Saturday, July 19, 2008

Acupuncture useless

Infertile women who spend hundreds of pounds on acupuncture during IVF treatment are doing nothing to improve their chances of having a baby, the most extensive review of the evidence yet conducted has found. Acupuncture has no effect at all on pregnancy rates following IVF, according to a study that has examined all the high-quality trials to investigate its use by fertility clinics.

The findings, from a team at Guy's and St Thomas's Hospital in London, will dismay thousands of infertility patients, among whom acupuncture has become the most popular complementary therapy. While no official figures on its use are kept, demand is so great that several fertility clinics, such as Hammersmith Hospital in London, have set up on-site acupuncture services for their patients. Costs vary, but the Hammersmith unit charges $480 for an "IVF package" of four acupuncture sessions.

The new research, led by Sesh Sunkara, is a meta-analysis, in which the results of many high-quality randomised controlled trials are pooled to provide a more complete picture of a medical procedure's effectiveness. She said that while she had been open-minded about acupuncture before starting the investigation, she felt that she could not recommend it to patients. "If women come to me and ask if they should have acupuncture, I have to say there is no evidence that it helps," she told the European Society of Human Reproduction and Embryology conference in Barcelona. "Women are investing hope, energy and time in something that has not shown a definite benefit.

"The reason we chose to do this was that in our IVF clinic, every day we have patients who ask whether they should have acupuncture to improve their success rate. There have been all sorts of papers saying that sticking pins and needles increases the pregnancy rate, which have been widely reported in the media, and we are looking at women who are very vulnerable, who want to do everything possible to increase their pregnancy chances. "We wanted to look at this in an unbiased, open-minded way, to help us advise our patients. We wanted to know whether we should be doing acupuncture routinely and setting up a service in our clinic, or whether we should be advising people that there is no evidence that it works."

In the study, Dr Sunkara identified 83 trials in the medical literature, of which 13 were found to be of suitable quality to be included in the meta-analysis. The others were rejected either because they were commentary articles that did not include data, or because they were inappropriately designed.

Pregnancy rate and live birth rate were the only outcomes considered, and the results showed that acupuncture had no effect on either, whether it was used during embryo transfer or for pain relief while eggs were collected.

The research contradicts a similar meta-analysis that was published in the British Medical Journal in February, which suggested that acupuncture can improve pregnancy rates by as much as 65 per cent if performed when embryos are transferred to the womb.

Scientists behind the new work said that the BMJ study had overlooked a number of good studies that reached negative conclusions. Professor Peter Braude, who supervised the Guy's and St Thomas' team, said: "The BMJ paper didn't include all the studies, and if you include the negative ones there is no effect. We can't turn around and say it does not work, but there is no evidence it does and hand on heart we can't come out and recommend it."

Dr Sunkara said that more large randomised clinical trials of acupuncture in IVF were needed to settle the issue.

Paul Robin, the chairman of the Acupuncture Society, said: "I'm really surprised by these findings. I've been treating people for 20 years and in my experience treatment does seem to improve their chances of becoming pregnant. This study has shown that there's no proof that acupuncture can help - so that suggests that there should be lots more studies to examine the question. I'm convinced it can help."

Other studies that have claimed a benefit for acupuncture have hypothesised that it helps with relaxation during embryo transfer, which may boost the chances of a successful implantation and pregnancy. It has also been suggested that the therapy may increase blood flow to the womb.


NHS chasing its tail over superbugs

They beat down one problem and another pops up

A big drop in MRSA infection has brought the NHS within reach of the Government's target of halving rates by this year - but infections caused by Clostridium difficile have risen . In 2007-08 the number of MRSA cases fell to 4,438 - 588 above the target, Health Protection Agency data show. However, in the first quarter of this year a trend of falls in C. difficile bloodstream infections was reversed, with a 6 per cent rise: there were 10,586 cases of C. difficile blood infections in patients aged 65 and over.

A total of 966 cases of MRSA were reported - an 11 per cent drop on the previous quarter and an average of 322 cases a month. In 2004 John Reid, as the Health Secretary, said that infections of methicillin-resistant Staphyloccocus aureus should be cut to a monthly average of 321. At the time that was said to be unachievable. Even within the Department of Health, leaked documents last year showed there was serious concern it would not be met. But the recent fall in cases suggests that high-profile initiatives such as the "deep clean" of all hospitals and introduction of a mandatory "hygiene code" may have had the desired [temporary] effect.

MRSA and C. difficile are carried by some healthy people, but the bacteria can cause illness when they grow unchecked, elderly hospital patients being particularly at risk. Annual figures showed a decline for both infections.

Alan Johnson, the Health Secretary, described the decreases as a remarkable achievement. "Our strategy is clearly having an impact, with our challenging target now within touching distance, but this is not an issue we can be complacent about and we will continue to focus our efforts on reducing infections further," he said.

Graham Tanner, chairman of National Concern for Healthcare Infections, said: "It should be remembered that over four years, more than 20,000 patients have suffered an MRSA infection, and in excess of 200,000 contracted C. difficile."

