New Website Launched

 

Target Health Website has a new look, although the banner designed by CEO Joyce Hays, remains as well as the famous Leaping Dog, a feature of our website from inception. We are also very proud of our publications, many of which are prescient and trailblazing.

 

For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 165). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel or Ms. Joyce Hays. The Target Health software tools are designed to partner with both CROs and Sponsors. Please visit the Target Health Website.

 

Joyce Hays, Founder and Editor in Chief of On Target

Jules Mitchel, Editor

 

QUIZ

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21st Century, and We’re Still Cupping. Do You Know About This?

A person receiving fire cupping therapy.  Source: Alanna Ralph from Philadelphia, PA, USA – Cupping, CC BY 2.0, https://commons.wikimedia.org

 

You can buy a cupping set on Amazon.com, for about $39.95.

 

Cupping therapy is a form of alternative 1) ___ in which a local suction is created on the skin. Cupping has been characterized as pseudoscience. There is no good evidence it has any benefit on health and there are some concerns it may be harmful. Through suction, the skin is drawn into the cup by creating a vacuum in the cup placed on the skin over the targeted area. The vacuum can be created either by the heating and subsequent cooling of the air in the cup, or via a mechanical pump. The cup is usually left in place for somewhere between five and fifteen minutes. It is believed by some to help treat pain, deep scar tissues in the muscles and connective tissue, muscle knots, and swelling; however, the efficacy of this is unproven. Cupping is poorly supported by 2) ___ evidence. In their 2008 book Trick or Treatment, Simon Singh and Edzard Ernst write that no evidence exists of any beneficial effects of cupping for any medical conditIon. A 2011 review found tentative evidence for pain but nothing else. The way it works is unclear but might involve the placebo effect. Advocates claim that cupping is an alternative treatment for cancer. However, the American 3) ___ Society notes that “available scientific evidence does not support claims that cupping has any health benefits“ and also that the treatment carries a small risk of burns.

 

Cupping is generally safe when applied by trained professionals on people who are otherwise healthy. It is not recommended for people with health problems, due to side effects from cupping. Cupping is not recommended as a replacement for typical treatments. Cupping may also result in bruising, burns, pain, and/or skin infection. Some research suggests that cupping is harmful, especially in people who are thin or obese: According to Jack Raso (1997), cupping results in capillary expansion, excessive fluid accumulation in tissues, and the rupture of 4) ___ vessels. Fire cupping can sometimes result in minor to severe burns, and may lead to hospitalization and may even require skin grafting to repair the injury. Also, other burns, due to carelessness with the flammable substances being used, such as spills and over application, can also occur.

 

Bamboo cups Source: Wikipedia

 

 

The dry cupping procedure commonly involves creating a small area of low air pressure next to the skin. However, there are varieties in the tools used, the methods of creating the low pressure, and the procedures followed during the treatment. The cups can be of various shapes including balls or bells, and may range in size from 1 to 3 inches (25 to 76 mm) across the opening. Plastic and glass are the most common materials used today, replacing the horn, pottery, bronze and bamboo cups used in earlier times. The low air pressure required may be created by heating the cup or the air inside it with an open flame or a bath in hot scented oils, then placing it against the skin. As the air inside the cup cools, it contracts and draws the skin slightly inside. More recently, vacuum is created with a mechanical suction pump acting through a valve located at the top of the cup. Rubber cups are also available that squeeze the air out and adapt to uneven or bony surfaces. In practice, cups are normally used only on softer tissue that can form a good seal with the edge of the 5) ___. They may be used singly or with many to cover a larger area. They may be used by themselves or placed over an acupuncture needle. Skin may be lubricated, allowing the cup to move across the skin slowly. Skin markings are common after the cups are removed, varying from simple red rings that disappear relatively quickly, to discolorization from bruising, especially if the cups are dragged while suctioned from one place to another, ostensibly to break down muscle fiber.

