Editorial
Sofica Bistriceanu*
Published : November 22, 2024
DOI : 10.56831/PSMPH-05-179
Case Study
Eugene Basandja Longembe*, Jean Panda Lukongo Kitronza and Joris Losimba Likwela
Published : November 22, 2024
DOI : 10.56831/PSMPH-05-180
Research Article
Home Treatment of Drinking Water in the Peri-Urban Environment of Bumba: Study Protocol
Michel Saliki Lifita*, Zoe Arthur Kazadi, Alliance Tagoto, Eugene Basandja Longembe, Theophile Yanyongo, John Panda Lukongo Kitronza and Joris Losimba Likwela
Published : November 22, 2024
DOI : 10.56831/PSMPH-05-181
Research Article
Theophile Yanyongo Twangaka*, Joris Losimba Likwela, Marcel Otita Likongo, Alliance Tagoto, Eugene Basandja Longembe, Michel Saliki, Raphael Iseayembele Bosalo, Franck Esuka and John Panda Lukongo Kitronza
Published : November 22, 2024
DOI : 10.56831/PSMPH-05-182
Case Study
Lucien Dias Nzali Mpeunguem, Cavin Epie Bekolo*, Patrice Landry Koudoum, Solomon Ifang Ndifon, Laure Manuella Djienang Edith, Roddy Yvain Saha, Djomene Junior Christian, Loïc Rudi Tagne, Angelot Marcel Fouakeu, Maelle Ange Kemsu, Freddy Njonbi Ndadjeu, Guy Calvin Mbongo'o Nko'o, Meli Meli Vivien and Armand Tiotsia Tsapi
Published : November 28, 2024
Research Article
Management of Allergy by Jewellery and Piercing through Ayurveda
Abhishek Singh* and MS Ayu
Published : November 29, 2024
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Generally, stillbirth is only experienced in about 1 out of every 200 pregnancies. Most stillbirths occur before delivery, however, up to 14% of all stillbirths do occur during the delivery period. Infection is an important cause of stillbirths worldwide: in low-income and middle-income countries, 50% of stillbirths or more are probably caused by infection. Infection may cause stillbirth by a number of mechanisms, including direct infection, placental damage, and severe maternal illness. A large variety of organisms have been associated with stillbirth, including many bacteria, viruses, and protozoa.
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The aim of the study - to investigate the influence of risk factors in the mother and morbidity in the neonatal period on the development of hypoxic-ischemic encephalopathy of newborns, depending on their gestational age, as well as to determine the effect of neuroprotection on the development of hypoxic brain lesions in premature infants.
Materials and Methods At the first stage, a retrospective analysis of the course of pregnancy, child birth and the condition of newborns was carried out in 150 women whose children had suffered from hypoxic-ischemic brain damage. Group I (I G) consisted of 62 women who gave birth to full-term babies, Group II (II G) - 88 women who gave birth prematurely at 26+6 - 33+6 weeks of gestation. At the second stage, the level of neurospecific markers of nerve tissue damage (NSE and S100) was prospectively investigated in 60 preterm infants at gestational terms up to 32 weeks, which were divided in to two groups. The main group (MG) consisted of 30 preterm infants whose mothers were injected with magnesium sulfate for the purpose of neuroprotection, the comparison group (CG) - 30 preterm infants whose mothers did not receive neuroprotection for various reasons.
Results and Discussion The risk factors for the birth of children with HIE include extra genital pathology in the mother (OR 1090.818, 95% CI 64.501-18447.401), urogenital infections-chlamydia (OR 21.87, 95% CI 1.264 - 378.397), prematurity, low weight bodies at birth, PROM, chorionamnionitis (OR 17.6, 95% CI 2.288 - 135.407), Apgar score <7 points, morbidity in the neonatal period. Neurospecific enolase (NSE) was significantly higher in children with gestational age up to 32 weeks and an Apgar score of <6 points. The lower concentration of protein S 100 in
newborns of the main group can be explained by the protective effect of magnesium sulfate on the central nervous system of a premature new born.
Conclusions Risk factors for neurological disorders in newborns include extragenital pathology, urogenital infections of the mother, prematurity, premature rupture of the membranes, the development of chorionamnionitis, and fetal growth retardation. Conducting neuroprotection
with magnesium sulfate before delivery is an important measure to prevent hypoxic-ischemic brain damage to the fetus and premature newborn.
Keywords: hypoxic-ischemic encephalopathy; prematurity; preterm labor; chorionamnionitis; neuroprotection
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The answer posed by the title of this article may seem obvious: that pandemic policies are formulated as a crucial part of public health. However, a more in-depth exploration show that the situation is complex and one may not simply assume that all pandemic policies equate with good public health. To do so would imply that these policies override all other aspects of public health. Current debates among Western societies on this topic are highlighted, and discussed with respect to current pandemic policies in Hong Kong, where differences in culture and health and social systems exist.
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Hand hygiene is fundamental to clinical practice and has been shown to reduce the risk of major diseases. School children and for that matter, primary school pupils are at higher risk the most because of the lack of paying special attention to a simple but very important personal hygiene behavior such as frequently washing hands with soap under running water and also due to insufficient knowledge on good hand washing with soap practice. Between November 2021 and March 2022, this study was conducted in Tehsil Lalian District Chiniot Pakistan. Data on hand washing practiced among primary school children were collected by using questionnaires. Ten students from each school were selected for the questionnaires and 20 schools in urban and 20 schools in rural areas were covered. The study helped us to check the current knowledge about hygiene and the availability of hand washing facilities in the school. Data were collected from above-mentioned schools by using questionnaires. Interviews were taken from the class students to check their knowledge about hygiene which they are given to the students to guide them about their hygiene and how they teach the students to keep them healthy. In rural schools, about 39% students were selected from class 3, 32% from class 4, and 29% students were selected from class 5, while in urban schools, about 35.5% students were taken from class 3, 36.5% from class 4 and 28% students from class 5 were selected. All schools (rural and urban) have the facility of hand washing points. About 96.75% schools have water supply within hand washing point while only 3.25 schools do not have a water supply. They have tissue papers facility instead of water. About 87.75% schools have sign boards of hand washing to guide the students while only 12.25% schools do not have sign boards on hand washing guide the students. About 71.5% students from rural schools wash their hands before eating food while 28.5% students wash their hands after eating. Further, 66.5% students from urban schools wash their hands before eating food while 32.5% students wash their hands after eating. About 74.5% students from rural schools, wash their hands after playing with friends while 25.5% students sometimes wash their hands. About 63.5% students from urban schools wash their hands after playing with friends while 36% students sometimes wash their hands and 0.5% never wash their hands after playing with friends. About 77% students know the importance to wash their hands with soap when in school and 23% students do not. About 42.75% students strongly agree that hand hygiene reduces the chances of spreading infections, 28% student only agree, 13% disagree, 12% don’t know while 4.25% strongly disagree. About 81% students think proper handwashing minimizes the risk of germ attack while 19% students do not think so. About 88.75% students know that if they fail to wash their hands properly, they will be exposed to the disease while 11.25% students do not think so. About 80.25% students think that poor hand washing can cause disease while 19.75% students do not think so.
Keywords: hand washing; disease prevalence; school children; washing practice; rural areas; urban areas
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This article is addressed to [1] All those who have been part of international development particularly in the healthcare sector long enough to be sick and tired of watching people die or suffer in outrageous numbers of preventable causes in more or less challenging environments, [2] Young professional who are witnessing unbearable facts (waste of minds, waste of resources, indifference, bias, etc.), and [3] Everyone who thinks the state of Global Health is disgraceful compared to what it could and should be and do not want to face any longer conditions included in the following loose and open-ended enumeration
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Behavior and cognitive functions are results of a fine tuning of multiple neuronal synapsis and a myriad of biochemical reactions whose number, location, components, sequence, and logic are unknown.
In entirely theoretical terms deleterious effects of reactive oxygen species (ROS) production during aerobic metabolism are neutralized by the antioxidant systems and in this manner the brain effectively regulates its oxygen consumption and redox generation capacity.
The knowledge about the metabolic processes of the CNS is so elementary, so theoretical, that only in the previous paragraph we find two notable errors: aerobic metabolism and oxygen consumption.
The phrase aerobic metabolism refers to the fact that the oxygen contained in any tissue of the human organism, such as the CNS, comes from the air that surrounds us, since it is supposedly absorbed through the lungs and reaches the bloodstream to be distributed to all the cells of the organism.
However, since 1850 researchers of the stature of Christian Bohr, Carl Ludwig, and Halender, published works in which, according to their experiments, the diffusion of atmospheric oxygen through the pulmonary alveoli could not explain the enormous difference between the concentration of atmospheric oxygen, which ranges between 19 and 21%, and the % SpO2 in the blood that reaches values of 98 and 99% [1].
It was precisely the search for the mechanism that would explain such a difference between oxygen in the atmosphere and blood oxygen, which led these researchers to publish that there was no such thing, and that diffusion alone did not explain such a difference.
Unfortunately, at that time, the work of Krogh appeared [2] who, by means of a theoretical mathematical model, apparently simple, explained the unlikely passage of atmospheric oxygen to the bloodstream through the pulmonary alveoli. Krogh’s lung gas exchange model has been the foundation of respiratory physiology for the past 100 years even though the mathematical concepts it handles are so far-fetched that they cannot even be experimentally contrasted.
Krogh’s original model has been modified and something like 100 equations have been added to try to explain the supposed passage of atmospheric oxygen to the bloodstream through the pulmonary alveoli, but even so, the experimental results do not
square with the predictions of such a model. So, research and care for patients during the past 100 years has been based on eminently theoretical models.
So, returning to the phrase “aerobic metabolism of the CNS”, we have the surprise that it is wrong because the oxygen we have inside the body does not come from the air that surrounds us but from the water that contains inside each cell that conforms us.
Keywords: Oxygen; aerobic; Krogh´s model; energy; combustion; CSF
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At my practice, Shirodhara technique was tested on a group of 25 people who did not know what they were going to test. Each received a treatment of approximately 1 hour.
The following questions were asked before and after the session:
“If 0% is the minimum and 100% the maximum of physical and mental stress that you have experienced in your life, how much stress do you feel right now, for physical stress and mental stress?”
The novelty of this research consists in studying the psychological, physiological and ethno-cultural aspects of the use of the ancient Kazakh musical instrument kobyz for health purposes.
Due to the modern stressful rhythm of life, ecological, economic and social problems there is an alarming tendency of general growth of mental morbidity and psychological disorders [1]. Therefore the search for new non-drug methods of psychological correction and recovery is the most actual modern task. Recently the methods of music therapy have become more and more widespread.
Keywords: Bai Chay hospital; Quang Ninh; cancer patient; treatment at home; scientific technology
El-Kass et al (2021) stated Cancer is the leading cause of death in economically developed countries and is a threat to human lives. Cancer and chemotherapy side effects may affect the daily activity of cancer patients and their families on many levels confronted by changes in health status and lifestyles, leading to impaired self-care efficacy. Bai Chay Hospital in Quang Ninh province has been a pioneer in applying tech ology in medical services. Hospitals increase IT application, move towards paperless hospitals, and at the same time improve operating capacity and modernize. Our study shows that Home care service for cancer patients who want palliative care after cancer treatment or terminal cancer patients has been developed in big cities in Vietnam in order to solve one important thing is the psychological problem, when treating at home and reducing waiting time for cancer patients at hospitals.
1. UV Laser (Excimer).
2. Visible Laser (Argon).
3. IR Laser (Ionization Resonance).
The word LASER stands for Light Amplification by Stimulated Emission of Radiation. According to this abbreviation that summarizes the energy generation; it is the light that occurs when the crystal between two full and semi reflective mirrors is exposed to intensified energy amplification the type of laser is named with the substance in the liquid crystal [1, 2]. Laser was first applied in the musculoskeletal system w by Whipple in 1984 using C02 laser. Classification according to the laser optic parameters (wavelength, power and dose) was developed in clinical trials after that date [1, 3]. Laser is known to change cell proliferation, motility and secretion at different doses. Tissue interaction can occur in the form of destruction, liquification, heating and evaporation depending on dose. The type of laser commonly used for the musculoskeletal system is resonance type which can be classified as follows [2];
Keywords: semi-arid; overexploitation of aquifers; planning; crops
The overexploitation of water sources together with the lack of rain due to climate change that causes problems in the recharge of aquifers, this has led to the analysis of possible crops suitable for the current situation to ensure food self-sustainability in the future. Using a system of linear equations in an optimization model, emphasizing the water requirements to ensure the total development of the crop with new technologies, as well as the restriction to the availability of water for agricultural use in the region, feasible and substitutes crops were found. These crops maximize the value of production from the producer’s point of view and cross-price elasticities of supply. This tool will support decision-making in strategic planning in agribusiness and government policies.
On psychiatric consultation of 546 cancer patients there was revealed that 54% of the referrals were diagnosed as having adjustment disorders, 15% delirium and 9% major depression [1]. The results showed elevated risk of comorbid common mental health disorders among persons who at the time of the study were undergoing treatment for cancer across all countries studied compared with either cancer survivors or cancer-free respondents.
Cancer diseases affect approximately 10 million people only in Europe. As a result of the demographic development, their prevalence is expected to double during the next 10 years. Cancer accounted for nearly ten million deaths worldwide in 2020, or nearly 1 in 6 deaths. Meanwhile the number of survivors continues to grow, not just because of earlier detection and treatment, but also because of revolutionary new therapies. This changes the landscape from a terminal illness to more of a chronic illness. Such perspective on neoplasms has broadened the scope of care from treating the disease alone to managing cancer-related symptoms at different stages of the disease trajectory including mental disorders.
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Recently, in standard family conditions, unsocial humans with repetitive behaviors attracts increasing attention. Autism spectrum disorders (ASD) with all its behavioral disorders with deficit communication leading to lack in social interaction, obviously, induced central nervous system perturbations. Awareness of caregivers remains the most important factor facilitating the early diagnosis of autism in children. The educated level in some studies did not contribute for solving the problem of people-misunderstand completely, because their awareness depends on education field and their personality. We suggest that deletion of coding and non-coding genes transmitted from mother to son, resulted from oxidative stress due high anxiety levels, induced ASD. The neuroprotective effect of SNL in combination with MEM, DNP, CTP and ARP exhibited by the restoration levels of dopamine, acetylcholine, serotonin and glutamate. Modulations in neurotransmitters and pro-inflammatory cytokines succeed in adjusting stereotypes behaviors of VAP rats and mice.
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Harmine recently known by its multi-beneficial effects like neuroprotection, anti-diabetic and antitumor effect, but its impact upon animals and human during pregnancy remain pre-estimated with undesirable effects of Peganum harmala, as the plant usually used as an abortifacient by Middle Eastern population, morocco and many other countries. It took place an in depth debate due to its multiple uses and importance, the most abundant alkaloid in the parts of the plant is harmine that concentrated most in dry seeds and roots, but miss in flowers.
Keywords: regenerative medicine; stem cells; classification; differentiation; proliferation
This article is devoted to important issues of regenerative medicine and fetal stem cells administration as its valuable instrument. Herewith we will describe various types of stem cells, mechanisms of stem cells action and the spheres of their broad clinical application.
The earliest land plants date back to around 3.70 Billion years before. Estimates on the number of Earth's current species range from 10 million to 14 million. They have major impact on Mankind. The impact of the Moon and its rotation around the Earth has many effects on life on the Earth and Mankind. Earth Science taught the Mankind, how to take care of the Nature and obtain the benefits of the atmosphere through plants so as to have a smooth life and healthy longevity.
The burning of fossil fuels by humans is the largest source of emissions of carbon dioxide which is one of the greenhouse gases that allows radiative forcing and contributes to global warming. For that reason humans should use plant based foods for their overall health instead of animal based foods and plants as a medicines instead of Chemical Drugs.
During the Nutrition month of September 2020, Government of India has taken a Plantation drive for Promotion of Kitchen Garden under “POSHAN KE LIYE PAUDHE ” (in Hindi language).
Plants give us various types of seeds and dry fruits which in tern give us Vitamin E. This Vitamin E plays important role in human personality as well as in immune system as an antioxidant, preventing important molecules and structures in the cell from reacting to oxygen. When the delicate components of living protoplasm are attacked by oxygen they are often injured. If one wants to live longer, he/she has to be very friendly with vitamin E. It has now been found out that it has good role to play in many types of pains, not as a pain killer but a pain reliever. Vitamin E may help ease muscle aches after a tough workout, a new study suggests. Researchers believe that the antioxidant mops up the damaging by products created by a strenuous workout.
Thus depending upon requirements of a person, various plants can be useful to maintain an overall health of a person so as to maintain his or her Healthy Longevity.
In one study participants took a relatively high dose of vitamin E, the average person could probably get the same benefits from lower doses of between 200 to 400 IU per day.
Thus the vitamin E which is a water soluble vitamin can be a good pain reliever as also immunity enhancer, if taken in proper proportion as also in proper Natural form.
Our day-to-day eating habits provide many opportunities for us to support our immune system’s power to protect us. All these are from plant foods like….
Black resins, dates & apple, provide us with Iron (Fe), Watermelon seeds give us Zn., Cereal sprouts give us Amino Acids. Gooseberry (Amala), Cranberry, Lime juice Sweet lime provide us vitamin C, Sunflower seeds give us Selenium. All these vitamins are plant sourced and are good for enhancing immunity but doses differs from person to person since unique physiological characteristics .Also it is important to know, how the nutrients are prepared & processed & what other substances accompany them into body. This is a Pharmacology of Nutrition. Further it considers alteration in food due to food processing, adulteration & contaminations. Hence food should be healthy & ideally suited to a particular person.
How can our diet affect immune health?
Our body produces highly reactive molecules called free radicals as part of normal metabolic processes & in response to exposures like pollution & tobacco smoke. Immune cells produce them as a way to fight infections. High levels of free radicals trigger inflammation. Antioxidant nutrients consumed in excess may actually interfere with the body’s antioxidant defences. One has to be very careful while using any nutrient, including plant that high doses of one nutrient can create deficiencies of other nutrients, including those needed by the immune system.
High-fibre diets can nurture gut microbes that provide anti-inflammatory protection. These microbes protect cells within the colon & seem likely to help protect against inflammation throughout the body. Now we are looking for plant based proteins and try avoid animal based proteins, so more of plant utilisation for our health.
Make nutrient-dense foods the majority of our plate to provide the wide range of nutrients needed for immune system cells & function. This includes – but is not limited to – minerals like Zn, Se, Fe & Cu,omega-3 fats & protein.
A few more examples where plants can be of more beneficial are like…
Lemon grass-Cloudy lemonade is served hot as a remedy for chest congestion. Ginger plant Juice-Contains gingerol, is very good muscle pain reliever. It is useful in cough and cold. Watermelon-Cucumber-Mint Juice This drink if taken during summer, it will have a soothing effect on hyperthermic body of a person. Cloves’ Powder and Honey.
Cloves contain a natural compound eugenol which helps to stabilize blood sugar & has positive effect on artery clogging cholesterol. Carrot juice along with lemon juice works in case of Diabetic persons. Coriander, Basil, Pudina, Aloe vera, Moringa, Turmeric, Garlic and such other plants are good for Human health.
The European Society of Clinical Nutrition and Metabolism guidelines on nutrition emphasize that their nutritional needs should be met through a balanced diet, adjusted as needed to meet each individual’s condition. But in general, the guidelines say that use of single high-dose micronutrients should be avoided.
In short, more is not always better.
Free radicals are normal. They are important signals within cells & “turn on” body antioxidant defences but excessive levels of free radicals can damage cells & promote inflammation. Likewise, short-term inflammation is part of how the body clears an infection. If inflammation is out of control however, it can create cell & tissue damage that is difficult to reverse. Most us may be tempted to assume, “if some is good, more is better,” to fight these diseases. But that’s not what evidence shows.
Pandemic Covid 19 has taught us many things during last two years. One of that is use of Plants for our health. Human body contents Plasma which carries substances like hormones, vitamins, amino acid & antibodies & also contains proteins called clotting factors that help the blood to coagulate. Balance of Saliva, Mucus & cerebrospinal fluids, is important for overall health of a person. Nature plays a major role in Human Health through various plants. Stress has been shown to increase clinical viral respiratory illness in humans. Immunity changes are associated with distress can contribute to the etiology and course of immunologically resisted diseases, such as infections, autoimmune diseases or cancer. So we will see how plants are associated with our health.
Keywords: Turmeric; In-vitro; Antioxidant; Ameliorative; Haemolysis; Radicals; Scavenging
Antioxidants are widely distributed in plants that are either used as food or medicine. These natural antioxidants, especially carotenoids, and polyphenols exhibit a wide range of biological effects which include; anti-inflammatory, anti-aging, anti-atherosclerosis and anticancer. Extraction and proper assessment of antioxidants from plants are crucial to explore the potential antioxidant sources and promote the application in functional foods, additives and pharmaceutical. The in-vitro antioxidant and ameliorating effect of butanol extract of Turmeric (C. longa) on osmotic-induced haemolysis was examined. Various experimental model including iron (III) reducing capacity, total antioxidant capacity, DPPH scavenging activity and in-vitro inhibition of osmotic-induced haemolysis were used for the characterization of antioxidant activity and ameliorating effect of the extract. The extract showed various degree of efficacy in each assay in dosed depended manner. In addition, at concentration of 1000µg/ml, the DPPH radical scavenging activity of the extract was found to compare well with that of the standard compound of ascorbic and gallic acids. From the obtained results, C. longa may be considered to be a source of antioxidant which can prevent oxidative stress.
An important element to consider is that people with dementia may have limited access to information on COVID-19 and experience difficulties in applying safety strategies (social isolation, self-quarantine measures, wearing masks, and personal hygiene). Therefore, people with dementia may be more dependent on family members and social caregivers to support them [7] to live within government guidelines. This is further impounded by the provision of information through social media and the implementation of digital health technologies. Older people with dementia living in residential settings have not been able to engage with their family members due to the banning of visitors and with the cessation of group activities [8], older people, and those with dementia, are becoming further isolated [9].
The consideration of the impact of COVID-19 on older people and those with dementia is essential due to the aging global population [10]. The global population of those over 65 years of age was estimated to be over 562 million in 2012, and the population of older adults rose by 55 million in 2015, which is projected to be double by 2050 [11]. Cognitive impairment is common in the older population, although is not a natural part of ageing [12]. The cognitive function of an individual may decrease with age, but mild cognitive impairment and dementia impacts on the person’s ability to independently complete their own activities of daily living, as well as impacting on their memory, language, and orientation. Recent studies showed that the use of computer helped in cognitive stimulation and improved cognitive function with mild cognitive impairment of elderly people [45]. The combined intervention of digital inclusion and physical exercise helped to prevent cognitive and functional loss with elderly [46]. Cognitive decline is a significant issue in aging and it is associated of dementia patients and increases independence, quality of life and falls. Thus, dementia can negatively impact on a person’s quality of life and life expectancy [13]. Dementia poses a challenge to the long-term financial sustainability of health systems worldwide [14]. Likewise, the number of people living with dementia in the developing countries will reach to 71% by 2040 [15] in developed countries such as Western Europe 9.9%, in North America 9.2%, and in America 9.1% of the population by 2040 [16] furthermore, older adults with dementia require further care services such as; care delivery, medication management, education and training for family members and informal caregivers, cognitive interventions, but also leisure activities to support a person with dementia to remain independent, all of which are currently extremely limited [17].
Interventions to support people with dementia at home, have begun to use video telehealth, which has been found to be feasible to deliver cognitive rehabilitation [18] and improve cognitive performance [19, 20]. Face to face videoconference [21], pharmacological interventions [22], technology-based behavioral interventions [23] and cognitive assessments [24]. These approaches demonstrate that technology-based interventions for older people and those with dementia appears both affordable [25] and reliable [26]. COVID-19 has forced and enabled the adoption of technology in dementia support and care in the form of prevention, early detection, care, management and diagnosis [27]. The applications of these technologies could support older people and those living with dementia in rural areas, and those who have migrated and may have linguistically diverse languages. The COVID-19 crisis has provided the opportunity to embrace technology, to support older people, and those with dementia to maintain their connections with the outside world during self-isolation. Health policy makers, service providers and clinicians need to consider these innovative opportunities and support the technological transformation of dementia practice in the coming years [28].
Digital health technologies can support a reduction in the provision of care in hospital settings, and support the management of infections [29]. Considering a significant contribution of digital technologies, the American Academy of Neurology has developed guidelines to implement telemedicine services for clinicians to assess and examine their patients, although some limitations have been acknowledged, such as the follow-up appointments [30]. However, this has not been converted into clinical practice as yet. COVID-19 has forced nations to consider the use of digital health, such as telehealth and e-health, which can contribute to the management of communicable diseases during the pandemic and possibly slow the infection rate of COVID-19 through supporting social distancing [31]. Digital health technologies provide and improve patients’ health, and reduces expenses and as well as the need for care facilities [32]. Telemedicine and mobile care tele-mentoring, tele critical care were significantly useful to offer care facilities during COVID-19 [33]. Within the specialist field of dementia memory screening tools, care, management of behavioral and psychological symptoms in dementia and consultations [34], have occurred through the use of remote technology. This approach has supported the difficult balance of maintaining social distancing and continuing to support people living with dementia, and those caring for them, but has also enable a significant cost reduction to the health system and decreased the risk of infections [35]. Furthermore, these processes have enabled clinical decisions, diagnoses and outcomes to be supported in a timelier manner, supporting earlier intervention opportunities [36] to support and improve mental health.
Technology can also contribute to the reduction of the burden on healthcare institutions and professionals [37]. Technology has also been applied through satellite monitoring, health sensors and apps, Drones (drones were applied in carrying medicine), spraying disinfectants and 3D Printing which was deployed to mitigate shocks to the supply chain and export bans on personal protective equipment [38]. Digital health technologies have not only supported older people and those with dementia, through remote screening and the facilitation of care during a pandemic [39]. Telehealth played directly and indirectly in reducing the contamination by enabling physical distancing, tracking symptoms and detecting timely using interventions [40]. Further, telehealth supported to bring out put with patients’ safety, reliable and flexible regulatory [41]. Virtual care using technologies in home patients and out patients care in health institution, initial COVID-19 hospital surge, and post pandemic recovery was most effective for the care of the dementia patients [42].