Andrew Lansley, the Conservative Shadow Health Secretary, said that the Government would not have met its MRSA target had it measured the yearly rates to March. To achieve half of the 7,700 MRSA infections in 2003-04, the NHS would have had to limit rates to just 3,850 cases this financial year, he said. "Every case of a hospital infection is one too many, but in four years Labour hasn't even been able to halve MRSA rates, he said. "They have only got round to admitting they have missed the target by moving the goalposts. This shows just how much they've dithered and delayed over tackling hospital infections."

Murray Devine, Safety Advisor for the Healthcare Commission, the NHS regulator, added: "This is great news for patients. There's no question that there has been a very significant turn around, but the challenge isn't over. This improvement has got to be sustained and infection rates brought down further."


Western society's war within is well advanced in Britain

It may begin with a chuckle, but it could easily end in tears. At least, if we are not careful. One may be tempted to scoff at the demand to legalise polygamy made recently by Khalil Chami of Sydney's Islamic Welfare Centre. But with the recent announcement by Archbishop of Canterbury Rowan Williams that the adoption of sharia law in Britain seems unavoidable, the joke may turn out to be on us.

Britain provides an instructive lesson on the interaction between increasingly radicalised sections of the Muslim diaspora community and its Western host society. From Dundee to Dover, traditional British values, already weakened to the point of collapse by a decades-long elite infatuation with mushy multiculturalism and cultural relativism, cannot provide resistance against the growing tide of extreme demands by radical self-styled community spokesmen.

The same way that the claim of racism has been used to shut down any debate on cultural identity, immigration and social cohesion, so is Islamophobia increasingly used to silence dissent. To merely raise certain issues is to give offence, and offending sensibilities is a hanging offence in our postmodern times.

While radicals agitate, a politically correct establishment, at pains to prove how enlightened and tolerant it is, even if it means tolerating the intolerance of others, usually stands on the sidelines, if not actively cheering on another challenge to the ostensibly oppressive, hegemonic Western culture and polity.

In January last year, Britain's Channel 4 television broadcast a documentary on jihadi incitement in mosques throughout England. The material revealed by this undercover investigative report was quite incendiary in nature. One Saudi-trained imam called for British Muslims to "dismantle democracy" by "living as a state within a state" until they are "strong enough to take it over". Another Islamic radical praised the Taliban for killing British soldiers and argued that women who declined to wear the burka should be beaten into submission.

After the program was aired, British authorities wasted no time springing into action. The West Midlands Police lodged criminal charges, not against the extremist imams but against the TV network. Responding to a complaint by the Muslim Association of Britain, the police accused Channel 4 of inciting racial hatred by means of an ostensibly distorted documentary that demonised Islam. When the Crown Prosecution Service ultimately declined to pursue the matter, police referred the complaint to the British government broadcast oversight agency, OFCOM.

Earlier this year, an officer from the Wiltshire Police ordered a motorist to remove England's flag of St George from his automobile because it was "racist towards immigrants".

Stand-up comedian Ben Elton recently asserted that fear of "provoking the radical elements of Islam" caused the BBC to censor jokes about Muslim clerics. "There's no doubt about it," Elton said, "the BBC will let vicar gags pass but they would not let imam gags pass."

This comes on the heels of a legion of other examples of often pre-emptive surrenders to yet unvoiced radical demands, such as some British banks withdrawing toy piggy banks or public institutions turning Christmas into an amorphous Winter Festival, all for the fear of offending Muslim sensibilities.

All this is rather ironic, since under the twin dogmas of multiculturalism and cultural relativism, all cultures and beliefs are meant to be equal. Like George Orwell's animals, however, some seem to be more equal than others. Commitment to cultural diversity all too often seems to disguise contempt for the dominant national culture that historically bound the society. No wonder such large sections of the British establishment don't offer any resistance to the claims of fundamentalist radicals.

The case against Channel 4 was ultimately dismissed and the broadcaster won a $200,000 civil judgment against the West Midlands Police. But even if sanity prevailed after much time and expense, the totalitarian echoes of this affair clearly have a chilling effect on freedom of expression. While a TV network has the requisite resources to wage a vigorous legal defence, less well-heeled victims of the thought police would be in real strife.

All this is worrying to the silent majority of Muslims who are not interested in political agitation but simply want to rear their families in peace, freedom and prosperity, so often lacking in countries where they or their ancestors have come from. It's hard to blame the moderates within the Muslim community for not speaking out more against the extremists when they see the establishment and the authorities so often and so easily buckling to radicals.


British Leftists beginning to face up to the housing shortage: "Thousands of new homes are set to be built on the green belt over the next 20 years under Government plans to force local councils to allow development on previously protected land across the south east. Waste incinerators and landfill sites could also be constructed on green-belt land, parks and even areas of outstanding natural beauty, under the Government proposals released today. Ministers want almost 100 new homes to be built every day in the south east for the next 20 years and are preparing to over-rule local opposition by allowing towns to spread into the green belt. The Government is pushing ahead with the large house-building programme despite the global credit crisis leading to a slump in the house-building industry. Several of the country's biggest developers are facing difficulties and laying-off staff. Although house-building is likely to stall for the next few years, ministers hope that the industry will recover to deliver the ambitious long-term programme. Documents released today reveal that ministers have ordered that the green belts around Oxford, Guildford, Woking and other towns in the south east are reviewed."

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