Alternative Medicine

The human race today is plagued with different diseases that came from several etiologies. Most of these diseases are caused by human abuse to themselves and to nature. Through time, humans developed a higher aspect of technology, which in turn pulls him away from his natural environment. This is most evident in the pollution that damages our environment each and every day. People pollute the air through factories and car exhaust which damages the ozone layer, thus, allowing harmful ultraviolet rays to cause skin cancer. Cancer is just one of those diseases that were not present in the past when people are still in harmony with nature.
   
People continue to abuse their bodies through vices like smoking, excessive alcohol drinking, and eating too much food which are packed with different chemicals and preservatives. The result of this constant abuse is disease. Hippocrates first laid down the laws of natural medicine. He stated that if nature will be provided with the opportunity, it can heal. In a religious point of view, the Creator provided us with all the things that we need. And if we only know what and where to look, definitely we can find a cure. Even the commercial medicines that we are using nowadays are getting the ingredients from nature. This just shows the healing power of natural occurring substances in nature. He also said that food should be medicine. This is very true because people eat to replenish the energy that they lost and to rejuvenate themselves.

When one gets flu, there is no medicine that can effectively kill the causative virus. However, one can eat foods that are immune boosters, thus, helping ones physical body to heal itself. He also said that disease is an expression of purification. He also noted that all diseases are systemic, that it affects the person as a whole. Although people often feel symptoms on a localized area, what most people dont know is that the symptom is just a part of a larger problem. A disease doesnt only affect the physical wellbeing of a person but it also has an impact on the emotional and mental status of the person. It can depress an ill person and can cause the person to think of suicide. Thus, it is not enough to cure the physical body but health care givers should also pay attention on other aspects of health of a person. This was pointed out by Plato, the Greek philosopher.

He stated that the physicians usually neglect to address the totally of the health of the person resulting in failure to cure the patient. He urged that a patient should be treated as a whole and not just part of his body because he believed that it is impossible to have a part in order if the whole is out of sync. It is not enough for the patient to take the prescribed medicines or to undergo a therapy without believing that he will be cured. This will contradict the process of healing because the person himself should will his body to heal. Thus, we should not underestimate the power of the mind.
   
In treating a patient, a naturopath should not only focus on the symptom but also to the oneness of the person as based on the philosophy of Hippocrates and Plato. He should use several approach in treating the person. A proposed method of treatment for a naturopath is having the patient natural, balanced diet and cleansing.

A natural and balanced diet will not only nourish the patient but also facilitate the healing process by providing the patients body all the natural elements it needs to repair itself. Cleansing is also important because it not only removes toxins from the body but also renews the person as a whole. However, it is important to educate the patient before starting any treatment because the pattern of progress may involve reappearance of some signs and symptoms which may worry the patient. Education will not only inform the patient about the process but also it will prepare him to accept a life of natural living. The patient should realize that lifestyle modification is the most important treatment must undergo, so the patient should be ready for all the adjustments he must make for him to be healed. The naturopathic way of approach should be incorporated in the management of patients by the physicians and that health care givers should accept that there is no better way to cure a patient but through naturopathy and the holistic approach to diseases.

Introduction In the modern age of scientific developments and clinical tests and trials, the acceptance of the complementary medication and alternative medicine has been authoritatively integrated as part of treatment and diagnosis of many psychological and psychosomatic diseases. In this reference the use of Meditative Yoga has been widespread in its use and practice for many clinical therapies in different dimensions of medical science. The community has accepted this as a complementary mode of treatment as the rising use of stimulants and other stronger sedatives in the management of the treatment led to drug abuse, dependency and many long term side effects which could be controlled by the integration of techniques of meditative yoga and visualization. The interventions have been provided with sound historical basis and theoretical support which makes it acceptable as an alternative mode of complementary treatment. Chan (2002) has very accurately described meditation as selected number one mind - body therapy which has the capacity to induce relaxation as well reduce hyper stimulation or arousal from a stressful stimulant. The theory tends to combine the techniques of relaxation as well meditation to induce therapeutic modifications within the physiology which can harness the harmful effects of the stressful factors.

History Meditation is the ancient technique of scientific techniques formulated in 2nd century BC by sage Patanjali which have been highly effective in treating psychological and psychiatric disorders as we acknowledge them today. The classical form of yoga focuses on the yoga sutras of Patanjali which has been the basis of the classical yoga and consists of 195 aphorisms or sutras which has been based on the eightfold principles of classical yoga.
   
The classical form of yoga as propounded by Sage Patanjali believed that an individual is made of composite matter which is composed of prakriti (the matter) and purusha (the spirit). The method of union between spirit and matter has been presented in the form of yoga aphorisms which leads to the union of the body and the mind. Meditation has been the essence of the yoga sutras propounded by Patanjali, the techniques were used to perfect the union between the body and the mind. Many yogis made and attempt to perfect their body and mind to eh level of immortality. The transformations were physiological, psychological and psychosomatic.

Theory The technique of Meditative Yoga involves combined integration of meditation techniques and breathing techniques in harmony with the medical treatment to address specific psychiatric issues like OCD (Obsessive Compulsive Disorder). The techniques are designed for specific treatment in relation to anxiety, emotional imbalance, chronic diseases and fatigue. The key theory is aimed at creating harmony in the person by addressing the mind of the person through physical and mental techniques. The intuitive mind is given command to address the psychosomatic issue which can help regenerate the central nervous system.
   
The techniques help mastery over self by a series of breathing techniques which induces relaxation and helps reduce stress which merges recurrently in the modern lifestyle. The objective is to manage fear, control anger, encourage positive thoughts and accept challenges with positive frame of mind. The techniques are designed in such a manner that they lead from one to another in a manner to bring the individual, community and medical science in harmony to deal with the specific disorder within a specified timeframe. These techniques can be applied to different phobias, psychiatric disorders, insomnia, grief and other major psychosomatic disorders of psychological and physiological nature. The objective is to induce personal healing through the use of breathing and meditative techniques which can uplift the patient and inspire him to take action and control of his personal condition with dedication and faith.
    
The theory involves mindfulness based stress reduction techniques and therapy as well as cognitive behavioral stress disorder. It has been observed that an eight week program results in significant control of the stress factors. It involves savasana which induces perfect relaxation practice of postures or asanas which prepares and trains the body for proper functioning of internal organs pranayama which focuses on proper control of breathing which helps control the mind proper diet and meditation which includes positive control of thought waves of the mind which enhances the psychological performance of an individual.
   
Essentially the principles of yoga were more community oriented and gradually took an inward route which helped transform the physical and psychological disorders existing within the human body and mind. Now it has been accepted by medical science through proven clinical trials and research as an effective method of treating many psychological disorders which cannot be controlled with the use of medication to control stress related ailments by induction of relaxation and meditative techniques. Meditative yoga has emerged as a very rapid movement which has been accepted by people to counter the dramatically changed lifestyle related issues which encompass everyday life of people.
   
Two critical summarized studies The case studies undertaken for evaluation and critical assessment have been the basis of clinical trials conducted to evaluate mindfulness based intervention in the light of the scientific impact observed and seen in the outcomes related to stress induced medical conditions.
Case study 1 The title of the case study was A Pilot study comparing the effects of mindfulness-based and cognitive behavior stress reduction by Smith BW, Shelley BM, Wiggins K, Tooley E, Bernard J. J Attern Complement Med. 2008, Apr, 14(3) 251-258. 
   
The objective of the pilot study was to do comparative evaluation of mind-body intervention in assessment of mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR) (Smith et al, 2008). The pilot study was conducted on 50 subjects who were voluntarily recruited from the community and were enrolled in the MBSR and CBSR courses which were taught for eight weeks at different time intervals. The gender, income and education were not the criteria for selection. The MBSR course comprised of eight week program which used meditation, gentle yoga and body visualization or scanning to increase the level of awareness and mindfulness. This was also integrated with CBSR scientific cognitive and behavioral techniques which could transform thinking and lead to reduction in stress levels. The study was designed to address the perceived levels of stress, energy levels, neuroticism, pain and any reporting of binge eating (Smith. Et al, 2008). The results indicated that MBSR subjects improved well on all eight levels of outcome, while CBSR subjects improved only on six outcomes. The level of differences in their outcomes was very significant. The multivariate analysis indicated MBSR subjects indicating better outcomes across all variables, in comparison to CBSR subjects. The univariate analysis showed MBSR subjects surpassed CBSR subjects in their outcomes with regard to Mindfulness, energy, pain and a trend for binge eating(Smith. et al, 2008).  It was evident that both MBSR and CBSR were effective in reduction of perceived levels of stress and depression, MBSR proved to be more effective in raising the levels with regard to mindfulness and energy levels which helped in pain reduction.

Case Study 2 The case study two includes various articles on effectiveness of meditative techniques as presented based on various clinical trials . The title of the article by  Shannahoff-Khalsa DS, An Introduction to Kundalini Yoga Meditation Techniques That Are Specific for the Treatment of Psychiatric Disorders , THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 10, Number 1, 2004, pp. 91101.
   