 

One method of fire cupping involves soaking a cotton ball in almost pure alcohol. The cotton is clamped by a pair of forceps and lit via match or lighter, and, in one motion, placed into the cup and quickly removed, while the cup is placed on the skin. 6) ___ heats the inside of the cup and a small amount of suction is created by the air cooling down again and contracting. Other types of fire cupping include using other flammable substances such as herbs, or paper in another cup and setting it on fire. As the fire goes out, the therapist puts the other empty cup upside down on the area of skin to be treated. As the air inside the cup cools, it creates a vacuum. This causes your skin to rise and redden as your blood vessels expand. Massage oil may be applied to create a better seal as well as allow the cups to glide over various muscle groups in an act called “moving cupping“. Dark circles may appear where the cups were placed because of rupture of the capillaries just under the skin. There are documented cases of 7) ___ caused by fire cupping. Wet cupping is also known as Hijama or medicinal bleeding. Today, wet cupping is a popular remedy practiced in many parts of the Muslim world. In Finland, wet cupping has been done at least since the 15th century, and it is done traditionally in saunas. The cupping cups were made of cattle horns with a valve mechanism in it to create a partial vacuum by sucking the air out. Cupping is still practiced in Finland as part of relaxing and/or health regiments.

 

People get cupping for many purposes, including to possibly help with pain, inflammation, blood flow, relaxation and well-being, and as a type of deep-tissue massage. The cups may be made of:

 

Glass

Bamboo

Earthenware

Silicone

 

Cupping therapy might be trendy now, but it’s not new. It dates back to ancient Egyptian, Chinese, and Middle Eastern cultures. One of the oldest medical textbooks in the world, the Ebers Papyrus, describes how the ancient Egyptians used cupping therapy in 1,550 BCE. As mentioned above, there are different methods of cupping, including:

 

Dry

Fire

Wet

Needle

 

A more modern version of cupping uses a rubber pump instead of fire to create the 8) __ inside the cup. Sometimes therapists use silicone cups, which they can move from place to place on your skin for a massage-like effect. Wet cupping creates a mild suction by leaving a cup in place for a few minutes. The therapist then removes the cup and uses a small scalpel to make light, tiny cuts on your skin. Next, he or she does a second suction to draw out a small quantity of blood. There may be 3-5 cups in a first session. However, it is rare to get more than 5-7 cups, the British Cupping Society notes. Afterward, one may use an antibiotic ointment and bandage to prevent infection. Skin should look normal again within 10 days.

 

Cupping therapy supporters believe that wet cupping removes harmful substances and toxins from the body to promote healing. But that’s not proven. Some people also get “needle cupping,“ in which the therapist first inserts acupuncture 9) ___ and then puts cups over them. There haven’t been many scientific studies on cupping; however, one report, published in 2015 in the Journal of Traditional and Complementary Medicine, notes that it could help with acne, herpes zoster, and pain management. That’s similar to the findings from a 2012 report, published in PLoS One. Australian and Chinese researchers reviewed 135 studies on cupping. They concluded that cupping therapy may be effective when people also get other treatments, like acupuncture or medications, for various diseases and conditions, such as Herpes zoster, Acne, Facial paralysis and Cervical spondylosis. However, many of the studies may be biased and better studies are needed.

 

The British Cupping Society says that cupping therapy is used to treat:

 

Blood disorders such as anemia and hemophilia

Rheumatic diseases such as arthritis and fibromyalgia

Fertility and gynecological disorders

Skin problems such as eczema and acne

High blood pressure

Migraines

Anxiety and depression

Bronchial congestion caused by allergies and asthma

Varicose veins

 

Cupping is fairly safe, as long as one goes to a trained health professional. But you could have these side effects in the area where the cups touch your 10) ___:

 

Mild discomfort

Burns

Bruises

Skin infection

 

Talk with a doctor before you start cupping or any other type of alternative or complementary medicine. And talk extensively with your cupping therapist, too, before you try it. Ask:

 

What conditions do they use cupping for?

What is your training?

What is your experience in using it?

Am I already getting the standard treatments for my condition?

Are there reasons I should not get cupping?

 

Sources: Wikipedia; WebMD Medical Reference Reviewed by David Kiefer, MD on August 10, 2016

 

ANSWERS: 1) medicine; 2) scientific; 3) Cancer; 4) blood; 5) cup; 6) Fire; 7) burns; 8) vacuum; 9) needles; 10) skin

 

History of Cupping as a Medical Device

Cupping set, London, England, 1860-1875 Cupping was a method of bloodletting, a practice once carried out to treat a wide range of diseases and medical conditions. Warm glass cups were placed on the skin to draw blood believed to be harmful to health to the surface of the skin. In wet cupping, the blood was released from the body using a lancet or scarificator (a set of spring-operated lancets). The set was made by S Maw & Son, a surgical instrument maker based in London. Medical Photographic Library.

