https://www.um.edu.mt/library/oar/handle/123456789/34151 2026-04-04T08:14:15Z https://www.um.edu.mt/library/oar/handle/123456789/141834 Title: The effectiveness and efficacy of acupuncture and associated modalities on the vasomotor symptomatology associated with perimenopause or post-menopause : an evidence based literature review Abstract: Background : Vasomotor symptoms (VMS), generally referring to ‘Hot flushes’ and ‘night sweats’, are the most common and frequent reported episodes of perimenopausal symptom affecting around 75% of menopausal women .The worldwide occurrence of VMS to be as high as 80%, with a range in variety and severity sufficient to affect the quality of life and overall health of women. These symptoms commence one to two years before menopause and may continue from six months to more than 10 years. Objectives: To investigate the degree of effectiveness or efficacy and safety of acupuncture and concomitant modalities in treating vasomotor symptoms in females during spontaneous perimenopause and after the menopause. Methodology: The design method is the literature of randomised controlled trials .A total of 20 databases were systematically searched for the related reports over the past 17 years from date of inception of search (2005-2023) ,for peer-reviewed, full-text journal articles of international studies published in English language. Acupuncture from any tradition was considered, including auricular acupuncture, electroacupuncture, acupressure, and laser acupuncture, moxibustion etc. A total of 118 potentially relevant articles were retrieved for this literature review. 109 studies were excluded since they did not meet the preselection criteria .Eventually, the 9 RCT studies that met the inclusion criteria and provided exclusive information about the use of acupuncture and its modalities for the treatment of Hot flushes were selected and incorporated in this literature review . The total population for 5 these studies were of 849 participants. The RCT’s were analysed for study strength using the STRICTA and CONSORT assessment tools. Additionally, the Cochrane Risk of Bias tool was used to appraise the risk of bias in the included studies . These tools aided in assessing the quality of the methodology of each study and the standard of reporting in each selected RCT’S. Results: The average CONSORT score for all the studies was 27.6 (74.5%: minimum 43.2% | maximum 89.2%) while the average STRICTA score was 13.4 (78.8%: minimum 64.7% | maximum 94.1%) The average combined STRICTA and CONSORT scores for the nine reviewed studies is 40.9 (75.8%: minimum 50.9% | maximum 90.7%. All but one study has a combined CONSORT and STRICTA percentage score of >65% with an average percentage score of 75.8%. This suggests that the RCT studies can be considered as having an adequate scientific rigorous validity though careful attention could be given to improve validity. However ,different bias parameters for the nine studies reviewed were found. Some studies had a particularly high risk of bias and high risk of uncertain bias score . Conclusion : This literature review explored and subsequently indicated that acupuncture and concomitant modalities is safe, useful and effective or efficacious in managing hotflushes in females during all stages of menopause and that it improves the related quality of life. Regrettably, the robustness of the results was however difficult to determine mostly due to the heterogeneity of the included trials , poor methodology of most trials, low study populations with several reporting and selection bias and various study limitations in all 9 RCT’s. Therefore, definite firm conclusions on both the effectiveness or the efficacy of acupuncture treatment or its modalities and which is the leading protocol to 6 follow , could not be reached. In the interest of evidence-based practice, rigorous large - scale studies adhering to CONSORT and STRICTA guidelines , aiming to reduce Bias and possibly incorporating a standardized protocol are needed ,to confirm findings and elucidate optimal treatment approaches in investigating the role of acupuncture and concomitant modalities, in managing hot flush symptoms during natural female perimenopause and after the menopause. Description: M. TCM(Melit.) 2024-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/140269 Title: The role of traditional Chinese medicine in cases of abnormal presentations in the third trimester : an evidence-based literature review Abstract: Background: Abnormal foetal presentation, particularly breech presentation, poses significant risks for both the mother and foetus. Traditional Chinese Medicine (TCM) offers alternative approaches like moxibustion and acupuncture, which may provide non-invasive options to address these presentations. This literature review examines the success rate of foetal cephalic version through the analysis of twelve studies focusing on interventions of moxibustion and acupuncture, separately or in combination, and as a complementary therapy to External Cephalic Version (ECV). Aims and Objectives: The aim of this review is to explore and compare the use of acupuncture and moxibustion used, both in conjunction and separately, in order to increase the chances of normal vaginal delivery in an abnormal foetal presentation