The article focuses on the ancient system of meditative technique which involves the arousal of the Kundalini, which has been studied through several clinical trials as an effective technique for treating psychiatric disorders. This has had very positive and specific outcome in treating obsessive-compulsive disorder (OCD). The paper focuses on two clinical trials which have been aimed addressing such disorder. The protocol and technique which is used to address OCD have also been found to be effective in treating other disorders of psychiatric nature like phobias, addictive and substance abuse disorders, major depressive disorders, dyslexia, grief, insomnia and other sleep disorders.( Shannahoff-Khalsa, 2004). Many Meditative techniques have been used to address the specific disorder and have been recognized by the specific medical community and scientific world.
   
The first pilot study was conducted by Shannahoff-Khalsa DS, Beckett LR. Clinical case report Efficacy of yogic techniques in the treatment of obsessive compulsive disorder. Int J Neurosci 199685117. This study involved eight patients out of which five completed the 12 month trial. The checklist of the symptoms was maintained and the severity index was also recorded. The role of Fluoxetine in controlling the symptoms was determined. The randomized study indicated that the meditative techniques helped those who did not drop out of the program. Those who completed the program were successful in observation of significant improvement clinically. It also confirmed that mediation protocol was important to maintaining the effectiveness of the outcome.

Critical Assessment of clinical trials It is important to recognize the fact that the Meditative Yoga techniques are complementary to the medical care and scientific intervention. It is important to integrate this technique under the knowledge of the medical care consultant and health care professionals. The meditation techniques in integration with medical intervention and control are an excellent tool for effectively controlling the symptoms which are found in addictive disorders, phobias and other mental disorders. The mediation protocol thus soundly asserts the and supports the medical and scientific approach with better and more long term stability in patients suffering from mental disorders.
   
The future demands that medical society integrate mediation as part of the treatment to alleviate different forms of mental and physical afflictions which have been rising with the modern age lifestyle. There is significant evidence which proves that mediation protocols have capacity to control the symptoms to a measurable degree. The knowledge and practice of this technique will help the medical and scientific community as well as the patients to a greater degree.

Conclusion There has been tremendous awareness based on scientific confirmation of the positive impacts of meditative yoga in overcoming the degenerating attitudes and the way of life in which people worldwide have slipped into. The everyday problems and the stress factors have grown to magnanimous leaps leading to change in attitude which concerns health and way of life. Spirituality has taken a back seat and morals have degenerated. The survival in these chaotic and stressful times requires nurturing of principles which provides protection from the sufferings and the psychical and psychological stressful situations which human beings are encountered with. The emergence and epidemic of new disease which have been mushrooming with vengeance against human race has led to lethal use of antibiotics and other medicines to the point of no return. Under these trying circumstances which afflicts human race meditative yoga provides a technique and methodology which can help curb the impact of these social and psychical ailments afflicting human race.

There is need for reform and positive change in attitude which is lifestyle based and in harmony with the body and mind requirements and has simplicity which merges with the environment. This is the only solution to the overdramatic life which magnifies everyday problems.

1.  A current course in Stress would not be complete without making a distinction between stress and trauma and the impact of the threat of terrorism in our society. Discuss how an event becomes traumatic rather than stressful. What are the primary differences between stress and trauma
   
Stress and trauma are primarily differentiated by the effect of the problematic situation upon the person experiencing it.  Stress occurs when there is any kind of conflict in a persons life, and trauma occurs when a person is not able to appropriately manage the stress (Dusek, Everly,  Girdano, 2008).  Any kind of problematic situation has the capacity to invoke a stress reaction, and any person is able to become traumatized when the stressful situation is too difficult to manage.  While some stressful situations are able to be rationally and emotionally handled, there are some problems and some people where stress turns excessive, leading to trauma.

2.  Discuss whether a large, though remote, event, such as 911 or Hurricane Katrina affects ones stress level more or less than a smaller, but more personal event such as a car accident or assault.
   
Large stressful events which occur on a large scale level at a remote distance from the person experiencing have about the same potential stress reaction as a smaller, more personal event such as a car accident or assault.  Broadly speaking, all problematic situations are able to invoke stress, yet individuals react in various ways to stressful situations (Dusek, Everly,  Girdano, 2008).  Some people are able to keep level headed and calm even in highly difficult situations, while other people have extreme reactions to what other people would consider to be small problems.  Every person reacts differently in different situations, so there is no way of saying exactly what will be more or less stressful or traumatic for a person.

3.  Chapter 11 offers information that will come as no surprise to anyone in the working world, when is asserts that work relationships are listed as the number one stressor in just about every survey on stress that is given.  Discuss the reasons for this, and use examples where possible.  To what extent does the most tension result from a persons personal expectations versus the expectations of others in the work environment
  
Personal expectations within the work environment are often at odds with the desires and whims of other people.  Although a worker may have an eye fixed on a particular project, goal, or position, it is not always the case that the worker is rewarded as one would like.  Stress may come from difficult managers, stressful peers, or frustrating employees.  Relationships at work are often at odds, because people see through different eyes and have varying priorities and perspectives (Dusek, Everly,  Girdano, 2008).  It is important to recognize that personal expectations may not always jive with the expectations of others in the work environment.  As a way to ensure a lower stress level, it is important for workers to set realistic goals, to accept that fact their desires may go unsatisfied, and to explore whether or not it makes sense to remain in present positions.

4. Role ambiguity and role conflict are contributors to frustration on the job. Discuss both but indicate which of the two is dominant as they would pertain to the following individuals.  Short of changing jobs, what strategies, could be employ to change the job environment from mostly a stressor to mostly an opportunity.

a) Married female with two teenage children (Both teens have extracurricular activities)
    This woman may find that she is facing role conflict as a worker.  Role conflict pertains to the fact that she may feel as if her role as a mother is at odds with her role as a worker.  Resolving role conflict may first need to stem from cutting out any unnecessary after school activities, so that she is able to spend more time with her children.

b) Military Spouse (Deployed Spouse)
This man may find that he is facing role conflict as a soldier.  Role conflict pertains to the fact that he may feel as if his role as a soldier is at odds with his role as a husband.  Resolving role conflict may first need to stem from discussing the situation with his wife, so that he is able to know exactly how his absence affects their relationship.

c) College Student
This woman may find that she is facing role ambiguity as a student.  Role ambiguity means that she is unsure about whether or not it is important for her to be in college.  Perhaps it would be good for her to make a list of the pros and cons of studying to obtain a degree.

d) Employed in a career that is highly technical in nature, long hours to include overtime, deadlines and increasing responsibilities.
This man may find that he is facing role ambiguity as a worker.  Role ambiguity means that he is unsure about whether or not it is important for him to be working in this position.  Perhaps it would be good for him to figure out ways to reduce his hours and responsibilities at work.

Stem cells are particular cells in the body that are able to renew themselves via mitosis and can differentiate into several diverse specialized cells. These cells play a key role in the developing treatments for a variety of medical issues that result in the deaths of thousands. Great success has been witnessed from the stem cell research and several potential cures for future development have been connected to the study. It was early 2009 when the FDA supported and gave its consent on the first human clinical trials utilizing these embryonic stem cells (Korobkin 77). There are three foremost sources for acquiring the stem cells and these are the cord cells, adult cells, and embryonic cells. According to studies, embryonic stem cells are more expansive than other adult stem cells (Ruse 64). Adult stem cells are said to be in general limited to differentiating into diverse and different cell kinds. Though, as embryonic stem cells are more favored and said to be more useful, there is a probability of it being rejected by the immune system as stem cells are not the patients (70).

Stem cell research has been going on for the past fifty years However, it is still considered to be a somewhat new technology that takes human cells and develops them into other varieties of cells found in the human body. Stem cells have been used for degenerative conditions, physical trauma, as well as genetic disorders.

This stem cell research brings huge potential in curing several diseases that will mentioned by the end of this research. Medical research has been anticipating the use of modern technologies to further enhance the stem cell research and be able to alleviate pains and disorders. The issue of stem cell research has long been controversial as the conception of a human embryonic cell line necessitates the human embryo to be destroyed considering the current state of technology that is present at the moment.

Pros
Stem cell research has been smothered with debates sparking since it was first launched. It has brought upon two sides to the topic, the positive and the negative side. The positive are the pros of stem cell research, while the negative are the cons.

One of the most distinct positive sides to stem cell research was its contribution to the medical field. It provides possible major breakthrough in the fields of therapeutic cloning and regenerative medicine (Bellomo 122). It had given several medical treatments possible today such as for patients of lymphoma and leukemia, and theoretically could bring more potential breakthroughs such as treatment for brain damage, heart conditions, and infertility throughout the medical field (Joseph 2004).
Promising is a word that can truly be attributed to stem cell research. Currently, several treatments and procedures for patients with leukemia would not be possible without the help of stem cell research. There are still more promising treatments that can cure serious and currently incurable diseases such as cancer and brain damage. If the cure for these diseases will be unlock, millions if not billions of lives will be spared from these very serious illnesses.