 

Woman receiving fire cupping at a roadside business in Haikou, Hainan, China. Source: Wikipedia Commons

 

 

According to traditional Chinese medicine (TCM), cupping is a method of creating a vacuum on the patient’s skin to dispel stagnation (stagnant blood and lymph), thereby improving qi flow, in order to treat respiratory diseases such as the common cold, pneumonia and bronchitis. Cupping also is used on back, neck, shoulder and other musculoskeletal conditions. Its advocates claim it has other applications as well. Cupping is not advised, in TCM, over skin ulcers or to the abdominal or sacral regions of pregnant women. For over 3,000 years, the practice has been typically performed unsupervised, by individuals without any medical background. Iranian traditional medicine uses wet-cupping practices, with the belief that cupping with scarification may eliminate scar tissue, and cupping without scarification would cleanse the body through the organs. Individuals with a profound interest in the practice are typically very religious and seek “purification.“

 

There is reason to believe the practice dates from as early as 3000 BCE. The Ebers Papyrus, written c. 1550 BCE and one of the oldest medical textbooks in the Western world, describes the Egyptians’ use of cupping, while mentioning similar practices employed by Saharan peoples. In ancient Greece, Hippocrates (c. 400 BCE) used cupping for internal disease and structural problems. The method was highly recommended by Muhammad. and hence well-practiced by Muslim scientists who elaborated and developed the method further. This method in its multiple forms, spread into medicine throughout Asian and European civilizations. In China, the earliest use of cupping that is recorded is from the famous Taoist alchemist and herbalist, Ge Hong (281-341 CE.). Cupping was also mentioned in Maimonides’ book on health and was used within the Eastern European Jewish community. There is a description of cupping in George Orwell’s essay “How the Poor Die“, where he was surprised to find it practiced in a Paris hospital.

 

Cupping has gained publicity in modern times due to its use by American sport celebrities including National Football League player DeMarcus Ware and Olympians Alexander Naddour, Natalie Coughlin, and Michael Phelps. Brad McKay,MD, wrote that Team USA was doing a great disservice to their fans who might “follow their lead“, calling cupping an “ancient (but useless) traditional therapy. Practicing surgeon David Gorski claims, it’s all risk for no benefit. It has no place in modern medicine. Critics of alternative medicine such as Harriet Hall, Mark Crislip, Simon Singh and Edzard Ernst have characterized cupping as pseudoscience nonsense, a celebrity fad, and gibberish. They’ve stated that there is no evidence that cupping works any better than a placebo. Pharmacologist David Colquhoun writes that cupping is laughable and utterly implausible. Sources: Wikipedia; WebMD

 

Extreme Temperatures May Increase Risk For Low Birth Weight

 

Low birth weight  refers to infants weighing less than 5.5 lbs. at birth. Infants may be of low birth weight because they are born prematurely, while others may be of low birth weight even though they have completed the 37-40 weeks that is considered to be a term pregnancy. Some are otherwise healthy, but are genetically predisposed to small size. Others are of low birth weight because of an underlying health problem — illness, infection or a failure to grow in the womb. Compared to infants of normal weight, low birth weight infants may be at higher risk for infection and developmental delays.

 

According to an article published in Environmental Research (27 February 2017), extreme hot or cold temperatures during pregnancy may increase the risk that infants born at term will be of low birth weight. The study found that exposure to atypically cold temperature during the entire pregnancy, or just during the second trimester and third trimester, increased the risk for low birth weight. Exposure to atypically hot temperatures during the whole pregnancy, or during the third trimester, also increased this risk. The odds for low term birth weight were highest when the whole pregnancy was exposed to extreme temperatures.

 

For the study, the authors linked medical records from 223,375 births at 12 U.S. clinical centers to hourly temperature records for the region surrounding each center. Extreme cold was defined as below the 10th percentile of average temperatures for a region; extreme heat was defined above the 90th percentile. Results showed that infants born at term to mothers exposed to cold during either the second or third trimester were 18 to 21% more likely to be of low birth weight. When exposed to extended cold over the entire pregnancy, term infants were 2.6x more likely to be of low birth weight. Term infants exposed to heat in the third trimester were 31% more likely to be of low birth weight, and infants born after the entire pregnancy occurred during atypically hot temperatures were 2.5x more likely to be of low birth weight.

