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Background Acupuncture is commonly used to treat menopausal symptoms and other gynaecological conditions. In this study, the authors aimed to investigate whether acupuncture has an effect on menopausal symptoms and to explore whether this effect is related to changes in hormone levels. Materials and methods A total of 53 postmenopausal women were alternately assigned into two treatment groups: acupuncture (n=27) and sham acupuncture (n=26). Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). The serum oestradiol, follicular stimulating hormone (FSH) and luteinising hormone (LH) levels were measured at baseline and again after the fi rst and last sessions. The Student t test was used for normally distributed data and the Wilcoxon signed rank test for not normally distributed data. The group differences in MRS scores were assessed using non-parametric Mann-Whitney U test. Results After treatment, total MRS, and the somatic and psychological subscale scores were signifi cantly lower in the acupuncture group than the sham group (all p=0.001). The severity of hot fl ushes was found to be signifi cantly decreased after treatment in acupuncture group (p=0.001). In the acupuncture group LH levels were lower and oestradiol levels were signifi cantly higher than sham group (p=0.046 and p=0.045, respectively) after treatment, but there was no difference in FSH levels. Conclusion Acupuncture was effective in reducing menopausal complaints when compared to sham acupuncture and can be considered as an alternative therapy in the treatment of menopausal symptoms. INTRODUCTIONPerimenopause syndrome, referred also as climacteric syndrome, results from the changing of relationship among the hypothalamus, pituitary and ovary during women's ageing process. Those changes take place fi rst in the ovary, then in the hypothalamus and pituitary, which are refl ected as the functional changes in the endocrinological and central nervous system, accompanied with a series of psychological symptoms.1 Oestrogen, either by itself or with progestins is the most consistently effective therapy for these symptoms. However, the Women's Health Initiative and Million Women Study have identifi ed important risk factors (coronary heart disease, stroke, breast and endometrial cancer) associated with hormone replacement therapy (HRT). [3][4][5][6] Those fi ndings have led to an expanded interest in non-hormonal therapies for managing menopausal symptoms. However, there are only limited data to support their use. The common conclusion in reviews regarding to complementary and alternative therapies for the management of menopause related symptoms was that the data were insuffi cient to recommend any alternative therapy and further investigation was still needed.7 8 In the area of complementary and alternative therapies, acupuncture and acupressure treatments are promising, however, the results of published randomised controlled trials of the effect of acupuncture on hormone levels and symptoms in postmenopausal women have been ...

The route of delivery had no effect on TBL. While bupivacaine was found to have no effect on neonatal bilirubin levels, levobupivacaine increased neonatal biluribin levels, but further studies are needed for definite results.

BackgroundWithin the context of the support program for smoking cessation, initiated by the Turkish Ministry of Health in 2011, those who present at ‘smoking cessation’ centres and are found to be suitable for pharmacological treatment are given varenicline and bupropion free of charge. As the smoking cessation programme is centralized, the selection of the medication is made randomly to provide a fixed distribution rate. The aim of this study was to evaluate the efficacy of both varenicline and bupropion in smoking cessation and to evaluate the effect of the smoking cessation programme.MethodsA total of 405 individuals who met the study criteria were included in the study. Smoking habits and degree of dependence were determined in all the participants with the Fagerstrom test for nicotine dependence (FTND) and bupropion or varenicline therapy was initiated in those who were eligible. Patients were followed up at 15 days then at 1, 2, 3, 6 and 12 months after smoking cessation. A level of CO < 5 ppm and ‘point prevalence abstinence’ were used as the criteria of success for smoking cessation and this evaluation showed the non-smoking status in the previous 7 days.ResultsThe mean age of the participants was 35.19 ± 7.73 years and 82.8% (n = 334) were male. Of the participants, 60.2% (n = 244) were given varenicline and 39.8% (n = 161) bupropion. The mean FTND and package/year was not significantly different between the groups. The rates of success in the 1st and 2nd weeks, and 1st, 3rd and 6th months were significantly higher in the varenicline group than in the bupropion group (p < 0.05). At the end of one year, the rate of smoking cessation was determined as 13.9% (n = 34) in the varenicline group and 6.2% (n = 10) in the bupropion gruop. The difference was statistically significant (p = 0.015). At the end of 1 year when the previous 7 days smoking status was evaluated with the ‘point prevalence abstinence’ measurement as the success criteria, success rates were 20.5% with varenicline and 18.6% with bupropion and the difference was not significant (p = 0.646). The individuals who used the medications for 45 days or longer were more successful in smoking cessation (p < 0.001). The most common reasons given for discontinuing the medication were the side-effects (31.5%). No significant difference was determined between the groups in respect of the side-effects observed.ConclusionsAlthough the rates of smoking cessation in all the other control points were higher with varenicline than with bupropion, no significant difference was found between the success rates of varenicline and bupropion used in smoking cessation based on the last 7 days at the end of one year. Those who used the medications for 45 days or longer were more successful in smoking cessation.

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