At present, some treatments and procedures that could be linked to the breakthrough in the stem cell research include the use of bone marrows and even umbilical cord blood stem cells to cancer patients with leukemia and lymphoma. Even with its side effects, chemotherapy still is arguably the preeminent treatment a cancer patient can receive. But as one of its side effects, the cytotoxic agents in chemotherapy not only kill cancer cells but also most of growing cells of a person, laying them most of the time weak. The unfortunate effects of the treatment to the patients are those that the Stem Cell Transplant attempts to reverse. And with more and more breakthrough, the todays system of using matching donor stem cells can be replaced with a more efficient and more effective stem cell directly gathered from the patient himself (Holland 29).

Researchers anticipates someday being able to use breakthroughs to find cure for diseases such as cancer, Type 1 diabetes mellitus, muscle damages, damages to the spinal cord and other currently incurable diseases and impairments with Stem Cells taken from the patient (Ruse 53). Very promising treatments are foreseen with the use of adult stem cells over with the use of embryonic stem cells as there are no rejection issues for stem cells are taken from the patient directly (Snow 103).

An argument pro to embryonic stem cell research emphasizes the use of unused embryos from unused zygotes that are not transplanted after its conception. It is narrowly noted that the world destroys hundreds of thousands of unused embryos supposedly for in vitro fertilization or for test tube babies. These wasted embryos could mean the discovery of cure for life threatening or life taking diseases humans face. Additionally, the value of the embryos could not equal the value of the human lives it may save as it is used for the research - Blastocysts are no more human that a skin cell as its cells are still clustered and have not been differentiated into any distinct organ tissues. They are more comparable to a skin cell than a human at that stage. It is clear that in Australia over 70,000 unused embryos are destroyed (Korobkin 297). In Vitro Fertilization generates these many excess of embryos that will only be destroyed anyway. Rather than putting the embryos to good use, they are instead destroyed by whatever means possible (Snow 140).

There are also arguments with the beginning of life with regards to the use of embryos. Claims that life begins with fertilization can be counter acted with the example of twins. A single fertilized egg can split into two to form identical twins, or a less common phenomenon is the fertilization of two different eggs that makes up fraternal twins but then fuses together and develops into a single human individual, such as a tetragametic chimera (Joseph 267). With these phenomena, it provides information that a human life does not exist at fertilization and therefore the blastocysts used for embryonic stem cell research still do not have human life and thus the ethical concerns can be dismissed.

The foremost argument of those against any form of stem cell research is the importance of the human life. Critics contend that the human life should not be messed with, and that people should not play like God. Arguments on how stem cell research might lead to knowledge on cloning humans in the future have been presented. No specific evidences have backed up these cloning issues yet critics are very watchful and very much in opposition of this scientific research. Whether or not the stem cell research will lead to cloning humans, research-programs have had destructive consequences like the nuclear research (Ruse 78).
There will be other methods available that can be of help to the human population. Researchers and scientists should focus more on finding and developing more ethical methods like the use of adult stem cells in order to have an ethical scientific breakthrough. Using embryonic cells in research is just unethical for the destruction of blastocysts, which are formed from the laboratory-fertilized human eggs, is inevitable (189). The blastocyst is considered as a human life as upon conception, life begins. Destroying blastocysts is morally wrong and intolerable.

Unless an egg is inhibited, it will become and develop into a human being once fertilized. Hence the value for an embryo should be as a high as a born human being. Religious doctrines can establish this theory as the beginning of life or the existence of soul starts during conception. It is simply unjust to voluntarily damage and destroy human life through embryonic stem cell research. Arguments have been laid out on how an embryo develops to human life remains to be subjective (Holland 89).

Another argument against the use of embryos for embryonic stem cell research focuses on the lives of these embryos. It follows that with the fertilization of an egg, unless inhibited, will mark the beginning of the human life. There are alternatives to embryonic stem cell research that does not include the use of destroying blastocysts. Also, there are several scientific claws in the embryonic stem cell research and the technologies used for it. Another is that the research potential of embryonic stem cell research are overstated and overused.

Critics are also very firm with their argument on how this scientific research has ethical concern and issues on the work on aborted fetuses. It has been supposed that the possible help or benefits from the stem cell research cannot justify the disregard for ethical concerns. According to these critics, the value for human life should be given even to a fertilized egg. Life should never be compromised for the sake of a scientific study. It is not and will never be ethical to destroy one human life for a probable solution or treatment to save another life.

Viability is yet another standard wherein fetuses as well as embryos are deemed to be human lives. In one case in the Unites States it was concluded that the acceptability of abortions carried out for reasons other than that of the womans or mothers health was determined by viability. Viability is defined to be the point where a fetus has the potential to be able to live outside the womb of the mother albeit by means of artificial support or aid (Snow 111).

It takes about 22 weeks to determine and decide the point of viability. It used to take 24 to 28 weeks but with the advancements in medical technology, fewer weeks were needed. As further technological breakthroughs will be made and will allow an egg and sperm to be combined and entirely conceive outside of a womb, the embryo will be viable and under the viability standard, it ascertains that life begins during conception

Much of the stem cell research controversy has sprung out from the different laws and policy governance implemented that concern the study and use for treatments of stem cells. These stem cell laws vary considerably by country and region. Stem cell research, with the use of human embryo is allowed in several countries in the European Union including Belgium, Finland, Greece, Sweden, Denmark, and Britain. It is however considered illegal in the Italian, Portuguese, Austrian, and German territories.
In the Americas region, the United States is divided with some states being pro stem cell research while others being very much against it. Canada permitted doing research on discarded embryos through in vitro fertilization process since 2006 (Korobkin 312). It however still prohibits the conception of human embryos for the purpose of research. In South America particularly Brazil, legislation has been passed that allows stem cell research by in vitro fertilized embryos given that these have been frozen for at least 3 years.
China does not allow human reproductive cloning but is in favor of creating human embryos for research as well as therapeutic intentions or purposes. Japan follows the same policy as well as South Korea who promotes cloning as long as its for therapeutic purposes. Australia is moderately in support of stem cell research while New Zealand prohibits the research.

For decades, stem cells have been used in treating conditions such as lymphoma and leukemia. With further studies, it is believed that these stem cells can be a potential treatment for numerous widespread disorders and diseases such as heart and brain damage, deafness, spinal cord injury, vision impairment and blindness, amyotrophic lateral sclerosis, diabetes, orthopedics, infertility, and neural as well as behavioral birth defects.

Those against the stem cell research are firm in their beliefs that it still lacks practicality and is very much unethical. On the other hand, supporters solidly claim that advances will come through further studies and with more time. Breakthroughs in the research are said to be unpredictable and will yield positive results in the medical field. The stem cell controversy still remains to be a strongly debated issue on both aspects.

An aneurysm is defined as a more than 50 increase in the diameter of an artery caused by a weakening of the arterial wall (Hallet 2008). Aneurysms of the aorta are the most common and may effect either the thoracic or abdominal portion of this artery. However, only 25 of aortic aneurysms affect the thoracic portion, striking both men and women equally. Abdominal aortic aneurysms (AAA) on the contrary are known to be three to six times more prevalent in men (Hallet 2008, Vardulaki 2000 cited in MASS 2002 1531). AAA are defined as an aortic diameter superior to three centimeters (Hallet 2008). Risk factors include smoking, hypertension, old age, family history, race and gender.

Statistical relevance
It is estimated that 0.5 to 3.2 of the population suffers from AAA (Hallet 2008) and that the disease is responsible for 2.1 of deaths in men over the age of 65 (MASS 2002). In the United States alone, this accounts for 9,000 deaths per year, 33,000 elective surgeries and 1400 to 2800 surgically related deaths (The Aneurysm Detection and Management Veterans Affairs Cooperative Study Group 2002).

Clinical aspects
Patients suffering from AAA rarely show clinical signs before the aneurysm ruptures (Lindholt 2005). When clinical signs are present, they tend to be discreet, depending on their size and growth rate. Though rare, rapidly growing aneurysms can be sensitive, especially before they rupture. In general, aneurysm patients that present clinical signs will complain of a constant pain in the lumbosacral region or will present an abnormal pulsating mass in the lower abdomen. In some cases, auscultation of the area will detect a systolic murmur (Hallet 2008). Unfortunately, the most commonly noted signs of AAA appear once the aneurysm has ruptured. Approximately half of these patients will die before arriving at a hospital and an additional 30 to 70 will die upon arrival (MASS 2002). This high mortality rate of 65 to 85 stresses the necessity for adequate screening of all patients at risk for AAA. 

Diagnosis
AAA can be diagnosed through different imaging techniques. Ultrasonography is the most cost efficient, minimally invasive technique. Other possibilities include computed tomography or magnetic resonance angiography which can be useful in defining the aneurism s size and anatomy (Hallet 2008). In some cases, routine radiographs performed in search of other abnormalities may allow the practitioner to view a calcification of the affected arterial wall.

Treatment
A ruptured abdominal aortic aneurysm requires emergency surgery. Two surgical techniques exist. The first involves open laparotomy. This technique is associated with a 50 mortality rate. Endovascular stent grafting has a lower, though still considerable mortality rate of 20-30 (Hallet 2008). Mortality rates are high in both cases due to the precarious cardiovascular state these patients arrive in and to preexisting concomitant cardiovascular diseases. In cases where AAA is detected before rupture occurs, elective graft surgery may be proposed depending on the risk of rupture but also on the presence or not of contraindications for surgery. Indeed, because the elective surgery is associated with a 2-6 mortality rate, it is important to carefully select patients for this preventive surgery (MASS 2002). Conservative treatment consists of controlling risk factors such as hypertension.