 

While the authors do not know why exposure to atypically high or low temperatures would affect birth weight, they noted that previous studies have suggested that heat exposure could affect birth weight by increasing oxidative stress i.e. toxic byproducts formed when oxygen interacts with cells and tissues, and by increasing inflammation. It is also possible that temperature extremes could reduce blood flow to the uterus, depriving the infant of oxygen and nutrients and hindering the placenta’s ability to remove fetal wastes.

 

The study adds to the researchers’ 2016 analysis of the same data in which they reported that extreme heat and cold may increase the risk of preterm birth.

 

Mixed Results of Trials of Testosterone Therapy in Older Men

 

Recent studies have yielded conflicting results as to whether testosterone treatment increases cardiovascular risk and/or slows down the rate of cognitive function decline with age. As a result, two studies (Testosterone Treatment and Cognitive Function in Older Men With Low Testosterone and Age-Associated Memory Impairment; Testosterone Treatment and Coronary Artery Plaque Volume in Older Men With Low Testosterone); were reported on 21 February 2017 in JAMA, which tested the hypotheses as to whether testosterone treatment of older men with low testosterone 1) slows progression of noncalcified coronary artery plaque volume and 2) is associated with improved verbal memory and other cognitive functions and age-associated memory impairment (AAMI).

 

The clinical trials were conducted at 12 sites across the country in 790 men age 65 and older with low levels of testosterone and symptoms to which low testosterone might contribute. The studies were funded primarily by the National Institute on Aging (NIA), part of the National Institutes of Health. Additional funding came from the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, all part of NIH. Additional funding, and the study drug and placebo, were provided by AbbVie Pharmaceuticals.

 

Study participants were randomly assigned to receive testosterone gel or a placebo gel applied to the skin daily. Serum testosterone concentration was measured at one, two, three, six, nine and 12 months. The men were also closely monitored for prostate and cardiovascular problems. In addition to low testosterone, the presence of complaints such as low sexual function, difficulty in walking or low vitality was required for eligibility to participate in the trials. The results of these outcomes were reported in 2016. The study also measured testosterone treatment’s effects on additional outcomes in the study population, which are reported in the current publications:

 

Anemia Trial

Of all the men enrolled, 64 had anemia from known causes and 62 had unexplained anemia. After one year of treatment, 54% of the men with unexplained anemia and 52% of those with anemia from known causes had clinically significant increases in hemoglobin (red blood cell) levels, compared with 15% and 12%, respectively, of those in the placebo group. These changes may be of clinical significance, as suggested by the magnitude of the changes, the correction of anemia in the majority of men, and the association of the increases with improvements in global impression of change in overall health and energy. Measurement of testosterone might be considered in men age 65 and older who have unexplained anemia and symptoms suggestive of low testosterone levels.

 

Bone Trial

The goal of this trial was to determine whether testosterone treatment would increase volumetric bone mineral density (vBMD) — the amount of mineral in bone —   and estimated bone strength in older men with low testosterone. Results showed that vBMD, a marker of increased risk for fractures, was measured in hip and spine at baseline and 12 months later. After one year of treatment, older men with low T significantly increased vBMD and estimated bone strength compared to controls, more so in the spine than in the hip. A larger and longer trial would be needed to determine if testosterone treatment reduces fracture risk.

 

Cardiovascular Trial

The study assessed the effects of testosterone treatment on the progression of noncalcified coronary artery plaque — a build-up within  the walls of the blood vessels in the heart — which is a risk factor for cardiovascular disease. The study found that noncalcified plaque volume increased significantly more in the testosterone-treated group compared to controls, as measured by coronary computerized tomographic arteriography, a special type of heart scan. The authors note that, because just 170 men had the scans, the clinical importance is uncertain and may depend on how testosterone affects different components of plaque. A larger and longer trial is needed to establish the clinical significance of these findings.

 

Cognition Trial

This trial sought to determine if testosterone treatment improved cognition in older men with age-associated memory impairment (AAMI), a mild form of impairment, distinct from dementia. Of the initial participants, 493 met the criteria for AAMI. After one year of treatment, there was no significant change in either the treatment or the placebo group in verbal memory, visual memory, executive function and spatial ability.

