What is a funnel plot?

Bismillah alhamdulillah:

Below is an interesting article on funnel plots and the variation in cancer rates in the UK by Dr Ben Goldacre.



Black seed nasal therapy

Bismillah alhamdulillah.

Treating chronic rhinitis can be a frustrating experience for both the doctor and the patient. The usual regime of antihistamines and allergen avoidance can in some cases bear little fruit. A trip to the immunologist can bear fruit for a patient who has a clearly identified allergen and is willing to undergo immomodulatory therapy which can last for upto 2 years.

It is not uncommon for patients to ask the opinion of their family doctor about alternative therapies. The requirement for double blinded RCTs and their lack leaves the family doctor reliant on their experience to answer the question or they simply play a very straight bat and reply that this is not their field and avoid answering the question.

I came across an alternative therapy based on a hadith by the Prophet Muhammad (S) which used the black seed. They are to be crushed and mixed in oil and then placed in both nostrils. The duration of therapy or the number of doses was not given. The hadith is present both in two collections of hadith called Bukhari and Muslim. Another website stated that the seeds should be crushed, nixed in oil and the medicament should be administered within an hour. According to the site black seed oil should not be used as the black seed is heated.

A bit of reading around shows that black seed oil is known as Nigella Sativa and is available in 3 varieties from India, Saudi Arabia and Ethiopia.

Whether such a prescription is equally applicable to chronic rhinitis is unclear. I wonder if there any studies dealing with this topic. Perhaps you have had some experience with this and would like to share your experience. Feel free to add your comments. Whatever the case the option of an exttra modality of treatment always gives hope to both the patient and physician and deserves to be investigated further.