Screening is an important measure in controlling AAA. Patients diagnosed with this ailment must be followed on a regular basis and informed of the possibility of elective surgery and of it s associated mortality rates. Ultrasonography is the technique of choice as it minimizes the patient s exposure to radiation. The following articles discuss different screening programs.

Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysms
The study clearly stated it s objective to compare the outcome of patients diagnosed with small AAA according to their treatment plan a) immediate surgical repair, or b) ultrasonographic or CT surveillance with surgery reserved for high risk aneurysms. Patients 50 to 79 years of age who had been diagnosed by CT with an AAA 4.0 to 5.4 cm in diameters within 12 weeks of the beginning of the study were included. A complete list of exclusion criteria was also provided in the article. The study was then correctly carried out as a RCT to avoid bias in treatment assignment, to facilitate blinding and to allow the use of the probability theory.

Patients were randomly assigned to one of two blocks (immediate repair or surveillance) by a computer generated random-number code. The study was composed of two equally sized groups of over 500 patients each. This allowed to statistically prove the results with a confidence level of 95. Randomization was stratified for each medical centre to ensure a proper balance of participants  characteristics between groups.

The two groups were very similar at baseline. Considering the surgical nature of the treatment made it was impossible to conceal to which group patients had been allocated. To compensate for this, neither patients nor investigators had access to the outcome data during the study and the causes of all deaths were determined by a blinded outcomes committee. CT scans were also evaluated by a central laboratory. Though not perfectly blinded, all efforts were made to eliminate observer bias.

The status (dead or alive  surgically repaired or not) of all 1136 patients was accounted for at the end of the study and the group related outcomes evaluated through intention-to-treat analysis. 92.6 of immediate-repair patients and 61.6 of the surveillance group patients had undergone surgery.  It was unclear why the remaining 7.4 of immediate-repair patients had not undergone surgery. Data from surviving patients was collected through follow-up visits and final CT scans. Causes of death were determined by an outcomes committee.
Results were presented as a relative risk of death, either from AAA-related causes or all causes. No significant difference in outcome was noted between the immediate-repair group and the surveillance group.

A confidence level of 95 was reported for all results. The results are precise enough to encourage patients to follow a surveillance program rather than opting for immediate elective surgery for small aneurysms.
This study proved that immediate-repair was not associated with a higher survival rate but rather with more hospitalizations and therefore a higher cost than a surveillance program. Unfortunately, the majority of the patients included in this study were men. Though their is a higher prevalence of AAA among older men, the study would have been more interesting had it included more women, especially considering that women are at a higher risk for AAA rupture. The results of this study are therefore relevant for men but not necessarily for women. 
Screening for abdominal aortic aneurysms single centre randomised controlled trial

The study was clearly focused on determining if AAA screening reduced mortality rates in Danish men (64 to 73 years old) from Viborg County. It was appropriately performed as a RCT, comparing a screening group to a control group. The means by which 12,639 men were randomly assigned to either the screening group (6333) or the control population (6306) are not described. Though the groups were balanced in numbers, little data is available making it impossible to judge if the two groups were statistically similar at baseline.

The patients were not blinded and were informed of the risk factors for AAA, possibly causing a behavior bias. All outcome data was analyzed by two blinded surgeons, thus eliminating observer bias. All 12,639 men who entered the trial were accounted for (dead or alive  treated or not). No patients were transfered from their original group even though 1481 men from the screening group did not attend screening. Analysis of all outcome data was carried out on an intention-to-treat principal. 
Patients  in both groups were followed up for 0 to 69 months. Though the two groups were apparently similar for duration of follow-up, this still represents a large variation in data collection. Data on deaths and surgical procedures were collected by the same means in both groups.

The results are presented as relative risks with a confidence interval of 95 and appropriate p values. They are very precise with very low p values and acceptably small intervals. The results prove that screening significantly increases the number of men to undergo elective surgery and decreases the number of ruptured AAA as well as the number of AAA-related deaths. The benefits of screening on outcome are as clear at the lower confidence level as at the higher level.

All outcomes (relative risk of outcome, elective or emergency surgery and AAA rupture) were properly considered between the two groups. The study excluded women and gave very little information on it s population, thus making it difficult for readers to compare the study groups to any local populations. However, the discovery that only 352 men must be screened to save one life makes the results of this study particularly interesting, even considering the study s shortcomings.  
The Multicentre Aneurysm Screening Study into the effect of abdominal aortic aneurysm screening on mortality in men a randomised controlled trial.

The study s clearly stated objectives were to evaluate the mortality rate (AAA-related and not) and the quality of life of men, aged 65 to 74 years living in the UK, screened for AAA in comparison with a control population. The study was therefore appropriately designed as a RCT with patients being randomly assigned to either a screening group or a control group. Patients were randomly allocated to one of the two groups through computer generated pseudorandom numbers. Randomization was then balanced at baseline for screening centre, age and social deprivation scores.

Attempts were made to carry out a blinded study. For instance, a data monitoring committee was responsible for evaluating death related information and the sponsors of the trial played no role in the study.
Results were not provided to the trial coordinators until all data had been collected.  80 of the men invited for screening were evaluated. Final outcome (dead or alive) was available for 99 of the men initially randomized.

Clinical follow-up was available for 81 of patients in whom screening had detected an aneurysm. Data was evaluated following a pre-specified plan. Death certificates were obtained through the Office of National Statistics and analyzed by a data monitoring committee. Surgical data was obtained through the medical centers and subsamples of each group completed identical tests to evaluate their quality of life following screening.

Before the trail began, it was determined that 66,000 men needed to be randomized to detect a 30 decrease in mortality with an 80 power of detection and a 5 significance level. This was based on approximately 115 ruptured AAA deaths in the control group. Over 70,000 men were therefore randomized which allowed to observe 91 deaths from ruptured AAA in the control population.
Results were presented as hazard ratios and corresponding absolute risks. AAA-related deaths were reduced in the screening group when compared to the control population (hazard ratio of 0.58). No significant change in mental health was noted in the men, regardless of their group and screening results. Outcome was evaluated with a 95 confidence level, a tight interval and a low p value of 0.0002. Mental health results were also subjected to low p values.

The financial aspect of screening was not discussed in this study. Though a reference was made to future publication of these results, a comment on the cost of screening would have been interesting.

Population based randomised controlled trial on impact of screening on mortality from aaa
The study aimed to discover if a screening program for AAA would reduce AAA-related mortality rates in Perth men aged 65 to 79 years. It was appropriately carried out as a RCT, comparing a study group to a control group. Participants were allocated to two equal sized groups balanced for age. No description of the randomization process is given making it impossible to evaluate if the process was appropriate or biased.

All attempts were made to eliminate observer bias. Australia s unified database system allowed for all data pertaining to the participants  surgical procedures andor deaths to be accounted for at the end. Data was submitted to an intention-to-treat analysis. A blinded researcher evaluated death certificates for cause of death. When AAA was involved, a second blinded analysis was completed for confirmation.

All outcome data was collected through Australia s unified database system. Both groups suffered equal losses between randomization and screening. Low participation rates may have biased the results in contrast to other studies with stricter inclusion criteria and higher participation rates. It was estimated that a study involving a control group of 20,000 men experiencing about 55 AAA-related deaths would allow to detect a 50 reduction in mortality with a power of 90. The study s control group was therefore composed of 19,352 men which resulted in only 27 AAA-related deaths.

Results were presented as ratios with confidence intervals of 95. Men in the screening group were twice as likely to undergo elective surgery (p0.002). Screening of men aged 65 to 83 did not significantly decrease the mortality rate. Men aged 65 to 74 (normal target group) benefited more from screening then older men, the odds ratio between this subgroup and the control group being of 0.19 (p0.001). Results considered significant in the study were presented with adequate confidence intervals and p values, making them reliable at both ends of the interval.

The inclusion of older participants in this study, combined with the lack of exclusion criteria and low attendance rates confounded the results. This did however stress the importance of targeting the proper age group in order to benefit from screening. The study also suggested that invitations to screening may be better accepted if sent by the patient s practitioner rather than an unknown source.

Randomised clinical trial of screening for abdominal aortic aneurysm in women
The study s objective was to determine the benefit of screening women living in Chichester, aged 65 to 80 years of age, for AAA. This was a RCT comparing the outcome of patients in a screening group to a control population. No information was provided on the randomization process. Participants were apparently randomly allocated to either the screening group or the control group, which were of equal sizes and age-matched. The article describes no attempts to achieve blindness.

Only 3052 of the 4682 women invited to screening accepted. The article provides no explanation for the number of participants selected nor any description of the statistical analysis that the authors planned to use to evaluate the results. Results pertaining to death were obtained for all participants through the district Registrar of Births and Deaths. Only women with detected aneurysms were invited to follow-up exams. Four of the ten women in the screening group who died from ruptured AAA had had normal initial scans.
The results are presented as absolute values or percentages, with no reference to ratios, confidence intervals or p values. However, the results are very clear. Indeed, the prevalence of AAA-related mortalities was so low in both the screening and control groups that statistical evaluation was unnecessary to prove that screening did not reduce the rate of mortality.

