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Hepatitis A

Definition:
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV).
This form of viral hepatitis also known as infectious hepatitis, due to its ability to be spread through personal contact. Hepatitis A is a milder liver disease than hepatitis B, and asymptomatic infections are very common, especially in children.

click to see the pictures

According to the World Health Organisation, there are an estimated 1.5 million new cases of illness due to hepatitis A each year worldwide, and many more people become infected without developing symptoms. It’s particularly common in less developed countries where poverty or poor sanitation are important factors.

Africa, northern and southern Asia, parts of South America, and southern and eastern Europe all have high rates of the disease. In these countries almost every adult carries antibodies to hepatitis A suggesting that it is quite usual for people to be exposed to the infection, usually in childhood, and to develop immunity.

The infection isn’t common in the UK, although it’s still the main type of infective hepatitis seen. (There are several other types of viral hepatitis, such as hepatitis B and hepatitis C.) In 2005, for example, there were 457 laboratory reports of confirmed hepatitis A virus (HAV) infection in England and Wales.

The majority of people from the UK who become infected with hepatitis A contract it when abroad in a country where it is very common.

Hepatitis A is an acute infection, rather than chronic (long-term). Rarely, it can cause life-threatening liver damage.Hepatitis A does not cause a carrier state or chronic liver disease. Once the infection ends, there is no lasting phase of illness.  However, it is not uncommon to have a second episode of symptoms about a month after the first; this is called a relapse.

Symptoms :
The incubation period of the virus before symptoms develop is between two and six weeks. How severely someone is affected varies from person to person. Some may not have any symptoms at all, while others may have just mild symptoms similar to those of a flu-like illness. This is particularly common among infants and young children.

The older someone is, the more severe the infection and symptoms are likely to be.

Possible symptoms include weakness, tiredness, headache, fever, loss of appetite, nausea and vomiting, abdominal pain and diarrhoea and dehydration. These may all occur for a week or more before jaundice appears.

Jaundice occurs in hepatitis infections because the liver becomes unable to remove a substance called bilirubin from the blood. This is a pigment that builds up in the body, causing the skin and whites of the eyes to turn yellow.

Causes:
HAV is found in the stool (feces) of persons infected with hepatitis A. HAV is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person infected with hepatitis A. This is called fecal-oral transmission. Thus, the virus spreads more easily in areas where there are poor sanitary conditions or where good personal hygiene is not observed. Most infections result from contact with a household member who has hepatitis A. Blood-borne infection has been documented but is rare in the United States. The common modes of transmission of hepatitis A are as follows:

•consuming food made by someone who touched infected feces
•drinking water that is contaminated by infected feces (a problem in communities with poor sewage treatment facilities)
•touching an infected person’s feces, which may occur with poor hand washing
•having direct contact in large daycare centers, especially where there are children in diapers
•being a resident of states in which hepatitis A is more common
•sexual contact with an infected person.

Risk Factors:
*Eating food that was prepared by someone who is infected with hepatitis A and poor hygiene.
*Consuming raw or undercooked shellfish (like oysters or clams).
*Eating raw foods (such as unpeeled fruits or vegetables) and drinking tap water or well water while traveling to countries where hepatitis A is common.
*Living in a community where hepatitis A is common and outbreaks occur (largely a risk factor for young children).
*Living in a house with someone who has hepatitis A.

Lifestyle factors that increase the risk of hepatitis A include:
* Travel to countries where hepatitis A is common.
* Be a man having sex with men.

Diagnosis
Hepatitis A symptoms often go unrecognized because they are not specific to hepatitis A, thus a blood test (IgM anti-HAV) is required to diagnose HAV infection. This test detects a specific antibody, called hepatitis A IgM, that develops when HAV is present in the body.

Treatment:
No specific treatment is available for hepatitis A. However, the following guidelines are often recommended:

•Fluids and diet. The best treatment is to make sure that the child drinks a lot of fluids and eats well.
•Rest. The child should rest while he or she has fever or jaundice. When fever and jaundice are gone, activity may be gradually increased as with the healthcare provider’s approval.
•Medications. The body’s immune system fights the HAV infection. Once the child recovers from hepatitis A, the virus leaves the body. Medications, prescription or nonprescription, should not be given without consulting the doctor.

About 15% of people will have a prolonged or relapsing illness lasting up to 9 months. Tragically, a small number of people die when the infection overwhelms the body. This is more likely to happen to people over the age of 60.