Emerging technologies are changing our daily lives under lockdown. The COVID-19 crisis has shown a further way that emerging technologies like the internet and artificial intelligence are not just tools, they are essential to the functioning of our society and economy in this 21st century. Thus, such digital tools must adapt as essential developmental procedure as the time progress. It is not only for COVID-19 issues but also should be implemented to make our daily life easiest than before to fight with communicable disease. Digital technology enables to educate from remote to health workers and populations to follow better care in limited resources and accurately using the Chatbots information getting update of current health systems and patients care home location of their activities and protect from the spread of the virus. Also, saved time, money and to all the sectors and will be cost effective [43].
However, is still a gap in the research regarding how and which digital health (DH) technologies can be effective to support older people and those with dementia patients. But the reality is we are seeking more reliable proof to apply and implement the full potential of this growing area in health science [44]. Therefore, supporting older adults with dementia and maintaining their well-being during COVID-19 has become an urgent to apply digital health technology.
COVID-19 is a global pandemic, with the highest rates in the US [1]. Many countries have enforced lockdown and social distancing as a process to control the epidemic [2]. Despite such stringent global efforts, the numbers of cases are again continuing to rise [3], and all aspects of society are being impacted [4]. The cases of COVID-19 in South Asian are comparatively less than developed countries, even though poor health care facilities are available [5]. Internationally, health authorities and governments are warning older people (those over 65 years old) of the high risk of negative outcomes associated with COVID?19 [6]. Older people and those with dementia are at high-risk of COVID-19 due to their age and multiple comorbidities.
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Keywords: Systematic literature review; systematic review; Meta analysis, protocols
Evidence in clinical practice shows us various effects of improper communication on individuals; they range from minor to significant alteration of people’s health, according to the subject matter, transmission channel [oral, written format], interaction [face to face, virtual] type of communication [verbal, and nonverbal], time and exposure magnitude, dissemination area, environment characteristics, and sensitivity and vulnerability of intended recipient. Middle-aged people and the elderly are more sensitive to offensive attitudes and inappropriate words' energy transfer to them. Unskilful interactions imply the adrenergic pathway increasing activity determining changes in the blood volume flowing through the vessels, finally altering the cell’s functionality in the fragile area. Transitory and persistent unsafe communication increases blood pressure; it is another key for initiating, maintaining, and accelerating the evolution of arterial hypertension, affecting the heart and blood vessels. High blood pressure in arteries determines changes and adaptation of their structure and function in line with time action, forces, and individual susceptibility; it goes along with other risk factors for the building-up of atherosclerotic plaque. Atherosclerosis narrows blood vessels, disturbing the corresponding areas working. If nutrients and oxygen supply decrease by another medical condition interplay, the summative for possible exponential count effects increases. Atrial fibrillation, heart failure, stroke, peripheral arterial disease, chronic kidney disease, vision loss, or altered mind activity may be some effects of such disturbed blood volume flowing. Suggestive clinical signs and symptoms accompany the gradual or sudden loss of function of altered zones. Compiling all factors implying the functionality of the cardiovascular system, including communication skills, we have a general picture of its changing harmony and possible fissures; brain haemorrhage is an unwanted situation. The loss of proper control of the individual working appears under excessive nervous tension. Usually, forceful discussions between business partners, family, and community members may generate haemorrhage in fragile areas. Words’ battle forces exceeding limits lead to subsequent disorders in the easily broken zone. Other effects of inappropriate communication are initiation and advances of dyslipidaemia, altered blood sugar control, leads to depression, and generates people’s conflict ending in their separation or death by victim’s physical aggression or suicide. Concern about the wrong delivery of bad news in clinical practice is necessary since unskilful transmission of such info can lead to disaster in a person at risk. Improper communication affects an individual [intended recipient], but the effects extend to their dear ones, who will suffer for their distress. Finally, unsuitable communication alters individuals’ well-being.
By contrast, the best communication skills delight people, amend the worsening of individual health, and improve life quality and expectancy. The right, kind words and attitudes act as medicines and must be considered in the personal therapeutic plan; they may resonate with a person, harmonizing his mind-sets. Practical, suitable terms and images created with the words assist the people passing trouble time for a better emotional state and enhance their ability to deal with dilemmas. Magnificent word composition energizes and inspires humans. Stars in this zone fascinate the individual since their words are a miracle in the body's functioning. The best words’ composition, products of divine inspiration, produces a good, bright effect.
There are communications in front of indifference.
Therefore the words represent a valuable communication channel for people’s collaboration; they inform us about the difference between individuals. Words influence the nervous system’s functioning through their energy and meaning. Appropriate word energy people use in interaction leads to effective clinical outcomes in practice. Unsuitable words’ energy and power alter their health and decrease work efficiency and social and professional life. For these reasons, communication skills represent a central theme for public health. In a family, there are differences between generations. The aspirations of older adults do not align with those of a young age, leading to conflict. Excessive debates and opinion differences generate nervous tension, leading to disaster for vulnerable people, as mentioned. Respect and appreciation for the parents’ input for their children’s professional, social, and cultural life formation are required. Over time the parents usually do not have a good memory or judgment. Their child has to impart compassion, be polite, and be attentive to them. Promoting good habits in doing well for other people, especially with the parents, is mandatory. Health promotion messages, such as ‘Be polite, and you’ll be rewarded,’ can effectively increase attentiveness and interest in communication. Encouragement and emotional support are essential for the elderly health improvement. We must advocate for the refinement into a partnership between the patient’s family, community members, and business partners. Professionalism in all domains is necessary. Unhealthy behavioural manifestations may originate in mental disorders, and we must identify and treat them. Modelling people's interaction adversities is a key to preventing and treating other disorders, including recuperating altered personality traits; social, professional, and culturally safe work is essential for society’s refinement and advancement. Artificial Intelligence supply offers another perspective for analysis, modelling, and applying the best communication skills in practice. Based on an analysis of ‘what happened?’ guided by AI experts, we can predict what will happen, and they can insert an influence mechanism as a solution and services for corrective actions to mitigate the harmful effects of an individual’s improper communication. Educational programs, hybrid models, IT devices, and artificial intelligence supply offer us the opportunity for instruction, modelling, and recovery in a short time, and that chance never existed before. They ensure human safety for a better life in an unceasingly changeable environment. The people must be aware, especially of words’ power to illuminate or destroy personal values. In this digital era of innovation, technological advances and discoveries allow us to use the words’ composition to our advantage, with cost and time saving, at our e-comfort, when and where necessary, for revitalization or peaceful moments. The ability to cope with harsh conditions makes us influential people in dilemmas. Improving our knowledge, communication skills in daily practice, customer centricity, increased revenue, and best interaction with other trades define us as professionals. Guidance in this direction assists us through excellence in the way of living, in the end, appreciation, and offerings abundantly supplying.
People interact with their energy with or without words, attitudes, and images thinking of them. Their relationships vary individual emotional states, ways of thinking, and acting toward others. Unsafe interactions between them alter the personal equilibrium, and the best communication skills offer comfort and improve life quality and the person’s health. Genetic and environmental factors influence verbal and nonverbal communication styles. Well-educated behaviour elements ensure people effective collaboration. Instinctive and unskilful cooperation between them is in front of illusory health, deceptive clinical manifestations following.
Aim
To highlight communication dimensions between generations and new choices for moral distress restoration in the digital era.
Material and Methods
A qualitative study performed by the author in the community, 2008-2022, relating to communication value for people’s health. The effects of inappropriate communication were noticed and corrected when and where necessary and preventive actions were initiated.
Findings
One day in the spring of 2021, a patient, 89, in interaction with a physician in public, used impolite attitudes and words, determining moral distress for the physician.
Patient medical history; widow: 1972; HTA: from 1972. Heart failure, NYHA class II, 2021; NYHA class III, 2022.
Patient family health history: brothers, sisters, parents: HTA.
Actions were taken
The physician made no comment in public, but a few hours after that incident, when observed the patient alone, she went to her and compassionately scolded her. The patient commented: ‘I said it, and if I said it, what should I do now? Take a cake here from mine to pass you by! I am upset since my son-in-law passed away; he was diagnosed with COVID, and today is the funeral.’ The doctor was affected by the situation and expressed her condolences. To amend the moral distress generated by interaction with that patient, the physician listened to a selected classical music program and enjoyed chosen lectures.
Results
No other offensive communications were noticed for that person.
Conclusion
Grave life events and medical conditions make an older person less attentive in interaction with others in public. Supportive actions from the community can ameliorate their suffering. The digital era offers a new perspective on moral distress restoration.
Discussion/ Implications
Older people were more affected by the pandemic COVID ID19; the loss of their dear ones makes them more vulnerable and sometimes unwise in interaction with others. That patient, in those moments, was probably furious with all physicians, considering the loss of her son-in-law. People must resonate with their suffering, understand their judgment impairment, and support them. Compassion, kind words, friendly attitudes, and encouragement are practical actions to ameliorate their distress. Moral distress restoration benefits in this era of technological advances; IT devices offer a new perspective that never existed before. The selection of the different programs according to individual preference, using the ‘watch on demand’ function, images from nature, reading stories of interest, and channels-mid conversation with dear ones are helpful instruments for restoration of moral distress. Digital products inspire, energize, and encourage us, even in difficult times. Walking in nature is another effective, cheaper technique for health improvement. Self-esteem in intersection with the principles for people’s collaboration in public may exceed the limits; the elderly often hurt us since time slowly undermine all.
The people interact through their energy, with and without words, attitudes, sounds, and images, thinking of them. Individual behaviour reflects mind activity relating to others. A young person’s voice usually varies from that of an older individual; the elderly often share memory impairment and judgment differences; sometimes, reasoning deviance and unskilful transmission of their viewpoint in public are observed.
The author of the article owns a series of publications highlighting the features of the pathogenesis of a new disease: "COVID - 19 - POSTCOVID SYNDROME", as well as a method of treatment and prevention of this disease based on the scientifically proven healing properties of Hirudo medicinalis medical leeches [3-13]. At the same time, the editors of three scientific medical journals have already adopted the author's concept of the name of the disease - "COVID - 19 - POST-COVID SYNDROME" [11-13], which reflects the understanding that this is a single disease that has two phases: the first phase is an acute process, which usually lasts 2-3 weeks - ("COVID - 19") and the next phase is the development of a chronic process - ("POSTCOVID]. The team of MGNOT doctors, represented by its Chairman - Professor A.P. Vorobyov, offers the following treatment for "Post-Covid syndrome": 1. Apply direct oral anticoagulants, twice a day; 2. Plasmapheresis - at least 900 ml, for 1 procedure, at least 5 procedures, daily, with plasma replacement with saline to reduce intoxication [6]. It should be noted that the use of direct anticoagulants has a number of limitations and significant complications with damage to the central nervous system, they can cause nasal, throat and renal bleeding. Plasmapheresis is applicable only if there is special equipment and trained personnel in the clinics. Given the huge masses of the population affected by the pandemic, the proposed treatment technology has no chance of large-scale application. SYNDROME"), which can last for 18-24 months.
Such a definition of the new pandemic is important not only from a taxonomic point of view, but, above all, from a mental point of view, so it gives the doctor an understanding of the complexity of the course of the disease and requires monitoring patients during the entire specified period, for example, monitoring the dynamics: D-dimers, prothrombin time, platelet count and the level of fibrinogen in the blood of convalescents. These are the recommendations of the International Society on Thrombosis and Hemostasis (ISTH) [15]. Now these are the most informative markers of the danger of thrombosis. The term "Long COVID" does not reflect the essence of the disease process [13].
It should be clearly distinguished that the cause of the disease is the virus "COVID-19" (Beta-coronavirus SARS-CoV-2), and the disease itself, for these reasons, should be called "COVID-19 - POSTCOVID SYNDROME".
Analyzing the pathogenesis of this disease, we will dwell on the analysis of the pathogenesis and treatment offered by two scientific schools of Russia. One of them is the analysis and opinion of doctors united in the Moscow City Scientific Society of Therapists (MCSST) named after Professor S.P. Botkin. After examination and treatment of a significant number of patients (more than 2,000 people), with a confirmed diagnosis of “COVID-19”, during 2020-2021, the diagnosis of «POSTCOVID SYNDROME" was formulated. According to MCSST " POSTCOVID SYNDROME " is: “Chronically occurring thrombovasculitis with a predominant lesion of the nervous system (Central, autonomous and peripheral) and skin” [14].
The team of MCSST doctors, represented by its Chairman - Professor A.P. Vorobyov, offers the following treatment for "POSTCOVID SYNDROME":
It should be noted that the use of direct anticoagulants has a number of limitations and significant complications with damage to the central nervous system; they can cause nasal, throat and renal bleeding. Plasmapheresis is applicable only if there is special equipment and trained personnel in the clinics.
Given the huge masses of the population affected by the pandemic, the proposed treatment technology has no chance of large-scale application.
Another clinical school, headed by academician Makatsaria A.D., believes that the leading pathological sign of this disease is the "Syndrome of disseminated intravascular coagulation - (DIC) syndrome [15]. The most unfavorable prognostic sign, according to the authors of this school, is coagulopathy.
If the parameters of the main markers of coagulopathy (D-dimers, prothrombin platelet time, count and fibrinogen levels) worsen, more "aggressive" resuscitation care should be carried out: Low molecular weight heparin (LMWH) should be prescribed to all patients with diagnosed “COVID-19” infection (including non-critical patients) who require hospitalization, in the absence of contraindications to LMWH in these patients. The use of LMWH drugs by this school (Enaxiparin, Nadroparin, Dalteparin) in a prophylactic dose is also justified, which does not require special control. It is recommended to take these drugs to all patients, even with a mild course of the disease, excluding active bleeding, platelet count < 25x109/l, intolerance to LMWH, severe renal failure.
At the same time, it is not known how these drugs will behave with prolonged use, except for the above limitations for them.
The author of this article spoke at the 11th European Congress for Integrative Medicine in 2018 in Ljubljana (Slovenia) [1] and at the 5th International Meeting on Traditional and Alternative Medicine in Rome (Italy) April 2019 with a report: "The Renaissance of hirudotherapy in Russia: The end of XX and the beginning XXI century [2]. These speeches and publications were positively received by the medical community, which served as an incentive for a more complete coverage of the topic of the current state of hirudotherapy in Russia [11-13].
Without reducing the importance of the recommendations of the MCSST therapy of "POSTCOVID SYNDROME"), we offer an alternative way to solve the problem of reducing mortality from pneumonia and other complications caused by “COVID-19”. Previously, we expressed the same point of view in the treatment of elderly people with multi-organ pathology, namely, they become primarily victims of this pneumonia [4].
This is the application of the "System Method of Leeching" (SML) - (hirudotherapy). The method is based on a combination of the principles of homeopathy and acupuncture (hirudopuncture, our definition). The proposed solution is based on the almost 30-year use of SML in elderly people with multi-organ pathology and children treated at the Academy of Hirudotherapy of St. - Petersburg [16]. The preventive and therapeutic plan for anticoagulant and antiplatelet therapy for the prevention of DIC- syndrome, distress syndrome is considered step by step from the standpoint of the “System Method of Leeching” (SML) in recent publications [4, 17].
We remind readers about some unknown properties of leech.
Over the past 30 years, the Academy of Hirudotherapy in St.- Petersburg has obtained a number of new fundamental facts when applying the “System Method of Leeching (SML), which can significantly enhance the clinical effect of its use, and will reduce the mortality of patients with pneumonia caused by the “COVID-19” virus.
In addition to the already known properties of hirudotherapy - antithrombic and thrombolytic, anti-inflammatory, countercurrent, new properties of medical leeches were discovered at the department:
Descriptions of all these discoveries are detailed in the author's publications [3-13, 17].
Therefore, as soon as the pandemic caused by the “COVID-19” virus was pumped up in Russia, our doctors, trained in the SML technology, began to actively apply this method in the treatment of the disease "COVID-19 - POST-COVID SYNDROME".
At the same time, it was shown that SML is a pathogenetic method of treating this disease, including well-known signs of damage to the central and peripheral nervous system, (restoring smell, hearing and vision loss, manifesting antidepressant syndrome) preventing the development of DIC - syndrome.
It should be noted that the use of SML has no restrictions on the timing of use, so a patient with a brain tumor - a neurinoma (schwanoma) received treatment for 23 years, demonstrating a positive result of treatment (Clinical case
described [18]).
Why do we refer to hirudotherapy as a “Method of information medicine”?
Not only because this method has about 20 types of therapeutic effect. But also because in the process of treatment with medical leeches, which is first shown in our studies, there is an impact on the information-entropy processes in the aqua system of patients, which leads to a process of harmony between the indicators of the chaos criterion (Cc) and the order criterion (Co), with access to the harmony parameters - "Golden Proportion" or "Golden Ratio", which is characteristic of a high level of health [5, 19].
Known for many centuries, the method of hirudotherapy, as part of Ayurveda or Ayurvedic medicine, is still revered and used in India and the countries of South-East Asia.
At present, thanks to new knowledge in the field of hirudology and hirudotherapy, reflected in the "System Method of Hirudotherapy", the Ayurveda method has acquired a new image, content and capabilities.
Conclusion
The SML method has no complications and can be used as monotherapy in both the acute and chronic stages of the disease "COVID - 19 - POSTCOVID SYNDROME".
The article discusses the mechanism of the disease "COVID - 19 - POSTCOVID SYNDROME". The mechanisms of pathogenesis of this disease are affected. The most proven mechanisms of the pathogenesis of the disease and the most effective methods of treatment according to the literature are considered. In comparative terms, the advantage of the "System Method of Leeching" in comparison with the proposed methods of treatment is shown. The possibility of monotherapy with medical leeches (hirudotherapy) of this disease is shown, as an example of information medicine.
Keywords: Disease "COVID - 19 - POSTCOVID SYNDROME"; damage to the nervous system (central and peripheral); DIC- syndrome; “System Method of leeching” (SML) - hirudotherapy; new effects of hirudotherapy
Robotics in medicine is very innovative field of research and exploration recently. Recent advancements in different robotics technologies utilized in medical and personalized healthcare are in huge concerns both in academia and industry fields. Getting yourself to be familiar in the recent state-of-art in the different fields covering robotics in medicine is great step towards being professional in high demand for medical, personal healthcare, robotics and IT industries.
Topic Field-1: The board Spectrum of Robotics Applications in Medical and HealthCare Monitoring.
Topic Field-2: Recent Advancements of Medical Teleoperations.
Topic Field-3: Medical Imaging and Image-guided Surgery.
Topic Field-4: Kinematics of Medical Robotics.
Topic Field-5: Tracking & Surgical Navigation.
Topic Field-6: Surgical Collaborative Robots.
Topic Field-7: The Rise of Metaverse in Future Surgery.
Topic Field-8: Towards Successful and Widely Adoption of Robotic Surgery in Common Surgical Procedures.
Topic Field-9: IoT and Digital Human-Body Twin for Precise and Reduced Cost Remote Robotic-Surgery.
Topic Field-10: The power of Artificial Intelligence in Personalized HealthCare and RoboticSurgery.
The section of robotics in medicine covers a wide spectrum of the recent advancements of connected modern technological infrastructure that allow collaborative and remotely precise surgical operations. The analysis of the potentials of the medical system under investigation in this book are hugely beneficial for researchers in the fields of personalized healthcare, remote precise surgical operation, modern image processing and visualization techniques and artificial intelligent automated services in medicine.
Public health medicine faces many obstacles and challenges, especially in developing countries. One of these challenges is that public health medicine is not given a high priority like other specialties of medicine. The reason is that health planners in these countries are focusing their efforts on secondary, tertiary, and advanced healthcare services and do not give the required support to public health medicine that considers effective wall to enhance the general health of the population, through the building of an integrated primary health care programs to detect and deal early with cases that may slip to higher levels of health care and cost healthcare systems a lot of money.
Governments and policymakers across the globe should give more attention to the public health medicine discipline as it is considered one of the pillars that enhance the health of societies and make them active and productive at the same time.
The health of the population is not the responsibility of the healthcare system, but of society as a whole. So, while public health may be within the health care system, it necessarily operates to a large extent beyond that system, at a community and societal level. Public health defines as the is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society. On other hand, Public Health Medicine is one of the specialties of medicine that aims to promote health and prevent diseases and injuries (primordial and primary prevention), in contrast to the medical model of care, which focuses more on reacting to the illness through diagnosing and treating them after they occur (secondary and tertiary prevention). Public health medicine also focuses on assessing and measuring the health status of populations and developing effective interventions at the population level rather than individuals and creating the conditions that enable people to make healthy choices to improve their health.
In fact, the feeding of human populations has gone from the collection of fresh vegetables in nature, to specialized production in large monoculture extensions, with high mechanization and use of agrochemicals; that is, from natural foods to those manipulated through different technological processes. The latter have become a few basic products, whose negative effects are well known, due to prolonged exposure over many generations to a low diversity of foods and their associated microbiota, which is why nutrition and immunity functions have been reduced naturally in the human microbiota (Vázquez 2022).
Paradoxically, families from periurban communities, sometimes socially marginalized, are more likely to obtain food in small spaces, which provide them with a diversity of seminatural fresh products, because they are obtained with minimal physical interventions, not chemicals and very little manipulation, whose biotic direct interactions contacts with family members influence nutrition and health, facilitating a sustainable quality of life despite living with low income. In fact, these periurban communities constitute coinnovation niches that can serve as a reference for designing the food systems of the future.
Habitat and feeding
An estimated 800 million city dwellers worldwide are involved in agriculture-related activities in cities and towns, where they produce food and generate income. A combination of data from national censuses, household surveys and research projects from various agencies indicate that up to two thirds of urban and periurban households are involved in agriculture, through local government, institutional, community and family programs (FAO 2010).
It is interesting to observe that in the members of these families there are contrasts of origin, training and ages, which converge with a permacultural, organic or agroecological perception regarding family farming, mainly when elderly people of peasant or rural origin live together, who transmit their cultural traditions; also, people who have received training that allows them to understand the differences regarding feeding with products from conventional agriculture.
Carrying out biodiversity management practices in small scale agricultural production systems, with social and environmental advantages in historical, socioeconomic, and geographical contexts in Latin America, has helped to maintain more sustainable agricultural systems than the technified ones (Mougeot 2006). These urban green spaces can provide vegetation structures and biodiversity for ecosystem functions and services, across fragmented habitats and spatial scales (Lin and Fuller 2013).
Although urban agriculture alone will not solve the complex ecological and social problems of cities, given the multiplicity of factors that intervene in it. Agrocultural development in the city constitutes an effective strategy for the management, protection, and recovery of the urban environment from various spheres of action (Moreno 2007). In fact, small scale agricultures are those that produce around 70% of the food worldwide, using only 30% of the productive resources, while industrial agriculture produces 30% of the food in 70% of the surface (ETC 2017).
Small scale food production in urban and periurban areas has become an important component in the design of feeding strategies in large cities of the developing world and is an agricultural production alternative with almost nonexistent negative environmental impacts (Morello 2000), experiences that justify the importance of integrating the habitat with the self management of food that can be considered as seminatural.
In fact, human health is closely related to the environmental factors (Mejías 2013). The different existing models on health determinants contemplate the environment as an important factor to take into account (Evans et al 1996). Considering that the city is the main environment in which life takes place for a large part of the population and that, as has already been seen, it is possible that it will increasingly accommodate a greater number of people, it seems advisable to study how to make these ecosystems healthy spaces (Mejías 2013).
Several studies indicate that contact with nature and the inclusion of green spaces in urban environments promote psychological wellbeing, stress reduction and improve the perception of health of its residents (Largo-Wight 2011).
Given this need, agroecology emerges as a discipline that provides the basic ecological principles on how to study, design, and manage agroecosystems that are both productive and conserving natural resources, and that are also culturally sensitive and socioeconomically viable (Altieri 2010).
Food and health
The modern diet is vastly different from that of our Paleolithic ancestors, who had an annual base of some 500 different plants, whereas ours has fewer than 50; they ate their food raw and often fermented, while we preserve, dry and cook our food, processes known to destroy many sensitive nutrients and antioxidants. This may be the reason why we are now seeing an increase in various atopic diseases, infections and so-called Western diseases (Bengmark 2001).
Several leading authoritative reviews have shown that dietary diversity is associated with better health outcomes, and that a monotonous diet, even biofortified, is associated with nutritional deficiencies and high rates of chronic disease (Bélanger and Johns 2008). Another potential positive effect of participation in urban gardens is an improvement in nutritional habits there are studies that indicate that the consumption of fresh fruits and vegetables is higher among horticulturists than among those who are not (Alaimo et al. 2008).
On the other hand, the postharvest rehandling of fresh agricultural products is a factor that can generate risks for healthy eating, mainly when good packaging, transportation and temporary storage practices are not guaranteed and the marketing circuits are long. This situation does not occur in family and community agriculture, where freshly harvested food is used or consumed in a short time, either by the family or community members.
Through social practice, societies have developed experiences and systematized special ways of "know and to know" about health and disease, which have gradually shaped a set of notions and knowledge formed in people's daily and spontaneous common practice, until arriving at the empirical practice that concentrates and systematizes the experience of the community in a long time. This informal knowledge, of unquestionable cultural value, is considered by some health professionals as something that must be preserved or recovered due to its secular value (Silva 1997).
Sustainable quality of life
The sustainable quality of life, although it is a highly complex socioeconomic challenge for health systems, can be considered as one of the priorities for the survival of human populations. It is a holistic approach to health conservation, which is particularly different in urban, periurban and rural systems, where factors that determine habitat quality, healthy eating and natural medication converge.