The study discovered that women are affected by AAA later in life and that, contrary to men, a higher percentage suffer from AAA rupture after the age of 80 years. It would have been interesting for the study to include women over the age of 80, even though these patients are much less likely to be eligible for elective surgery.

Discussion

The study entitled Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysms compared survival rates in patients aged 59 to 70 years of aged, diagnosed with an AAA. Patients either underwent immediate surgical repair of their aneurysms or entered a surveillance program, with surgery reserved for certain situations. This study was well designed with proper attention put on randomization and blinding. However, the study was composed of a limited number of participants when compared to the other studies. Furthermore, participants were aged from 50 to 70 years of age, which is lower than the recommended screening age. According to the United Kingdom National Screening Committee (UKNSC), screening for AAA should be offered to men 65 years or older. By including younger individuals in their study, the authors may have biased the results. Indeed, younger patients would be healthier and more resistant to surgery. This study should have been designed according to the UKNSC screening criteria to better evaluate the proper target group and ensure the credibility and relevance of the results.

The Danish study entitled Screening for abdominal aortic aneurysms single centre randomised controlled trial was carried out on a larger scale. However, the lack of details provided concerning the randomization process is a major weakness as it may hide any number of biases. Furthermore, the participants were all chosen from the same county which may have been another cause for bias. Finally, the age limit of patients accepted into the trial was slightly lower than the age recommended by the UKNSC. This is another possible cause of bias that may have altered the results, making them less applicable to the United Kingdom.
The UK multicentre study was a very well designed study. The participants selected corresponded to the UKNSC criteria. Statistical analysis provided credible results and proved that screening the proper population of men for AAA reduced AAA-related deaths by 42. The study s main weakness was the use of death certificates to determine cause of death. Indeed, though all efforts were made to limit bias at this level, the retrospective approach may have altered some of the results. Finally, only a limited number of participants were questioned to determine the effects of screening on quality of life. This may also have biased the results.

The Western Australian study clearly demonstrates the importance of correctly choosing the screening population. In screening men younger than 65 years of age, no significant reduction in mortality rates was noted. However, when the data for the proper age group was evaluated alone, the results became significant. This study may have other sources of bias hidden in the group allocation process. Indeed, the article failed to describe the randomization process used.

Finally, the UK screening study performed on women was a weakly designed and poorly presented study. Whereas the UKNSC recommends screening men over the age of 65, this study screened women over the age of 65. As was predictable when considering the lower prevalence of AAA in women, the program showed that screening women was neither beneficial in saving live nor cost efficient. Furthermore, the results of this study are unreliable for many reasons. First, no description of the randomization process was provided. Second, the data was not provided with confidence intervals, p values or any mention of statistical analysis.

To summarize the results of these five studies, a proper screening program for AAA aimed at men over the age of 65 years will be beneficial in saving lives.

People view life as ideal when it is in equilibrium. Almost all peoples believe in the principle of equilibrium, wherein everything should be in balance. They believe that only in balance can one find harmony. Some believe that this is achieved when an excess is balanced by another force. The principle of equilibrium mainly focuses on the persons personality and health, wherein these depend on all of the humors. Thus, when there is an excess or deficiency in one or more of the humors, the human body becomes ill.

The Tibetan term nyes pa, which means defect, is translated in English as humor. There are three classifications of humors, namely wind, bile and phlegm. These three humors have five sub - classification. The five classifications of wind humor are life-sustaining, pervading, fire-accompanying, ascending and descending wind.  On the other hand, the five classifications of bile humor are digestive e, accomplishing, color-transforming, complexion  clearing, and sight  giving. Also, the five kinds of phlegm are the supportive, experiencing, decomposing, satisfying, and connective phlegm. These three humors are believed to come from three mental afflictions of attachment, delusion and hatred. Tibetans believe that attachment is the primary cause of the imbalances that results to wind humor. On the other hand, delusion produces imbalances of phlegm humor and hatred is the cause of bile imbalances. At equilibrium, these humors sustain the human body thus a person has good health but during illness, the humors produce cold and heat disorders (Dondes, 2000).

The Chinese has a different perspective on the principle of equilibrium. As discussed in class by Pam Kemp, they believe that the body structure of a human being is composed of a Yin and a Yang. It is believed that the front of the body is Yin and the back is Yang. This also applies on the body organs. The Yin organs are those you cannot live without, while the Yang organs are those you can live without, example spleen. The Yin and

Yang are of opposite nature however, they depend on each other.
Thus, different races believe that an imbalance to the elements sustaining life and good health leads to illness. There are different etiologies of illness, as discussed in class. On naturalistic point of view, illness is caused by an imbalance of the elements, which may be humors, dosha, or yin and yang. On the other hand, the personalistic point of view believes that illness is caused by the intervention of a non-human or supernatural agent.

These different views on the cause of illness guide the treatment done by the health care provider before the modern medicine. As Diane Mandel said, healing is recognizing that there is an interrelationship of all things. This is important to remember because an illness is not only localized in one area or aspect but it can also affect the whole system of the body and even the mental health of the person. The Tibetans has a way of treating illness that uses sound. The sound bowl healing is a therapy wherein healing with sounds brings us to consciousness of oneness. This sense of wholeness is perceived as a divine light energy that we came into existence with. They also believe that this energy continues to exist in the physical world even after a person leaves his body because they believe that energy is finite and doesnt leave the planet. On the other hand, one of the treatments that Chinese do on the ill person is acupuncture. Pam Kemp discussed in class that although there are hundred of points in the body, it is not necessary to stick needles in all these points. The Chinese believe that through these needles, the negative energy can flow out of the body, thus balancing the forces within the body and in the process healing the person.

It is widely accepted that different races have different belief on the forces that brings ones health and the world into balance. There is no cardinal way in treating an illness even in modern medicine. Although the Tibetan and Chinese way of treating an illness is not well supported by research studies done scientifically, years will tell us that these methods of treatment are effective.

In the ancient times before the advent of the modern diagnosis and treatment methods, each culture had its own way of diagnosing, treating, and explaining diseases and illnesses. Today, there are complex scientific methods that are designed to identify and manage anomalies in the human body through rational explanations. However, some of the effective ancient methods are still in use while others are gaining acceptance. Such methods are usually referred to as Alternative Medicine. Any method that does not fall within the category of the conventional medicine and encompasses cultural and ancient practices is referred to as alternative medicine.
   
The Tibetan and Hmong medical practices are some of the ancient practices that have persisted and continue to thrive in the era of modern conventional medicine. However, in all medical systems, there are certain aspects that are common. The healing systems relate the body to the cosmos, have explanations for causes of illnesses, have diagnostic tools and methods, have healers and helpers, and they have preventive and curative measures. This article will focus on these aspects (universals) in the context of the Tibetan and Hmong systems and compare them with the western biomedical model.
Relation of the Body and the Cosmos
   
Cosmos relates to a harmonious balanced system. The Hmong and Tibetan medical systems hold that the body, the soul, and the spirits exist in a harmonious system. The Hmong believe that the human world and the spirit world exist in balance and the good relationship is maintained by ceremonies and sacrifices to please the spirits. They also believe that the ancestors who are now part of the spirit world determine a persons health and wealth (Lecture 8 notes).
   
On the other hand, the modern western biomedical system has a one dimensional view. It holds a naturalistic view that only the material world exists and that everything operates within the natural laws (Lecture 2 notes).
Causes of Illnesses
   
The Tibetan and Hmong systems hold that illnesses occur when there is a disturbance of the cosmos balance. To the Tibetan and Hmong, an illness is a punishment by the spirit world due to transgressions or violations against the spirit world or the social world (Lecture 7 notes). Mandel notes that among the Tibetan, illnesses are embraced and not pushed away (30910) as they represent an imbalance.
   
The modern biomedical system holds that an illness is caused by changes in the body as a result of an imbalance in natural body elements or functions. An illness is a manifestation of the imbalance (Lecture 7 notes).
Diagnostic Methods and Tools
   
Among the Tibetan and the Hmong, diagnosis of an illness is done through divination. Divination involves communication with the spirits and interpretation of their demands to correct the transgressions against the spirits and the society. The tools used in diagnosis in these systems include Tarot cards, palmistry, and casting of stones and may be accompanied by ceremonies (Lecture 7 notes).
   
The biomedical relies on scientific instruments and procedures for bodily examination to explain the symptoms and hence identify the illness. The biomedical system examines the symptoms and then uses scientific machinery and procedures to identify the imbalances within the body that are causing the illness. The methods and tools are usually less intrusive (Lecture 7 notes).
Healers and Helpers
   
In the Tibetan and Hmong systems, a shaman plays the role of the healer of the body, mind, and soul. The shaman acts as a mediator who is able to connect the spirit world and the human world. The spirits then communicate their desires to the shaman who then relays the information to the human world. The shaman goes into a trance whereby his spirit leaves the body and travels to the spirit world (Lecture 9 notes). The shamans are usually assisted by their apprentices.
  