A person with hepatitis A should avoid drinking alcohol until their liver is completely back to normal, as alcohol is toxic to liver cells and will slow its recovery.

Ensuring good personal hygiene practices – washing your hands after using the toilet and maintaining good food preparation – is essential in avoiding infection with hepatitis A, especially if you visit a high risk area.

When visiting high-risk countries, it’s a good idea to avoid eating raw or inadequately cooked salads and vegetables, ice cream, unpeeled fruit and shellfish. Also avoid unpasteurised milk and drinks with ice, and check whether tap water is safe to drink before you go.

There’s an effective vaccination to protect people from hepatitis A infection. It’s available from your GP or high street travel centres, who will be able to advise you whether you need it for the country you are visiting. It’s recommended for anyone travelling to the high-risk regions of the world.

Those people who have already had hepatitis A usually have life long immunity.

Prognosis:
Viral hepatitis symptoms usually last three weeks to two months but may last up to six months. Children may return to daycare one week after symptoms first appear, with the doctor’s permission. Most children with hepatitis get better naturally without liver problems later in life. However, some children do have subsequent liver problems. For this reason, it is important to keep in close touch with the treating physician and to keep all followup appointments. Chronic, or relapsing, infection does not occur with hepatitis A. In the United States, serious complications are infrequent, and deaths are very rare.

Prevention:
According to the Centers for Disease Control and Prevention (CDC), routine vaccination of children is the most effective way to lower the incidence of hepatitis A nationwide. The CDC encourages implementation of routine hepatitis A vaccination programs for children in the 17 states which have the highest rates of hepatitis A. Hepatitis A vaccine has been licensed in the United States for use in persons two years of age and older. The vaccine is recommended (before exposure to hepatitis A virus) for persons who are more likely to get hepatitis A virus infection or are more likely to get seriously ill if they do get hepatitis A. The vaccines licensed in the United States as of 2004 were HAVRIX(r) (manufactured by Glaxo SmithKline) and VAQTA(r) (manufactured by Merck & Co., Inc).

Parents should teach their children always to wash their hands with soap and water after using the bathroom and before preparing and eating food. Travelers should avoid water and ice if unsure of their purity, or they can boil water for one minute before drinking it.

Short-term protection against hepatitis A is available from immune globulin, a preparation of antibodies that can be given before exposure for short-term protection against hepatitis A and for persons who have already been exposed to HAV. It can be given before and within two weeks after suspected contact with the virus.

Parental Concerns
The best way to prevent exposure to HAV is good habits in washing hands. Children should wash their hands every time they go to the bathroom. Good handwashing should be enforced at home and at daycare facilities. It is also very important to keep a clean environment, such as clean toilets, bathrooms, and clothing. If a child is diagnosed with HAV, other family members should be treated to prevent spread of the disease. The healthcare provider can help parents to plan treatment for the entire family.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.answers.com/topic/hepatitis-a
http://www.bbc.co.uk/health/physical_health/conditions/hepatitisa1.shtml

http://nationalnursingreview.com/tag/hepatitis-a-sign/
http://www.utmedicalcenter.org/your-health/encyclopedia/general/image/9394/
http://medicalsin.com/risk-factors-hepatitis-a-symptoms-increase/
http://www.fehd.gov.hk/english/safefood/library/prevent_hepatitis_A/2.html

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Drug Cuts the Risk of Prostate Cancer

Two-panel drawing shows normal male reproducti...
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Men at an above-normal risk of prostate cancer may be able to reduce their risk of developing the disease by taking a drug already on the market.

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In research reported yesterday, the drug dutasteride, currently used to shrink enlarged prostates, was found to reduce the risk of prostate cancer by about a quarter in high-risk men.

The drug apparently caused small tumors to stop growing or even to shrink, a research team reported in the New England Journal of Medicine.

The medication is sold under the brand name Avodart.

A previous study had found that a similar drug, finasteride, could also lower the risk of prostate tumors, but the new research – conducted at 250 sites in 42 countries – suggests that dutasteride is slightly more effective.

The new study “is further evidence that there is a role for these drugs in risk reduction,” said Dr. Jack Jacoub, a medical oncologist at Orange Coast Memorial Medical Center in Fountain Valley, Calif., who was not involved in the study. “If a patient understands all the issues [associated with the drug], I think it would be appropriate to provide it.”
Dr. Howard M. Sandler, an oncologist at the Cedars-Sinai Medical Center in Los Angeles, was even more emphatic.