People who have a working life in different occupations in society, find a moment to take care of plants and animals, which means a change of work that they do with pleasure, because it has the double function of contributing to the wellbeing of the family and their health, for being doing physical work. This is the integral health of the family, because they coexist in harmony with plants and animals that provide them with different benefits, be they food, nutrition, medicine and pleasure.
Another problem is the social isolation suffered by a significant number of older people, which is an important risk factor for developing other disorders or pathologies (Kharicha et al 2007). It is mentioned that, for example, in Sri Lanka the shade, freshness and diversity of these orchards are considered essential for people's physical and mental wellbeing (Lok 1998).
Although the current needs of human populations are diverse and of a high magnitude, integrating orchards into urban, periurban, and rural family homes has an invaluable contribution to sustainable quality of life, because it contributes to rediscovering habitat, food, and health.
The original human populations lived in communities, where they coexisted in a feeding system integrated into the natural habitat. With social development, they were regrouped into urban (towns and cities), periurban and rural socioecosystems. These characteristics have contributed to the fact that today's society is made up of population conglomerates in anthropized habitats, where the quality of food and the state of health, which are still valued separately, have become important social problems, including in rural areas, where the influences of modernity have eroded traditional food culture and medication.
Our world revolves around its advanced axis. Everything is progressive and innovative. Newer technology is on the horizon, and it has changed the spectrum of our world and transformed the way people live. This digital rise brought pros and cons to our scheme. This technological breakthrough contributed to different spheres of existence.
The security of its citizens is the government's first priority. Since individuals are the most valuable resource the government has, improving medicine and medical procedures is essential if we want to win the public's trust. The delivery of public health is efficient if one medical practice is effective. We refer to this as the "parallel effect."
Public health and medicine are intricately intertwined. The understanding of and contribution to public health made by medicine are changing along with the world. All facets are moving toward high definition and the internet of things as we reach the fourth industry. The cosmos is increasingly facing extreme climate change, which has negative effects on human health and the ecosystem. People are more involved in unrelated work, which increases the likelihood that health hazards will arise. Because of this, innovation in medicine and public health must coexist.
By properly implementing various programs and curricula related to the effective use of medication as a therapy for any disease, public health is the process of creating a healthy environment for healthy people. The challenge here is how well public health professionals can treat everyone with inclusive medication in order to prevent any health complications. The 4thIndustrial Revolution has profoundly changed the medical industry in many ways, so it is important to take that into account while promoting public health. Extensive learning is essential in order to practice advanced medicine.
In a general sense, the primary goal of medicine and public health is to promote and improve the health of every individual and the whole population. This must include appropriate program implementation for the right people at the right time and in the right place. A comprehensive and thorough understanding of how to carry out this attempt in order to promote healthy well-being and a disease-free environment that is resilient throughout the seasons.
The exceptional effect of COVID-19 disease greatly affects everything in the system. When it strikes, many lose their jobs and even their precious loved ones. Everything was on the brink of closure, and health is the major concern at this time. For the past two years of battling against COVID-19 disease, we have been in a health recovery as we face the so-called "new normal. Post-pandemic experiences improved the medical world's understanding of public health issues and concerns. Medicine, like technology, is evolving at a rapid pace today.
Best practices of hospital, efficient leadership in healthcare, appropriate delivery of services to the patient at right time/ pace and empowered patient are the scenario of win-win. The grapes not only appear sour but also bitter! Countries, companies and organisations are all striving to contain cost but the tug of war is highly imbalanced.
What is the solution?
A techie / IT professional is much well paid, doctor is always on the receiving end, nurse is never polite and what not. Despite all Care of the infirm is a priority. Let us strive and make the system better. Pleasant interactions at a hospital are possible with these
To err is human, agreed. But amidst these humans exist the divine species of healthcare workers. Governments, policy makers and the general masses need to realise this and implement this in day to day lives.
As per IMCA London, Cost Accounting is defined as “the process of accounting of cost from the point the expenditure is incurred or committed or committed to the establishment of its ultimate relationship with cost center & cost unit”. F.1
Three Kenya Medical Training college campuses were selected purposively, mainly, Bungoma in Bungoma County, Webuye in Bungoma County and Kakamega in Kakamega County. Across sectional analytical Study design was employed. A sample of 222 students and 12 key informants were included in the study. Systematic random sampling was used for selection of students. Structured questionnaires were used to collect data from students, Interview schedules used to collect data from Key Informants. Collected data was entered in the SPSS Version 21.0 and data analysed by descriptive statistics using percentages and means and inferential statistics of odds ratio used to test strength of association and 0.05 set as p value used to test the hypothesis in academic dishonesty. The response rate was (90.1%) n=202. The study findings revealed that out of 202, (47%) n=95 agreed to have been involved in some form of academic dishonesty; Most students, (40.1%), n=81 confessed to have received information on academic honesty through students’ hand book. The results revealed examination cheating as the main form of academic dishonesty (71.6%) n=145. The main contributing factor to academic dishonesty was lack of lecturers adhering to policies in administration of examinations and overcrowding (OR: 2.3; 95% CI: 1.2-4.5; p=0.01), students not aware of college rules (OR: 0.6; 95% CI: 0.3-1.0; p=0.07) followed by family pressure to score high 47.8% (n=97). Students reported that punishment, remedial teaching and ant plagiarism software detection strategies were explained to them at the beginning of the training (OR: 1.4; 95% CI: 0.7-2.7; p=0.03). Consequences for academic dishonesty differed from college to college (OR: 1.9; 95% CI: 0.9-4.0; p=0.04). The most employed strategy for addressing academic dishonesty was use of punishment. In conclusion, the study revealed that academic dishonesty was prevalent in the three colleges with cheating as the commonest form. Punishment was the commonest of all strategies used to deter students’ involvement in academic dishonesty. This study therefore recommends that lecturers should adhere to college policies particularly during invigilation of examinations and provision of enough spacing during examination to reduce examination malpractices and more current strategies like software plagiarism detection to be employed by the college administration in curbing academic dishonesty.
Globally, over 80 % (6.8 millions) of college students believe dishonesty in academics is a necessity to excel. On average, 70% of students confessed to having engaged in different forms of academic dishonesty. In Sub Saharan Africa approximately 50% (4.1 millions) students were involved in acts of academic dishonesty. In Kenya about 50% (70234) academic dishonesty occurs in most colleges in the Kenya Medical Training College with various forms being reported in the year 2012 and specific to western region, about 50% (20,243) of students in higher institutions of learning admitted to have engaged in different forms of academic dishonesty. A report by Kenya Medical Training College for the year 2015/2016 revealed an upsurge in academic dishonesty in most colleges nationwide. Contrary to the fact that Student are expected to be honest in their training as their future career revolved around taking care of people. Specific to Western region in Kenya, there has been limited documentation on academic dishonesty. Therefore, this study aimed at investigating academic dishonesty among nursing students in Kenya Medical Training Colleges in Western Kenya to specifically identify prevalence, factors contributing to academic dishonesty and strategies to prevent the same.
Keywords: Epidemiology; bacteriology; urinary tract infection; Sikasso; Mali
The objective of this work was to describe the epidemiological and bacteriological aspects of urinary tract infection in Sikasso hospital. This descriptive prospective cross-sectional study took place from February to August 2022 in the laboratory of Sikasso hospital. The identification of the bacteria was made from cultural, biochemical (Api 20E gallery) and antigenic characters. Antibiotic resistance was performed using the disc technique in agar medium and interpretation was made according to the recommendations of the antibiogram committee of the French microbiology society. We practiced 448 uine cytobacteriological examinations of which 61 met the urinary tract infection criteria, ie a prevalence of 13.62%. Gram-negative bacteria accounted for 98.36% of isolates with a predominance of E. coli 75.40%, followed by Klebsiella pneumonia 18.03%. The age group 60 and over in males was the most affected with 64.86% (p: 0.0001) of cases. A significant relationship was found for age (p: 0.0001), gender (p: 0.04) and the urinary tract infection. Concerning sensitivity to antibiotics E. coli opposed a resistance of 92.50% to aminopenicillins, 82.93% to cotrimoxazole, 76.09% to 3rd generation cephalosporins and 65.22% to ciprofloxacin. The resistance mechanism by extended-spectrum betalactamase production was observed in 47.83% of E. coli strains. At the end of this study, the hospital prevalence of urinary tract infection is estimated at 13.64% with Escherichia coli and Klebsiella pneumoniae as the majority microorganisms.
Clinical Presentation
A 50 years old non diabetic, non-hypertensive male patient presented with acute onset fever for past 5 days and persistant hiccough and drowsiness for last 1 day. Fever was intermittent (twice daily), not associated with chill and rigor. It was associated with generalised weakness and myalgia. There was no history of cough and cold, dyspnea, abdominal pain, dysuria, headache, nausea, vomiting.
On examination, patient was drowsy, GCS 14/15. Neck rigidity was absent. Chest examination revealed mild inspiratory crepitations over left lower zone.
Investigations
Complete hemogram shows Hb 11.5, TLC 3500 (N58L40E1M1), platelet 75000. LDH 780.
Liver function test showed total bilirubin 0.8, SGOT 170, SGPT 44, ALP 92, albumin 3.1, total protein 6.
Renal function test showed urea 51, creatinine 1.5, serum sodium 125, potassium 3.6.
C reactive Protein was 75.5.
Urine examination was normal.
Chest x ray was normal.
USG whole abdomen showed liver 14 cm, spleen 14 cm.
2 D echocardiography- Normal.
Malarial parasite and Dual antigen Negative.
Dengue IgM Negative, Typhidot IgM negative.
Leptospira IgM-positive (titre-1:80).
Scrub typhus IgM-positive (titre-1:80).
Clinical Course
Patient was managed conservatively with Ceftriaxone, Doxycycline and 3% Nacl, But didn't improve. He developed dyspnea and progressive drowsiness.
CSF analysis showed protein 72mg/dl, sugar 54mg/dl.cell count 3, all lymphocytes.
Further examination revealed Triglyceride was 613mg/dl, ferritin was 14540mg/dl.
Bone marrow examination revealed Haemophagocytes.
Management
The patient was diagnosed with Macrophage Activation Syndrome secondary to Scrub typhus and Leptospirosis. He was treated with intravenous dexamethasone along with antibiotics. Patient improved dramatically from third day and he was discharged with oral antibiotic and oral steroid for total 14 days.
Learnings
We have to keep Macrophage Activation Syndrome in our mind while treating a febrile patient who was not responding to antimicrobial therapies rather who was gradually deteriorating because antimicrobials without immunosuppresion in these cases can lead to fatal consequences.
Reference
Acute onset febrile illness is one of the most challenging disease to physician. It can occur in various infective, inflammatory, neoplastic diseases. Sometimes it is very difficult to find the cause and sometimes it is also difficult to treat.
Keywords: Sepsis; Septic Shock; Biomarker; Presepsin; Procalcitonin; C-reactive Protein; Interleukin-6
The number of different biomarkers used in patients admitted in ICU for SIRS, sepsis and septic shock is extremely high, but no single one has high specificity and sensitivity so it has been suggested that combinations of several biomarkers may be more effective than single biomarkers. The aim of this study was to investigate the use of Presepsin, a soluble fragment of the cluster of differentiation marker protein 14 (CD14), involved in pathogen recognition by innate immunity. In selected ICU patients and cardiac surgery patients we tried to investigate the diagnostic and prognostic value of Presepsin (PSP) compared to Procalcitonin (PCT), C-reactive Protein (CRP), White blood cells (WBC) and IL6. The assay for biomarkers were performed on whole venous or arterial blood, on days 1, 2, 4, and 7 from admission of patients eligible for the study. The diagnostic accuracy of the biomarkers studied was evaluated using the areas under the curve (AUCs). The accuracy of all biomarkers decreases with time until they are no longer useful. The use of Presepsin (PSP) to early detect the presence of infection could improve patient survival and outcome in distinguishing sepsis from SIRS in intensive care unit.
Keywords: Autism Fetal stem cells Transplantation Cell therapy Biopharmacy
Autism spectrum disorders (ASDs) are heterogeneous complex neurodevelopmental pathologies defined by behavioral symptoms, but which have well-characterized genetic, immunological, and physiological comorbidities. Despite extensive research efforts, there are presently no agreed upon therapeutic approaches for either the core behaviors or the associated comorbidities. In particular, the known autoimmune disorders associated with autism are appealing targets for potential stem cell therapeutics. Of the various stem cell populations, fetal stem cells (FSCs) offer the potent immunoregulatory functions found in primordial mesenchymal stem cells, while exhibiting rapid expansion capacity and recognized plasticity. These properties enhance their potential for clinical use. Furthermore, FSCs are potent and implantable “biopharmacies” capable of delivering trophic signals to the host, which could influence brain development.
Keywords: Athlete; Semi-marathon; caffeine-based stimulant drink; acute dehydration; athlete's heart
Syncope is one of the rare but serious heart attacks occurring in an athlete during a semi-marathon race. The aim of this case report is to bring awareness of such accidents to the sports community in sub–Saharan Africa where little is published about syncope in athletes. We are reporting the case of a 31-year-old Cameroonian half-marathoner with no contributing past medical history, and whose Precompetition medical assessment (PCMA) performed 48 hours before the race was normal. The young man started the race at a favorable temperature of 26°C at 6 AM in Yaounde. An hour prior to the beginning of the race, the semi-marathoner drank without medical advice 66cl of a caffeine-based energy drink. After 17 kilometers of running without oral rehydration (out of medical advice), he abandoned the race, due to intense physical asthenia, constrictive pain under the diaphragmatic muscle, dizziness, palpitations, then fall from its height occurring 30 minutes after stopping the race with the spontaneous recovery of the state of consciousness a few minutes later during his medical transportation to the Emergency center of Yaounde were the early management showed a conscious, restless athlete with stable hemodynamic parameters: BP: 116/53mmhg, Regular and symmetric pulses at 63 pulsations/minute, Regular Respiratory Rate: 22 cycles per minute, the Body temperature of 37,8°C, Blood saturation (SaO2) of 94% in ambient air, Glycemia on the spot found at 1,03 g/l. The resting 12 leads Electrocardiography done at the emergency unit was like that of the PCMA excluding the absence of bradycardia. Doppler echocardiography is normal, as well as Troponin that was done 12 hours (H12) after the beginning of chest pain. So far, the working diagnosis was syncope due to a probable coronary Vaso spasm following the ingestion of a stimulant substance in the context of acute dehydration and intense physical exertion. The possibility of a paroxysmal rhythm disorder was still to be excluded.
Keywords: Deaths; cholera; conceptual mode; DRC
Context. In the Democratic Republic of Congo (DRC), the epidemiological profile is dominated by infectious diseases including cholera. It evolves in endemic and epidemic form depending on the province. Despite multisectoral and multidisciplinary interventions organized in the field, the number of deaths remains high, as some contributing factors remain unknown while interventions need to be directed towards these factors.
Objective. Develop and analyse the conceptual model of the factors underlying cholera deaths in the community and in cholera treatment centres (CTCs).
Methodology. A retrospective cross-sectional study, from 2000 to 2013, of descriptive and exploratory type was used. It used the Directorate of Disease Control (DLM) database of 500,670 cases and 11,560 deaths. Finally, the qualitative and prospective method was carried out from 16 September to 16 December 2016, multicentric and covering five cities: Kinshasa, Lubumbashi, Kisangani, Mbandaka and Kalemie. Focus group techniques with 50 community leaders, an in-depth semi-structured interview with 50 patients, 15 health experts and 25 cholera patients. And a structured face-to-face interview with 15 health workers assigned to the CTC was organized. The percentage (%) of respondents' responses was calculated. Content analysis and triangulation of information was performed. Some qualitative survey data was collected by telephone, for obvious reasons.
Results. Four main groups of factors: (i) Organization of services (training of providers, availability of inputs, principles of separation of treatment rooms, lack of working hours, poor management of inputs, lack of systematic follow-up and evaluation of patients, poor clinical evaluation of patients), (ii) Individual factors (physiological state, pathological state and immunological status), (iii) Cholera profile (endemic area, epidemic and virulence of Vibrio cholerae). (iv) Socio-community and anthropological factors (perception and representation of cholera on the one hand, and treatment on the other). These factors can be influenced by complex interrelations without linearity.
Conclusion. Our study, to the importance of developing a conceptual model of the factors of death due to cholera. Understanding the factors that influence and interact with death is the straight line on which efforts must be focused to effectively and significantly reduce mortality from this disease. This conceptual model was designed to develop and analyze more than 96% of these factors, with the exception of those related to the biology of Vibrio cholera, including virulence genes. An ongoing prospective analytical study will determine virulence gene characteristics and antibiotic susceptibility profiles of Vibrio cholerae O1 in clinical and environmental isolates in Lubumbashi, Democratic Republic of Congo.
Conclusion. Our study showed the importance of developing a new conceptual model of cholera death factors. Understanding the factors that influence and interact on death is the straight line on which efforts must be focused to effectively and significantly reduce mortality from this disease. In our view, actors targeting these factors would ipsofacto reduce cholera deaths in the Democratic Republic of Congo.
Early diagnosis and management of COVID 19 improves prognosis. During the onset manifestation, the most common symptoms were fever (98%), cough (76%) and myalgia or fatigue (44%); less frequent symptoms were sputum production (28%), headache (8%), hemoptysis (5%) and diarrhea (3%) and more than half of the patients developed dyspnea [3]. At this stage, primary viral replication followed by cellular damage is presumed to occur in the mucous epithelium of the upper respiratory tract (nasal cavity and pharynx), with additional multiplication in the lower respiratory tract and the gastro-intestinal mucosa [4]. Activation of the immune system, which follows, is important. If this immunological response is adequate, the infection can be controlled and the patient remains asymptomatic. In contrast, it has been shown that SARS CoV 2 can block this antiviral immunity early, effectively and durably in the most serious cases [5]. Anticoronavirals should be helpful during this stage. It should be remdesivir (by antiviral activity against SARS-CoV-2), ritonavir boosted nirmatrelvir (SARS-CoV-2 main protease inhibitor and an HIV-1 protease inhibitor and CYP3A inhibitor), chloroquine and its derivative hydroxychloroquine (by a modification of an attachment protein on the head of the virus), baricitinib (by inhibiting cyclin G), among others. After this stage, major manifestations could be occurred.
Major clinical manifestations linked to COVID 19 include digestive disorders, coagulation disorders, acute respiratory distress syndrome (ARDS), macrophagic activation syndrome, etc. These imply specific therapeutic approaches over anticoronaviral therapy.
Digestive disorders
The digestive manifestations during COVID 19 are various: anorexia (83.8%), diarrhea (29.3%), vomiting (0.8%) and abdominal pain (0.4%) [6]. The interaction between SARS COV2 and intestinal microbiota on the one hand resulting a modification of microbiota, thus favoring the appearance of the cytokine storm and on the other hand interaction between SARS COV 2 and intestinal cells leads to their destruction [6]. Therefore, one of the therapeutic targets would be to add commensal bacteria to improve this modification. Another would also be to manage the cytokine storm. Some biological Disease-Modifying Antirheumatic Drugs (bDMARD) and targeted synthetic Disease-Modifying Antirheumatic Drugs (tsDMARDs) have given encouraging results in the cytokine storm management.
Coagulation disorders
It manifests as thrombosis of small pulmonary vessels, pulmonary embolism, thrombosis of small skin vessels, deep vein thrombosis, hemorrhage of small vessels, disseminated intravascular circulation (DIC), etc. Activation of the coagulation system and fibrinolytic system result from systemic inflammation, endothelial dysfunction by interaction with SARS COV 2, severe hypoxemia and the production of antiphospholipid antibodies leading to clot formation. Anticoagulants are therefore essential in the management of these coagulation disorders. Heparin and direct oral anticoagulants can be used [7].
Acute respiratory distress syndrome (ARDS)
It is characterized by acute onset of respiratory distress maked by dyspnea with hypoxia and hypocapnia; tachypnea; intercostal, sub sternal, supernal, supraclavicular pulling; crackling rales etc. The interaction between SARS COV 2 and red blood cells leads to a decrease in the capacity of hemoglobin to transport and efficiently exchange CO2 and O2 through the alveolo-capillary barrier which in the long term causes an alteration of the alveolo-capillary barrier, then can progress to pulmonary fibrosis. In addition, the interaction between SARS COV 2 and alveolar epithelial type II cells leads to the destruction of alveolar epithelial type II cells with production of hyaline membrane plus the alveolo-capillary barrier damage [2, 8]. A treatment based on hydroxychloroquine (by its action on the preservation of hemoglobin) allows to maintain the normal transport of oxygen (O2) and carbon dioxide (CO2) through the alveolo-capillary membrane. Certain bDMARDs can be used such as interleukin-6 (IL-6) blocker that seems to hold great promise for managing the massive cytokine storm associated with the development of typical lung damage and ARDS). tsDMARD can be also used (by interference with Janus kinase) in its management. Corticosteroids reduce excessive and harmful pulmonary inflammation, but they also inhibit the beneficial immune response which allows the patient to eliminate pathogens.
Macrophagic activation syndrome
It manifests clinically by high fever, hepatosplenomegaly, lymphadenopathy among others and biologically by hyperferritinemia, hypofibrinogemia, pancytopenia, hepatocellular insufficiency etc. The interaction between SARS COV2 and cells having ACE 2 receptor induces an activation of the inflammatory process: vasodilation, vascular hyperpermeability, infiltration of inflammatory cells leading to the release of pyrogenic cytokines or even a cytokine storm (interleukin-6, interleukin-8, interleukin-10, tumor necrosis factor, etc) [2]. Therapies targeting the pro-inflammatory cytokines can improve macrophagic activation syndrome. Corticosteroid therapy and certain bDMARDS such as Anakinra (interleukin 1 receptor antagonist) have been discussed in management.
So, what therapeutic strategy? The complexity of its pathophysiology, the multiple therapeutic targets and the absence of effective anticoronaviral monotherapy proven at the current state of knowledge are arguments to say that it is necessary to consider blocking several therapeutic targets in order to increase the anticoronaviral effectiveness. Hence the need to combine anticoronaviral therapeutic means taking into account the type of COVID 19 patient and in particular all the major clinical manifestations linked to COVID 19.
Anticoronaviral multitherapy proposed by some authors may be the solution, if and only if, it can suppress viral replication and prevent the immune system from dysregulation. Indeed, clinical trial is underway to assess the efficacy and tolerance of the triple-drug therapy combining baricitinib, lopinavir / ritonavir and remdesivir [9]. The genetic susceptibility of COVID 19 patients to develop the severe form is not yet well established. Could anticoronaviral multitherapy prevent progression towards severe form? However, it has been shown that a reduced viremia does not prevent the immune system from racing and its progression towards the severe form [1]. Suppressing the virus does not seem to be enough. It would be better that all the management strategies are focused on the early diagnosis and adequate treatment of the type of COVID 19 patient and in particular all the major clinical manifestations linked to COVID 19. Anecdotally, we will say that no drug proposed is effective, all the drugs proposed are effective, it is a question of early diagnosis and adequate treatment of the types of patient and all the major clinical manifestations linked to COVID 19.
This information will help to develop therapeutic strategies depending on the type of COVID 19 patient and in particular all the major clinical manifestations linked to COVID 19 instead to continuing to take account only an anticoronaviral monotherapy or anticoronaviral multitherapy, knowing well that the immune system dysregulation with its inflammatory corollary persists despite the decrease of viremia.
Competing interests
Authors declare no competing interests.
Authors contributions
Authors has read and agreed to the final manuscript.
References
The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. World Health Organization (WHO) reported, globally, the number of new weekly cases (21 to 27 November 2022) was just fewer than 2.7 million new cases reported and the number of new weekly deaths with about 8400 fatalities. And, as of 27 November 2022, 637 million confirmed cases and 6.6 million deaths have been reported globally. Three types of COVID 19 patients are distinguished from the French study, (i) patients with few clinical signs but with a high nasal viral load and being highly contagious; (ii) patients with mild symptoms at the beginning but worsening towards the tenth day with the appearance of a severe acute respiratory syndrome despite a decreasing viral load; (iii) patients with a rapid worsening to an acute respiratory syndrome with persistence of a high viral load in the nose and throat and appearance of SARS-CoV-2 blood viremia causing multivisceral failure leading to death [1]. The major clinical manifestations linked to COVID 19 are numerous and diverse, among which there are digestive disorders, coagulation disorders, acute respiratory distress syndrome, macrophagic activation syndrome, myocarditis linked to SARS COV2, acute tubulopathy linked to SARS COV2, meningoencephalitis linked to SARS COV 2. These can be explained by the fact that the cellular tropism of SARS COV 2 is numerous as well as the physiopathogenic consequences. It concerns all cells with an angiotensin-converting enzyme 2 (ACE 2) receptor (example, alveolar epithelial type II cells, upper and stratified epithelial cells of the esophagus, absorbent enterocytes of the ileum and colon, pancreatic cells, glial cells, Sertoli cells) [2]. The interactions between SARS COV 2 and ACE2 cells lead to their internalization and massive viral replication with cellular damage, activation of the inflammatory process, activation of the immunological system, stimulation of the coagulation system, among others [2]. The various physiopathogenic consequences during COVID 19 largely explain its numerous therapeutic targets. What physicians need to know about physiopthothogeny with identified therapeutic targets, holistic diagnostic and therapeutic approach of Covid-19 is the subject of ongoing updates from experts at this Journal.
References
Sampling design is one of the most recurrently conversed and discussed topics in research studies. Which sampling design is preferable and suitable in research primarily depends on the characteristics of a population through which we form a sample for the study. A sampling design is distinct plan for attaining a sample from the given population. The principal objective of this article is to choose the appropriate probability sampling designs in research studies. The present study is qualitative in nature and the data are collected from the secondary sources. This article will no doubt be beneficial to the persons who are engrossed in research studies as it provides them with a clear concept of types of the probability sampling designs so that they can cull an apt probability sampling design to carry out the research studies.