during the third trimester by correcting the foetal presentation to cephalic. Additionally, the review also examines the concurrent application of these Chinese medicine treatments with Western medicine's External Cephalic Version, with the aim of delivering improved outcomes for expectant mothers. Moreover, the objective of this dissertation is to carry out a literature review of systematic methodologies for the analysis of research such as randomised controlled trials (RCTs), where the effectiveness of Chinese traditional medicine treatments on abnormal foetal presentation in the third trimester was analysed, comparing this to the western medicine approach. Research questions: • Does the use of Traditional Chinese medicine techniques of moxibustion and acupuncture, in conjunction as well as separately, have an effect on abnormal foetal presentation in the third trimester? And if there is, is there a difference in the outcome when the different use of these techniques is compared? • Do these modalities have an effect on improving the outcomes of an ECV procedure? Method: A literature search was conducted using databases accessed through EBSCOhost and PubMed with the University of Malta Library platform Hydi. The available and relevant research evidence was identified to answer the proposed research questions. The included studies were limited to papers written in English and published in the last 25 years. They addressed moxibustion and acupuncture in addition to conventional care for breech presentations in pregnant women. Studies addressing treatment derivatives or these interventions but focusing on other outcomes were excluded. Search outcome Twelve RCT studies met the inclusion criteria. Method of appraisal: The STRICTA, CONSORT, and Jadad score frameworks were used to critically appraise the selected studies. Results: Some findings from this review suggest that treatments of moxibustion and acupuncture, in conjunction or separately, are promising. In the other studies, such treatment was found to have a different level of effectiveness. Differences in the methodology of the interventions of the trials may have led to discrepancies in the findings. Conclusion: This literature review underscores the need for more rigorous studies to validate the efficacy and safety of moxibustion and acupuncture in managing breech presentations. While initial findings are promising, comprehensive clinical guidelines and practitioner training are essential for effectively implementing these techniques in prenatal care. Implications: Raising awareness of the effectiveness of moxibustion and acupuncture therapy in prenatal care for abnormal foetal presentations. Detecting gaps in the currently available studies. Encouraging the integration of TCM techniques with conventional obstetric practices to improve maternal and foetal outcomes. Description: M. TCM(Melit.) 2024-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/60173 Title: Traditional counter-stimulation practices in a Central Mediterranean island population Authors: Savona-Ventura, Charles Abstract: A review of the medical folklore of the Maltese Islands identifies the use of counter-irritation practices dating to the prehistoric period. These practices are very much reminiscent of those in contemporary Traditional Chinese Medicine. Because of the distances involved, it is unlikely that direct cultural intercourse took place and it is suggested that these similarities were the result of isolated parallel development of ideas based on observation and experimentation. 2020-08-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/49567 Title: The attainment of knowledge Authors: Savona-Ventura, Charles Abstract: Writing two and a half millennia ago, Confucius stated that “By three methods we may learn wisdom: First, by reflection, which is noblest; Second, by imitation, which is easiest; and Third by experience, which is the bitterest.” The edict fully applies to modern medical education and training. The attainment of knowledge through experience may be the fruit of the personal and/or collective compilation of knowledge gathered by personal observation of individual cases or case series. It may also incorporate formal randomized clinical experimentation to compare outcomes attained from two or more different management options. Originally transmitted down the generations by oral tutor-student communication, it eventually was more widely made available by the publication of case presentations, case series, or randomized controlled trials. This compilation of knowledge by experience is the most bitter since for every success story documented, there would be several failures that would have fallen by the wayside or eventual successes that were only accepted after a pendular shift in attitudes towards their use. The importance of experiential knowledge in current practice can be best illustrated by Isaac Newton’s comment that "If I have seen further it is by standing on the shoulders of giants." We are where we are today because of the giants that have preceded us. With their experiential, experimental and rational acquisition of knowledge throughout the ages, they have laid down the foundations of knowledge that we have developed and rely upon in modern practice. 2019-10-01T00:00:00Z