 

According to the authors, the results on diverse outcomes indicate the potential trade-offs between benefits and risks of testosterone treatment in older men. However, clarifying the effects of testosterone on many major clinical outcomes such as cardiovascular events, fractures, and disability will require longer, larger scale trials. The authors added that the results also illustrate that decisions about testosterone treatment need to be individualized, taking into account each patient’s balance of risks for the various conditions that testosterone treatment could affect.

 

The U.S. Food and Drug Administration has additional information about testosterone.

 

Approval of First Treatment for Nocturnal Frequent Urination to Overproduction of Urine

 

Nocturia (wakening at night to urinate) is a symptom that can be caused by a wide variety of conditions, such as congestive heart failure, poorly controlled diabetes mellitus, medications, or diseases of the bladder or prostate.

 

The FDA has approved Noctiva (desmopressin acetate) nasal spray for adults who awaken at least two times per night to urinate due to a condition known as nocturnal polyuria (overproduction of urine during the night). Noctiva is the first FDA-approved treatment for this condition. Noctiva is taken daily, approximately 30 minutes before going to bed. It works by increasing the absorption of water through the kidneys, which leads to less urine production.

 

Noctiva’s efficacy was established in two 12-week, randomized, placebo-controlled trials in 1,045 patients 50 years of age and older with nocturia due to nocturnal polyuria. Although these trials showed a small reduction in the average number of night-time urinations with Noctiva compared to placebo, more patients treated with Noctiva were able to at least halve their number of night-time urinations, and patients treated with Noctiva had more nights with one or fewer night-time urinations.

 

Noctiva is being approved with a boxed warning and a Medication Guide because it can cause low sodium levels in the blood (hyponatremia). Severe hyponatremia can be life-threatening if it is not promptly diagnosed and treated, leading to seizures, coma, respiratory arrest or death. Health care providers should make sure the patient’s sodium level is normal before starting Noctiva, and should check sodium levels within one week and approximately one month after starting treatment and periodically thereafter. The lower Noctiva dose is recommended as the starting dose for those who may be at risk for hyponatremia, such as the elderly. Noctiva should not be used in patients at increased risk of severe hyponatremia, such as those with excessive fluid intake, those who have illnesses that can cause fluid or electrolyte imbalances, certain patients with kidney damage, and in those using certain medicines, known as loop diuretics or glucocorticoids.

 

Noctiva should also not be used in patients with symptomatic congestive heart failure or uncontrolled hypertension because fluid retention can worsen these underlying conditions. Use of Noctiva should be discontinued temporarily in patients with certain nasal conditions such as colds or allergies until those conditions have resolved.

 

Noctiva is also not recommended for the treatment of nocturia in pregnant women. Nocturia is usually related to normal changes in pregnancy that do not require treatment with Noctiva. Noctiva should not be used in children.

 

The most common side effects of Noctiva in clinical trials included nasal discomfort, cold symptoms (nasopharyngitis), nasal congestion, sneezing, high or increased blood pressure, back pain, nose bleeds, bronchitis and dizziness.

 

Before considering Noctiva, health care providers should evaluate each patient for possible causes for the nocturia, and optimize the treatment of underlying conditions that may be contributing to the night-time urination. Because Noctiva is approved only for adults with nocturia caused by nocturnal polyuria, health care providers should confirm overproduction of urine at night with a 24-hour urine collection, if one has not been obtained previously. Health care providers should also be mindful of underlying conditions that can cause nocturia, but that make treatment with Noctiva unsafe, such as excessive drinking of fluids or symptomatic congestive heart failure.

 

Although there are other FDA-approved medications that also contain desmopressin, none of those medications are approved to treat nocturia.

 

Curry Zucchini Dumplings and Curried Tomato Cream Sauce

All those wonderful spices did not disappoint; their warm aroma filled our home and whetted our appetites. ©Joyce Hays, Target Health Inc.