Keywords: Probability; research; sample; sampling design
References
Background: Cameroon faces security challenges that significantly impact the demand for blood and blood products in its care facilities, including military ones. The blood bank of the Military Hospital Region I Yaounde (MHRI) because of its human, material and managerial potential, and its situation provided the framework for analysing the communicational issues of the blood supply.
Methods: A descriptive qualitative-quantitative situational analysis of the military hospital's blood bank communication system, and its deployment in 2017 has been carried out. The 2014 Who Global Database on Blood Safety (OMS) collection and analysis tool used the bank's staff and routine documents.
Results: The bank registered 1101 candidates in the [18-27] bracket. There was no communication programme geared towards defence institutions, schools and university faculties. The staff's action, restricted but of good quality, was supported by financial and technical partners.
Conclusion: There are significant mobilization potentials at MHRI, and the value of setting up and supporting communication strategies to unite these dynamics for an efficient blood supply is needed.
Keywords: blood; communication; supply; MHRI
Patients’ social behaviour toward the medical team mainly supposes appreciation and respect since there is a considerable investment in a medical carrier: long education period, financial resources, and emotional involvement. In medicine, responsibility is at the highest level; nothing can replace the loss of dear ones, and our mission is to improve and save life. To achieve these goals, a professional in the healthcare industry must have specific knowledge, quickly manage info and deliver medical services when and where necessary. The art of communication with patients and community members with different backgrounds helps us to attain the best results in clinical practice. To do that, theoretically, a medical team member must not be buried, not in his daily program or society. But in their daily routine, they can experience offensive comments or attitudes from persons with reasoning or communication problems.
How much must we tolerate facing daily work adversities from the patients or other individuals?
Genetics, perception abnormalities, info-processing deficiency, reasoning nonconformity, and tolerance groups determine a patient’s social behaviour deviance. Medical conditions may affect them at various levels. Misinformation sources must be disapproved, detected, and punished when necessary. Broad-minded groups must be trained for multiple situations that are emerging offensive human actions. Identifying the origin of an individual’s wrong and cruel actions towards others and corrective actions are needed. An ethical, respectful approach to the problem must be considered.
Patients’ intentions may differ from their actions’ end. Good intentions following the worst results reveal judgment impairment or misinformation processing; modelling such gaps helps us improve behaviour and joy in redressing individual misconduct in social interaction.
Repetitive unpleasant people interactions must be stopped when necessary since improper people collaboration may lead to depression, hypertension, type 2 diabetes, or dyslipidaemia in vulnerable persons.
So, making the individual aware of the consequences of his unconventional social behaviour is mandatory.
The healthcare professionals offended by the patient may deny the further patient’s requests for healthcare services [except emergency care], The patient will be obliged to look after another healthcare provider, and that technique may initiate the patient’s reflection about his actions, consciousness’ activation and self-awareness for further interactions with professionals. Applying this possible convincing technique adds benefit to problem-solving mastery.
Suppose the patient’s social behaviour deviance maintains after initial corrective actions. In that case, interdisciplinary collaboration, a multi-level intervention approach, and a corporate strategy for individual life quality and safety are required. Prompt and proper attitudes for social behaviour improvement can solve harsh work conditions.
In this digital era, AI supply quickly detects and offers an ending to this problem with positive changes.
Usually, medical conditions alter the individual judgment and actions toward others, especially for senior adults; we may tolerate their social behaviour deviance, but not in repetition and not too much, to protect ourselves.
Time slowly undermines all, early enough for each one, and it is better not to get its work done in advance.
Individual behaviour is how one acts or conducts oneself, especially toward others. Human conscious or subconscious response to various internal or external stimuli communicates to us about the person’s approach in different circumstances; it reflects the individual’s genetics, educational and relational development in a specific environment.
References
The countries of the Peysonnia belt are paying a heavy price for bacterial meningitis. Morbidity and mortality of bacterial meningitis is linked to certain factors.
It is a descriptive and analytical prospective study over a period of two months from April 15 to June 15, 2015 in subjects admitted for suspected meningitis at the National Hospital of Niamey. Identifying predictors of poor prognosis during this outbreak is our goal.
One hundred and five patients were enrolled. The majority were young. Signs of severity were coma (22.9%), seizures (12.4%), signs of focus (9.5%), shock (7.5%). Delay in management and hyperproteinrachia have also been identified as poor prognostic factors. Sequelae were balance disorders (n=20; 19%), hearing loss (n=7; 6.6%), purpura fulminans (n=13; 12.4%). There were 12 deaths or 11.4% of which 11 comas (91.66%), 2 convulsions (16.66%), 1 purpura fulminans (8.3%), 6 shock (50%), 5 signs of focus (41.66%), 8 of these patients (66.66%) came 3 days after the onset of signs.
Poor prognosis factors were related to brain damage, shock and delayed management. Improving Niger's health system will reduce them.
Keywords: bacterial meningitis; poor prognostic factors; Niamey; Niger
References
Introduction: The objective of the study was to describe the epidemiological, diagnostic, therapeutic and evolutive aspects of long bones primary tumors at the Regional Hospital of Sokode.
Patients and Method: It was a prospective descriptive study of patients with long bone primary tumors for a period of 04 years from January 2019 to December 2022.
Results: Twenty-eight tumors were identified in 18 men and 10 women. The morphological assessment was standard radiography (n=28), CT scan was performed in 18% (n=05). These were osteolytic tumors (39.2%), osteocondensing tumors (21.4%), mixed tumors (25%) and mixed tumors with fracture (14.4%). Anatomopathology examination of 14 patients showed osteosarcoma (n=06), chondrosarcoma (n=03), Ewing's sarcoma (n=01) and an osteochondroma (n=04). Surgical treatment by transfemoral amputation was performed in 06 cases for malignant tumors. An excision biopsy was performed for the 04 lesions whose diagnosis was an osteochondroma.
Conclusion: Diagnosis and treatment of primary long bone tumors is difficult in isolated surgical areas. The subsidy of their treatment, the implementation of diagnostic and therapeutic tools could improve the vital prognosis of patients with malignant tumor.
Keywords: bone tumor; radiography; biopsy; treatment
According to their disorder, middle-aged people and senior adults may experience difficulties in physical exercises; in that case, a remote job [virtual] or another job selection is recommended.
Regular physical activity maintains and improves the well-being of people in good health. Daily fine-organized exercise program duration, frequency, and intensity ensure a better life, but excessive limits for physical exercise make an individual vulnerable.
People at risk of various medical conditions, with specific demographic data, may carry out physical exercises well settled beyond hurt.
For a weak individual, disproportionate physical activities can lead to disaster. In addition, the warm or cold season easily facilitates brain haemorrhage or myocardial infarction for these individuals doing excessive physical work.
Generally, physical exercise, including walking in nature, is recommended to maintain and improve individual health. For young and middle age people with moral distress but a good heart activity, walking in nature is an effective remedy; fresh air, water flow sound, floral scent, and impressive or rousing trees have a positive impact on the respiratory system, blood flow and composition, and on mental functioning. It is a relatively inexpensive mode to attain expected clinical outcomes.
Some senior adults may benefit from an accurate physical exercise program. Most old persons are registered with heart failure, respiratory diseases, and mobility problems. For this category, physical exercises may generate dyspnoea, fatigue, and pain with additional discomfort on relatives and social workers excessively implied in their care. Clinical practice evidence shows that even walking a short distance can be fatal for older adults with advanced heart disease. But in the digital era, they may use IT devices to admire nature’s splendor or paintings, watch on-demand musical programs and movies, update the information of interest, lecture, and communicate with their loved ones, and this option never existed.
Physical exercise is a convenient remedy with a wide range of advice or limitation, adjusted to individual medical history and clinical and demographic data. Harm and benefit are two facets of the same method for dealing with problems for recovering and improving mental and physical health.
There is a time to use or decline the physical exercises in the best interest of the individual health.
The art of adjusting specific procedures to personal data to achieve the desired target return in the form of gratitude and admiration from the community we serve.
Better to keep physical exercise limits on the way, and in the end, be able to open the door coming the night.
Work ennobles us and assures our dignity and prosperity in a never-ending natural world.
‘Those who do not work do not eat, except for individuals with serious illnesses’ - is a divine message.
There is a hierarchy of work design, effecting, and monitoring; each individual has to be in a position according to his expertise and ability to play his role. Harmonic mental and physical activities ensure job performance.
Job descriptions inform in some way prospective employees about their work-out to achieve better duties. A person’s good health facilitates job completion, but an altered physical activity declines a specified standing for an individual. Each selection compels work necessities and personal health, and individual medical conditions impose attention not to harm.
Introduction
A significant global public health and economic concern was raised by the recent (COVID-19) outbreak brought on by (SARS-CoV-2). Every day, more information is learned about how the COVID-19 virus spreads. In order to open up society during the (COVID-19) crisis, many nations intend to make face masks compulsory. In order to avoid the transmission of (COVID-19) and other respiratory viral illnesses, it is recommended that people use masks as part of a comprehensive package of preventative and control measures.
Face masks are the ubiquitous symbol of a pandemic that has sickened 35 million people and killed more than 1 million. In hospitals and other health-care facilities, the use of medical-grade masks clearly cuts down transmission of the (SARS-CoV-2) virus. But for the variety of masks in use by the public, the data are messy, disparate and often hastily assembled.
Face masks are incredibly popular right now due to the corona virus outbreak. According to prior advice from the World Health Organization, healthy individuals should only use masks when caring for someone who may have (COVID-19) or when they are coughing or sneezing. However, using a mask alone is insufficient to provide an effective level of protection or source control; additional actions at the individual and community levels should be taken to prevent the spread of respiratory viruses. Whether or not masks are worn, adherence to hand cleanliness, physical segregation, and other infection prevention and control (IPC) measures is essential to preventing (COVID-19) transmission from person to person. The World Health Organization (WHO) has created particular advice on IPC strategies for healthcare settings [1], Long-Term Care Facilities (LTCF) [2] and home care [3].
Face masks can help protect against many respiratory infections that are spread through the droplet route, and that includes coronavirus and the flu. Proper donning and doffing technique are also critical measure to prevent disease transmission. The (WHO) also cautions us that masks are only effective when they are worn in conjunction with regular, effective hand washing. Furthermore, if we choose to wear a mask, we must know how to utilize it and properly dispose of it out of an abundance of caution.
WHO advises health professionals administering direct care to (COVID-19) patients to wear a medical mask in the absence of Aerosol Generating Procedures (AGPs) [4] (in addition to other PPE that are part of droplet and contact precautions). Activated carbon, spun bond, and melt blown materials are used to make facial masks (breathing masks). Combination masks with activated carbon can reduce hazardous pollution. Many diverse approaches exist for masks to protect both the wearer and others. Mechanical interception and inertial impaction are the two "intuitive methods" that masks filter bigger aerosols. A substance filters more effectively the denser its fibers are. Because of this, greater thread counts result in greater efficacy. Just more virus blockers are available. However, some masks (such those made of silk) also possess electrostatic qualities that can attract tiny particles and prevent them from passing through the mask as well. We can reduce our risk of contracting the corona virus by using one of two different types of face masks. The first of the two face masks is a surgical face and of the second type are also referred to as (N 95) masks.
The general public does not need the (N 95) respirator. The (N 95) respirator filters at least 95% of airborne particles but is not resistant to oil [5]. Filtering face piece respirators, commonly referred to as (N 95) masks, are regulated by the National Institute for Occupational Safety and Health.
N: Respirator Rating Letter Class: This. It stands for ("Non-Oil,") indicating that you can use the mask in a work setting if there are no oil-based particulates present. Other mask classifications include R (eight hours of oil resistance) and P(oil proof).
95: Masks ending in a 95, have a 95 percent efficiency. and that is the same as a High Efficiency Particulate Air(HEPA) and Aerosol Generating Procedures (AGPs).
Microns: Dust, mist, and fume pollutants are filtered out by the masks. Large droplets and particles with a minimum size of.3 microns won't be able to cross past the barrier, according to the Centres for Disease Control and Prevention (CDC.)
Material: The filtration material on the mask is an electrostatic non-woven polypropylene fiber.
Valve: halation valves are available as an option with some disposable N95 masks. According to the (CDC), "having an expiration valve reduces exhalation resistance, which makes it simpler to breathe (exhale)".
N 95 masks, which are worn by medical professionals and emergency personnel, offer superior shielding from corona virus particles than fabric or surgical masks. Protecting people who are most at risk of infection requires the use of N 95 respirators. The N 95 mask is designed for healthcare professionals, and the (WHO) states that it can be used for several patients with the same diagnosis for up to four hours. Gloves and labels should be applied to the N 95 masks before disposal. Used masks need to be destroyed or properly disposed of. Even though the majority of readily accessible N 95 pollution masks can be worn and used again, they do have a shelf life. When the mask wears out or the filter becomes clogged by pollutants, it loses its ability to effectively shield us from pollution. Masks contaminated with corona virus debris have recently emerged as a major global environmental issue. In one day, millions of masks are used and subsequently discarded globally. contrary to popular belief, the CO2 footprint of the cotton face mask is 20% greater than that of the N 95 protective face mask. 850 tonnes of CO2 are emitted by just 17 million of our protective N 95 masks. Imagine that a straightforward adjustment in the face masks' material may cut their impact by 20%. If 12 billion masks were used, 144.000 tonnes of CO2 emissions would be avoided.
N 99 masks, which are one of the best options for blocking the virus because they can reduce average risk by 94-99% for 20-minute and 30-second exposures, are more effective at filtering airborne particles than N 95 masks. However, they can be difficult to find, and there are ethical considerations such as leaving those available for medical professionals.
From a purely medical perspective, the effectiveness of measures to contain the spread of the virus is independent of the geographic area where these measures are implemented. A well-fitting mask keeps the virus from reaching others. It can also protect the wearer from becoming infected.
Masks should be worn anytime you are in public or people are nearby. Masks act as a physical barrier to protect you and others from viral and bacterial particulates. Many people unknowingly infect others by going out and spreading germs by coughing or touching other. Infections spread from person to person in the community, and it is essential to identify and implement measures to reduce transmission to slow down or even stop spread. Public officials and governments strongly encourage the use of wide spread face masks in public, including the use of appropriate regulation. Research on the efficacy of face shields, including in combination with masks, is needed, along with research into the efficacy of masks with transparent windows for the mouth. It is also important for health authorities to provide clear guidelines for the production, use, and sanitization or reuse of face masks, and consider their distribution as shortages allow.
Diagnosis
Fever, exhaustion, dry cough, dyspnea, and other signs of an upper respiratory infection are also present in SARS-CoV-2 illness cases.
Conclusion
In conclusion, masks and other Personal Protective Equipment (PPE) are essential for individuals battling the pandemic and are frequently utilised by the general people. Environmentalists worry, however, that the fight against mask pollution and adverse effects on animals would result from improper disposal of masks. In the future, we must ensure that we are prepared for pandemics like this one and that we are prepared to respond to them sustainably and one does not have to come at the expense of the other.
References
One of the most harmful, communicable, and infectious diseases nowadays is COVID-19. The SARS-CoV-2-related illness COVID-19 is extremely contagious. Wuhan, China is where the corona virus first appeared, and it has since spread over the entire world. Common signs of this virus include headache, shortness of breath, fever, cough, cold, and sore throat. At this point, risk assessments and starting outbreak control efforts depend on readiness, openness, and information exchange. Face masks may become quite popular if a pandemic affecting the respiratory system breaks out. her individual and societal steps should be taken to prevent the spread of respiratory viruses because the wearing of a mask alone does not provide an appropriate level of protection or source control. Used masks need to be destroyed or properly disposed of.
Keywords: Covid-19; SARS-Cov-2; Face masks; N 95; respiratory viruses
Cloud and Edge Computing
Many traditional healthcare and medical systems have faced a big problem of massive unstructured, diverse, and exponential-growing data collected from different sources, thus arising much more challenges to store and process data effectively and securely. To this end, the advanced techniques and high capacities of cloud computing allow analysing healthcare and medical big data. F
Immersive Technology
Immersive technology, a term that refers to the technologies for reality extension using the neuroscience of the human brain, aims to create distinct experiences by merging the physical world with a digital or simulated reality.
Besides augmented reality (AR) and virtual reality (VR) as two primary types of immersive technologies, it includes ex- tended reality (XR), mixed reality (MR), holography, telepresence, digital twins, and first-person view (FPV) drone
flight. The above-mentioned immersive technologies can be briefly featured as follows:
Enabling Technologies of The Metaverse for Healthcare
This section presents a detailed discussion of the enabling technologies of the Metaverse for healthcare, which includes extended reality, blockchain, artificial intelligence, IoT, 5G and beyond, digital twin, big data, quantum computing, human-computer interaction, computer vision, edge computing, and 3D modelling. The illustration of the above- mentioned enabling technologies of the Metaverse for health- care is depicted in the next Fig. F
A. Extended reality
Extended reality includes technologies such as augmented reality (AR), virtual reality (VR), and mixed reality (MR), aided by artificial intelligence, computer vision, and connected devices like mobile phones, wearables, and head- mounted displays. By incorporating voice, gestures, motion tracking, vision, and haptics, this new technology is transforming the way services are delivered, improving the quality in various sectors.
B. Blockchain
The foundation of blockchain emerged in a 2008 white paper written by Satoshi Nakamoto. A blockchain is a digital database of transactions that is duplicated and dispersed over the entire blockchain network. Each block in the chain contains several transactions, and whenever a new transaction occurs on the blockchain, a record of it is added to all participant’s ledgers.
C. Artificial Intelligence
Artificial intelligence (AI), also known as machine intelligence, focuses on the development and management of technology that can autonomously learn to make decisions and carry out tasks on behalf of humans. AI is a collection of technologies that incorporates any software or hard-ware component that facilitates machine learning, computer vision, natural language understanding (NLU), and natural language processing. AI will help strengthen the Metaverse infrastructure, enhancing the 3D immersive experience, and boosting the virtual worlds’ built-in services. AI technology will also help in improving the quality of services and the Metaverse ecosystem.
The health industry has recently begun utilizing revolutionary techniques such as XR and big data combined with AI in software and hardware to increase the efficacy of medical devices, reduce the cost of health services, enhance healthcare operations, and broaden access to medical.
D. Internet of Things
The phrase "Internet of Things" (IoT) refers to the billions of devices that are currently connected to the Internet and exchanging data. Due to the introduction of low-cost computer chips and the broad availability of wireless net- works, everything from smartphones to intergalactic operations can now be connected to the IoT. Due to the incorporation of sensors and the capacity to communicate with one another, these devices can share real-time data without the need for a human supervisor.
E. 5G & Beyond
The term "5G and beyond" refers to the fifth generation and beyond of wireless technology. It outperforms 4G LTE networks in terms of both speed and latency, and it has a higher capacity. In contrast to the maximum speed of 4G technology, which is only 1 Gbps, the maximum speed of 5G technology can exceed 20 Gbps. Additionally, delivers reduced latency, which has the potential to enhance the performance of commercial applications and other digital experiences.
F. Digital Twin
A digital twin is a virtual representation that acts as the digital counterpart of a physical object or process in real-time. The first practical definition of a digital twin was proposed by NASA in 2010 to enhance the physical-model simulation of spacecraft.
G. Big Data
Big data is defined as the "Information asset characterized by such a High Volume, Velocity and Variety to require specific Technology and Analytical Methods for its transformation into Value".
H. Quantum Computing
Quantum computing is a form of computation whose activities can exploit quantum mechanical phenomena such as superposition, interference, and entanglement.
I. Human Computer Interaction
Human-computer interaction (HCI) is a multidisciplinary topic of research that focuses on the design of computer technology and, specifically, the interaction of humans and computers. Voice, gesture, visual, and brain signal interaction have replaced textual or display-based control as the dominant paradigm in HCI. HCI, VR, AR, and the future of content creation and collaboration technologies will enable the creation of the Metaverse. The visual interactions in the Metaverse will be carried out by HCI technology which is called wearable consumer head-mounted displays (HMD). These HMDs will play a crucial role in the communication between the users and surroundings in the Metaverse.
J. Computer Vision
Computer vision is the study of how computers visualize and interpret digital images and videos. Computer vision encompasses all activities done by biological vision systems, including perceiving a visual signal, interpreting what is being seen, and extracting complicated information in a form accessible by other processes.
K. Edge Computing
Edge computing is a distributed computing paradigm that moves computation and data storage closer to the data sources. Edge computing will improve response times and conserves bandwidth.
L. 3D Modeling
3D modelling is the process of producing a mathematical coordinate-based representation of any three-dimensional surface of an item using specific 3D modelling techniques. As a result of advancements in image processing, computer- aided design, and modelling techniques, it is now feasible to create extremely realistic and trustworthy 3D models. Multiple sectors, including cinema, animation, and gaming, as well as interior design and architecture, utilize 3D modelling.
Medical diagnosis is the process of determining the medical condition of a patient based on the symptoms. Adoption of the Metaverse in healthcare significantly helps in efficient diagnosis of the medical conditions of a patient with the help of various advanced technologies such as AR and VR enabled MIoT models, extended digital twin, blockchain, 5G and so on. F
A. Medical Diagnosis
Medical diagnosis is the process of determining the medical condition of a patient based on the symptoms.
B. Patient Monitoring
The convergence of telepresence, digital twinning and blockchain will reap amazing benefits of the Metaverse in healthcare, especially in terms of patient monitoring.
C. Medical Education
The Metaverse is a remarkable milestone in the field of medical education.
D. Surgeries
The Metaverse is becoming an important technology in the medical industry, especially in surgery. Surgeons are currently using tools that range from VR headsets to haptic gloves to mimic surgical procedures, boosting prepared- ness and efficiency in the operating room.
E. Medical Therapeutics & Theranostics
Medical therapeutics can be regarded as the branch of medicine that deals specifically with the treatment of diseases. Digital therapeutics (DTx) deliver evidence-based therapeutic interventions and can be considered as a class of digital medicine. Digital Therapeutics Alliance defines digital therapeutics as products that “deliver evidence-based therapeutic interventions to patients that are driven by high quality software programs to prevent, manage, or treat a medical disorder or disease”. F
Ongoing and Upcoming Projects
Challenges & Open Issues
References
The rapid progress in digitalization and automation have led to an accelerated growth in healthcare, generating novel models that are creating new channels for rendering treatment with reduced cost. The Metaverse is an emerging technology in the digital space which has huge potential in healthcare, enabling realistic experiences to the patients as well as the medical practitioners. The Metaverse is a confluence of multiple enabling technologies such as artificial intelligence, virtual reality, augmented reality, internet of medical devices, robotics, quantum computing, etc. through which new directions for providing quality healthcare treatment and services can be explored. F
The amalgamation of these technologies ensures immersive, intimate, and personalized patient care. It also provides adaptive intelligent solutions that eliminates the barriers between healthcare providers and receivers. Healthcare is one of the most significant determinants of ensuring general, physical, social and mental well-being of the entire human population.
In the world. The primary objective of any healthcare system is to channelize its efforts towards activities that promotes, restores, maintains and improves healthcare services. The recent pandemic of COVID-19 have added enormous pressure to the global healthcare sector and related workforce, infrastructure and supply chain management. The COVID-19 has been the primary reason for accelerating rapid change across the healthcare ecosystem and have compelled the stake holders to pursue adaptation and innovation of all the technologies used in this sector. The need to deploy advanced digital tools and services has become a necessity to provide optimized This digital transformation has significantly impacted the healthcare ecosystem by improving their working capability, access to services, patient-clinician experience by using artificial intelligence, cloud computing, Augmented Reality (AR), Virtual Reality (VR) technologies]. The healthcare system in the Metaverse provides health-care service experience that is interactive, immersive and recreational customized to meet individual patient’s needs. The use of these technologies provides exposure towards new ways of delivering treatment in significantly lower cost thereby enhancing patient outcomes. The Metaverse technologies can help healthcare professionals in effective planning and diagnosis of diseases. The Metaverse environment enables enhanced surgical pre-operative planning by transforming CT scans into 3D reconstructions using headsets. This also helps the surgeons to specifically view, isolate and manipulate anatomical regions to perform critical surgeries. Plastic surgery is an extremely complex procedure which requires reconstruction of human body parts. In case of plastic surgeries, the use of VR in the Metaverse could play an important role wherein the virtual avatar could accurately predict the outcome of a plausible plastic surgery.
The health data can be visualized by the patients on the virtual dashboard helping them to communicate with clinicians, researchers, nutritionists, and other stake holders for achieve individual care and treatment. The Metaverse has the potential to revolutionize medical education and training. The use of AR provides the conducive environment to explain practical procedures rather than disseminating theoretical knowledge.
The Metaverse can provide 360 degrees visualization of the body ailments and can act as the most helpful surgical training tool fostering optimum level of cooperation and highest degree of immersion.
The global statistics of the Metaverse reveal that the global healthcare market in the Metaverse holds a value of 5.06 billion Dollars in 2021 and is expected to reach 71.97 billion Dollars by 2030 with a compound annual growth rate (CAGR) of 34.8 percent during considered period of forecast.
Sensors
The precision of personal healthcare analysis partly depends on the measurement of different physiological parameters using sensors. Recently, an innovative wearable temperature sensor technology which utilizes freestanding single reduction graphene oxide fibre was introduced and developed with many benefits, such as fast response, high stability and repeatability under mechanical deformation, and wearable comfort. Despite being readily available, medical equipment is costly and consumes a lot of power. With biomedical sensors, medical systems are flexible with machine-to-machine interactions, saving time of both patients and medical institutions, and offering treatment plans over tele diagnosis. Among various sensors, temperature, electrocardiogram (ECG), and pulse are the most important ones for health status evaluation besides blood pressure, accelerometers, and imaging sensors.
The following part will discuss some relevant sensors commonly used in healthcare and medical systems.