 In the biomedical system, the healers are persons who have been highly trained and some attaining a high degree of specialization. The healers use scientific based methods to deal with the illnesses. The helpers of the healers are also highly trained in dealing with the illnesses.
Preventive and Curative Measures
   
One of the causes of illnesses under the Tibetan and Hmong systems is by the individuals allowing themselves to be vulnerable to spirit intervention or by allowing one to be vulnerable to witchcraft. Measures such as protecting oneself from witchcraft can be used as preventive measure. Items such as talismans are used to ward off evil spirits and curses.  Curative measures may include sacrificial offerings, herbal remedies, or a request (Lecture 9 notes). Mandel discussed in class that among the Tibetan, sound bowls are used for better health and well being (30910).
   
In biomedical systems, vaccinations and risk reduction measures are used as preventive measures. Curative measures involve the elimination of the elements causing the imbalances. The treatment measures are mostly chemical or lifestyle based.

Stem cells are particular cells in the body that are able to renew themselves via mitosis and can differentiate into several diverse specialized cells. These cells play a key role in developing treatments for a variety of medical issues that result to deaths of thousands. Great success has been witnessed from stem cell research and several potential cures for future development have been connected to the study. In the beginning of 2009, the FDA supported and gave its consent on the first human clinical trials utilizing these embryonic stem cells (Korobkin 77). There are three major sources for acquiring stem cells. They include the cord cells, adult cells, and embryonic cells. According to studies, embryonic stem cells are more expansive than adult stem cells (Ruse 64). Adult stem cells are said to be, in general, limited to differentiating into diverse and different types of cells. Though, as embryonic stem cells are more favored and said to be more useful, there is a probability of it being rejected by the immune system as stem cells are not patients (70).

Stem cell research has been going on for the past fifty years. However, stem cell research is still considered to be a relatively new technology that takes human cells and develops them into other varieties of cells found in the human body. Stem cells have been used for degenerative conditions, physical trauma, as well as genetic disorders. Besides, the future research in the stem cell research will enable researchers to develop technologies that will help in treating serious cases, which result from spinal cord injuries, Amyotrophic lateral sclerosis, and Parkinsons diseases (Gurtner and Longaker 306) Stem cell research brings huge potential in curing several diseases that will be mentioned by the end of this research essay. Medical research has been anticipating the use of modern technologies to further enhance the stem cell research and be able to alleviate pains and disorders. The issue of stem cell research is controversial in the state of technology currently in use due to the conception that a human embryonic cell line necessitates the human embryo to be destroyed.

Pros
Stem cell research has been smothered with debate since it was first launched. It has both pros (positive) and cons (negative) which will be explored in this essay.
One of the most distinct positive sides to stem cell research is its contribution to the medical field. Stem cell research provides possible major breakthroughs in the field of therapeutic cloning and regenerative medicine (Bellomo 122). It has given way to several medical treatments possible today such as for patients of lymphoma and leukemia, and theoretically could bring more potential breakthroughs such as treatment for brain damage, conditions of the heart, and infertility throughout the medical field (Joseph 2004).

The main usage of the embryonic stem cells in stem cells research and the further usage of the results from the research for therapeutic purposes can be attributed to the superiority of the embryonic stem cells. The first delimitation associated with these cells is that they are easy to develop and isolate which makes it convenient for researchers while doing their laboratory exercises and analysis. Secondly, embryonic stem cells help in reducing the cost of research because they are simple to create thus high number of cells are generated and hence they keep the research programs continuing.

Promising is a word that can truly be attributed to stem cell research. Currently, several treatments and procedures for patients with leukemia would not be possible without the help of stem cell research. There are still more promising treatments that can cure serious and currently incurable diseases such as cancer and brain damage. If the cure for these diseases will be unlocked, millions if not billions of lives will be spared from these very serious illnesses.

At present, some treatments and procedures that could be linked to the breakthrough in stem cell research includes the use of bone marrow and even umbilical cord blood stem cells to cancer patients with leukemia and lymphoma. Even with its side effects, chemotherapy still is arguably the preeminent treatment a cancer patient can receive. But as one of its side effects, the cytotoxic agents in chemotherapy not only kill cancer cells but also most of the growing cells of a person, laying them most of the time weak change how this ends.

The unfortunate side effect of the treatment to patients are those that stem cell transplants attempts to reverse. With more and more breakthroughs, todays system of using matching donor stem cells can be replaced with a more efficient and more effective stem cells directly gathered from the patient himself (Holland 29).

Researchers anticipate being able to use breakthrough to find cures for diseases such as cancer, Type 1 diabetes mellitus, muscle damage, damage to the spinal cord and other currently incurable diseases and impairments with stem cells taken from the patient (Ruse 53). Very promising treatments are foreseen with the use of adult stem cells over with the use of embryonic stem cells, as there are no rejection issues for stem cells taken from the patient directly (Snow 103).

A pro argument to embryonic stem cell research emphasizes the use of unused embryos from unused zygotes that are not transplanted after conception. It is narrowly noted that the world destroys hundreds of thousands of unused embryos supposedly for in vitro fertilization or for test tube babies (Young et al. 115). These wasted embryos could mean the discovery of a cure for life threatening or life taking humankind diseases. Additionally, the value of the embryos could not equal the value of the human lives it may save as it is used for the research - Blastocysts are no more human that a skin cell as its cells are still clustered and have not been differentiated into any distinct organ tissues. They are more comparable to a skin cell than a human at that stage. It is clear that in Australia over 70,000 unused embryos are destroyed (Korobkin 297). In vitro fertilization, many excess embryos that are generated are destroyed regardless. Rather than putting the embryos to good use, they are instead destroyed by whatever means possible (Snow 140).

There are also arguments related to the beginning of life with regards to the use of embryos. Claims that life begins with fertilization can be counteracted with the example of twins. A single fertilized egg can split into two to form identical twins, or a less common phenomenon is the fertilization of two different eggs that makes up fraternal twins but then fuse together and develop into a single human individual, such as a tetragametic chimera (Joseph 267). With these phenomena, it provides information that a human life does not exist at fertilization and therefore, the blastocysts used for embryonic stem cell research still do not have human life and hence ethical concerns can be dismissed.

Ultimately, the current population in developed countries such the US and European counties that have adopted stem cell research have enjoyed longer life expectancy as compared to those in developing world and therefore stem cell research should be advocated for in order to increase the life expectancy of both populations in developing and developed countries. This would be possible due to emerging methods of curing ailments at the old age through adoption of new technologies in the stem cell research. This would greatly help in reducing the inconveniences caused by ailments such as absenteeism from work.

Cons

The foremost argument of those against any form of stem cell research is the importance of human life. Critics contend that human life should not be messed with, and that people should not play God. Arguments on how stem cell research might lead to knowledge on cloning humans in the future have also been presented. No specific evidence has backed up these cloning issues yet critics are very watchful and very much in opposition of this form of scientific research. Whether or not stem cell research will lead to cloning humans, research-programs have had destructive consequences much like the nuclear research (Ruse 78).
Other available methods can be of help to the human population according to opponents of stem cell research. Researchers and scientists should focus more on finding and developing more ethical methods like the use of adult stem cells in order to have an ethical scientific breakthrough. Using embryonic cells in research is just unethical for the destruction of blastocysts, which are formed from the laboratory-fertilized human eggs, is inevitable (189). The blastocyst is considered a human life as upon conception, life begins.

Destroying blastocysts is morally wrong and intolerable.

Unless an egg is inhibited, it will become and develop into a human being once fertilized. Hence the value for an embryo should be as a high as a living breathing human being. Religious doctrines can establish this theory as the beginning of life or the existence of soul starts during conception. It is simply unjust to voluntarily damage and destroy human life through embryonic stem cell research. Arguments that have been laid out on how an embryo develops to human life remains to be subjective (Holland 89).
Another argument against the use of embryos for embryonic stem cell research focuses on the lives of these embryos. It follows that with the fertilization of an egg, unless inhibited, will mark the beginning of the human life. There are alternatives to embryonic stem cell research that do not include the use of destroying blastocysts. In addition, there are several scientific claws in the embryonic stem cell research and the technologies used for it. Also research potential of embryonic stem cell research are overstated and overused which calls for other alternatives.

Critics are also very firm with their argument on how this scientific research has ethical concern and issues on the work on aborted fetuses. It has been supposed that the possible help or benefits from the stem cell research cannot justify the disregard for ethical concerns. According to these critics, the value for human life should be given even to a fertilized egg. Life should never be compromised for the sake of a scientific study.

It is not and will never be ethical to destroy one human life for a probable solution or treatment to save another life.

Viability is yet another standard wherein fetuses as well as embryos are deemed to be human lives. In one case in the Unites States, it was concluded that the acceptability of abortions carried out for reasons other than that of the womans or mothers health was determined by viability. Viability is defined to be the point where a fetus has the potential to be able to live outside the womb of the mother albeit by means of artificial support or aid (Snow 111).

It takes about 22 weeks to determine and decide the point of viability. It used to take 24 to 28 weeks but with the advancements in medical technology, fewer weeks were needed. As further technological breakthroughs will be made and will allow an egg and sperm to be combined and entirely conceive outside of a womb, the embryo will be viable and under the viability standard, it ascertains that life begins during conception (Korobkin 176).

