cupping and Al-hijamah.</li>
	<li>&nbsp;While traditional wet cupping is commonly practiced in China, Korea, and Germany, wet cupping is popular in the Middle East and North Africa.</li>
	<li>The method of cupping, how it relieves pain and promotes healing is still being studied. A large number of people believe in healing through cupping and get this treatment quite often.</li>
	<li>The suction increases the negative pressure; as a result, the small blood capillaries rupture and release blood. But the blood loss in this case is harmless if done with the right technique. Your body sends more blood to the injured area to fasten the healing process.</li>
	<li>It also signals the erythropoietin system to enhance the process of maturation and release of new blood cells. It clears pores and releases toxins that your body produces.</li>
	<li>&nbsp;Some practitioners leave the cups in the same position for several minutes; others choose to slightly move the cups to produce tension and massage the area. The number of cups used in the treatment can also vary.</li>
	<li>&nbsp;A study in 2017 showed the medicinal effects of cupping. According to this report, cupping increases the blood flow in the body, initiating a healing process in compromised areas of the body. It also stretches the underlying tissues.</li>
	<li>Heme oxygenase-1 is a gene that prevents vascular inflammation. According to a study, cupping therapy activates this gene, thus, proving to be beneficial for local as well as systemic health.</li>
	<li>Cupping is sometimes done along with acupuncture treatment. For best results, professionals recommend either to fast or to eat light meals approximately 2-3 hours before each session.</li>
	<li>In 2010, a study revealed that cupping therapy is quite effective in treating medical conditions like herpes zoster and associated pain, facial paralysis, cervical spondylosis, carpal tunnel syndrome, musculoskeletal pain, fibromyalgia, and cardiovascular diseases.</li>
</ul>

[1] Furhad S, Bokhari AA. Cupping Therapy. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

[2] Cupping: Back pain, neck pain, types, benefits, treatment. Cleveland Clinic.

[3] Marcin A. What is cupping therapy? Healthline.

[4] Al-Bedah, A., Elsubai, I. S., Qureshi, N. A., Aboushanab, T. S., Ali, G., El-Olemy, A. T., Khalil, A., Khalil, M., & Alqaed, M. S. (2018). The medical perspective of cupping therapy: Effects and mechanisms of action. Journal of traditional and complementary medicine, 9(2), 90–97.

What Is Speech Therapy?

A 2015 survey found that approximately 8% of kids between 3 and 17 had a communication issue in the previous year1. Moreover, nearly 7.5 million Americans in 2014, according to the National Institute on Deafness and Other Communication Disorders (NIDCD), had problems using their voices<a href="#accordion">[1]</a>.

This is where speech therapy comes in. Speech therapy is a fascinating field that combines the art of communication with the science of human development and anatomy. The intervention is meant to help people improve their speech and language skills and their ability to swallow, eat, and drink. It helps develop early language abilities besides voice and sound production, understanding, fluency, clarity, and expression.

So, why is it not popular among parents of a child struggling with speech or language delay? Or even among adults who know they need help to improve their own speech and language skills but choose not to. Research and anecdotes paint speech therapy as a fun and rewarding experience. Then what makes people hesitate from going to a speech therapist? 
&nbsp;

<h5>The Social Stigma</h5>

The fact that some people consider it a disability; that they bully individuals with a speech issue whose insecurities and anxiety multiply so much that they withdraw on their own or are excluded from social events. Some will even assume that individuals who speak differently or have a speech disorder are unintelligent. Besides mocking, some peers may resent people with special needs for getting &lsquo;special privileges.

As a result, the self-esteem and overall quality of life for people with speech issues is affected, and they avoid therapy to avoid being in the limelight.

This article highlights why, despite everything, you should pursue speech therapy for yourself or a loved one. 
&nbsp;

Understanding the Significance of Speech Therapy

Let&rsquo;s begin by understanding who&rsquo;s a speech therapist.

A speech-language pathologist (SLP), also known as a speech therapist, is a health professional trained to evaluate and treat individuals with speech, language, or swallowing disorders.

Both people with speech problems brought on by disease or injury and children with developmental delays will be referred to an SLP for evaluation and therapy. 
&nbsp;

According to several studies, speech therapy is a successful strategy for assisting both adults and children in improving their communication abilities.