In general, big data is currently characterized by seven Vs as follows: volume (a large amount of data), variety (including structured, semi-structured, and unstructured data with different formats), velocity (high rates of data inflow and real-time processing), veracity (detailed data accumulation), value (in-depth and meaningful information), variability (offering extensionality and scalability), and valence (data interconnection).
Artificial Intelligence
In the last decade, several modern technologies and tools based on distributed architectures, along with large memory and powerful computing units, have been introduced for big data processing in healthcare and medical domains:
All in healthcare is an all-encompassing term used to describe the use of ML algorithms to mimic human cognition in presenting, analysing, understanding, and learning complex healthcare and medical data. In fundamental, most of the existing AI/ML algorithms can be grouped into two categories: traditional techniques and advanced techniques, which can solve three principal problems: clustering, classification, and regression. Conventional AI/ML algorithms usually performs four data-based learning types: supervised learning (i.e., learn the relation between input and output via a mapping function using labelled data and classify/predict the outcome for an unforeseen input sample using the trained model), unsupervised learning (i.e., involve the utilization of ML algorithms for unlabelled data analysis and clustering, and can find out data groups without the need for human intervention), semi-supervised learning (i.e., trained upon the combination of clustering similar data using an unsupervised learning algorithm and using the existing labelled data to label the remaining unlabelled data), and reinforcement learning (i.e., make a sequence of decisions, in which an agent learns to attain a goal in an uncertain and complex environment). Recently, deep learning (DL) is a subset of ML with advanced architectures, e.g., recurrent neural network, long short-term memory network, and convolutional neural network, relying on multi-layered artificial neural networks, to attain ground-breaking performance in many classification and regression tasks of healthcare and medical domains.
Wireless Communication Networks
Many innovative communication technologies have been introduced in the last decade due to the explosion of IoT technologies with edge and mobile devices along with the diversity of applications and services, especially in the health- care and medical domains.
Cellular network: As so-called mobile network, a cell network is a radio network distributed over land areas called cells. Each cell is served by at least one fixed-location transceiver, a.k.a., cell site or base station. Remarkably, cellular networks can enable a huge number of portable receivers to communicate with each other and other fixed transceivers via base stations.
Wi-Fi: is a wireless networking technology that allows diverse devices, such as computers (desktops, laptop, and tablets), mobile devices (smart phones, smart watches, and wearables) and others (printers, TVs, projectors, and video cameras) to connect the Internet.
References
Introduction: Currently prostatic biopsy on target found at the multiparametric MRI of the prostate is the best way to diagnose prostate cancer.
The European Association of Urology guidelines, updated to 2022, recommend to perform MRI-targeted prostate biopsy plus standard prostate biopsy when a PI-RADS 3 to 5 lesion is detected.
The aim of the study is to establish if there is a real benefit of perfoming MRI-targeted prostate biopsy plus standard sampling when every PI-RADS 3 lesion is detected.
Case study: We performed a retrospective monocentric study at “San Pio” Hospital of Castellaneta, Italy.
76 patients underwent MRI-targeted prostatic biopsy with fusion or cognitive approach, associated with random sampling.
Results: Among the 124 biopsies on PI-RADS 3 lesions of our study only two PI-RADS 3 reported a positive outcome for not significant PCa detection.
Conclusion: Our results do not show a sure and real advantage in performing targeted prostate biopsy in all the patients with only PI-RADS 3 lesions and it may be appropriate to evaluate biopsy performance in these patients from case to case.
Keywords: Transperineal Prostate Biopsy; Fusion-Targeted Biopsy; Cognitive-targeted biopsy; Magnetic Resonance Imaging; PI-RADS 3; Prostate Cancer; Detection Rate
References
Quality assured patient care is expected by nurses all over the world. Caring has been acknowledged as the inner and essence of nursing. For a critical care nurse, caring for a patient implies saving life. While working in an intensive care unit, learning about various life saving procedures such as Cardio pulmonary resuscitation, endotracheal intubation. inserting a central venous catheter is a wonderful experience. Postings in different intensive care units gives worthwhile experiences in different specialties. However, when providing reassurance to patient about their wellbeing, they taught us how to fight with life. Apart from providing care to the patients, critical care nurse acts as a communicator, a liasor between patient, relatives and health care team. The demand of critical care nurses is in increasing trend all over the world. One should not think twice before choosing critical care as a speciality. From creating a spark of hope in patient’s eyes to provide them care at the end of life, critical acre nurses acts as a sole support for the patients and family.
Keywords: critical care nurse; perspective of critical care nurse
References
The defensive enzymes like glutathione preoxidase, glutathione reductase and catalase along with the defensive metabolites like reduced glutathione and oxidised glutathione were measured in red blood cells of acute constipated rats also along with sanay treated constipated rats. It was observed a decrease in GPx activity in both sexes of rats i.e., males and females. The GR activity in constipated rats was shown to be increased by more than GPx activity. The catalase activity has been observed to be increased insignificantly in acute condition. However, the GSH levels were found to be decreased in acute constipated rats but GSSG levels enhanced in acute condition. The sanay leaves treatment to acute condition rats restored the changed enzymes activities and metabolites levels.
The liver function test carried out by the two enzymes namely GOT & GPT which increased in constipated rats. It shows that the enhanced GOT & GPT activities caused dysfunction of liver and invite kinds of liver diseases. The creatinine levels in red blood cells showed insignificant changes in both acute constipated rats and its treated condition with sanay leaves. It may be concluded that sanay treatment restores the low defense system found in constipated rats as well as the liver function which is slightly changed during constipation.
H. pylori could migrate or get forced to migrate to the colon under the influence of antibiotics where it will continue to produce ammonia for a reason or no reason leading to accumulation of profuse amounts of ammonia un-opposed or buffered by any acidity. Accumulation of profuse amounts of ammonia in the colon is toxic and could constitute a biological stress to the body causing toxic pancreatitis that could lead to potential stress diabetes in predisposed children. The spread of H. pylori-induced childhood diabetes could constitute more than 90% of the world’s burden of childhood diabetes during the latest three decades specifically since the implementation of the triple anti-H. pylori antibiotic eradication strategy in 1986 [7-10].
The concept of the biological toxic stress leading to an onset of H. pylori-induced childhood diabetes is not just hypothetical or scientific fantasy as upon the basis of this concept the newly-discovered childhood diabetic condition has been readily and adequately corrected in many children; around 89% of cases in some recent studies [10].
Colon clear with the senna leaves extract purge and vinegar-mixed food therapy have been recently demonstrated to effectively deal with the challenge of H. pylori including eradication of colonic and abnormal-behavior gastric H. pylori strains in addition to prevention of recurrence [8, 9].
Therefore; countries should follow a characteristic strategy towards H. pylori dyspepsia and H. pylori-related dysglycemia:
References
The frequency of ketoacidosis at onset of childhood in the world particularly in developing countries is significant. Prevention of diabetic ketoacidosis and control of its rising frequency should be a healthcare target [1]. The epidemic of childhood diabetes is a worldwide challenge that could be directly related to the whole world challenging epidemic of childhood obesity or it is simply part of the dramatic spread of adulthood diabetes worldwide [2-4].
Similar to the spread of adult DM, Helicobacter pylori could arise as a major environmental reason that could be directly related to the flaring challenge of childhood diabetes. A possible link between H. pylori and diabetes mellitus in children has been mentioned in some studies while this relation has been denied by other reports [5, 6].
References
Background: There may be some significant relationships between smoking and triglycerides and low density lipoproteins (LDL) in the plasma.
Methods: Consecutive daily smokers at least for a period of six months and age and sex-matched non-smokers were included into the study. Cases with regular alcohol consumption (one drink a day) and patients with inflammatory, infectious, or devastating disorders including eating disorders, malignancies, acute or chronic renal failure, cirrhosis, chronic obstructive pulmonary disease, hyper- or hypothyroidism, or heart failure were excluded from the study.
Results: The study included 150 smokers (99 males) and 162 non-smokers. The mean age of smokers was 45.9 years, and 66.0% of them were male. Although the mean body weight, body mass index, systolic and diastolic blood pressures, and hematocrit values were similar in both groups, triglycerides (163.3 versus 151.8 mg/dL, p<0.05) and LDL (126.1 versus 117.4 mg/dL, p<0.05) were higher in the smokers, significantly. Similarly, erythrocyte sedimentation rate (ESR) (10.8 versus 9.4 mm/h, p<0.05) and C-reactive protein (CRP) (2.5 versus 2.1 mg/L, p<0.05) values were also higher in the smokers. On the other hand, high density lipoproteins (HDL) (41.1 versus 44.0 mg/dL, p<0.05) and fasting plasma glucose (FPG) (101.9 versus 111.9 mg/dL, p<0.01) values were lower in the smokers, significantly.
Conclusion: Smoking causes a low-grade systemic inflammation on vascular endothelium terminating with an accelerated atherosclerosis-induced end-organ insufficiencies all over the body. As significant indicators of the systemic inflammation, smoking increases triglycerides and LDL, parallel to ESR and CRP, whereas decreases HDL and FPG in the body.
Keywords: Smoking, triglycerides, low density lipoproteins, high density lipoproteins, fasting plasma glucose, erythrocyte sedimentation rate, C-reactive protein
Among the commensal community, mucosa associated commensal species such as segmented filamentous bacteria (SFB) are a minority regulating strongly the host immune response. Autoimmune diseases, especially RA, are involved in such modulation by gut microbiota. SFB drive autoimmune arthritis in the K/BxN mouse model of arthritis by triggering signals that instruct gut T helper 17 (Th17) cells to differentiate and help in autoantibody production.
T follicular helper (Tfh) cells contribute in the production of high-titer antibodies (Abs) through helping B cells to produce high affinity Abs and long-lived plasma cells by inducing somatic hypermutation and class switching.
The frequency of Tfh cells significantly increased in RA peripheral blood and this was accompanied by increased level of anti-citrullinated protein autoantibodies (ACPAs) indicating the possible involvement of Tfh cells in development of RA.
In a K/BxN RA mouse model, SFB interfered with Tfh differentiation in Peyer’s Patches and supported antigen specific Tfh dissemination at systemic sites which could also support the contribution of both SFB and Tfh in RA pathogenesis.
The effects of long-term antibiotics on the microbiota are not yet understood and the emergence of resistance due to genetic alteration in microbiota, still to be investigated.
In conclusion, the crucial role of the microbiota in health and disease is well firmly established. Studies must be undertaken to better understand human microbiome in terms of composition, metabolic pathways and its role in RA. There is evidence that targeted modulation of the microbiota may improve clinical outcome in RA suggesting that personalized treatment strategies based on patient microbiome profiles may increase drug efficacy, safety, and prognosis. This might benefit in establishing a highly individualized management for each RA patient.
Background
Rheumatoid arthritis (RA) is a chronic autoimmune disorder where genetic and environmental factors contribute to the pathogenesis of disease.
RA leads to functional disability; it was found that 30% of patients are unable to work after 3 years of disease. The gut contains about 29% of all micro-organisms that live in and on the human body. Their function is to help in digestion, nutrition, energy production and vitamin synthesis. Gut microbiota are an environmental factor that regulate the immune system thus providing health benefits to their host.
References
Using the example of modern biopsychosocial urological models, the article shows that the syndrome of chronic urological pelvic pain has a multi-factorial Genesis and requires an integrative, multidisciplinary approach (urologist, neurologist, and clinical psychologist).In this regard, the identification of individual urological clinical phenotypes of patients allows us to identify predisposing, provoking and supporting factors that determine the course of the disease and the response to therapy. The phenotypic urological systems are described: Marr, UPOINT, and DABBEC. The specifics of mental comorbidity (depression, panic disorder, borderline personality disorder, etc.) in this group of urological patients are detailed. The Association of symptoms of depression and changes in sexual functioning with urological chronic pelvic pain syndrome is shown. For the first time, the models of urinary-bladder-bowel-brain by L. Karsten are described; accumulated stress and falsification of anxiety, loss of control in patients with urological pelvic pain by D. Dasalakis and models of the influence of the patient's mental state on muscle-tonic manifestations in the urological clinic of Yaong Ki. Personal characteristics of patients with urological pelvic pain neuroticism, compliance, openness, conscientiousness, conscientiousness, changes in masculine identity, alexithymia, catastrophization) are systematized and described. The tactics of conducting a full and rapid comprehensive psychological assessment of a urological patient are presented.
Keywords: chronic prostatitis; chronic pelvic pain syndrome; prostatitis; biopsychosocial approach; catastrophization, neuroticism; depression
References
The paper conducts an analytical review of the history of understanding the phenomenon of health, reveals all the diversity in approaches and judgments about this conceptual category. It is emphasized that the interpretation of the concept of health is important not only the medical and scientific aspect, but also has a key socio-psychological significance for the development of modern society and the formation of a person's personality. On the example of coronavirus infection, the article provides a justification for the relevance of the semantic content of this conceptual category now. The scientific novelty of this work lies in the analytical studies of the concept of health as a basic socio-psychological conceptual category and the development on this basis of new theoretical approaches and corresponding definitions of the concept of health and its main derivatives. The proposed interpretations, according to the author, have a more pronounced social and psychological determinant for the formation in modern society of a new worldview regarding the concept of health and its derivatives. Because of new conceptual priorities, as shown in the work, it is possible to significantly strengthen the health of the population, increase the individual, herd level of immunity, and improve, ultimately, the quality of the very realization of a person in all spheres of his life.
Keywords: psychology; social psychology; practical psychology; health; mental health; physical health; reproductive health; sexual health; terms and concepts
References
During instrumentation of a root canal, ethylenediaminetetraacetic acid (EDTA) as a chelating agents may be used during cleaning and shaping. EDTA demineralizes dentin and may inadvertently contribute to root canal transportation. The purpose of this study was to evaluate the effect of chelating agents used in moderately curved canals during instrumentation using micro-computed tomography (µCT) and imaging/modelling technology.
Methods: Moderately curved root canals of 36 identified mandibular premolars were standardized in length and divided into 3 groups (n=12). Initial scans were taken using µCT. All canals were instrumented with Profile® DENTSPLY0.06 taper NiTi rotary instruments using saline, 17% EDTA (Pulpdent Corp., Watertown, MA) or RC Prep™(Premier). After instrumentation, lengths were re-measured and all the teeth were re-scanned. Using computer software, 3-dimensional models were created from the pre and post-instrumentation scans. Models were compared for changes in volume and transportation.
Results: There was no statistically significant difference between the groups for any of the variables evaluated: working length, volume and transportation. Conclusion: Under the conditions of this study, the use of chelating agents during instrumentation did not affect the size or position of the root canals.
Keywords: EDTA; chelating agents; root canal preparation; transportation; micro-computed tomography
Reference
A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including ScienDirect, PubMed, Scopus, and ISI Web of Science. The search was applied to the articles that were published between January 2020 and early 2023 With strict literature search and screening processes, it yielded 14 articles from 373 articles of initial literature database. Among 14 study results, there was acceptable for immunogenicity, both humoral and cellular immune responses in 11 studies (78.57 %), whereas acceptable potent immunogenicity was found in patients aged more than 40 years with chronic diseases, particularly, chronic respiratory diseases and coronary artery diseases. Only potent T-cell response was identified in one study. No significant difference in vaccine safety compared with healthy subjects and effective neutralizing antibodies (two doses completion) against SARS-CoV-2 (COVID-19) in patients older than 60 years with diabetes and/or hypertension were demonstrated after completion of COVID-19 vaccination. Immunogenicity and safety in aged people and individuals living with various chronic diseases (both infectious and non-infectious) is highlighted in this study. In conclusion, specified local and systemic AEs and unsolicited AEs, AESI, and SAEs after each vaccination and after the second dose should be monitored. Recording the adverse events of special interest (AESI) and serious adverse events (SAEs) throughout the patients’ vaccination course should be performed and can decrease COVID-19 vaccination hesitancy in these persons.
Keywords: adverse reactions; COVID-19; immunogenicity; neutralizing antibody; safety; vaccine
Historical Background
Before 1967, abortion was generally illegal in the United States of America except to save the patient’s life [1]. From 1967 to 1973, some states like New York, Washington, Alaska, Hawaii and California liberalized abortion laws. The landmark US Supreme Court judgement of Roe and Wade in Jan 1973 legalized abortion nationwide [1] Despite this, opposition across the US led to the camps of abortionists and the Pro–life. This had a great impact on the political dynamics of the country and also globally. The abortionist camp through advocacy, sponsorship, education and NGOs campaign against unsafe abortion and its implications led to the adoption of abortion laws or modified forms in different counties.
Despite the obvious positive effects of Abortion laws in reducing maternal mortality and morbidity, the Pro-life in the US continued its efforts to repeal the laws through legislation and the Courts. In 1992 the Supreme Court almost overturned the Roe decision, (Planned Parenthood of Southeastern Pennsylvania v Casey, 505 US 833) [1].
About fifty years after the Roe decision that legalized abortion was overturned on June 2022 by the US Supreme Court and individual states in the US were empowered to decide the legal parameters for abortion [2]. The effects of this decision will not only affect women in the US but globally, considering the global impact of US policies. The US is the leading donor globally to family planning and abortion care and has a rule that prohibits the use of its funds for a program that conflicts with its policies. The “global gag rule” will affect reproductive rights services in other countries especially the Sub –Saharan Africa which depends heavily on donor-funded program [2].
Unsafe Abortion and abortion laws in Sub-Saharan Africa
Globally there were about 6.8 million unsafe abortions annually with the majority occurring in sub-Saharan Africa. Evidence has shown that the incidence of abortions is the same worldwide whether abortion law is liberalized or restricted. Thirty-five per cent of abortions are unsafe in regions where the abortion laws are restrictive while only 1% of abortions are unsafe in counties where the abortion laws have been liberalized [3]. In Sub-Saharan Africa, 77% of abortions are unsafe due to restrictive laws on abortions [3].
According to 2019 figures, sub-Saharan Africa has the highest case fatality of 185/100,000 unsafe abortions resulting in over 15,000 avoidable deaths [3]. This was a remarkable improvement from the 2000 figure of 315 / 100,000 which was due to the availability of abortion care / post-abortion care services and the improvement of abortion law in the region [3].
Extensive work was done on unsafe abortions and abortion laws in the last two–three decades by Bankole et al of the Guttmacher Institute and published in 2020 titled “From unsafe to safe abortion in Sub-Saharan Africa: Slow but steady progress”. From the study, great progress has been made. The African Union Maputo agreement of 2003 stipulated the legal criteria of allowing abortion when the woman’s life or physical or mental health is threatened and in cases of rape, incest and grave fetal anomaly. Some countries have gone beyond the Maputo agreement and have liberalized abortion laws (Category 6) including South Africa, Cape Verde, Guinea-Bissau, and Sao Tome & Principe. Zambia also has broadly liberalized abortion law - Category 5. Twenty-seven of the 48 – sub-Saharan African countries have moderately restrictive abortion laws (abortions to save the woman’s life and to preserve her physical or mental health).
The majority of the countries in the Sub-African have either liberalized or moderately restrictive laws on abortion. Despite the above statement majority of the populace live within the highly restrictive due to the high population of countries like Nigeria in this category.
Other countries in the region have highly restrictive abortion laws which are to save the life of the mother (Category 2) except for six with total restriction on abortion – Category 1(Madagascar, Angola, DRC, Mauritania, Seria-Leone & Senegal).
Most of the progress in ensuring safe abortions in this region through legal and political means was hinged on the Roe and Wade case, the global funding for safe abortion and NGO partnership. The question of whether this overturning will have effects on reproductive rights and the safety of our women in the reproductive age is not in doubt.
The effects and the way forward
The effect of restrictive abortion laws is not limited to the termination of unwanted pregnancy but may affect adequate post-abortion care after miscarriages, and those with a significant maternal or fetal condition that requires interventions [2]. All these will hinder the achievement of the United Nations Sustainable Development goals of reducing maternal mortality to 70 per 100,000 live births by 2030.
One of the main drives to liberalize abortion law in this region was the US bio-political pressure emanating from Roe and Wade’s decision for the last half a century [2]. Reversal of this decision and the anti–abortion policy at the Federal level, may lead to counter bio-political pressure in the opposite direction.
Most of the abortion care and family planning materials were donor-driven and subsidized. This reversal may lead to reduced funding and an increase in cost even when available, coupled with the current economic downturn worldwide will harm SDG -Goal 3 3.
The decision to restrict abortion at the federal level in the US may resonate in African countries with more countries becoming more restrictive too. As it had been shown restrictive abortion law does not reduce the incidence of abortion but rather increases the incidence of unsafe abortions [1.3]. This will further increase the maternal mortality rate thereby making SDG 2030 unrealistic.
This decision will also have negative implications for medical education funding in abortion care and will influence the knowledge, skills, and quality of care provided by medical practitioners as documented by Traub and co-workers. This will be more pronounced since most funds for reproductive health education and training were from International NGOs and Partners of which the US accounts for the bulk of the donation
Conclusion
There is no doubt the Overturning Roe and Wade decision will adversely affect the African policy on Safe abortion practices and with the likelihood of increased unsafe abortion with associated mortality and morbidity.
Africans need to meet to take their destiny into their hand by ensuring local funding for reproductive health services and post–abortion care to manage complications from unsafe abortions.
References
Unsafe abortion and its complications remain a major contributor to maternal mortality which is still very high worldwide, especially in the sub-Saharan. The legalization of abortion remains the most impactful way of minimizing the mortality and morbidity from unsafe abortion and its complications.
The legalization of abortion remains one of the most contentious issues in modern medicine with great emotional, religious, cultural, legal, political and medical discourse.
Reference
Background: Engaging in athletic training not only improves cardiovascular, pulmonary, and musculoskeletal function but also has been shown to enhance neural capabilities.
Purpose: The purpose of this study is to examine how the positioning of the forearm and elbow joint affects median nerve conduction velocity (NCV) among three groups: throwers, archers, and non-athletes.
Method: This study included a total of 34 subjects of both genders, with body mass indices (BMI) ranging from 18.5 to 24.9 Kg/m2. To measure median nerve conduction velocity (NCV) across the elbow joint at various angles (0° elbow extension, 45°, 90°, and 120° elbow flexion) and different forearm positions, NeuroStim NS2 EMG/NCV/EP System was used.
Result: Repeated Measure Analysis of Variance (RMANOVA) demonstrated a statistically significant difference in the mean values of median NCV across different angles, forearm positions, and groups (p<0.05).
Conclusion: The positioning of the forearm and elbow joint can significantly impact median nerve conduction velocity, particularly among athletes who engage in repetitive upper limb motions. Study showed that the archers had significantly faster NCV than throwers and non-athletes at 0° of elbow flexion.
Keywords: Angles; Joints; Motor; Peripheral nerve
Unintentional errors necessitate moderation in spreading data, compassion, and even forgiveness.
Minor to moderate unintentional errors may benefit from the community's emotional support; frequently, they explore the problem and consider the individual's past performance and successful activities completed before the error happens. Their actions during his troubled time express their inner voice toward him.
If this doesn't happen, he must reflect on his past acts to be sure if there are some possible gaps in effecting job requirements or relational problems; these potential breaches must be detected and corrected accordingly.
Their attitude of criticism or a lack of interest in him in troubled times will determine a similar response from him when they are in need.
Intentional errors must be identified and punished; minor to significant corrective and curative actions, according to error, will be used to avoid other misconduct with more people suffering.
Consciousness and more reflection on mistakes following undesired effects on the individual and community level are necessary. Through the power of a negative example, remediation is possible only using the image of such action, without any words or aggression.
Individuals with genetic abnormalities facilitating disapproval behaviour should be re-educated for improvement since each individual has an ineffable spark.
The people responsible for spreading misinformation must be punished, paying for moral distress to the intended recipient.
In this digital era, spreading bad news about an individual alters his credibility. Honour is essential for practical, successful work, and its alteration by lousy information shared wide affects personal health.
If an untruth is applied rapidly, a disaster could follow since affected personality traits for an innocent, not guilty person exponentially amplify his distress, leading to significant mental and physical disorders.
Verification for honest info before spreading prevents possible disasters.
Sometimes, envy subtly controls the envisioned steps to attain the intended goal. Such encounters are better to be identified and exposed to the public so as not to fall again someone.
The world includes a variety of individuals, and not all are gentle, honest people. Selective relationships for life quality improvement define us, ensuring ill prediction, termination, and rehabilitation of the individual.
People's successful relationships suppose truth, respect, and consideration. To work in dignity is a requirement, and the individual good morality and integrity assure esteem in the community.
Lack of respect and admiration from our community alters mind functioning and job performance and declines perspective.
Error is usual, but not exceeding limits for survival.
Disgrace means the loss of people’s respect as a response to the individual’s misconduct.
Personal acting up has various effects on the community and determines feedback; the error in practice outlines humiliation.
In the digital era, good and bad news rapidly spreads. Usually, people are curious and quickly respond to new info. The data spread about someone may be correct or false, including intentional or unintentional errors. The fast distribution of inaccurate data dangerously works on the equilibrium of the receiver, sender, and producer.
In the healthcare industry, individual medical errors rapidly circulate by media, commonly generating people to disapprove and censure the following behaviour. People's criticism increases the suffering in the heart and mind of an individual making mistakes; prolonged suffering can lead to disaster since the mind's activity influences bodily function, and fragile areas can decline their activities under excessive distress. Therefore, reputation must be ameliorated and recuperated quickly, whenever possible. Proper actions to rapidly establish the truth and collective support for health improvement may ease the torment.
References
In the month of December 2019, Wuhan which is a city of Hubei, state of China suffered an unusual outburst of pneumonia of unclear origin. The causative agent was described as a novel coronavirus, which the WHO (World Health Organization) designated as COVID-19. Coronavirus-19 is initiated by a β-coronavirus called SARS-Covid-2 that presents itself as pneumonia and disturbs the lower respiratory tract in individuals. It's related to SARS and MERS. Covid-19 continues to spread amid worldwide isolation and quarantine attempts. We summaries the existing state of awareness concerning COVID-19 as a response to this global outbreak.