“The question might be, why isn’t every man taking one of these drugs?” he said. “They help people urinate better by shrinking the prostate, they probably reduce baldness, and they reduce the risk of prostate cancer. There seems to be very little downside to them.”

GlaxoSmithKline, which manufactures Avodart, said on Monday that it would apply to the Food and Drug Administration for permission to market the drug for risk reduction in men with high PSA levels, a measure of prostate cancer risk; a family history of the disease, or other risk factors such as ethnicity.

But because the drug is already available, doctors do not need to wait for such permission to prescribe it as a preventive.

Considering the low risk of the drug, that might be a safe option, experts said. Insurance companies are not likely to pay for it for that purpose, however, until the FDA approves it.

Both dutasteride and finasteride are already approved for treating benign prostatic hyperplasia, or BPH, an enlargement of the prostate gland that causes urinary and other problems.

Finasteride is sold by Merck & Co. Inc. under the brand name Proscar.

In the study, researchers enrolled 8,231 men, ages 50 to 75, who had elevated levels of PSA but no evidence of prostate tumors on a biopsy.

Half received dutasteride daily for four years; half received a placebo.

All the men received biopsies two years after enrollment and again two years later.

Overall, 659 men taking dutasteride were diagnosed with prostate cancer (19.9 percent), compared to 858 men (25.1 percent) taking a placebo – a 23 percent reduction.

Among men with a family history of prostate cancer, the drug reduced risk by 31.4 percent.

Price may be a problem. According to GlaxoSmithKline, the wholesale cost of Avodart is $3.23 per pill. Finasteride is available in a generic form and is thus cheaper.

Prostate cancer is the most common cancer in men after skin cancer. It affects 192,000 men a year and kills 27,000.

Source : The Blade : April ’01. 2010

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Epididymitis

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Definition:-
Epididymitis is a medical condition in which there is inflammation of the epididymis (a curved structure at the back of the testicle in which sperm matures and is stored). This condition may be mildly to very painful, and the scrotum (sac containing the testicles) may become red, warm and swollen. It may be acute (of sudden onset) or rarely chronic.
…..Click to see the picture..

click to see the pictures

1: Epididymis

2: Head of epididymis
3: Lobules of epididymis
4: Body of epididymis
5: Tail of epididymis
6: Duct of epididymis
7: Deferent duct (ductus deferens or vas
Epididymitis is the most frequent cause of sudden scrotal pain. In contrast with men who have testicular torsion, the cremaster reflex (elevation of the testicle in response to stroking the upper inner thigh) is not altered. If the diagnosis is not entirely clear from the patient’s history and physical examination, a Doppler ultrasound scan can confirm increased flow of blood to the affected epididymis.

Infection is the most common cause. In sexually active men, Chlamydia trachomatis is the most frequent causative microbe, followed by E. coli and Neisseria gonorrhoeae. In children, it may follow an infection in another part of the body (for example, a viral illness), or there may be an associated urinary tract anomaly. Another cause is sterile reflux of urine through the ejaculatory ducts. Antibiotics may be needed to control a component of infection. Treatment otherwise comprises pain killers or anti-inflammatory drugs and bed rest if necessary, and symptom control by resting the scrotum in a supported position.
Males of any age can get epididymitis, but it’s most common in men between the ages of 20 and 39.

Classification
Epididymitis can be classified into acute and chronic.

Acute Epididymis:>-click & see    .Swelling in a patient with epididymitis

1. Ductus Deferens
2. Epididymis
3. Testicle

Chronic epididymitis..>.click & see
Chronic epididymitis is epididymitis which ensues for more than six weeks. Chronic epididymitis is characterised by inflammation even when there is no infection present. Tests are needed to distinguish chronic epididymitis from a range of other disorders that can cause constant scrotal pain. These include testicular cancer, enlarged scrotal veins (varicocele) or a cyst within the epididymis. As well, the nerves in the scrotal area are connected to those of the abdomen, sometimes causing pain similar to a hernia (see referred pain). This condition can develop even without the presence of the previously described known causes.