One research of more than 700 kids with speech or language impairments found that speech treatment significantly improved their abilities. The findings indicate that communication performance greatly improved after 6 months of speech therapy lasting an average of 6 hours. Over the same period, speech therapy was also much more beneficial than no treatment. 
&nbsp;

In another study, the impact of speech therapy on individuals with aphasia brought on by a <a href="https://merisehat.pk/disease/stroke">stroke</a> was examined. According to the findings, speech therapy can effectively address these communication problems. The research also demonstrates that intensive therapies have a stronger impact and are highly effective in the early post-stroke period, usually the first six months.

Additionally, according to a study, speech therapy may be helpful in the management of aphasia. It demonstrated that 16 speech therapy sessions over 8 weeks increased communication abilities<a href="#accordion">[1]</a>. 
&nbsp;

These include<a href="#accordion">[1][2][3]</a>:

<ul>
	<li>Aphasia &ndash; Aphasia is a language disorder caused by damage to the language center of the brain. It often occurs due to&nbsp; stroke. The individual finds it difficult to speak, understand, read, and write language. Approximately 1,000,000 people in the US are affected by aphasia and almost 180,000 new cases are reported each year. 
	&nbsp;</li>
	<li>Articulation Disorders &ndash; Articulation disorder is a speech disorder where individuals have difficulty producing sounds. It occurs due to issues with the coordination of their lips, tongue, teeth, palate, and breathing. This can result in mispronunciation of words and difficulty making certain sounds. Many people with articulation disorders also have other language development issues. 
	Phonological disorders are similar to articulation disorders. The person can produce the sounds correctly, but use them in the wrong place. 
	&nbsp;</li>
	<li>Specific Language Impairment &ndash; Also known as developmental language disorder, language delay, or developmental dysphasia, SLI affects a child&#39;s language skills, including speaking, listening, reading, and writing. It is not caused by any known neurological, sensory, or intellectual disability. This condition affects around 7-8% of kindergarten children and can persist into adulthood. 
	&nbsp;</li>
	<li>Stuttering &ndash; Also known as stammering, stuttering is a speech disorder characterized by the repetition of sounds, syllables, or words, causing difficulty with clear and natural speech. The person knows what they want to say but has trouble speaking it fluently. 
	&nbsp;</li>
	<li>Resonance Disorder &ndash; A resonance issue can be brought on by a barrier or obstruction to the normal airflow through a person&#39;s mouth while they speak. This condition affects the vibrations that cause speech, which muddles speech. Healthcare professionals frequently link cleft palates and other neurological conditions with this speech issue. 
	&nbsp;</li>
	<li>Apraxia &ndash; People with apraxia are aware of what they want to express but struggle to put it into words. Reading, writing, swallowing, and other motor skills may also be difficult for them. 
	&nbsp;</li>
	<li>Cognitive-Communication Disorders &ndash; Communication problems occur when the part of the brain that regulates thinking is affected. Cognitive-communication impairments affect a person&#39;s ability to listen, speak, remember information, and solve problems. 
	&nbsp;</li>
	<li>Dysarthria &ndash; Some neurological conditions, such as a stroke,&nbsp;amyotrophic lateral sclerosis,&nbsp;or multiple sclerosis, can cause the muscles that govern your speech to weaken. Dysarthria patients may speak slowly or have slurred speech. 
	&nbsp;</li>
	<li>Receptive Disorders &ndash; A person with a receptive disorder finds it difficult to understand or process what others say. As a result, they can be verbally limited, have problems following instructions, or appear uninterested in the conversation. 
	&nbsp;</li>
	<li>Dysphonia (Voice Disorders) &ndash; This refers to a persistent change in a person&#39;s voice, resulting in hoarseness, strain, raspiness, or weakness. It&rsquo;s caused by speaking too much or too loudly, improper breathing, problems with the larynx such as vocal nodules, or psychological factors like depression or stress. 
	&nbsp;</li>
	<li>Trouble Swallowing &ndash; Swallowing problems result from a disruption in the muscle movements involved in swallowing, causing difficulty moving food through the mouth and throat. The underlying causes can be a nervous system disorder, such as Parkinson&#39;s disease, multiple sclerosis, dementia, infections such as Lyme disease or tetanus, or a head injury. When a person has swallowing problems, food can enter the lungs and lead to potentially life-threatening complications. 
	&nbsp;</li>
</ul>

Children are provided speech therapy in a classroom context (e.g., in a small group or one-on-one setting) based on their type of speech disorder. To assist patients in overcoming their particular problems, the speech therapist&nbsp;will use therapeutic exercises and activities. 
&nbsp;

These include<a href="#accordion">[1][4]</a>:

<ul>
	<li>Language Activity &ndash; This involves engaging in play and conversation with the kid while promoting language development through images, books, and objects. The therapist&nbsp;may also apply repetition exercises and teach proper pronunciation to improve the child&#39;s linguistic abilities. 
	&nbsp;</li>
	<li>Articulation Activities &ndash; They are also known as sound production exercises. The therapist will frequently engage in play activities with the child while demonstrating the proper sounds and syllables in words and phrases. The degree of play is according to the child&#39;s developmental stage and demands. The SLP will show how to move the tongue to produce particular sounds, such as the &quot;r&quot; sound. 
	&nbsp;</li>
	<li>Feeding And Swallowing Therapy &ndash; The therapist&nbsp;may implement oral exercises, such as facial massage and various tongue, jaw, and lip&nbsp;exercises to improve the mouth muscles needed for eating, drinking, and swallowing. They may also introduce various food textures and temperatures to improve a child&#39;s oral awareness during eating and swallowing.</li>
</ul>

The child will receive homework assignments and strategies from a therapist. They can practice at home by using these exercises to work through specific tasks with a parent or caregiver. 
&nbsp;

Note: It&#39;s advised to start therapy as early as possible. Early therapy intervention &mdash; before the age of 5 &mdash; is associated with better outcomes for children than later intervention. This is not to say that older children won&#39;t benefit from treatment. However, because they have ingrained tendencies that need to be broken, their progress will comparatively be slower<a href="#accordion">[4]</a>. 
&nbsp;

Activities you can try at home with your child are<a href="#accordion">[2]</a>:

<ul>
	<li>Read To The Child &ndash; Reading to your child is a fantastic approach to help them improve their language and speaking. Allow them to read to you if they are old enough to do so. Let them describe what they see in the photos if they can&#39;t yet read the words. Ask your youngster to point to the images you name for them or to name the images you point out. 
	&nbsp;</li>
	<li>Reduce Your Child&rsquo;s Screen Time &ndash; According to research, excessive screen time can hinder language development. The most effective technique to teach your child good speech is to speak and use language in front of them. 
	&nbsp;</li>
	<li>Be Patient And Attentive &ndash; It&#39;s crucial to exercise patience if your youngster struggles with communication. Do not pressure them to speak. This could lead to further worry, which would worsen the issue. Instead, you should tell them, &ldquo;I&#39;m listening, so take your time; you have my attention.&quot; Then give them your complete attention as they speak. 
	&nbsp;</li>
	<li>Play Interactive Games With Your Child &ndash; The best board games for improving language abilities involve guessing, describing, or asking questions about various objects. 
	&nbsp;</li>
	<li>Be A Good Speech Role Model &ndash; Make your speech clear, concise, and easy for your child to copy. Inform them of your activities. Label body parts, apparel, colors, and shapes. 
	&nbsp;</li>
</ul>

A speech therapist can use many different techniques for adult speech therapy, including<a href="#accordion">[1]</a>:

<ul>
	<li>Social Communication &ndash; The therapist may employ problem-solving techniques, memory exercises, and conversational exercises to enhance communication. 
	&nbsp;</li>
	<li>Breathing Exercises &ndash; Breathing techniques are recommended for resonance problems. 
	&nbsp;</li>
	<li>Mouth Exercises &ndash; Mouth exercises help develop oral muscles and enable better communication. 
	&nbsp;</li>
	<li>Swallowing Exercises &ndash; Stroke, Parkinson&#39;s disease, and oral cancer are some illnesses that make it difficult to swallow. Hence, swallowing exercises are used by a speech therapist&nbsp;to assist a person in managing these problems. 
	&nbsp;</li>
</ul>

Adults who have speech disorders can benefit greatly from exercises done at home. You can try<a href="#accordion">[2]</a>:

<ul>
	<li>Tongue Exercises &ndash; Put your tongue out, hold it there for 2 seconds, and then retract it. Continue doing this numerous times. The same exercise can also be performed while moving your tongue for 2 seconds to each corner of your mouth. Finally, continue to move your tongue in the same manner up and down. Your tongue will learn to move in coordinated patterns as a result of these workouts. 
	&nbsp;</li>
	<li>Smiling &ndash; Just grinning in front of a mirror can help with motor skill improvement. Smile. Relax. Smile once more. Repeat this procedure multiple times. 
	&nbsp;</li>
	<li>Puckering Your Lips &ndash; Make a pout. Then relax your facial muscles. Repeat this several times. This can assist you to control the movement of your mouth. 
	&nbsp;</li>
	<li>Reading Aloud &ndash; Reading aloud can be a great practice if your speech issue prevents you from moving your mouth and tongue appropriately. Stick to a few simple sentences at the beginning. 
	&nbsp;</li>
	<li>Playing Word Games &ndash; Crossword puzzles, word searches, and memory games evidently help maintain cognitive function and enhance thinking abilities. 
	&nbsp;</li>
</ul>