Much of the stem cell research controversy has sprung out from the different laws and policy governance implemented that concern the study and use for treatments of stem cells. These stem cell laws vary considerably by country and region. Stem cell research, with the use of human embryo is allowed in several countries in the European Union including Belgium, Finland, Greece, Sweden, Denmark, and Britain. It is however considered illegal in the Italian, Portuguese, Austrian, and German territories.

In the Americas region, the United States is divided with some states being pro stem cell research while others being very much against it. Canada permitted doing research on discarded embryos through in vitro fertilization process since 2006 (Korobkin 312). It however still prohibits the conception of human embryos for the purpose of research. In South America particularly Brazil, legislation has been passed that allows stem cell research by in vitro fertilized embryos given that these have been frozen for at least 3 years.

China does not allow human reproductive cloning but is in favor of creating human embryos for research as well as therapeutic intentions or purposes. Japan follows the same policy as well as South Korea who promotes cloning as long as its for therapeutic purposes. Australia is moderately in support of stem cell research while New Zealand prohibits the research.

For decades, stem cells have been used in treating conditions such as lymphoma and leukemia. With further studies, it is believed that these stem cells can be a potential treatment for numerous widespread disorders and diseases such as heart and brain damage, deafness, spinal cord injury, vision impairment and blindness, amyotrophic lateral sclerosis, diabetes, orthopedics, infertility, and neural as well as behavioral birth defects.

Those against the stem cell research are firm in their beliefs that it still lacks practicality and is very much unethical. On the other hand, supporters solidly claim that advances will come through further studies and with more time. Breakthroughs in the research are said to be unpredictable and will yield positive results in the medical field. The stem cell controversy still remains to be a strongly debated issue on both aspects.

The integrated study of the Chinese and modern medical case record indicates an effort made to combine Chinese medicines with scientific modern science which may appeal better to the modern man. This is the integration of the eastern and western approach with special emphasis on the techniques used to combine the effectiveness of both approach for the control and cure of hypertension. The significance of maintaining the medicinal case record plays an important role in the medical consultation process. The emphasis is on proper diagnosis and penetrating analysis which records the details of the case history of the patient, in the light of which the medical case record and prescription is developed. The case record is an integral part of the medicinal practice. The ailment is recorded and the precise therapy is advised and recorded for future reference. The adherence to the Chinese medical case records have their roots in the traditional and past records through the dynasties and have played an important role in the development of the traditional medical theory. The data involves precise information, which are set of clinical records and complicated and intricate data gathered from the basis of past experience. In attempting to illuminate the plurality in Chinese medical practice, Scheid redefines-and in some cases abandons-traditional anthropological concepts such as tradition, culture, and practice in favor of approaches from disciplines such as science and technology studies, social psychology, and Chinese philosophy.(Scheid, 2002, p.345)

The Case Report The patient is a man in his forties, who lives in London and has western mindset. Hence planning of the food prescription needs to be coordinated in accordance with his need, understanding and acceptance. The patient has been suffering from hypertension for the past few years and has faith in integrated approach and wishes to modify his diet to control his symptoms of hypertension through lifestyle and dietary modifications. Hence is important address the medical issue of hypertension in harmony with Chinese medicinal approach which provides a systematic food therapy for the control and management of the symptoms of hypertension.
   
There should be special consideration made to keep in mind the availability of the food products in London which are in harmony with the Chinese food therapy principles. Hence it will require a certain degree of integrated approach.
Medical Case Record The medical history requires use of special forms which are in compliance with the government and the hospital regulation. The process begins with registration of the unique identification number for the patient, which is the key to the authentic documentation. The documentation involves information such as age, address, occupation. The next step is to identify the symptoms and Chinese medical diagnoses, the previous treatments proposed, and outcomes of such treatments.
   
The first section of the case record consists of double case history of the patient both in Western medicine and Chinese medicine. The three day record of the symptoms and the adjusted treatment is recorded for future reference. This is called da bingli and it also serves as the legal document. The case record also provides the unique historical access to the patient-physician interactions.(Hsu, 2001, p325)
   
In the context of the patient who is suffering from hypertension it is necessary to examine the vitals from Chinese point of view. Hypertension has been one of the most studied subjects and hence requires a thorough approach to determine an effective strategy to administer targeted food therapy based on Chinese medicinal system for the control and the management of the symptoms. The superiority of Traditional Chinese Medicine and their targeted Food therapy has been recognized in management and control of such symptoms. In recent 40 years, the Chinese medical workers have made deep studies in the treatment and prevention of hypertension.(Wangzhong, 1996)
   
There are some precise and specific criterias which are considered in the context of the treatment as well the effective prevention of the symptoms and the conditions of hypertension. Some of the key clinical observations which are recorded in Chinese medicinal system are
    1.The pulse condition
    2. The appearance of the tongue
    3. The evaluation of the pathophysiological symptoms in connection with     hypertension.
    4. Establishing a treatment plan based on the Food therapy and dietary therapy guidelines to intervene,  prevent and control the side effects of hypertension.
   
In the context of the present case study we have accepted the dietary and food therapy aspect of intervention which can help alleviate and control the symptoms of hypertension. This would help reduce the complications of hypertension.

The Dietary and Food Therapy The traditional Chinese medicinal treatment takes food therapy very seriously as supplemental therapeutic methodology to control and alleviate hypertension in a patient. This therapy involves the family and patient consciously takes charge of their intake and systematic management of their diet and food intake with attention to the symptoms recorded in the case history.  There are some standard foods which have been observed over time and studied to have beneficial effect in the treatment of hypertension. These foods are celery, sea cucumber, jelly fish and sunflower seeds. (Wangzhong, 1996)
It is important to help build up patients health by management of the stress factors by providing proper rest and good nutrition. Food therapy plays an important role in implementing such path which leads diet therapy which has no side effects and balances the energies within the body and stimulated self healing.
   
The Food Therapy is targeted to consider that hypertension has close link with the liver function and hence the disease is associated with irrational selection of food intake which depletes the inner energy. The statistics gathered from ages indicate that such people have preference for fatty and rich food which plays a key role in determining the emergence of the symptoms and if this be controlled and the symptoms would naturally get corrected.
   
It is very important to advise patient to plan out a proper diet which involves     1. Taking less alcohol and more tea infusions. 
    2. Take light food which is low in salt.
    3. Include in the diet good combination of vegetables and use of vegetable oils .
    4. Have sufficient protein in the diet.
    5. Include staple foods like corn porridge, lotus leaf porridge and celery porridge.
    6. Have ample fruits, like water melon, which serves as natural diuretic. Include bananas which has capacity to lower chronic symptoms and dysfunctions within the body. And also include Haw, which has effective blood pressure lowering potential.
    7. The role of aquatic products is also very beneficial in management of hypertension. These aquatic foods must be included lotus seed pistil, kelp, mussels, Jelly Fish .
    8. The role of honey is known to have very positive results. There are also some instant drinks which need to be included in the part of the food therapy program.
    9. The meal should include stews, soups, tea and inclusion of garlic, vinegar and peanuts with their blood pressure lowering properties.
   
Three day menu for control and prevention of Hypertension
Day one
   
Breakfast        Before breakfast - eat one or two garlic segments which                     have been soaked in vinegar.
                1 cup chrysanthemum tea
                Corn porridge
                Watermelon

    Lunch            Honey in luke warm water
                Vegetables cooked in vegetable oil
                Rice
                Broccoli with oyster sauce
                Chinese cole slaw

    Mid Snack        1cup green tea
                Bananas
       
               
   
    Dinner        Crystal sugar and vinegar Soup
                Steamed jellyfish with steamed vegetables
                Chinese Noodles
                One Persimmon

Day Two

Breakfast        Before breakfast eat one or two garlic segments which have                 been soaked in vinegar.
                1 cup green tea
                Lotus leaf porridge
                Bananas

    Lunch            Honey in luke warm water
                Jellyfish preparation in vegetable oil
                Rice
                Glazed carrots   
                Cucumber salad           
           
    Mid Snack        1cup chrysanthemum tea
                Bananas
                Persimmon               
   
    Dinner        cream corn soup                
                Stir fry Gai Lan and bean sprouts
                Chinese Noodles
                Watermelon

Day Three

Breakfast        Before breakfast eat one or two garlic segments which have                 been soaked in vinegar.
                1 cup chrysanthemum tea
                Celery porridge
                Haw drink
    Lunch            Honey in luke warm water
                Vegetables cooked in vegetable oil
                Rice
                Asparagus stir fry               
                Steamed eggplant
    Mid Snack        1cup green tea
                Sunflower seeds
                Peanuts celery
                           
                               
   
    Dinner        Corn soup with crabmeat
                Shanghai vegetable Rice
                Stewed Beef with tomatoes
                Chrysanthemum and cassia tora drink

Function Garlic soaked in vinegar has effective results in lowering blood pressure the vinegar in which it has been soaked can also be taken. The results can be seen in two weeks time. The use of honey in lukewarm water enhances the results in the reduction of blood pressure and is more effective with persistent implementation. The consumption of corn porridge helps in prevention of constipation and expelling cholic acid which lowers the levels of cholesterol in the bloodstream. The lotus leaf porridge helps secretion of saliva and the body fluids. This helps in the reduction of the blood pressure. Celery porridge is an ideal breakfast which has been confirmed by laboratory tests to have high blood pressure lowering capacity along with tranquilizing function. It also helps control overexcitement and headache in the patients suffering from high blood pressure.
   