 

Dumpling Ingredients

 

2 eggs

2.5 pounds zucchini, washed, keep skin on

2 pinches kosher, sea salt or Himalayan

1 pinch black pepper

1 red onion, peeled and coarsely chopped

2 Tablespoons raw cashews

10 large cloves garlic, peeled

1.5 Tablespoons curry powder (more for spicier)

4 lengthwise slices from a fresh ginger root

1 red chili, stem & seeds removed (more for spicier)

1/3 cup chickpea flour

4 Tablespoons rice flour

2/3 cup finely chopped fresh cilantro leaves and tender stems

Canola oil for deep-frying

 

Sauce Ingredients

 

2 Tablespoons ghee or canola oil (ghee from Amazon)

1 teaspoon cumin seeds

1.5 Tablespoons curry powder

10 fresh garlic cloves, sliced

1 red onion, peeled and coarsely chopped

1 red chili, stem & seeds removed (more chilies for spicier)

1 cup raw cashews

1 cup golden raisins

1 Tablespoon raw ginger root, minced

1 (14.5-ounce) can diced tomatoes (Cento)

1 pinch kosher or sea salt or Himalayan

1/4 teaspoon ground turmeric

1/2 cup half-and-half

1/2 cup chicken broth, to start; then use the whole can

1 teaspoon garam masala

2/3 cup + finely chopped fresh cilantro leaves and tender stems, (plus extra for garnish)

 

These are not your usual suspects. This group of ingredients, combines in an extraordinary way, yielding flavors so-o delicious, you will find that you can’t stop. Jules gives my recipe a 5+. ©Joyce Hays, Target Health Inc.

 

Directions for making dumplings

 

1. Prepare the dumplings: Shred zucchini using a box grater. Collect shreds in a large bowl and sprinkle with salt, not listed with the ingredients. Let stand for about 30 minutes.

 

2. Meanwhile, place onion, cashews, garlic, one egg at a time, ginger, curry and chilies in a food processor. Pulse until mixture forms a spicy-smelling, slightly chunky paste. Use a small spatula and get every bit of this mixture, scraped out and into a mixing bowl.

 

3. Back to the zucchini. Rinse all the salt off the zucchini. Wrap zucchini in a clean kitchen towel and squeeze out all the liquid, over the sink. You may not think this is necessary but it’s worth doing, in order to get as much liquid out of the zucchini, so later the dumplings hold together better.

 

Here, the salted (grated) zucchini has been draining for 30 minutes, after which salt rinsed off, and squeezed with clean kitchen towel. ©Joyce Hays, Target Health Inc.

 

 

4. Place the squeezed squash into the mixing bowl and stir it into the onion paste mixture until well combined. Add chickpea flour, rice flour and cilantro and stir to combine into a slightly wet batter.

 

Here, all the dumpling ingredients are in this bowl, except for the flour. ©Joyce Hays, Target Health Inc.

 

Finally, both flour types, are added. ©Joyce Hays, Target Health Inc.

 

Half the dumplings made, and about to go into the oven. The other half will be fried. ©Joyce Hays, Target Health Inc.

 

 

5. Now, you can either bake the dumplings in a 375 degree oven for about 25 minutes, or until they’re golden brown. Or you can fry the dumplings in canola oil over medium-high flame. For baking, line a baking sheet with parchment. For frying, have a large skillet ready with canola oil in it, heating slowly, while you make the dumplings. Use tongs for frying. I have baked as well as fried. Both turn out well, so it’s up to you.

 

6. Working quickly, place a heaping Tablespoon of batter in the palm of your hand and squeeze it slightly, to form into a ball; transfer dumpling to baking sheet. Repeat with remaining batter to make about 25 dumplings. The longer you let the batter stand without using it, the more liquid-y it will get, making it difficult to handle. Adding more flour will take away from the flavor and texture of the dumplings.

 

7. If you’re going to fry the dumplings, wait until you have formed about 8 dumplings and then put them all into the skillet to cook, while you make the remaining dumplings. Carefully, turn the dumplings with tongs to be sure that the whole surface of each dumpling is cooked to a golden-brown color. Each batch should take about 5 minutes to cook. Set aside.

 

Just turned dumplings over. ©Joyce Hays, Target Health Inc.

 

 

8. Cover a plate with paper toweling, to put the fried dumplings, so they can drain away some of the oil. Set aside

 

9. If you bake the dumplings, remove from oven when done. Set aside.

 

Fried dumplings are done and cooling on a paper towel. ©Joyce Hays, Target Health Inc.

 

This batch of dumplings, just came out of the oven. ©Joyce Hays, Target Health Inc.

 

Chopping herbs for the sauce. ©Joyce Hays, Target Health Inc.