Keywords: Coronavirus (COVID-19); Pathogenesis; Global Outbreak
References
The present study deals with identifying the impact of COVID-19 pandemic and vaccination in context of India. The impact of pandemic on the organization, management, and Health of people of India has been thoroughly described. Several strategies have been taken by management and Indian government in order to control the pandemic situation. The strategies and the importance of vaccination has been discussed in the study. Vaccination can be seen as an important part for mitigating health issue and control the risk of spreading the virus. This study focusing on discussing the vaccination process and how the vaccination helps the country to improve its condition and mitigate the pandemic risk. Quantitative research strategy has been employed in the study in order to collect data and achieve get an outcome of the research. Primary data has been collected from 51 participants and statistical analysis has been done on the collected data. According to the analysis of the data it can be stated that, Covid-19 pandemic reduces movement of the people that are forced to stop production of several organization. Moreover, vaccination method was more seen to be helpful for different management and organisation to mitigate issues and reboot financial activities.
References
Chronic constipation developed by loperamide in Wistar rats were subjected to experimentation and their treatments with senna leaves extracts. It was observed that there was an increase of body weight, swollen stomach and belly size. The stools were hard and less in amount in constipated rats which all they got normalized with sanay treatments.
In chronic constipation the glutathione peroxidase activity was observed to be decreased by 18% approximately in case of male and 16% approximately in case of female. The glutathione reductase activity also increased by 22% in male and 25% in female rats red blood cells. The catalase activity has shown an increase of 14% in males and 32% approximately in female rats red blood cells. The GOT activity increased by 54% in males and 48% in females. The GPT activity in red blood cells was observed to be increased by 36% approximately in case of male and 44% in female. The catalase activity was found to be increased by 14% in male and 32% in female rats red blood cells. All these enzymes activities normalized after sanay leaves extract treatments to chronic constipated rats.
The metabolites levels of GSH also decreased by 25% in both male and female rats and the GSSG levels increased by 77% in male and 66% in female. The sanay treatments to both male and female rats normalized the metabolites levels.
In chronic constipation the creatinine levels were observed to be increased by 8% approximately in case of male and 13% in case of female. This metabolits level was observed to be normalized after sanay leaves extracts treatments to chronic constipated rats.
It may be concluded that the female rats suffer the most biochemical dysfunction in comparison to male in chronic constipation.
References
Participation of young tennis athletes can be highly influenced by parents. There are times when the parents are over-involved in their children’s sports career when their eagerness turns into obsession, especially among junior tennis athletes, in which may influence the psychological development of the athlete. This paper describes the relationship between parental involvement and their self-esteem as perceived by Malaysian junior tennis athletes. The Parental Involvement in Sports Questionnaire (PISQ) and the Rosenberg Self-Esteem (RSE) scale were used and filled by a total of 169 Malaysian junior tennis athletes aged between 11 to 16 years old. The participants were also categorized by age group of 11 to 12 years old, 13 to 14 years old, 15 to 16 years old. It was revealed that a significant difference between the component of the athlete-perceived parental involvement in sports on the combined dependent variable of the four components of Directive Behaviour, Praise and Understanding, Acting Involvement and Pressure among the three age groups. ANOVA test also indicated a statistically significant difference in the self-esteem scores for the three age groups. Correlation analysis showed a small but positive correlation between the Praise and Understanding component and the self-esteem. It can be concluded that age groups does significantly differ in both components of parental involvement and self-esteem among Malaysia junior tennis athletes. Praise and Understanding is also the only component of Parental Involvement that is positively related to the self-esteem of the Malaysian junior tennis athletes. The practical implications of these findings could serve to improve the experience of participants in youth sport.
Keywords: parent; praise: understanding; juniors; participation
References
Background: Patellofemoral pain (PFP) is a chronic condition that usually results in long-term functional impairments both in adults and adolescents PFP has been found to decrease activity levels in individuals.
Purpose: The purpose of the present study was to investigate whether the additional use of electrical stimulation to an intervention program could result in greater improvements in the knee function and the level of pain compared with the intervention program itself.
Material and Methods: 22 women reported anterior knee pain symptoms clinically allocated in the patellofemoral region and confirmed through the patellar position, analyzed by magnetic resonance imaging (MRI). They randomly assigned into two groups with the same strengthening program. The experimental group used electrical stimulation combined with knee extensors and flexors strengthening exercises. The main outcome of the study was the visual analogue scale (VAS) in order to assess pain and the Anterior Knee Pain Scale (AKPS) to evaluate the functionality of the knee joint. All the outcomes were analyzed and compared pre and post a 6-weeks intervention period.
Results: Statistically significant differences were found between the two rehabilitation groups at the end of the intervention period both in VAS (F1,20 = 44.083, p < 0.001) and functional assessment (F1,20 = 35.687, p < 0,001), suggesting that the conventional intervention program with the use of electrical stimulation is more effective regarding the pain degrees and the knee function.
Conclusion: The use of electrical stimulation, combined with conventional strengthening program, could provide greater beneficial effects on PFP female individuals compared to the strengthening program itself.
Keywords: Anterior knee pain; conventional training; electromyostimulation; pain; functionality
References
This article is devoted to sexuality as a fundamental socio-psychological conceptual category. The paper provides an analytical review of the history of understanding sexuality as a construct of socio-political relations and the formation of state power, reveals all the diversity in approaches and judgments about this conceptual category. The paper shows that the interpretation of sexuality as a concept is not only an important general scientific aspect, but also has a key socio-psychological significance for the development of modern society and the formation of a person as a person by gender. Using the example of various sexual transformations, the article substantiates the relevance of the formation of the semantic content of this conceptual category in our time, when sexuality can no longer be considered separately from the state of the human psyche and those negative trends and various deformations of social consciousness that inevitably affect both the reproductive function of a person and the whole way of family and marriage relations in the modern world. It is possible to change the situation for the better in this area only by forming fundamentally new ideological priorities in the public consciousness. The scientific novelty of this work consists in analytical studies of the concept of sexuality as a fundamental socio-psychological conceptual category and the development on this basis of new theoretical approaches and corresponding definitions of the concept of sexuality and related conceptual categories. The proposed interpretations, according to the author, have a more pronounced social and psychological determinant for the formation of a new worldview in modern society regarding the development of a person, taking into account gender, which will ultimately lead to the improvement of reproductive function, improvement of demographic indicators and, in general, will contribute to improving the quality of life of a modern person in his social and physical realization.
Keywords: psychology; social psychology; practical psychology; medical psychology; sexuality; sex; asexuality; asex; sexual health; terms and concepts
References
One of the main socio-psychological conceptual categories is the concept of personality, while there is no generally accepted interpretation of this term. The basis of scientific ideas about the personality of a person at the moment is a number of theories and ideas, which are characterized by different scientific approaches, diverse semantic content and ambiguous interpretation.
At the same time, the problems of modern society urgently require the development of a fundamentally new theory of personality, which, by analogy with integrative psychology, would act as a unifying principle of all paradigms of psychological thought in the context of interpreting the concept of personality and would contribute to a unified approach to understanding this basic conceptual category in other social and philosophical sciences.
This article consistently outlines a new theory of personality, which is based on the main provisions of integrative psychology and, accordingly, is called the Integrative theory of personality. According to the author, this theory can act as a consolidating principle, both in the scientific worldview and in practical implementation. On the basis of analytical research, the paper shows the main approaches to understanding the content of personality theory, gives a definition of the concept of personality, describes the structure of personality as the basis of human behavioral manifestations, and also shows and discloses the basic terminological concepts that the Integrative Personality Theory operates on. Based on its main provisions, the author of the article interprets the key issues that are most often discussed in scientific and popular science literature regarding the conceptual category of a person's personality.
Keywords: psychology; sociology; social psychology; practical psychology; integrative psychology; personality; personality theory; personality structure; terms and concepts
The use of radiation in diagnosis and therapy is common but not without fear of detrimental risks and a general feeling of uneasiness. Effects of LDR have not been adequately elucidated and more research is needed to unravel the underlying mechanisms. However, LDR is known to cause stimulations in a variety of cellular processes resulting in beneficial effects which offer new opportunities to harness the protection to normal cells and therapeutic outcomes through toxic effects. It is pertinent to recall that billions of years ago the living organisms from bacteria to humans evolved in high ionizing radiation background and they armed themselves with complex protective machineries for survival against external stressors. In the present time, average annual natural environmental radiation is estimated ~2.4 mSv which, of course, varies at various locations on the earth ranging from about 1 mSv in Japan to 260 mSv in Iran. Most interestingly, it is found that people residing in such natural high background radiation (HBR) areas live a normal life and there are no reported significant health issues.
The living organisms exhibit adaptation offering protection against radiation exposure and learn to live below certain threshold dose. Furthermore, a low radiation dose causes stress to cells which turn on genes at specific threshold of radiation dose. The radiation activated genes up-regulate the protection systems which produce enhanced positive effects e.g. prevention of cancer, risk prediction and suppression of diabetes etc. Presumably, the LDR induced positive effects arise due to intracellular production of reactive oxygen species (ROS) which initiate production of endogenous antioxidants for its neutralization and signaling processes. More importantly, LDR activate repair of the damaged DNA, induce the mechanism of apoptosis causing the self-destruction of cancerous cells. LDR could modulate excessive inflammatory responses, regulating lymphocyte counts, and controlling bacterial co-infections in patients with COVID-19. Also, it is known to boost immunity which can annihilate cancer cells as well as reduce or counter virus assaults. Overall, LDR initiates recruitment and rescue operation in the injured cell which results in protection against radiation in normal cells or to the pathogenic agents including COVID-19 virus attack. On the other hand, a higher dose of ionizing radiation overstresses the organisms and the genes are turned on/off at specific radiation doses. It is known that different genes are activated by high and low doses. Thus, the built in protection system in cells is overtaken at higher doses and harmful effects are observed. That is to say, the low dose induced beneficial effects are generally marred by high dose radiation exposures. Another important finding in radiobiology is the observation of damage to non-irradiated cells called bystander effect. The DNA damage, apoptosis and other effects in non-irradiated cells show different patterns. It remains to be seen how bystander effect will modify cancer therapy outcome, risk estimates(carcinogenesis) and protection against radiation. Evidently, the promise of LDR in therapy of cancer and other diseases (e.g.cardiovascular) needs to be isolated, identified and tested in clinic. More importantly, a new opportunity is in the sight to optimize a window of LDR doses, say between 10 mSv to 200 mSv, that needs to be tested and optimized in the therapy of chosen lung cancers and novel COVID -19 infection which locates in the lower respiratory system and causes pneumonia symptoms leading to breath deterioration and eventually death.
In the evolution of life, organisms have harnessed the low dose stimulation to their survival advantage. It is no surprise that extensive LDR research in environmental ranges at molecular, cellular, and animal level has shown no adverse or detrimental effects. Thus, the concern for likely safety of health issue is critical. In fact, the safety concerns of scientists from LDR therapy seem to entail from the Reports of International Commission for Radiation Protection (ICRP) which believes in Linear-No- Threshold (LNT) model which is based on the assumption that no dose is safe however small. The ICRP prefers to ignore biological fact of intrinsic cellular repair machinery and hence believes in no threshold. Radiobiological studies on the surviving population from Hiroshima and Nagasaki atom bomb have shown that the cancer rate increases in proportion to the amount of exposure to radiation at acute high doses. However, there is no convincing data that shows the increase in cancer rate with a low level of exposure. On the contrary, there are even reports indicating that the cancer rate declines in high background radiation studies in China, India Brazil and Iran. The observed adaptability and the built in intrinsic protection system in living organisms against radiation are ignored for establishing the regulation and standards for radioprotection. In this context, the observed threshold of LDR dose at which genes are turned on and the dose at which they are turned off are important transition from beneficial to harmful effects of radiation. Of course, the dose thresholds and the amounts of benefit and harm observed are the characteristics for each organism. But, the remarkable demarcation of response of organisms from a LDR to acute radiation dose (ARD) is frequently observed which needs re-examination for the validity of LNT model.
In summary, the studies on low dose radiation effects on living organisms needs re-focus and role of LDR therapy in fighting cancer merits re-examination, a fresh look at carcinogenic risk evaluation/prediction (in view of Adaptive response and bystander effects) and developing novel tools for treating COVID-19 appear highly urgent and it’s use in therapy deserves re-evaluation and rigorous analysis of the clinical data. International scientific community is divided on the carcinogenic risk of LDR but recent surge in publications on evaluation of low dose therapy in the treatment of pneumonia caused by the novel COVID-19 and cancer re-emphasizes the need for technical developments and brings new hope for saving human life.
References
Research on the low dose radiation (LDR) effects on living systems especially the doses in environmental ranges (< 200 mSV) has evinced increasing interest to meet the new health care challenges in present time. Low dose exposure situation is witnessed in diagnostic and therapeutic applications and in cases of mine workers, watch dial painters. In recent years, there have been increasing incidences of cancer globally after high dose radiation exposure endangering human health and causing deaths. Moreover, at this point of time, the world has faced a grave health danger due to novel CORONA-19 virus pandemic posing serious threat to human health and resulting in millions of deaths globally. It is fairly well known from cellular and animal researches that low dose irradiations suppress the incidence of cancer by subsequent acute radiation dose exposures (~ 1000 mSv), a phenomenon called adaptive response (AR) or hormesis. It is also widely accepted that LDR exposures stimulate immune responses offering protection from radiation and disease-causing pathogenic stress. Therefore, it seems reasonable to apply LDR in fighting cancer, evaluation of risk and COVID-19 virus onslaught on the vulnerable human population. The advantage can be derived from the externally applied radiation and other stressors induced anti-inflammatory cytokine storm in human body’s immune system which goes into an overdrive to fight an infection or other forms of trauma.
References
Background: Knee osteoarthritis (KOA) is a degenerative disease with over 600 million people suffering worldwide. KOA is considered a major burden for the health systems as the annual healthcare expenses are to be calculated at over 27$ billion only in the USA.
Purpose: The purpose of the present study was to investigate the acute effects of a stretching intervention program in KRoM and knee stiffness in patients with KOA.
Material and Methods: Twenty female selected patients with diagnosed KOA were recruited and randomly assigned into the two groups. The intervention group performed a stretching protocol on an isokinetic dynamometer. The intervention consisted of three times of 60sec. All the measurements were performed on an isokinetic dynamometer. The main outcomes of the present study were the range of motion (KRoM), the maximum torque, and the joint stiffness of the knee joint to assess the joint's functionality. All the parameters were analyzed and compared pre and post-the stretching protocol.
Results: Statistically significant differences were found between the two groups right after the stretching intervention in all outcomes, suggesting that the passive stretching stimulus could be effective regarding KRoM (F1,18 = 8.352, p < .001) and the joint stiffness (F1,18= 6.384, p = .021).
Conclusion: Passive stretching could provide immediate benefits to KOA female individuals, possibly leading to better knee functionality during activities of daily living.
Keywords: Range of motion; Joint stiffness; passive torque; osteoarthritis; activities of daily living; knee functionality
References
The global spread of the COVID-19 pandemic has highlighted existing social determinants of health (SDH) that have contributed to health disparities and inequities in India. In this study, we aimed to track the SDH during the COVID-19 pandemic in India using close-ended surveys. Our findings suggest that vulnerable populations, such as those with lower income and education levels and poor housing conditions, are at heightened risk of the pandemic infection and poorer mental health outcomes. Access to healthcare is also a concern for vulnerable populations during the pandemic. These findings have important implications for policy and practice, highlighting the need to address SDH and health inequities to ensure equitable health outcomes during the COVID-19 pandemic in India.
Keywords: SDH; Covid-19; India; Survey; Health Outcomes; Food Security; Health Outcomes; Mental Health; Access to Healthcare; Policy
References
The study has depicted the usages of IoT (Internet of things), AI (Artificial intelligence), and big data, which are mainly integrated health, financial and transportation system. IoT assist in establishing advanced connection between one device to another with the specific region with an application of sensor or wireless connection. The IoT in the healthcare help to create connection between doctors system to patient’s system for mentoring the patients. This application in financial sector helps to transact confidential information, which specifically happened with block chain technology. In the transportation, the sensor or wireless connection help to develop a connection thorough airspace and this also create a better connection with land to understand the direction. Similarly, the application of AI and Big Data can help gather accurate and insightful information that can help take better decisions in each of sectors for future growth and development. To evaluate and investigate the application of artificial intelligence, the internet of things (IoT), and big data in healthcare, finance, and transportation. The paper has used secondary data to provide the required insights on the topic and address its purpose. It is quite evident from the conducted research that the application of these technologies is only going to increase in the mentioned sectors considering their positive impact on growth and development of the respective sectors.
Keywords: IoT (Internet of things); AI (Artificial intelligence); big data; technological advancement; connection; healthcare; financial sector
References
The objective of this study was to determine the influence of personal and environmental factors that affect the participation likelihood of athletes in wheelchair basketball. Convenient sampling was used. The Participation Likelihood Assessment Tool for Wheelchair Basketball (PLAT-WB), developed by Khumalo B, Van Heerden J, and Skalko T. was used to collect data. Data was analysed through the method prescribed for scoring the questionnaire. The T-test (SPSS version 20) was used to find the significance difference of how the influential factors affect males and females. A total of 38 questionnaires, of which 18 from women and 20 from men, were correctly completed. The results showed that there is a 92.11% moderate likelihood to participate, 2.63% very low likelihood to participate in wheelchair basketball. Males have 5% low likelihood, 90% moderate likelihood and 5% high likelihood to participate in wheelchair basketball. Females showed a 5.6% low likelihood, 0% low likelihood, 94.4% of moderate likelihood and 0% of high likelihood to participate in wheelchair basketball. There is no significant difference (p = 0.215) between men and women participation likelihood as affected by environmental factors and no significant difference (p= 0.918) by personal factors. Generally, men (92.11%) and women (92.11%) with a moderate participation likelihood are quite likely to play WB. The study revealed that the personal and environmental factors have the same influence in the participation likelihood levels for both males and females. Thus, the barriers that hinder the possible WB to participate affect both males and females in a similar way.
Keywords: Perception; Participation; Restrictions; Environmental Factors; Personal Factors
References
Since the pandemic began, India has confirmed more than 35 million cases and 50 lakh deaths (COVID19). The country has the second-highest number of Covid-19 infections in the world. As a result, vaccines that are both safe and effective required. The most widely used vaccinations in India are CoviShield and Covaxin. While the Serum Institute of India in Pune produces CoviShield, Covaxin is wholly designed, developed, and manufactured in India. CoviShield, a viral vector vaccine developed, it delivers spike proteins and mounts a tolerable immune response to a live virus using an adenovirus discovered in chimps, ChAD0x1. Covaxin is an inactivated coronavirus vaccine. India has reached the milestone of more than 1 billion vaccination doses. In addition, India achieves a world record by administering 2.5 million vaccines in a single day. The major goal of this research is to distinguish between the two most often used vaccinations in India, CoviShield and Covaxin. Also everyone in the public is aware of how it works, safe, effective and harmful it is. As a result of these vaccines, India plays a critical role in halting the coronavirus in the present and near future, perhaps saving millions of lives.
Keywords: CoviShield; Covaxin; Vaccine; Covid-19; India; Virus
Healthy relationships always suppose trust, respect, and appreciation between interest groups; sicknesses play down these fundamental components, annoying the beneficiaries.
Prosperous affairs or weak spots going down them continuously appear, soothing or distressing the individuals. Younger individuals are more candid, genuine, heartfelt, and open to challenging situations. Still, they have less life experience than adults or seniors. Old individuals are frequently registered with many diseases, including arterial hypertension and type 2 diabetes shading their performance. For all categories, illnesses get in the way of thinking and acting and may cause disruptions in interpersonal relationships. An unfair manifestation of judgment makes partners terminate the connection, amplifying mental suffering in the sick individual.
Rational thinking and performing duties gratifies people working and attract individuals, but imbalanced actions can harm their other relationships. People look for another collaborator when they are disappointed by unsafe collaboration. They usually need to prepare for such turning effects and want a more direct and effective way of interaction.
Persistent bad feelings disturb the human equilibrium, primarily affecting lipid profile and glycaemic control that alter cell functioning.
Therefore, people’s health ensures a prosperous social, professional, cultural, and emotional life. A deep look through the factors implying the appearance and evolution of various illnesses is necessary. A medical team’s mission is to identify all risk factors connected with the clinical manifestations of multiple diseases that affect reasoning and measures to attenuate or eliminate them when possible.
Disorder management has a different approach in this century. Person-centricity leads to a better- understanding of diseases, moving to their origin, and considering human life evolving and undergoing rational transformation.
People’s complex connectivity infers numerous parts that vary by age, instruction, setting, surroundings, and circumstances. The inability to select the most advantageous factors for enhancing professional and social life needs improvement.
Occasionally dire conditions cannot be avoided, and the individual must be prepared to deal with dilemmas. Successfully coping with unexpected problems defines the capacity to beat barriers, or if an inevitable fall occurs, rising above is preferable. The excellent position gained after falling depicts the victory against overcoming adversities, illuminating a path for restorative health and optimistic well-being improvement.
Sometimes illogical actions originate in intentional immoral thinking, finally repulsing, revolting, or shocking the recipients. Corrective and informative actions are indispensable to going back to normality. The artificial Intelligence supply and instruction hybrid model add benefit for remodelling unhealthy behaviour.
Acting as professionals, we gain recognition from the community we serve.
And so, mental activity may also be evaluated by the effectiveness of connections between individuals with various backgrounds and demographic data.
Individual reasoning change over time is expected. It should be better to have its improvement, but if decline appears, it has to be eased, and it is preferable not to fall again. Rising once more for the beauty of life in this natural and perceptible world that will end up sooner or later for each one is wanted.
Humans share various communication styles in the community according to their culture, education, genetics, and medical conditions.
As individuals evolve, their reasoning transforms through experiences, training, and possible disorders.
Affairs ground society’s evolution, promoting sustainable production of goods and services. The human virtual or physical connection and a chain of command for doing that may be effective or ineffective, in line with individual expertise, available technologies advancement, and refinement in collaboration with other parties implied more or less in the creation process.
References
Learning to write by hand begins with copybook models, which gradually evolve into individual features as writers acquire their own traits over time. In this paper, two separate scripts were used, and commonalities between the two scripts were found based on the way the two scripts formed letters that looked similar to one another. Nine distinct lookalike letters were noted and investigated. 200 handwriting samples from 100 people were gathered (50 each from familiar and non-familiar writers). These observations have been compared using a graph. The t-test, a statistical tool, was used to examine the significance of the overall hypothesis. 4.5547 was the t-test value at 5% significance, which is significant at df 16.
Keywords: Inter-script; Comparison; Lookalike alphabets; Stylistics
References
Introduction: The term pandemic is considered to be the most dangerous thing that the world witnessed, however Covid-19 is considered to be the scariest thing till date. It damaged many things in the Nation, people lost life, their closed ones, earning sources and mental peace. The effect of Covid -19 is not over yet, however the seriousness of the virus is under control with proper vaccination and guidelines followed in India.
Objective: The objective of this research was to understand the dynamics of Covid -19, discussing the measures taken by the Government and challenges faced during its implementation and lockdown scenarios implemented in the nation in different phases. The paper also discusses the proactive role of the Indian Government and the risk management journey of the nation as a whole.
Methodology: The paper used secondary for studying the dynamics. The information was taken from authentic sources, online database; government reports, print media articles and different journals and research papers. The researcher used exploratory research design and secondary research approach to meet the research objectives.
Results: The article reports there was positive as well as negative effects of the lockdown in India.
Keywords: Pandemic; Lockdown; Covid- 19 in India; SARS Cov-19
References
The hair follicle is known to be the most important organ in the mammalian system, determining appearance, gender difference, providing severe temperature protection, and playing a part in self-defense. Many lifestyle-related changes, such as fatigue, anxiety, junk food consumption, and the use of various hairstyling/coloring methods, have caused serious hair loss difficulties in the younger generations. The thinning of one's hair In most situations, it is not transient, but it causes alopecia. Due to excessive anxiety and tension, many people suffering from hair loss seek different remedies, ranging from mythology to conventional and therapeutic healing to the use of minoxidil and finasteride. Hair root activation is necessary to improve hair development and prevent hair loss.
Keywords: Hair stimulant; Hair loss; serum
References
Surgical site infections [SSIs] remain a common postoperative complication despite the use of prophylactic antibiotics and other preventive measures, mainly due to increasing antimicrobial resistance. SSIs increase postoperative morbidity and mortality and may require hospital admission, intravenous antibiotics and even surgical re-intervention. A hospital based descriptive study was conducted on 100 consented postoperative patients with clinical SSIs. Data on patients was obtained using structured data collection form. Swab samples were collected aseptically from each patients. Bacteriological culture examination and identification was done following standard microbiological techniques. Antibiotics sensitivity test was done by Kirby-Bauer disc diffusion method. Ninety (90%) bacterial isolates were recovered from surgical site infection. Gram negative bacteria (GNB) were predominant (83.3%) with the dominant being Escherichia coli (27.78%) and Staphylococus aureus (16.67%). All the isolates were highly resistant to amoxicillin/clavunalate, ceftazidime, cefuroxime, levofloxacin and all the isolates were resistant to metronidazole but susceptible to imipenem, polymycin B and amikacin. The plasmid analysis in this study revealed that out of the 40 (44.4%) multi-drug resistance isolates, 35 (87.5%) of which were Gram-negative bacteria had 9 (22.5%) detectable plasmid pattern with the molecular weight of between 2027kbp to 23120kbp while the remaining 26 (74.6%) had no plasmid bands. The remaining 5 (12.3%) which was Staphylococcus aureus isolates had 2 (40%) detectable plasmid pattern with the molecular weight of between 23130kbp and 6557 while the remaining 3 (60%) had no plasmid bands. Imipenem is the drug of choice in the treatment of surgical site infections in this study area These findings necessitates judicious antibiotic use and calls for surveillance of SSIs periodically as well as strict adherence to good sanitation practice to reduce spread of drug-resistant pathogens.