Typically, a second, longer round of treatment is used. It is believed that the hypersensitivity of certain structures, including nerves and muscles, may cause or contribute to chronic epididymitis. A procedure called a cord block is a last measure. This consists of an injection into the nerve that traces along the epididymis. The injection is a compound of several medications including a steroid, pain killers, and a high dose of an anti-inflammatory. This treatment can quell the pain for 2–3 months in ideal conditions. Some patients may only experience an even shorter duration of 2–3 days, while the fortunate ones in rare occasions are never bothered again. This procedure would of course have to be repeated when necessary, until the problem goes away completely, or until the routine is simply too bothersome. As a last resort, a patient may then decide to have the epididymis completely removed.

Symptoms:–
Epididymitis symptoms depend on the cause. They can include:

#A tender, swollen, red or warm scrotum
#Testicle pain and tenderness, usually on one side — the pain may get worse when you have a bowel movement
#Painful urination or an urgent or frequent need to urinate
#Painful intercourse or ejaculation
#Chills and a fever
#A lump on the testicle
#Enlarged lymph nodes in the groin (inguinal nodes)
#Pain or discomfort in the lower abdomen or pelvic area
#Discharge from the penis
#Blood in the semen

Causes:-
#Infection is the most common cause of epididymitis. The bacteria in the urethra back-track through the urinary and reproductive structures to the epididymis. There can be associated urethritis (inflammation of the urethra). Rarely, the infection reaches the epididymis via the bloodstream.

In sexually active men, Chlamydia trachomatis is responsible for two-thirds of cases, followed by Neisseria gonorrhoeae and E. coli (or other bacteria that cause urinary tract infection). Particularly among men over age 35 in whom the cause is E. coli, epididymitis is commonly due to urinary tract obstruction. Less common microbes include Ureaplasma, Mycobacterium, and cytomegalovirus, or Cryptococcus in patients with HIV infection. E. coli is more common in boys before puberty, the elderly and homosexual men.

#Other infections. Boys, older men and homosexual men are more likely to have epididymitis caused by a non-sexually transmitted bacterial infection. For men and boys who’ve had urinary tract infections or prostate infections, bacteria may spread from the infected site to the epididymis. Rarely, epididymitis is caused by a fungal infection.

#Non-infectious causes are also possible. Reflux of sterile urine (urine without bacteria) through the ejaculatory ducts may cause inflammation with obstruction. In children, it may be a response following an infection with enterovirus, adenovirus or Mycoplasma pneumoniae.

#The heart medication amiodarone. In some cases, this anti-arrhythmic medication causes inflammation of the epididymis. Epididymitis caused by amiodarone is treated by temporarily discontinuing the drug or reducing the dose.

#Tuberculosis. In some cases, tuberculosis can cause epididymitis.

#Urine in the epididymis. Known as chemical epididymitis, this occurs when urine flows backward into the epididymis. It may occur with heavy lifting or straining.

Epididymitis can also be caused by genito-urinary surgery, including prostatectomy and urinary catheterization. Congestive epididymitis is a long-term complication of vasectomy. Chemical epididymitis may also result from drugs such as amiodarone.

Diagnosis:-
Epididymitis can be hard to distinguish from testicular torsion. Both can occur at the same time. A urologist may need to be consulted.

Epididymitis usually has a gradual onset. On physical examination, the testicle is usually found to be in its normal vertical position, of equal size compared to its counterpart, and not high-riding. Typical findings are redness, warmth and swelling of the scrotum, with tenderness behind the testicle, away from the middle (this is the normal position of the epididymis relative to the testicle). The cremasteric reflex (if it was normal before) remains normal. This is a useful sign to distinguish it from testicular torsion. If there is pain relieved by elevation of the testicle, this is called Prehn’s sign, which is however non-specific.

Analysis of the urine may or may not be normal. Before the advent of sophisticated medical imaging techniques, surgical exploration was the standard of care. Nowadays, color Doppler ultrasound is the preferred test. It can demonstrate increased blood flow (also compared to the normal side), as opposed to testicular torsion. Nuclear testicular blood flow testing is rarely used.

Additional tests may be necessary to identify underlying causes. In younger children, a urinary tract anomaly is frequently found. In sexually active men, tests for sexually transmitted diseases may be done. These may include microscopy and culture of a first void urine sample, Gram stain and culture of fluid or a swab from the urethra, nuclear acid amplification tests (to amplify and detect microbial DNA or other nucleic acids) or tests for syphilis and HIV.

