Is the advantage of coronary bypass graft surgery over percutaneous coronary intervention in diabetic patients with severe multivessel disease influenced by the status of insulin requirement？

Several studies have shown that coronary artery bypass graft surgery （CABG） is superior to percutaneous coronary intervention （PCI） in patients with diabetes and multi-vessel disease. Whether this advantage of CABG over PCI is confined to diabetics who require insulin is unknown. We review the published literature comparing CABG with PCI in diabetics including 8 cohorts and 4,786 patients. There was a lower rate for all-cause mortality （Relative risk （RR）： 0.78, 95% confidence interval （CI）： 0.62-0.99）, and for major adverse cardiac and cerebrovascular events （MACCE, RR： 0.59, 95% CI： 0.47-0.75） for CABG compared to PCI. Composite outcome of mortality, myocardial infarction and stoke was similar between CABG and PCI （RR： 0.87, 95% CI： 0.54-1.42）. Visual inspection of the forest plots showed that in most analyses, the point estimates of the RR are similar between the insulin requiring group and non-insulin requiring group. On meta-regression, there was no interaction between status of insulin requirement and revascularization strategies （P 〉 0.05 for all）. The pre- sented data on the still unpublished analysis of the FREEDOM trial showed similar results. Thus, in the current era, CABG is superior to PCI with lower mortality and MACCE rates, but the state of insulin requirement had no effect on the outcomes from the two revascularization strategies.

New Erra with Auto-Haemotherapy

The active researchers, till now, did not find a curative treatment for many diseases threatening lives of the patients. Proper management and treatment for those patients can give them longer and healthier lives. Over the years, auto-haemotherapy has been used to treat illnesses and diseases such as： arterial circulatory disorders, autoimmune diseases as rheumatoid arthritis, gout, bronchitis, allergies, ache vulgaris, skin eczema, leg ulcers, chronic sinusitis, skin lesions, HIV infection, HCV, Lyme disease, connective tissue diseases, fibromyalgia, asthma, history of heart attack and fungal infections. It helps in cessation of smoking, treatment of drug and alcohol addiction, decreasing the appetite, losing weight in obese patients and speeding up the recovery after a long period of illness. It has also been used in combination with conventional cancer treatment. Auto-haemotherapy is a simple technique where the blood is drawn from a vein and re-injected into a muscle. The blood in the muscle works as a foreign body that will be rejected by the reticulo-endothelial system. It stimulates the immune system and the bone marrow to increase the production of macrophages which are the body＇s cleaners. The macrophages cleanse everything, they eliminate bacteria, viruses, cancerous cells called neoplastic cells, this is a spring cleaning, and they even eliminate fibrin which is a clotted blood. Auto-haemotherapy is a very powerful technique with a low cost. It requires a syringe and a physician who knows how to withdraw blood from a vein and straight away does an intra-muscular injection with this blood under aseptic condition which increases and stimulates the immune system. Minor auto-haemotherapy technique was applied to 176 patients suffering from different diseases such as： Type I diabetes mellitus, bronchial asthma, chronic sinusitis, allergic conjunctivitis, allergic rhinitis, skin problems （vesicles, eczema, ulcer）, finger nail problem （infection, paronychia）, acne vulgaris, gastro-intestinal tract problem, lactose intolerance, connective tissue disease, AFS （adrenal fatigue syndrome）~ myasthenia gravis, fibromyalgia, gout, generalized osteoarthritis, joint osteoarthritis, low back pain with MODIC changes Type 1 on MRI （with or without spinal canal stenosis）, auto-immune diseases （ankylosing spondylitis, rheumatoid arthritis）, and infectious vaginal discharge. Also it has been applied to patients in order to stop smoking, and to other patients in order to lose weight. Results showed that the patients suffering from the previous different diseases improved significantly after being treated with auto-haemotherapy. In addition, the heavy smokers were able to decrease dramatically the number of cigarettes they were smoking, and the obese patients were able to lose their weight and they had less appetite.