It may take some time, effort, and practice to recover from a speech impairment. But persistence and compassion go a long way. Ask your healthcare practitioner about scheduling a screening with a speech-language pathologist if you or your kid have trouble communicating. The benefits of speech and language therapy include increased independence, self-assurance, and a higher quality of life for you and your kid. 
&nbsp;

Key Takeaways

<ul>
	<li>Speech is one of the most complex and amazing human abilities. Speech is essential to express our thoughts, ideas, and feelings. But for some people, speaking can be a challenge.</li>
	<li>Speech therapy is an intervention that helps people improve their speech and language skills, and their ability to swallow, eat, and drink. It aids in the development of early language abilities, as well as voice and sound production, understanding, fluency, clarity, and expression.</li>
	<li>A speech-language pathologist or speech therapist evaluates and treats individuals with speech, language, and swallowing disorders.</li>
	<li>Aphasia is a language disorder caused by damage to the language center of the brain, often resulting from a stroke.</li>
	<li>Articulation disorder is a speech disorder where individuals have difficulty producing sounds due to issues with the coordination of their lips, tongue, teeth, palate, and breathing.</li>
	<li>Specific language impairment (SLI) is a developmental disorder that affects a child&#39;s language skills, including speaking, listening, reading, and writing.</li>
	<li>Stuttering is a speech disorder characterized by the repetition of sounds, syllables, or words, causing difficulty with clear and natural speech.</li>
	<li>A resonance issue can be brought on by a barrier or obstruction to the normal airflow through a person&#39;s mouth while they speak.</li>
	<li>Receptive disorders make it difficult for a person to understand or process what other people are saying.</li>
	<li>Swallowing problems result from a disruption of the muscle movements involved in swallowing, causing difficulty with moving food through the mouth and throat.</li>
	<li>A kid may receive speech therapy in a classroom context, either in a small group or one-on-one, depending on the type of speech disorder they have.</li>
	<li>To assist patients in overcoming their particular problems, the speech therapist&nbsp;will use therapeutic exercises and activities. 
	&nbsp;</li>
</ul>

[1] Speech therapy: For adults, kids, and how it works. Medical News Today.

[2] Speech therapy: What is it? types, tests & treatment. Cleveland Clinic.

[3] InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is speech therapy?

[4] Hartnett JK, ed. Speech-language therapy (for parents) - nemours kidshealth. KidsHealth.

Mariam Chughtai

Back pain is one of the most common and costly musculoskeletal conditions. Unfortunately, traditional therapies such as bed rest and medications don&rsquo;t always work. 
&nbsp;

PRP has come a long way, from being used in dental implant procedures to treating muscle injuries, joint injuries, and even cosmetic procedures. 

PRP stands for platelet-rich plasma, i.e., plasma with more platelets than are typically present in the blood. The normal platelet counts range from 150,000 /&mu;L to 350,000 /&mu;L However, the concentration of platelets in PRP can be 5-10 times richer than usual<a href="#accordion">[6]</a>.&nbsp; 

So, what makes it so wonderful for the patients?

Platelets are crucial in wound healing. They are rich in growth factors and cytokines. Not only do they form clots to stop bleeding at the site of injury, but support cell growth as well. This is why the therapy is increasingly used to promote muscle healing, treat <a href="https://merisehat.pk/article/natural-relief-for-arthritis-exploring-effective-remedies">arthritis</a> symptoms, and address various other health issues.

A medical professional takes a sample of the patient&rsquo;s blood to prepare a PRP injection. The amount of the sample depends on where the PRP is to be injected. It is sealed in a container and placed in a centrifuge. The spinning separates the blood sample into its components, one of which is PRP. The plasma is then extracted and prepared further for administration.

While doctors usually prefer PRP as a standalone treatment, injecting it into areas of tissue damage or inflammation, some mix it with other treatments like bone graft therapies to accelerate repair. 
&nbsp;

Major growth factors, like vascular endothelial growth factor, platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-), insulin-like growth factor 1, and epithelial growth factor, are found in large quantities in platelets. They facilitate healing when released from degranulated platelets. In addition to chemokines, cytokines, and metabolites, growth factors are crucial for angiogenesis, chemotaxis and migration, cell proliferation, and differentiatio.<a href="#accordion">[1]</a>

The issue arises when these wound-healing mechanisms don&#39;t always take place where required or at the speed required for the best restoration. Imaging techniques, like ultrasound, help doctors locate the specific areas for injection, like the tendon, which in turn helps to alleviate discomfort and return normal function to the spine.