Fruits like watermelon along with its rind have diuretic function which helps in management of high blood pressure. It should be noted that people with weak stomach should take this in moderation. Bananas are great for lowering the chronic dysfunction of the internal organs, and patients suffering from blood pressure cab have five bananas a day. Haw is highly effective in lowering blood pressure and so is persimmon.
   
There are some very effective aquatic products which serve as an aid in reduction of blood pressure like lotus seed pistil, which should be taken in the form of broth every day. Kelp which contains ammonia acid also has blood pressure lowering power which is further enhanced with combination of cassia tora and kelp. Jellyfish has potent blood pressure lowering power and its use should be reduced when conditions become normal and symptoms are under control. The combination of mussels and celery is also very effective in controlling the symptoms of high blood pressure.
   
It is also important to limit the intake of liquor, as it tends to lower the systolic function of the heart and hence affects the functioning of the internal organs and blood vessels which causes blood pressure. The consumption of tea is benefical for high blood pressure patients as the tannin which is the main ingredient in the tea has an effect of vitamin E which strengthens the capillary walls. The constant consumption of tea helps in weight reduction and controlling blood lipids. Strong tea should be avoided as it causes overexcitement and leads to faster heart beat.
   
Special consideration should be made to eat food which is light and less in salt. Too much consumption of salt has a tendency to stagnate the blood circulation and it also changes the colour of the blood. People with high blood pressure or hypertension should take low fat, low cholesterol and low calorie food . One should also avoid animal fat, as it causes deposits in the blood vessels.
   
There is tremendous role of vegetables, vegetable oils and protein foods such as fish, egg whites, beans. Vegetable oil also plays an important role in promoting oxidization of cholesterol into cholic acid which tends to get expelled from the body and resulting in lowering the blood pressure and enhancing the function of capillaries. 
   
Asparagus has the potential to regulate the cholesterol and hence helps to maintain proper working of the kidneys, which play an important role in maintaining blood pressure by its effective diuretic action. (Hude  Xingcho)

Analysis The Chinese Food Therapy focuses on treating the symptoms of hypertension with a more holistic approach which takes into account eh whole body rather than just an individual symptom. The development of hypertension in the view of medical science is a result of combined dysfunctioning of various organs such as heart, brain and kidney not in harmonious balance. Thus the pathological state of hypertension requires an approach which can balance the blood supply in the above mentioned organs. The food therapy addresses this very effectively.

Conclusion The role of clinical case record plays an important part in the traditional Chinese medicinal treatment. Making the right diagnosis based on the pulse and tongue evaluation is the foundation for the therapeutic treatment. The control of alcohol intake, generous intake of herbal teas and green tea and modified food structure can be highly effective in controlling the symptoms of hypertension. It will also help alleviate the symptoms and lead to reduced blood pressure which can controlled through healthy eating habits. Consideration of the subjective phenomena is important in the treatment process.

Acupuncture has been used for decades to relieve pain and gain therapeutic response. The process includes the use of filamentous needles inserted to the different points of the body to create alleviating treatment for some health-related conditions such as hypertension. Many studies have been published and claimed that acupuncture is one of the best ways to either reduce or treat hypertension effectively. However, this therapeutic method is still being criticized by many researchers and health professionals due to a lack of scientific information to support it. In relation to this, the panel would like to present the reasons that acupuncture helps alleviate hypertension.

What is acupuncture
Acupuncture is one part of the following several well-known essential parts of traditional Far Eastern Oriental Medicine. 1 It is self regulating and considered as the safest system of medicine in existence.2
Acupuncture widely viewed as mainly useful for accomplishing pain relief especially of mucoskeletal origin. It has many potential clinical strengths, as in womens reproductive health, mood issues, immune systems modulation, and digestive, respiratory, neurological and skin health.3

The art of acupuncture depends on knowing precisely which nerve to stimulate in a given disease.2 We can call it a self-regulating system of medicine, for the nerve-passes stimulated by the needle are the very ones the body itself uses to regulate its several physiological processes. 2 The nerves directly stimulated by the way of branch of the nerve network going to the skin.2
The prick of the needle at certain precisely defined points on the skin stimulates specific nerves, which transmit electrical impulses to the spinal cord and lower centers of the brain and thence to the diseased area.2  Nerves are supplied to every part of the body, under the direct or indirect control of one or group of nerves nearly all processes going on in the body.2

They called the principal nerve endings acupuncture points and the main course of a similar group of nerve endings meridians.2

According to the Stein and Oz, the theory called moxibustion is the reason behind the acupuncture process and that there is a special herb burned to the needle to heat it and the heat will be transferred to the body.4

Evidences that acupuncture can alleviate hypertension.

Acupuncture reduces hypertension. Evidence shows that acupuncture is a promising adjunctive therapy for essential hypertension. A randomized controlled trial (RCTs) on acupuncture for hypertension was published by Neurological Research. Forty-one hypertensive or pre-hypertensive volunteers were randomly assigned into real or sham acupuncture group. The volunteers were on antihypertensive medication. The sham acupuncture group showed no significant change in mean BP, while the real acupuncture group showed a significant (p0.01) decrease in mean BP after 8 weeks of intervention from 136.883.7 to 122.176.8 mmHg1.5

Acupuncture was studied to lower blood pressure. Randomized one hundred sixty (160) outpatients with uncomplicated arterial hypertension in a single-blind fashion to a six-week course of active acupuncture or sham acupuncture. Seventy-eight percent were receiving antihypertensive medication, which remained unchanged. Primary outcome parameters were mean 24-hour ambulatory blood pressure levels after the treatment course and 3 and 6 months later. There was a significant (P0.001) difference in post-treatment blood pressures adjusted for baseline values between the active and sham acupuncture groups at the end of treatment. Acupuncture according to traditional Chinese medicine, but not sham acupuncture, after 6 weeks of treatment significantly lowered mean 24-hour ambulatory blood pressures the effect disappeared after cessation of acupuncture treatment.6

This article identifies and comments on published studies of acupuncture treatment for hypertension and stroke. 13 were hypertension papers with 3 being of controlled trials, and 14 were stroke papers with 5 controlled trials. The articles consisted of randomised controlled trials (RCTs), controlled trials, and case series studies. The hypertension papers also involved some cohort studies. In general, sample sizes of these studies were small. Acupuncture in these papers was used as a secondary intervention for treating hypertension and as a tertiary intervention for stroke rehabilitation. All the case series suggested that acupuncture was an effective treatment. The RCT evidence for stroke showed that the effectiveness of acupuncture was similar to that of conventional treatment.7

A study from Nahas was also performed to review the evidence supporting complementary and alternative medicine approaches used in the treatment of hypertension. Evidence from systematic reviews supports the blood pressurelowering effects of coenzyme Q10, polyphenol-rich dark chocolate, Qigong, slow breathing, and transcendental meditation. Vitamin D deficiency is associated with hypertension and cardiovascular risk supplementation lowered blood pressure in 2 trials. Acupuncture reduced blood pressure in 3 trials in 1 of these it was no better than an invasive placebo. Melatonin was effective in 2 small trials, but caution is warranted in patients taking pharmacotherapy.8

A systematic review was conducted to estimate the effect of acupuncture on blood pressure (BP) in hypertensive patients. Electronic literature searches for randomized controlled trials (RCTs) of acupuncture were performed in six electronic databases to June 2007 without language restrictions. Eleven RCTs testing acupuncture either as an adjunct or an alternative met our inclusion criteria. Three sham-controlled trials out showed systolic BP (SBP) change was not statistically significant (mean difference -5 mm Hg, 95 CI (-12, 1), P  0.12) and acupuncture only marginally reduced diastolic BP (DBP) by 3 mm Hg (95 CI (-6, 0), P  0.05), but substantial heterogeneity was observed (I2  92 for SBP, I2  79 for DBP). When given with antihypertensive medication, acupuncture significantly reduced SBP (-8 mm Hg, 95 CI (-10, -5), P  0.00001) and DBP (-4 mm Hg, 95 CI (-6, -2), P  0.0001) and no heterogeneity between studies was detected. The results of the meta-analysis of the three sham-controlled studies, the notion that acupuncture may lower high BP is inconclusive. More rigorous trials are warranted.9

A preliminary study was performed to determine the effect of acupuncture-point stimulation on diastolic blood pressure in hypertensive subjects. Electrical stimulation of four specific acupuncture points (Liver 3, Stomach 36, Large intestine 11, and the Groove for Lowering Blood Pressure) was examined in order to determine the effect of thb stimulation on diastolic blood pressure in 10 subjects with diastolic hypertension. Subjects were randomly divided into two groups an Acu-ES group, which received electrical stimulation, applied to the four antihypertensive acupuncture points and (2) a Sham-ES group, which received electrical stimulation applied to non-acupuncture-point areas. A repeated measures analysis of variance revealed a significant, immediate post-stimulation reduction of diastolic blood pressure for the Acu-Es group versus the Sham-ESgroup.10