Keywords: Surgical Site Infections; Antimicrobial susceptibility; Gram negative; Bacteria; Gram positive; Plasmid Profile; Clinicians; Operating Room
Among these, newer possibilities are being searched which could fulfil the purpose. One of these is Fish Protein Hydrolysate produced from the visceral waste of fish, which is an excellent nutritional supplements and most researched fishery product in last decade. It bears bioactive properties and get absorbed easily in diverse metabolic operations. The abundance of amino acids, PUFAs, antioxidant peptides and low fat content makes it an attractive option of nutraceutical. Besides, it exhibits antimicrobial, immunomodulatory, anticancerous, anti-coagulant, anti-obesity and anti-tumorous activity. It is being commonly marketed as nutraceutical in some countries. Noteworthy among those are PROTIZEN®, AMIZET®, Nutripeptin®, Seacure®, Vasotensin®, LIQUAMEN®, Stabilium®200, etc.
However, the functional properties of the hydrolysate depend upon source of the viscera and the hydrolysis method. Fish protein hydrolysate, on the other hand is considered as best way to combat underutilized or by-catch fish as it minimises the perishable article and gives away a useful product. Operators of food businesses should generally assure product safety. Before a food ingredient is made available on the market, its safety requirements must be documented. When protein hydrolysates are made with proteases of food grade and are synthesised from proteins that have a history of being safe for consumption, protein hydrolysates can be regarded as safe. The manufacturing should assess the safety of fractions and bioactive peptides produced from safe hydrolysates before introducing them to the market. Moreover, the utilisation of fish waste may not be acceptable to certain regions of globe due to religious issues but it can be overcome by creating awareness and emphasising global waste problem.
Both humans and animals can benefit from medicines in the treatment and prevention of disease. However, due to the nature of medicines, they may also have unintended effects on animals and environmental microorganisms. The potential environmental effects of the manufacture and use of medications are less well understood and have only lately emerged as a topic of study interest, despite the fact that the side effects on human and animal health are typically explored in depth safety and toxicity studies. In every region of the world, antibiotic resistance is increasing to dangerously high levels. Our ability to cure widespread infectious diseases is being threatened by the emergence and global dissemination of new resistance mechanisms. As antibiotics lose their effectiveness, a growing number of infections, including gonorrhoea, blood poisoning, pneumonia, and tuberculosis, are getting harder to treat and occasionally becoming incurable. The COVID-19 epidemic that is currently threatening the health of the entire world's population has halted activities in a number of important economic sectors. This is adding to the pressure placed on dietary supplements and nutraceuticals.
Individual working reflects genetics, education, social connection, and environmental characteristics. It is advisable to maintain an equilibrium between intellectual activity and physical exercises. Moreover, intellect work can relax in the digital age, along with a personal choice from diverse virtual offerings aiding in recharging, ensuring a harmonious state of being.
People’s data fast circulates by media, helping individuals to better decide on their collaborators. Personal reputation, appreciation, trust, and respect are fundamental for long-lasting relationships. Good partnership work ensures a prosperous social, cultural, professional, and emotional life. Unsafe people interactions have detrimental effects on their health and, consequently, decline work efficiency and well-being. IT advancement facilitates blocking collaboration with dishonest or uneducated people.
The medical team’s mission is to detect the negative impact of unhealthy behaviour on individuals’ well-being and provide timely solutions for that, utilizing information technology resources for a swift recovery.
Immoral conduct in daily work is easily identified by using specialized electronic tools for monitoring; applying reasonable measures for remediation makes possible fast restoration of bad habits and ameliorates offensive people collaboration. Nowadays, corrective actions for harmful human behaviour are used more gently and with more permission, exploring self-reflection value for improvement.
AI-powered tools can assist in restoring health, expanding knowledge, and enhancing the overall quality of life, finally leading to increased life expectancy.
The latest technological advancement in healthcare delivery is used in clinical diagnosis, which may be established using only virtual patient data. Various IT devices are available for both rich and poor people in need. But just using a modest mobile phone makes the connection between the physician, nurse, and patient possible; online voice analysis combined with breath characteristics and face and hands info enables a rapid clinical diagnosis with no more time-consuming. This new practice model is more facile and accessible, gaining benefits for all parties implied in dealing with medical conditions: health professionals, patients, their families, pharmaceutical departments, and representatives of other trades connected for social support.
Recording people’s physical or online interactions allows us to revisit communication for analysis; this helps detect possible gaps, correct them, and improve business or corporate performance.
Customer experience reflects the professionalism of individuals collaboratively working and offering their products; the client’s knowledge, involvement, skills, emotional state, and proficiency are examined by gathering data from various touch-points and other communication channels. Consumer satisfaction ensures increased revenues, improved practice efficiency, and societal progress.
People’s interaction with robots replacing their labour is a new, more accurate, rapid, and cost-saving alternative in service mode.
As for each fact, there are two opposite facets of the advancement of technologies these days. The optimistic attributes of IT may fascinate us but are easily eclipsed by other elements with detrimental effects on individual health: more absorbed time to navigate them, a decreased program for physical activities or relaxation in nature, less time interacting in person, and disturbed slipping rhythm. These factors, if unbalanced, can lead to increased body mass index and brain disorders; sleep disruption represents a point start of other medical conditions. Ingenuity for an educational platform focussing on people’s health in the digital age is imperative.
A fair digital program for an individual ensures a healthy life expedition, attaining excellence in living in the natural and perceptible - audible and visible world.
People’s interaction has changed over time. Traditional face-to-face interaction is frequently replaced with virtual interaction, offering communication comfort without walking or traveling at a low cost. Reduction of time-consuming for that, saving money, and the opportunity to arrange exchanges with selected people according to personal interests and preferences means lifestyle change influences public health.
Using IT devices for quick communication, immediate info available if necessary, and even acquiring expertise in one’s chosen domain by accessing on-demand educational programs and online certification represent a more convenient way of instruction and living.
References
The main purpose of the study is to evaluate the case of COVID-19 pandemic situation in 2023 in context of India. The recent scenario has highlighted the appearing of new wave of corona virus, which has hit the nation at a highest rate in which Maharashtra has seen many cases that are more active rather that other state. The vaccination has also been done to prevent this unpredictable case. The secondary qualitative and quantitative study has assisted in gathering of much useful information about the pandemic. The political and social condition has drastically been affected due to new wave of this virus that is affecting many people. On the other hands, the careless nature of many people has resulted as highest chance to increase the rate of pandemic situation. The threat of the pandemic is yet not over for India in 2023 and this in turn has various implications for the economic policies of the nation. Hence, a complete survey of the scenario in India in 2023 has been provided in the article with the help of secondary sources.
Keywords: COVID-19; corona virus; pandemic; economy political
Reference
Impulsivity has been conceptualized as a predictive factor among various problem behaviours of people who are clinically diagnosed with psychiatric disorders. In recent decades, there has been an attempt to understand impulsivity in terms of brain activities. The trait impulsivity is measured through P3a and P3b amplitudes to understand how they might change in pathological populations. Altered P300 is a biomarker for psychotic disorders, neurotic disorders, and various disorders related to addiction. Overall, P300 can be associated with impulsivity and inhibitory control. However, in different psychiatric disorders, the nature of changes in P300 indicated different types of underlying processing in decision-making and response inhibition.
Keywords: Impulsivity; P300; Psychopathology; Addiction; Psychosis
References
Introduction: In order to guide antibiotic therapy, most often probabilistic this study aimed to characterize the different phenotypes of antibiotic resistance of E. coli strains responsible for urinary tract infections. Materials and methods: This was a prospective cross-sectional study with descriptive purposes that took place from January to December 2020 at the medical biology laboratory of Niamakoro FOMBA Hospital in Ségou. Uriselect 4 Agar was used for urine culture followed by biochemical identification by API 20E gallery. The antibiogram was then performed by the disc method according to the 2019 recommendations of the antibiogram committee of the French Society of Microbiology. Results: During this study, 56 enterobacteriaceae were isolated and identified in urinary tract infections, including 43 strains of E. coli or 76.79%. Regarding resistance patterns, the ESBL phenotype was the most observed with 46.51% for the beta-lactam class. Aminoglycoside resistance affected 41.46% of strains resistant to all aminoglycosides tested. Quinolone resistance was identified with 88.10% of strains resistant to all quinolones. ESBL profiles were associated with resistance to aminoglycosides, fluoroquinolones and sulfamethoxazole + trimethoprim in 13.95% of cases. Conclusion: The present study on resistance phenotypes in E. coli isolates reports worrisome results for the main classes of antibiotics.
Keywords: Antibiotics; E. coli; urinary tract infection; resistance phenotypes
Reference
Curry Leaf (Murraya koenigii) is a South Asian native that is used in a variety of cuisines for its flavour and smell. Herbal drugs, which are relatively affordable and have few side effects, have long been used to treat a wide range of ailments. Curry Leaf is commonly utilised in traditional Ayurvedic medicine. Small deciduous shrub having medicinal and nutritional properties that could make it a future industrial crop. Murraya koenigii contains antibacterial, antifungal, and antiprotozoal effects, according to the literature, particularly in the leaf, stem, bark, and oil. The herb as a whole is used as a tonic and stomachic. The purpose of this research is to look at the classification, origin, physical properties, and traditional usage of curry leaf around the world.
Keywords: Extracts; Leaves
References
Introduction: Very low birth weight (VLBW) is a term used to describe babies who are born weighing less than 1,500 grams (3 pounds, 4 ounces). Infants who are born preterm with low birth weight and secondary to intrauterine growth restriction, can be subjected to increased morbidity, mortality, and cost [5]. Babies with a very low birth weight are at a higher risk of motor development, depression, Attention deficits and other psychiatric conditions in adulthood, compared with those born a healthy weight [6]. The purpose of this study is to find out the effect of very low birth weight and gestational age on motor development in preterm infants at 18 months of corrected age.
Materials and Methods: This study is a observational study design and was conducted in VAPMS College of Physiotherapy, outpatient Department and R.K. MISSION hospital. A study sample of 50 subjects was selected on simple random sampling method. The study questionnaire was applied and the infants were prospectively evaluated using Alberta Infant Motor Scale (AIMS) for their gross motor development at 18 months of corrected age. The observational study was done for 20 minutes for each infant. In addition, the perinatal and the socio-environmental data were obtained from the parental interview. The assessment emphasizes the anti gravity movement of the limbs in prone, supine, sitting and standing positions, postural alignment, weight bearing of the body with further evaluation in attainment of gross motor skills.
Results: The sample was segregated into three sub group model and thus identified 3 motor trajectories among VLBW preterm infants: stably normal (n=36), slightly deteriorating (n=11), persistently delayed (n = 3). Infants with a normal trajectory manifested the typical motor performance with AIMS Z scores of 0.4 to 0.5. Infants with deteriorating trajectory displayed the motor performance in the typical range initially but then deteriorated from 12 months. Infants with a persistently delayed trajectory revealed a significant delay from 9 months. All the infants were observed at 18 months of corrected age.
Conclusion: The study concluded that very low birth weight has a significant effect on the motor development observed in preterm infant. The early motor trajectories were also a predictive of subsequent developmental outcomes in preterm infants specifically with VLBW. In addition the study emphasizes that socio-environmental factors are not associated with motor trajectories in preterm infants with VLBW.
Keywords: Very low birth weight; Preterm infant; Gross motor trajectories
Research supported the evidence stating that mental health is likely multifaceted by nature, that includes genetic, biochemical, physiological, and environmental factors. The Human Genome Project, completed in 2003, opened new avenues for genetic research. Since then, genome-wide association studies (GWAS) and other genetic analyses have identified specific genetic variants associated with mental health disorders. Genetic variations can contribute to an individual's susceptibility to mental health disorders.
Over the years, researchers have made significant progress in identifying and understanding various biomarkers associated with mental health disorders. In the mid-20th century, researchers started investigating the relationship between neurotransmitters and mental health. Scientists have learned that alterations in neurochemicals are related to mental diseases. For instance, the significant milestone was the discovery of antipsychotic drugs in the 1950s, which specifically targeted dopamine receptors and shed light on the involvement of neurotransmitters in conditions such as schizophrenia (Sawa &Snyder, 2003). Another early discovery was the neurotransmitter serotonin. These neurochemicals are released into the synaptic region in depressed individuals than in healthy individuals. Selective serotonin reuptake inhibitors (SSRIs), a class of drugs, work by increasing the quantity of serotonin in the synaptic region, which alleviates symptoms of depression (Bethesda, 2007). Several combinations of single nucleotide polymorphisms in an individual's genetic makeup and some environmental stressors may contribute to these mental conditions. When a person is stressed, the cortisol hormone is released into the bloodstream (Cay et al., 2018). In the 1980s and 1990s, the role of cortisol as a prognostic biomarker in mental health disorders gained attention. Studies found dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to abnormal cortisol levels. Cushing's syndrome (Lacroix et al., 2015) is caused by too much cortisol, while Addison's disease (Charmandari et al., 2014) is caused by adrenal damage and is associated with too little cortisol. Drugs related to cortisol (e.g., prednisolone) will suppress cortisol secretion from the adrenal gland if taken for a period. The inherited genetic error can cause disorders in the human body, such as Huntington's disease (HD). HD is caused by the mutation in the gene resulting in increased repetition of cytosine, adenine, and guanine (CAG). This error in the DNA codes for genes makes defective nerve cells in the brain gradually break down and die, causing the body to lose important signals to keep it in its proper function and response.
These breakthroughs emphasized the significance of neurotransmitter imbalances in mental health disorders and paved the way for further research in this field. Measuring these chemicals in the blood or the cerebrospinal fluid with neuroimaging techniques, mass spectrometry, and genetic testing can help identify these biomarkers. Advances in neuroimaging techniques like positron emission tomography (PET), magnetic resonance imaging (MRI), and functional MRI (fMRI) can reveal structural and functional brain abnormalities associated with mental health disorders. Brain imaging biomarkers help understand brain circuitry, identify treatment targets, and evaluate treatment response.
Multi-omics approaches, such as integrating multiple biological data sources, such as genomics, proteomics, metabolomics, and transcriptomics, have opened new avenues for biomarker discovery. These multi-omics approaches allow researchers to explore complex interactions and networks underlying mental health disorders. It's important to note that the field of mental health biomarkers is still evolving. Many biomarkers are in the early stages of research and require further validation and standardization before they can be implemented in clinical practice. Nonetheless, the ongoing discoveries in this field hold great promise for personalized approaches to diagnosis, treatment, and understanding of mental health disorders.
References
My awe of the biology of cancer led me to work around biomarkers for breast cancer. I have considered great importance in this venture to find the cause and the potential cure for this dreaded disease. We hope that one day, our novel biomarkers discovered from our sophisticated instruments and advanced bioinformatics tools will end breast cancer (Cation & Ramos, 2022). But unlike most types of cancer, mental disorders are presented differently in each patient, and their diagnosis is challenging to date. A mental illness is a medical disorder that affects a person's thoughts, feelings, or behavior (or all three) and results in functional challenges, suffering, and discrimination for the individual. Just like other diseases, mental illness can vary from mild to severe conditions and are treatable. The dynamic and ongoing process of searching for mental health biomarker discovery was born to address this emerging condition. Biomarker for mental health refers to measurable biological indicators that can be used to assess and monitor various aspects of mental health conditions (Glannon, 2022). These biomarkers include genetic, neurochemical, hormonal, neuroimaging, and physiological measurements. The development and utilization of biomarkers hold promise for improving the diagnosis, treatment, and understanding of mental health disorders.
References
Introduction: In a study conducted at tertiary care center, Bangalore, a total of 144 late preterm neonates were studied. The majority of the neonates were born with a birth weight of more than 2 kg, and the study found that 28.33% of late preterm infants developed one or more complications leading to a hospital stay of more than 7 days. Most of the neonates required intravenous infusions, antibiotics, and were subjected to investigations for sepsis. In a study by Shapiro Mendoza et al, 22.8% of late preterms experienced at least one complication that could lead to prolonged hospital stay.
Methods: Late preterm infants are at high risk for neonatal morbidities, including neonatal hyperbilirubinemia requiring phototherapy, respiratory distress, sepsis, and feed intolerance. The duration of hospital stay was prolonged in late preterm neonates, with most requiring more than 7 days hospital duration. The rate of rehospitalization was also high.
Discussion: The study highlights the need for further studies to establish and evaluate strategies, routines, and protocols for premature interruption of pregnancy, reducing the number of premature births and developing obstetric protocols that increase the precision of methods for estimating gestational age (GA). Additionally, the study suggests using antenatal corticosteroid after 34 weeks to reduce respiratory pathologies and prevent a significant number of deaths in this group of neonates.
Conclusion: In conclusion, late preterm infants are at high risk for neonatal morbidities, including neonatal hyperbilirubinemia requiring phototherapy, respiratory morbidity, mechanical ventilation, sepsis, and hypoglycemia. Prolonging pregnancy to the maximum safest gestation can result in a decrease in these morbidities.
References
Background: In Bangladesh, Pharmacists have an advantage over other healthcare professionals as they have easier and more frequent access to the public.
Objective: This study aims to address this knowledge gap and provide valuable insights to guide future interventions.
Methods: The study was conducted through cross-sectional quantitative methods in purposively selected eight districts from October 2020 to December 2020. A structured questionnaire was distributed among a sample of pharmacists, and the collected data was analysed using statistical methods. The ethical clearance of the study was taken before data collection. Sixteen trained data collectors collected 627 data through face-to-face interviews with the Pharmacists using a pretested structured questionnaire. Descriptive analysis was performed, and quality control and risk management were performed strictly for maintaining the accuracy of the data.
Results: The study found that about 70% (n=438) pharmacies were found registered, and above 77% (n=483) pharmacies were owned by Pharmacists themselves. About 85.5% (n=536) had knowledge on counselling of patients in pharmacy but only 62% (n=389) had knowledge on SRH-related counselling. The highest duration of counselling of patients by Pharmacists was 1-5 minutes, 66.2% (n=355). Only 48.5% (n=304) had knowledge on complications and 69.7% (n=437) had knowledge on the side effect of SRH medicines. About 64.6% (n=405) of Pharmacists reported hearing the SRH-related issues from patients before selling medicine. About 80% (n=501) of Pharmacists reported having knowledge on menstrual hygiene, 49.4% (n=310) had knowledge of post-abortion care, and 56.8% (n=356) had knowledge of Postpartum family planning. About 76.6% (n=480) Pharmacists had knowledge of maternal complications, where 75.8% (n=475) mentioned haemorrhage and 71.1% (n=446) mentioned eclampsia as maternal complications. About 90.6% (n=568) of pharmacists mentioned that they required training on dispensing SRH-related medicine.
Conclusions: Though A grade (Graduate Pharmacist) and B grade (Diploma Pharmacist) Pharmacists had little knowledge of SRH medicine dispensing but C grade (Pharmacy Technician) had no proper knowledge and practices regarding SRH-related medicine dispensing. Most of the Pharmacists were in C grade, so their training on SRH-related medicine dispensing is very much essential. The findings contribute to evidence-based strategies for enhancing pharmacists’ involvement in promoting SRH and FP services in Bangladesh.
Keywords: Pharmacists; Sexual and Reproductive Health; Family Planning; Bangladesh
References
Background: Fistula in Ano is a chronic abnormal communication runs outward from anorectal lumen (int opening) to an external opening on the skin of perineum or buttock. History of ischiorectal, perianal abscess is the main hindering reason. Tuberculosis, IBD (Crohns or ulcerative proctocolitis), trauma can also lead to development of anal fistula. Sometimes termed as nonspecific, idiopathic or cryptoglandular and intersphincteric anal gland infection. chronic discharge, occasional pain and blood staining, foul smelling, cloths soiling and disturbance in religious purposes for muslims are the reasons to operate.
Objectives: To specify duration of healing in low variety fistula in Ano after surgery and staying time in Hospitals. Other concomitant issues in perioperative period.
Methodology: This cross sectional study was carried out in Bangabandhu sheikh Mujib Medical university from April to Sept 2012. Total 50 patients were selected as study population whom were admitted with low anal fistula and internal opening is below anorectal ring. Horse shoe, high variety fistula, associated disease (TB, IBD), malignancy were excluded from study population. Patient were grouped in A and B. A for Fistulectomy and B for fistulotomy. 25 patients in Group A, 25 patients in Group B. surgery was conducted by spinal anaesthesia and preoperatively 1 gm ceftriaxone and 1 bottle (500 gm) metronidazole given in each patient. Patients were discharged in 2nd post operative day with some guidelines and education of treatment maneuver. First follow up after 7 days and 2nd follw up after 4 wks.
Results: Total 50 patients admitted in BSMMU surgery Department and grouped in A (Fistulectomy) and B (Fistulotomy). Age range was 20-70 yrs and male are suffered more than female. low socioeconomic groups are presented more with history of anorectal abscess. Mean hospital stay was more in Fistulectomy with raised pain score than fistulotomy.
Conclusion: Anal fistula is a common cause of chronic pain and anal nuisance. Delineation of anal anatomy and identification of fistulas tract is important to prevent recurrence. Fistulotomy patient has less post operative pain with less hospital stay than fistulectomy in low variety anal fistula.
Keywords: Fistulectomy; Fistulotomy; Low variety fistula
References
Pharmacognosy was initially described by C. A. Sydler as the study of therapeutic plants or products. The physical, chemical, and biological properties are used in these investigations. Adulsa (or Vasaka) is the popular name for the plant Justicia adhatoda (Linn.), which is a member of the Acanthaceae family. Adhatoda leaves have a long history of usage in Ayurvedic medicine, mostly for respiratory conditions. In the current pharmacognostic study of vasaka (leaves), major pharmacognostic techniques such as macroscopy, microscopy, surface preparation, powder characteristics, and physicochemical characteristics were used to identify the presence of trichomes and vascular bundles as well as moisture content, ash values, and extractive values in various parameters.
Keywords: Justicia adhatoda; Pharmacognosy; Morphology; and Microscopy
References
The old Law of conservation defines that “Energy is neither created nor destroyed” (Universal Law). But the modified Law of conservation expresses that “Energy is created at a certain point and is destroyed up to the certain limit. In between creation and distortion, we can see ‘conservation’ which means one energy gets converted into another energy”.
The energy is created/generated in the universe. God’s power means, G-Generation, O-Operation, and D-Distortion. These true facts of God’s power are described in the paper as a ‘gift of God’.
American countries and China's scientists make Artificial Sun. These Artificial Sun has transformed into a monumental creation that's fast reshaping the future of energy and how we perceive human (Ref: Google Search, 02-Aug-2023)
*We well known that just now, scientists have proved practically and scientifically as they create artificial Sun in Laboratory, for extra energy create by artificial Sun, which is used in future as power…Chinese Scientists Launched Artificial Sun To Prove ..YouTube - https://www.youtube.com › watch,(02-Aug-2023).
As per above discussions, in our mind one question, who was responsible for creation of Universe in first initial stage…...? who was starts Universe in old initial stage ….? Some body is responsible ……?
No doughty! Ans. God’s power was only responsible starts /creation of Universe……! GOD’s means!.......G-Generations! O- Operations! D-Distortions!...... .
Thus, energy is created/generated by God’s power. New modified Law of conservation expresses that “Energy is created at a certain point and is destroyed up to the certain limit. In between creation and distortion, we can see ‘conservation’ which means one energy gets converted into another energy”. It’s true facts ….!
Keywords: Law of Conservation; Energy creation; Energy conservation; Energy distortion; God’s power; Supreme God's power
References
Introduction: Intraocular medulloepithelioma is a rare, nonhereditary neoplasm of childhood arising from primitive medullary epithelium, often involving the ciliary body. It is a slow-growing tumour and most patients present between 2 and 10 years of age with loss of vision, pain, leukocoria and/or conjunctival congestion. It is difficult to estimate the true incidence of this tumour because of its rarity and paucity of large-scale population-based studies. To the best of our knowledge, this is the first reported case of histologically diagnosed primary malignant ocular medulloepithelioma in Nigeria.
Case presentation: We report the case of a 16-year-old female who presented with painful progressive left ocular swelling and visual deterioration of 8 years duration with associated redness and tearing. At presentation, a soft fleshy mass was seen protruding from the inferior aspect of the left eyeball, and enucleation of ocular contents was subsequently performed. Microscopic evaluation of the lesion showed distorted eye tissue with infiltration of the cornea, uveal tract and retina by malignant primitive neuroepithelial cells disposed in sheets, anastomosing cords and multiple classic Homer Wright rosettes with areas showing neuronal differentiation and marked nuclear atypia. The tumour also had a high mitotic index. The features seen were consistent with the diagnosis of a malignant teratoid medulloepithelioma. The patient had chemotherapy and radiotherapy and was subsequently discharged home for follow-up at the outpatient clinic.
Conclusion: Primary intraocular medulloepithelioma is a rare neoplasm occurring usually in the first decade of life. Before this, no case has been reported from Nigeria, especially in an adolescent female. The mainstay of treatment is surgery with chemo-radiation. This case also highlights the challenges involved in arriving at a definitive diagnosis.
Keywords: ciliary body; malignant medulloepithelioma
The evidence in clinical practice shows that extended and intense mental activities and sleep deprivation can be in front of heart disease for people in four or five decades. More intellectual and emotional engagement in daily work for a prolonged period leads to sleep schedule disruption. The body’s nervous system cannot adequately recover from sleep deprivation, resulting in accumulating fatigue. Unbalanced fatigue determines the nervous cells’ inefficiency in controlling bodily function, and chaotic heart activity can follow sooner or later in connection with adrenergic pathway activation. Therefore an unhealthy lifestyle can negatively impact mental and heart function, so informative programs are needed.
In the digital age, technological advancement facilitates fast disorders management.