Research in 2019 emphasized that PRP can restore function and structure in the spine following disc degeneration<a href="#accordion">[7]</a>. 
&nbsp;

Understanding of PRP therapy for back pain

Depending on the device used, the base platelet count of the patient, and the technique employed, a 30-cc venous blood draw generally produces 3-5 cc of PRP. 

A double centrifugation process of PRP entails<a href="#accordion">[5]</a>: 
&nbsp;

<ol>
	<li style="text-align:justify">Collection of approximately 34 ml of whole blood in anticoagulated vacutainer tubes.</li>
	<li style="text-align:justify">First spin or soft spin at a steady pace.</li>
	<li style="text-align:justify">Transfer the upper layer with a buffy coat to empty sterile tubes.</li>
	<li style="text-align:justify">Second spin or hard spin at a faster pace.</li>
	<li style="text-align:justify">Platelet pellets with few red blood cells accumulate at the bottom of the tubes.</li>
	<li style="text-align:justify">Platelet pellets are homogenized by thoroughly mixing them into the lower 1/3 volume of the plasma while discarding the upper 2/3 portion. 
	&nbsp;</li>
</ol>

Note: It&rsquo;s imperative to stop the platelets from activating too early or before use; hence, an anticoagulant such as citrate dextrose A is used. 
&nbsp;

These include:

<ul>
	<li style="text-align:justify">Premature release of growth factors via degranulation</li>
	<li style="text-align:justify">Growth factors released for a brief period after activation</li>
	<li style="text-align:justify">Growth factors are susceptible to proteolytic enzymes</li>
	<li style="text-align:justify">Varying concentrations and quality due to individual differences 
	&nbsp;</li>
</ul>

Moreover, despite extensive study, the optimal time for PRP implantation, the ideal platelet concentration in the PRP sample, and whether to use an inactivated or activated type of PRP is still not established.

Also, even though the substance being injected is from your own body, the fact that PRP involves injecting into the skin, there are some side effects involved. For example, infection, pain at the administration site, bleeding, nerve injuries, and tissue damage. The risk of allergic reactions is there, too, albeit lower compared to other injectable medications such as corticosteroids. 
&nbsp;

In a nutshell, this form of regenerative medicine is still controversial. New research has documented positive outcomes for the intramuscular injection of PRP to treat back discomfort. However, additional trials with bigger sample numbers and control groups are necessary to demonstrate its effectiveness and establish its regular use in surgery. 

It won&rsquo;t make you feel better instantaneously and will take time to work. But more research is needed to determine the stage of back pain at which PRP is most beneficial and how PRP infusions compare to more traditional treatments like NSAIDS and exercise. 
&nbsp;

<ul>
	<li style="text-align:justify">PRP has become hugely popular in recent years as a treatment for various conditions, ranging from hair loss to sports injuries.</li>
	<li style="text-align:justify">The therapy involves drawing the individual patient&rsquo;s blood, concentrating its healing properties (aka plasma), and reinjecting it back into the patient to speed up healing, reduce inflammation, or alleviate pain in the affected area.</li>
	<li style="text-align:justify">Some doctors still consider it as an experiential treatment. More research is warranted to corroborate its effectiveness.</li>
</ul>

[1] Gui K, Ren W, Yu Y, Li X, Dong J, Yin W. Inhibitory effects of platelet-rich plasma on intervertebral disc degeneration: a preclinical study in a rabbit model. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2015;21:1368.

[2] Marx RE. Platelet-rich plasma: evidence to support its use. Journal of oral and maxillofacial surgery. 2004 Apr 1;62(4):489-96.

[3] Navani A, Li G, Chrystal J. Platelet rich plasma in musculoskeletal pathology: a necessary rescue or a lost cause?. Pain Physician. 2017;20(3):E345.

[4] Hussein M, Hussein T. Effect of autologous platelet leukocyte rich plasma injections on atrophied lumbar multifidus muscle in low back pain patients with monosegmental degenerative disc disease. SICOT-J. 2016;2.

[5] Dhurat R, Sukesh M. Principles and methods of preparation of platelet-rich plasma: a review and author's perspective. Journal of cutaneous and aesthetic surgery. 2014 Oct;7(4):189.