Treatment:-
Antibiotics are used if an infection is suspected. Fluoroquinolones are no longer recommended for sexually transmitted infections, because of the resistance of Neisseria gonorrhoeae . A cephalosporin (such as ceftriaxone) combined with doxycycline is an alternative. Azithromycin can be used for susceptible strains.

For cases caused by enteric organisms (such as E. coli), ofloxacin or levofloxacin are recommended.

In children, quinolones and doxycycline are best avoided. Since bacteria that cause urinary tract infections are often the cause of epididymitis in children, co-trimoxazole or suited penicillins (for example, cephalexin) can be used. If there is a sexually transmitted disease, the partner should also be treated.

Household remedies such as elevation of the scrotum and cold compresses applied regularly to the scrotum may relieve the pain. Painkillers or anti-inflammatory drugs are often necessary. Hospitalisation is indicated for severe cases, and check-ups can ensure the infection has cleared up. Surgery is rarely necessary, except, for example, in those rare instances where an abscess forms.

Home Remedies & Change of Lifestyle:-
Having epididymitis usually means you’re experiencing considerable pain and discomfort. To ease your symptoms, you may  try  the advices:

#Rest in bed. Depending on the severity of your discomfort, you may want to stay in bed one or two days.

#Elevate your scrotum. While lying down, place a folded towel under your scrotum.

#Wear an athletic supporter. A supporter provides better support than boxers do for the scrotum.

#Apply cold packs to your scrotum. Wrap the pack in a thin towel and remove the cold pack every 30 minutes or so to avoid damaging your skin.

#Don’t have sex until your infection has cleared up. Ask your doctor when you can have sex again.

Risk factors:-

Sexually transmitted epididymitis
Several factors increase your risk of getting epididymitis caused by an STD, including:

#High-risk sexual behaviors, such as having multiple sex partners, having sex with a partner with an STD and having sex without a condom.

#Personal history of an STD. You’re at increased risk of an infection that causes epididymitis if you’ve had an STD in the past.
Non-STD infections:-
Several things increase your risk of epididymitis caused by an infection other than an STD, including:

#Past prostate or urinary tract infections. Chronic urinary tract infections or prostate infections are linked to bacterial infections that can cause epididymitis.

#An uncircumcised penis or an anatomical abnormality of the urinary tract. These conditions increase your risk of epididymitis caused by a bacterial infection.

#Medical procedures that affect the urinary tract. Procedures such as surgery or having a urinary catheter or scope inserted into the penis can introduce bacteria into the genital-urinary tract, leading to infection.

#Prostate enlargement. Having an enlarged prostate that obstructs bladder function and causes urine to remain in the bladder puts you at higher risk of bladder infections, which increases the risk of epididymitis.

Epididymitis may eventually cause:

#Scrotal abscess, when infected tissue fills with pus

#Chronic epididymitis, which can occur when untreated acute epididymitis leads to recurrent episodes

#Shrinkage of the affected testicle (atrophy)

#Reduced fertility, but this is rare

If the condition spreads from your epididymis to your testicle, the resulting condition is known as epididymo-orchitis. Signs, symptoms and treatment options are basically the same as they are for epididymitis.

Prevention:-
If your epididymitis was caused by an STD, your partner also will need treatment. If your partner doesn’t get treatment, you may contract the STD again. Safer sexual practices, such as monogamous sex and condom use, help protect against STDs that can cause epididymitis.

If you have recurrent urninary tract infections or other risk factors for epididymitis, your doctor may discuss with you other ways to prevent epididymitis from recurring.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


Resources:
http://en.wikipedia.org/wiki/Epididymitis
http://www.mayoclinic.com/health/epididymitis/DS00603

 

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Go Easy on Paracetamol, it Could Hurt Liver

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Go easy while popping pain-killer drug Paracetamol. The medicine is safe as long as used within the prescribed dose, but an accidental   overdose may be dangerous and cause potential liver damage. Problems about the safety of the drug, also called acetaminophen, have been highlighted by a US Food and Drug Administration committee which is also in favour of stricter ‘‘black box’’ warnings on labels of paracetamol combinations.

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The panel has said that consumers should restrict use of the drug, and asked for lowering the maximum recommended dose from the existing 4 gm in a day.