 

Chopping red onion and garlic, for the sauce. ©Joyce Hays, Target Health Inc.

 

 

Directions for the sauce

 

1. Heat ghee or oil in a large saucepan over medium-high heat. Add cumin seeds and cook until they sizzle and darken, 5 to 10 seconds. Immediately add onions, garlic, chili, cashews and raisins. Stir-fry until onion is soft and golden, chili is pungent, cashews have turned honey brown, and raisins are swollen and darkened, about 5 minutes.

 

Sauteing ingredients for the sauce. ©Joyce Hays, Target Health Inc.

 

 

2. Add tomatoes, salt and turmeric to the saucepan, stirring once or twice to combine. Add all seasonings and spices and herbs, now. Stir again to combine.

 

 

3. Transfer all the tomato sauce ingredients to a food processor and pur?e, scraping downward, with a small spatula, the inside of the glass bowl, as needed, to make a smooth and spicy-sweet red sauce.

 

4. Pour sauce back into saucepan, using the spatula to scrape all the sauce into the pan. Pour 1/2 cup chicken stock or broth, into blender and swish it around; add this liquid to pan. Stir in the half-and-half and garam masala. Stir all together to combine well.

 

Here is the thick sauce. I will add a little more chicken broth, very slowly, stirring the whole time, until I get the exact consistency I want. ©Joyce Hays, Target Health Inc.

 

 

5. At this point, I usually find that the sauce is too thick, so I slowly add a little more chicken broth to the sauce, while stirring the whole time. In the end, I always add all the remaining chicken broth. Do this slowly, so that you’re sure the sauce will not be too thin. If it becomes too thin, it’s hard to add a thickening agent and be sure you won’t dilute the flavor, so don’t let the sauce get too thin, by adding the broth too quickly.

 

6. When you’re ready to serve, gently add all the dumplings to the sauce, making sure they do not break apart.

 

Sauce is just right and I’ve added the dumplings to the sauce, as they get reheated. ©Joyce Hays, Target Health Inc.

 

 

7. Heat over medium flame, until sauce starts to bubble, then lower heat, cover the pan, and simmer until dumplings are warmed through and have absorbed some of the sauce, about 5 minutes; do not stir. Sprinkle with cilantro before serving.

 

Just brought the pot from stove to table and added some cilantro. Ready to serve. ©Joyce Hays, Target Health Inc.

 

As Jules wolfed down the curry dumplings, I managed to get a photo`of one, cut in half. Dee..lish ! He gave my new recipe a 5+. ©Joyce Hays, Target Health Inc.

 

 

Serve warm with mango chutney on the table, some sour cream and chopped cilantro.

 

This was a scrumptious meal filled with such a myriad of flavors. We started with our chilled Pouilley-Fume and a simple tomato/avocado salad (fresh lemon & oil dressing); then the new recipe, the awesome curried zucchini dumplings with equally spectacular sauce. I love spoiling my dear, husband, so also made a favorite of his, fried chicken thighs. To complete the entr?e, I also served broccoli sauteed in extra virgin olive oil, a dab of butter and plenty of sliced garlic. Fresh fruit for dessert. We’re in a mango groove these days. Such a refreshing way to end a meal. ©Joyce Hays, Target Health Inc.

 

This well chilled Pouilly Fume was perfect with the whole meal. Pouilly Fume is a bit drier than Pouilly-Fuisse. I happen to like Pouilly-Fuisse better, for what it’s worth. If I had to compare (remember, I’m no wine expert), I would say that if you like Chardonnay, then you might prefer Pouilly-Fume. Whereas, IMO, those who like Sauvignon Blanc, which I do, would probably like Pouilly-Fuisse. ©Joyce Hays, Target Health Inc.

 

We saw a wonderful revival this weekend, on Broadway (The Samuel J. Friedman Theater). August Wilson is the playwright and the play with raving reviews is: Jitney. All of the acting is beautifully done, with excellent direction. IMO, the writing is splendid, especially Act 2 and the last scene of Act 1. The end of any play is particularly difficult. The sensitivity and skill of August Wilson’style is clear as he navigates to the final words of this gem Here’s a play not to miss. There’s another week or so to go. Try to catch it. The end is stunning!

 

 

From Our Table to Yours !

 

Bon Appetit!