Doctors here say that the medicine if taken in the prescribed dose is the safest analgesic and fever-lowering medication, but in the West ‘paracetamol poisoning’ is happening with the drug being abused, sometimes even intentionally. The drug has been under review as cases of acetaminophen-related liver injury are going up in the US. The risk accentuates if there is a combination of paracetamol with codeine (found in cough and cold medications). When contacted, a GlaxoSmithKline spokesperson said: “GSK continues to believe that paracetamol medicines are appropriate for OTC, prescription and combination use when taken as directed. As consumer safety is paramount, GSK supports any change that helps or educates our consumers on the safe, effective and appropriate use of medicine”.

GSK owns the two most popular brands of paracetamol — Crocin and Calpol, while others sold in the country include Pacimol, Metacin and Pyrigesic. Doctors say that paracetamol is the ‘‘safest pain killer’’ and liver damage is rarely seen, but should be used as directed. Says Anupam Sibal senior consultant pediatric gastroenterolgy “Paracetamol is the safest anti-pyretic and medication for fever. But since it is available over the counter people should use it with caution. While administering to kids, you should not confuse drops with syrup, as drops are highly concentrated”.

Source:The Times Of India

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Arthritis Therapies ‘Ineffective’

Most complementary therapies used by people with rheumatoid arthritis are not effective, a study has suggested.

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The Arthritis Research Campaign looked at the scientific evidence available for 40 treatments.

Two thirds of treatments for rheumatoid arthritis and a fifth of treatments for osteoarthritis were found to be ineffective by the researchers.

The Arthritis Research Campaign said it wanted people who used the therapies to know what evidence was available.

Rheumatoid arthritis is caused by inflammation of the lining (synovium) of the joints.

Osteoarthritis is caused by the breakdown of protective tissue called cartilage in the joints. Inflammation results when the unprotected bones of the joint begin to rub together.

It most commonly affects the joints of the fingers, knees, hips, and spine.

In total, 60% of people with arthritis are thought to use some form of complementary medicine.

Antler velvet

The researchers looked at compounds taken by the mouth or applied to the skin.

Effectiveness is measured by improvements in pain, movement or general well-being.

When the researchers examined treatments for rheumatoid arthritis, they found 13 out of 21 complementary medicines were shown to have no or little effect based on the available evidence.

The 13 were: antler velvet powder, blackcurrant seed oil, collagen, eazmov (a herbal mixture), feverfew (herb), flaxseed oil, green-lipped mussels, homeopathy, reumalex herbal mixture, selenium, the Chinese herb tong luo kai bi, vitamins A, C and E, and willow bark.

However, fish body oil was given five out of five in the report, for being effective in reducing joint pain and stiffness.

In addition, six out of 27 treatments for osteoarthritis were shown to have little or no effect based on the available evidence

Capsaicin gel, made from chilli peppers, proved most effective in relieving pain and joint tenderness.

But the effectiveness of glucosamine, a popular supplement used by people with OA which costs around £10 a month, which researchers have previously said was ineffective, again called into question.

For fibromyalgia, which causes widespread pain in muscles and joints, only four products were assessed, none were found to be highly effective with three medicines scoring two out of five, and the fourth just one.

Side effects

The researchers also examined how safe compounds were.

One – thunder god vine, a traditional Chinese medicine – was given a “red” classification, meaning there were serious safety concerns.

A quarter of the compounds were given an “amber” safety classification, because there were some reported side-effects.

The team said they were unable to evaluate the effectiveness of 36 therapies, including basil, green tea, sarsaparilla and St John’s Wort because there was insufficient data.

Professor Gary Macfarlane, from the University of Aberdeen, said while different things worked for different people, “it is useful to also have the scientific evidence available and just as important to know how safe we think they are to use.”

Professor Alan Silman, the Arthritis Research Campaign’s medical director, added: “We didn’t start this saying this was our opportunity to knock complementary medicines.

“The message is not ‘don’t take them’. The message is ‘if you are going to take them, be aware of what the level of evidence is’.”

Dr Peter Fisher, clinical director of the Royal London Homeopathic Hospital, said the report focused on tablets and preparations applied to the skin, missing out therapies such as acupuncture and osteopathy.

“I think what really comes across in this report is how sorely under-researched this area is,” he said.

Jane Gray, president, of the National Institute of Medical Herbalists added: “This report is a commendable attempt to provide information on self help products for osteo and rheumatoid arthritis.”

Sources: BBC NEWS:

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