An acute episode of heart disease imposes laboratory testing and specific investigations. Typically, the family physician’s clinic may not have all the necessary tools for a precise medical diagnosis, as specialized departments can do it in a public or private hospital. Their referrals to specific medical units ensure the best management of illnesses, and cardiology is at the top of necessity. A cardiologist is best equipped and finalizes an accurate diagnosis and treatment, while a family doctor can provide more information about the origin of heart disorders.
The family physician accumulates more info about the patient’s lifestyle since their longitudinal data are accounted for. Business continuity ensures endless patient observation, motivation, and the effectiveness of corrective measures applied when necessary. The cooperation of a family doctor with colleagues from other medical specialties is imperative for the sake of public health. Instant communications of interest for the patient and the medical team, discoveries of new drugs, and various alternative therapies can all make the patient’s recovery more straightforward and accessible in this digital world.
The person-centred approach offers another dimension for understanding and applying the knowledge in practice; a deep look at the origins of the clinical manifestation of the illnesses and utilizing advanced technologies to address them enables a short revitalization. In a clinical case analysis, possible cumulative internal and external risk factors must be considered: their magnitude, interdependence, time action, and individual vulnerability - to predict their adverse effects on people’s equilibrium.
Research data from the Hospital and the Primary Care Clinic supplies the gaps in the disease approach. Their collaborative work, rapid communication, and the use of a new AI algorithm in handling data lead to healthcare betterment, increase patient enjoyment, life quality, and expectancy, and offer a prosperous personal, professional, and social life in a world where time is our precious gift.
Lifestyle and environmental characteristics influence human well-being, and the individual equilibrium is easily affected when one or more components of them, in considerable amounts, outweigh others, deteriorating their balance, finally leading to more or less clinical expressive disorders, in line with genetics and other medical conditions.
Human activity, if adjusted to demographic characteristics, in a comfortable setting offers enjoyment and motivation for a guaranteed existence; the daily program well-organized in a friendly atmosphere ensures a healthy life. Inadequate conduct in day-to-day work, even in a suitable setting, can disrupt one’s functioning. It is essential to organize harmonized mental and physical activities to maintain equilibrium.
Young individuals are more enthusiastic, dynamic, and cheerful than seniors. They can control transitory intense physical and mental activity, but middle-aged people and seniors usually experience health deterioration in such conditions.
References
Headache is a universal experience. It is one of the most common complaints in the field of medicine & neurology. The article deals with the issue of ‘headache’ in the field of medical science. It does not consider ‘Migraine’. It hampers the quality of life in all age sections as headaches have multiple reasons. Headaches are a part of everyone’s lives. Most headaches are usually harmless but in some cases they\can be harmful too. The article covers both harmful and harmless headaches that hamper the quality of life. Medical science has not been successful to elicit the cause of each headache and thereafter treatment plans are multiple in nature, confusing and a definite plan has not been deduced.
Ancient references to headache, migraine & neuralgia can be found in the Ebers Papyrus (1200 BC). Evidence of trepanation of 9000 year old Neolithic skulls suggests the first headache treatment. Visual symptoms associated with the headache were described by Hippocrates who lived during 460-370 BC. The father of medicine from Greece on whose name the Hippocratic Oath is taken by the budding doctors across the globe was the first to scientifically elucidate headaches clinically through his observations. That is why Hippocrates is known as the first analytical epidemiologist. Aretaeus provided one of the earliest classifications of headache around 200 AD.
The reader will get an idea of the problem of headache at the global & national level through the eyes of clinical health in the beginning sections before delving in to the Homoeopathic system of the AYUSH platform. Currently, the AYUSH platform has regained its value in the era of the current pandemic. The pandemic has further escalated the issue of headache, further precipitated by the increased stress levels. In the absence of effective therapy in the modern medicine, the article delves into what homoeopathy can offer to deal with headache issues that fulfil the triad criteria of essential medicines as per the National List of Essential Medicines (NLEM). The criteria is that these medicines need to be effective clinically, clinically safe and should be without side effects. Thus Homoeopathy is the leading therapeutic system that can deal with headaches and can cover masses while being cost effective [1-3, 17-19].
Brief of the article
The current article looks into the aspects of headache during the life period out of which managing headaches is one of the main challenges.
The article looks into the brief history of public health programs on headache issues in India & the emergence of headache as an issue. As headaches are a cross cutting problem among many health conditions, there is no specific public health program on headaches. However, there are programs like National Programme for Prevention & Control of Cancer, Diabetes, Cardio Vascular Diseases & Stroke (NPCDCS) & National Mental Health Program (NMHP) that cover both the primary & secondary headaches. These health issues that cover both mental and physical aspects are triggering factors for headaches.
The article now moves on to the current situation of headaches in India & the role of Homoeopathy to deal with these headache disorders therapeutically as a component of Ministry of AYUSH. The article suggests the integration of medical pluralism in headache therapy through inclusion of Homoeopathy in the gamete of physical and mental health conditions that are related to headaches.
As each & every drug in Homoeopathy is only proved on human beings, all the drugs have a mental component as it is only human beings who can express their physical & mental symptoms during proving of the drugs as per the guidelines set by the Homoeopathic Research Councils (HRC) of each nation. In India, Central Council for Research in Homoeopathy, an autonomous body under the ministry of AYUSH lays out such guidelines.
The article gains more relevance during the current COVID 19 pandemic which has precipitated the stress levels of population since March 2020 and most of the adults are more prone to headache disorders during their life stage besides finding it difficult to manage these headaches [14, 15, 18, 19].
Keywords: Headache; Homoeopathic Materia Medica; Constitutional medicine; Nosode; Bach Flower Remedy; Bowel Nosode; Miasms
References
Among the developing countries of the world India has made its own identity in the health care department or in the pharmaceutical department. Currently India is considered to be a world of pharmacy of generic medicines. Generic drugs are those drugs which are same as the branded one. This is mandatory that generic drugs only manufactures after expiry of innovative drug’s patent. Generics have an important role to play in public health as they are well known for their affordable prices. After expiry of the patent it is open to manufacture and marketing generic by everyone. According to WHO there is no precise legal definition for widely available worldwide, generic drugs play an efficient role in pharmaceutical expenditures. Generic medicines stay in trend because these are available on a reasonable price in the market which is easy to grab for the Indian market. The healthcare system of India offer generic drugs 20-90% cheaper than original branded drugs. Objective of this study is to provide a high description of what generic drugs are and how these drugs are different from branded or innovative drugs, and what the regulatory and legislative levels of generic drugs are, here we initiate the study from the historical and current regulation of the generic medicines.
References
Diseases are the result of a complex interaction of physical, biological, and economic variables. The term "disease association" refers to the occurrence of two diseases more frequently than would be predicted by chance. To put it another way, diseases are said to be linked when they occur more frequently than one could predict by coincidence. The primary goal of this study is to evaluate the disease association with correlation coefficient in the study region. Total of 115 villages are chosen and 23 villages from the list of ITDP villages have randomly chosen for sampling survey. By using a probability proportional size of the various tribes, a total of 10 households (HHs) from each chosen village have been covered. For all disorders, the correlation co-efficient value computed is 0.019. As a result; they have a strong relationship with one another. Gastroenteritis, typhoid, dysentery, and amoebiasis are closely linked to nutritional deficiency diseases such as anaemia and malnutrition.
Keywords: disease association; ranking; co-efficient; correlation; morbidity
References
Introduction: An athlete's life revolves around their sport. Retirement from sports is a unique transition that influences significant identity, body, and lifestyle changes [1]. While competitive athletes exceed recommendations for physical activity, this only translates into regular physical activity after retirement from sports. Research suggests the nature of competitive sports participation may need to be more conducive to lifelong physical activity [2] Falling out from sports and physical activity leads the body into deconditioning. The study aims to analyze the effectiveness of Pilates in improving speed, agility and back extensor endurance in a deconditioned athlete.
Materials and Methods: The clinical setup for the case study was arranged at VAPMS College of Physiotherapy in Visakhapatnam. The pre and post-tests were performed on the premises of the institution. The subject is a male athlete, a middle-distance runner. The subject received Pilates training four sessions/week for eight weeks for 40 minutes. Speed, Agility and Back extensor endurance were assessed with the outcome measures 20-meter sprint, Illinois agility test and Biering Sorensen test.
Results: Results obtained from the present case study indicate that eight weeks of Mat Pilates improved speed, agility and back extensor endurance. Based on this study, there is a difference in the values recorded pre and post-Pilates training. Two trials were performed for each outcome measure, and the better of the two trials was considered.
Conclusion: The results from the present case study concluded that the Mat Pilates exercise training is effective in the improvement and enhancement of the speed, Agility and back extensor endurance of the athlete. Overall, it shows that an athlete's re-conditioning is possible with Pilates training.
Keywords: Pilates training; speed; Agility; back extensor endurance
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Objective: To determine and analyze the frequency of fetal growth restriction (FGR-syndrome) in pregnant women with hypertensive disorders as a variant of perinatal complication.
Methods: A retrospective analysis of the delivery histories of 2735 women with singleton pregnancies at the regional perinatal center in 2020 was conducted, including 2680 live births (97.9%) and 55 stillbirths (2.21%). Hypertensive disorders during pregnancy were present in 272 women (9.95%). FGR-syndrome in women with hypertensive disorders was detected in 130 cases (47.8%), while in normotensive courses of pregnancies it was 28.2% (680 children from the total number).
Results: A detailed analysis of pregnancy course in 42 women with hypertensive disorders and FGR revealed that gestational hypertension was present in 6 (14.3%), chronic arterial hypertension in 6 (14.3%), and preeclampsia in 30 (71.4%). A high percentage of preterm deliveries occurred in women with hypertensive disorders - 22 (52.38%). The degree of prematurity of newborns according to gestational age was: I - 18 (81.82%), II - 2 (9.09%), III – 0, IV - 2 (9.09%). The number of low birth weight infants for gestational age was 28 (66.67%), and varitable FGR-syndrome of grade 1 (below the 10th percentile) was present in 6 (14.29%) infants, and grade 2 in 8 (19.05%) infants.
Discussion: According to the obtained data on the mass-growth parameters of newborns and analysis using the T. Fenton table (2013), it was established that true FGR-syndrome in women with hypertensive disorders was detected in 33.33% of cases, while in 66.67% there were low-weight babies for their gestational age.
Conclusions: Based on a retrospective study of the course of pregnancy and childbirth, it has been established that women with hypertensive disorders are a high-risk group for adverse perinatal outcomes and the birth of children with congenital anomalies. It is advisable to further analyze and organize possible methods of comprehensive diagnosis of changes in peripheral vascular resistance in the cardiovascular system of the mother and fetus in hypertensive disorders in order to prevent the aforementioned complications.
References
Background: Vacuum suction drainage is an obligatory practice following mastectomy for breast cancer. recent studies showing that the pressure of the vacuum suction drainage is of value in determining the volume of seroma formation and thereby the drain indwelling time, duration of hospital stays and patient morbidity. Half vacuum suction may be of greater value in this regard comparing full vacuum suction drainage.
Objectives: To assess and compare the clinical outcome of half versus full vacuum suction drainage following modified radical mastectomy in breast cancer.
Methods: Forty patients of histologically proven breast cancer had been chosen purposively and systematically randomized in two equal groups. Group A with half vacuum suction (device was squeezed up to half of its vertical length) and Group B with full vacuum suction (device was squeezed to its maximum). The outcome measured were postoperative drainage, drain indwelling time and post-surgery length of hospital stay.
Results: Patients having half vacuum suction had a significantly reduced mean total drainage volume (364.25 ± 128.52 ml versus 822.00 ± 251.30 ml), drain indwelling time (5.50 ± 1.32 days versus 9.05 ± 1.90 days) and post-surgery hospital stay (7.15 ± 2.58 days versus 10.25 ± 2.55 days) in comparison to the full vacuum suction group.
Conclusion: low vacuum suction drain ensures a lower drain collection and were removed earlier and hence reduced the length of hospital stay significantly than high vacuum suction drains.
Keywords: Breast cancer; modified radical mastectomy; vacuum suction drainage; seroma; Drain Indwelling Time (DIT); Length of Hospital Stay (LOS)
References
Epilepsy is a chronic and common neurological condition worldwide. It generates psychological and social suffering in those who suffer from it. In order to objectify the effect of the representations and the experience of the disease on the coping strategies adopted by patients suffering from epilepsy, we conducted research with 46 patients aged 18 and over suffering from this condition.
Our data were collected using a questionnaire, Carver's Brief COPE scale (1997) and a semi-directive interview guide. The data was processed using the Sphinx Plus² program.
Our results show that most patients with epilepsy see the disease as being neurological (80.4%), curable (82.6%), and financially and/or socially burdensome (91.3%). Compared to the experience of the disease, the results show that patients suffering from epilepsy are frequently driven by fear (97.8%), shame (76.1%), a feeling of worthlessness (34.8%) and more adopt coping strategies centered on emotion (73.9%) and other strategies much more specific to the disease and the sociocultural context. Our results showed a significant effect of representations (at the .05 threshold) and illness experience (at the .01 threshold) on coping strategies (adaptation) adopted by patients with epilepsy.
This study therefore calls on health professionals to provide holistic care for patients suffering from epilepsy.
Keywords: Epilepsy; representations; experience; coping strategies
References
Introduction: Bell's palsy is a unilateral weakness or paralysis of the face due to acute peripheral facial nerve dysfunction with no identifiable cause. Peripheral facial palsy is the most frequent cranial neuropathy and can originate from various kinds of damage to the VII cranial nerve. The study aims to determine the effectiveness of the proprioceptive neuromuscular facilitation technique on facial disability in rehabilitation of Bell’s palsy. It also analyses the effectiveness of hold -relax technique between the two experimental groups.
Materials and Methods: This comparative study setup is at VAPMS College of Physiotherapy and KGH Visakhapatnam. A study sample of 20 subjects was selected based on inclusion and exclusion criteria. The subjects are randomly allocated into two groups through random sampling method, an experimental group-1(n=10) received electrical stimulation and facial exercises, and experimental group-2(n=10) received PNF (hold-relax) technique and electrical stimulation for three weeks (12sessions) for 30-40minutes. The subjects' assessment is done using outcome measures of Sunny Brook Facial Grading Scale.
Results: The results show that there is no significant difference between the groups means value of Experimental Group 1 is 57.60, the mean value of experimental group 2 is 60.80, the p-value is 0.2915, and the t-value is 1.0866, which is not statistically significant.
Conclusion: This study concludes that improvement was seen in both groups. PNF with electrical stimulation is slightly more effective than conservative therapy with electrical stimulation. As there is no significant difference according to statistical analysis both the treatments are recommended.
Keywords: Bell’s palsy; Electrical stimulation; Sunny Brook facial grading scale
References
A study was carried out to find out the existing knowledge of students and to develop, implement and evaluate for nursing students about knowledge about safety measure and prevention of covid-19 among nursing students. In the present study non-experimental design was used. The study was conducted at V3 College of nursing at Rudrapur. 100 Nursing students were selected as sample by non-probability convenient sampling technique. Data were collected in 2 parts; part A includes the questions regarding their demographic characteristics and part B the knowledge questionnaire regarding safety measures and prevention of covid-19.1 Section A: description of sample in term of demographic variables. Section B: - it includes 34 questionnaires which are divided into 3 parts Introduction, Safety measures and Prevention.
The study shows that out of 100 samples most of the nursing students (63%) was having moderate knowledge, (36%) students were having inadequate knowledge and (1%) has adequate knowledge. It was revealed that majority of the students (54%) were belonged to the age group of 18-20 Years followed by (42%) age group of 21-23 years and (4%) students were from age group above 24 years. Maximum numbers of students (85%) were females and (15%) students were male. Maximum numbers of students (54%) were belonged to non- medical family background and (46%) students were belonged to medical family background. Majority that is (95%) had previous information about safety measures and prevention of covid-19 while only (5%) do not have previous information about safety measures and prevention of covid-19. Source of information like majority of information was found from television that is (37%), social media that is (35%), other source of information that is (20%) and newspaper that is (8%).
In demographic variables we found that the mean value of Age is 20.5 with SD=1.72, in Gender mean value of male was found 0.15 with SD=1.48 and mean value of female was found 0.85 with SD=8.41, in educational status for B.Sc. nursing mean value is 0.64 with SD=6.33 and mean value for GNM was found 0.36 with SD=3.56, In family income the mean value was 33.33 with SD=18.19, in medical family background the mean value was found 0.46 with SD=4.55 and in non-medical family background the mean value was found 0.54 with SD=5.34, in previous knowledge about covid-19 if yes the mean value was found 0.95 with SD=9.40 and if No the mean value was found 0.05 with SD=0.48 and source of information the mean value was found for newspaper 0.08 with SD=0.78, for television the mean value was found 0.37 with SD=3.66, for social media the mean value was found 0.35 with SD=3.46 and any other the mean value was found 0.2 with SD=1.97.
The chi square analysis was carried out to determine the association between knowledge level and demographic variables. It was evident from result that nursing students were influenced by their Gender, Family income, Family background, previous information about safety measures and prevention of covid-19, and source of information. Here the H1 was accepted for association of knowledge level with variables Gender, Family income, Family background, previous information about safety measures previous and prevention of covid-19 and source of information. By using inferential statistics knowledge level of students were associated with their selected demographical characteristics. In gender the chi square value was found(p=0.271) which is less than the table value at(p=5.99), in family income the chi square value was found(p=4.93) which is less than the table value at(p=9.49), in family background the chi square value was found (p=2.989) which is less than the table value (p=5.99) and previous knowledge about the safety measures and prevention of covid-19 the chi square value was found (p= 0.101) which is less than the table value at ( p=5.99), If yes, source of information the chi value was found (p=7.685) which is less than the table value (p=12.59) at the 0.05 level of significant which clearly indicated that there is association between the these above demographical variables and knowledge of students.
However, demographical variables such as age, and educational status were found to be non-significant. According to age chi square value was found (p=30.59) which is more than the table value (p=9.49), which is clearly indicate that there is no association between the age and knowledge of student. In education status the chi square value was found (p=9.5835) which is more than the table value (p=5.99) which is clearly indicated that there is no association between these demographic variables and knowledge of students.
On the basis of present study, the researcher concluded that most of the nursing students had moderate knowledge about safety measures andprevention of covid-19. Researcher assessed the knowledge about safety measures and prevention of covid-19 to prevent suffering from covid-19. Researcher also open-up new pathway for future studies on the topic for more generalization. This concluded that the how many students are aware about safety measures and prevention of covid-19.
Keywords: covid-19; safety measures; prevention; knowledge; students
References
Introduction: HPV infection is the leading cause of cervical cancer and cancer deaths among women in Cameroon. It constitutes a real public health problem. The aim of this research was to study the factors associated with non-adherence to the HPV vaccine by the parents of young girls aged 9 to 14 in the MIFI Health District.
Methodology: This was a descriptive cross-sectional study with an analytical aim. This study was carried out among the parents of young girls aged 9 to 14 living in the Mifi Health District. The data was collected over the period of May to July 2023; using a face to face administered questionnaire. Questionnaires were administered after obtaining an informed consent from each participant. The data were subsequently compiled using Excel software, then analyzed using SPSS version 25 software. Descriptive and inferential statistics were used to present the results; with a significance threshold set at 0.05.
Results: A total of 430 parents were accessed, of which 83.5% (359/430) of them were female. 34 parents declared to have vaccinated their children against HPV, for a vaccination coverage of 7.9%. 81.6% (351/430) of parents admitted to know about cervical cancer. 55.1% (237/430) of them had never heard of HPV and only 48.6% (209/430) of parents knew that this virus constitutes a risk for their health and that of their daughters. Regression analyzes showed a significant association between vaccination status and knowledge of the disease by parents/guardians [aOR=4.30(3.18-6.76); pvalue =0.001], the fact of not have received information on vaccination [aOR=3.02(1.51-5.65); pvalue =0.003], not having confidence in the vaccine [ORa =5.21(4.33-6.12); pvalue ≤0.001], having never heard of HPV [ORa =5.85 (4.43-6.88); pvalue ≤0.001], fear of side effects [ORa =5.79 (3.17-6.91); pvalue≤0.001], and parent's profession [ORa =4.98(3.35-6.77)); pvalue =0.004)].
Conclusion: Strengthening communication around the importance of vaccination against HPV becomes essential to reduce the incidence of cases of cervical cancer.
Targeted group of people who are the candidate for transplantation and the donor selection criteria is a big chapter. In our common practices organ donation is still cumbersome in way of donor selection, non biasness, matching with patient and some medicolegal issues. Brain death donor or deceased donor would be the ideal organ donor though large, prompt, and dedicated group of medical people and logistics is the prime criteria and is demanding.
A successful Liver transplantation is combined success of two surgery, both donor and receipient and the donor is prime one. Completion of two successful surgery at a time is lead by chief transplant surgeon, co-surgeon, Anaesthetist, Medical team including paramedics, technicians, nurses, and postoperatively by dedicated critical care unit in comprehensive manner which is lead by ICU consultant.
Success is - return to home and maintain quality of life in both donor and receipient. Peroperative good surgical recovery is a finest work of a transplant surgeon and is directly a gift from Allah (swt). Liver surgery in Donor is segmental resection, lobectomy, partial hepatectomy. In receipient it’s a wide work in liver parenchyma, Major vascular structures and in biliary tree. This finest anastomosis is the key to successful outcome.
Immediate postoperative recovery is very vital. In donor –fluid management, nutrition and pain management with coverage of broad spectrum antibiotics and closely observe the immediate response of residue liver by biochemical analyzer. In receipient- start from whether receiving the organ in new host and then proper functioning of vascular and biliary anastomosis. Total calorie value estimation, fluid and pain management with control of sepsis is a finest co ordination. Every hours maintenance of intake output, meet up exact calorie demand, fluid management by measuring CVP (central venous pressure), orotracheal clearance and lungs care is the prime concern for good functioning of newer receipient tissues.
Execution of first 24 -72 hrs services –A group of ICU doctor, nurses, patient care attendant, ward boy, cleaners participation is mandatory. A good handover of Doctor – Doctor, Nurse – nurse is a safe transfer of patient to a safer one. In our common practices many mishaps are conducted by negligence, ignorance of medical team which was avoidable if prompt/alert action was taken immediately even in mid night. Should be kept in mind this initial hours of monitoring has no day night. This is in count of hours – for a good recovery.
A transplant surgeon should have the vast knowledge not only in surgery but also in critical care / Acute care services. Good co ordination is mandatory with critical care team and transplant team. In near future we wont loose any diseased with lack of organ and comprehensive services.
Organ transplantation is a milestone development in holistic medical services. An organ failure person can feel the misery of life in every moment. In that time a kind hearted angel of earth has devoted a well functioning organ to love ones by keeping risk in own life. The bridging of that super work between patient and donor is accomplished by a team of dedicated health care group of workers.
Liver is most rapidly regenerating organ and works in multiple ways. Transplantation of Liver is not only a focused work but also fine co-ordination of larger group of medical workers and lead by transplant surgeon who is actual hero of our society.
Spoken words extend human energy, interrelating with other energies and surroundings. This combination modifies their energetic picture in motion, which can maintain, improve, or decline their functionality. Evidence in clinical practice has shown that positive energy resulting from these interactions improves cell functionality; suitable and helpful word energy use in disorders management benefits everyone involved in patient care, including providers, clients, their dear ones, and families. Therefore, the medical team must model and use positive speech energy to improve patients’ emotional well-being, ultimately leading to increased satisfaction, better experience, business or corporate efficiency, enhanced reputation, and long-term client relationships. An increase in return on investment validates their work effectiveness, improving personal, professional, and social life satisfaction.
By contrast, aggressive words energy use in collaboration with others declines cell functionality in fragile areas, leading to disorders such as dyslipidaemia, type 2 diabetes, other endocrine diseases, arterial hypertension, and even brain haemorrhage or tumour. These disorders can be attributed to genetics and the frequency and magnitude of exposure to inappropriate communication. Words and tone misuse generate discomfort and decline the production process, altering mainly the emotional lives of collaborators. Deceptive people interactions harm the individual equilibrium.
Personal attitudes, words, and voice nuances validate individual thinking and abilities to use knowledge in collaboration with others. Expertise in the domain prepared for, fast and efficient data handling, building trustful, respectful relationships with partners, professional behaviour in society, and appropriate voice utilization in daily work are all essential to ensuring a prosperous personal, professional, social, and emotional life. These drivers contribute to the success of any endeavour.
Professionally speaking, sharing the presence, applying info in practice, and dealing with adversities make an individual esteemed and appreciated in the community they serve.
Unprofessional conduct in daily work causes detriment to all parties involved in affairs.
The healthcare industry professionals can utilize voice analytics for managing various disorders. They can focus on respiratory and heart functioning, nervous system control, distribution and composition of human body fluids, velocity, digestive, endocrine abnormalities, or environmental characteristics. Voice can be used as a clinical sign offering adequate details for analysis and decision-making in clinical practice.
Subjective or AI for voice analysis are options for disease management in the digital age, according to preferences and financial capacity, to adhere to new monitoring algorithms.
The speech analytics market has several major vendors, including Almawave, Avaya, CallMiner, Chorus.ai, Cogito, Dialpad, Genesys, Invoca, NICE, OpenText, Plum Voice, Prodigal, Qualtrics, Salesken, Talkdesk, Tether, and Verint. Speech analytics solutions are mainly utilized by industry verticals such as retail, telecom, banking, healthcare, travel, and hospitality. NICE, CallMiner, and Verint are the speech analytics industry’s top performers and market leaders.
Promising projects using AI for voice analysis conduct to healthcare advancement. AI provides a fast diagnosis, but even without technological progression, we can make a clinical diagnosis by just using an individual's face and hand info and listening to a few words.
In today's digital age, voice analytics has become an essential tool for businesses; analysing voice data allows them to gain valuable insights into clients' behavior and preferences. This info helps businesses to improve their clients' offerings, individualize marketing works, and ultimately increase revenue. With technological advancements, voice analytics has become more precise and effective; it is an increasingly current choice for businesses of all sizes.
People perform activities in line with their expertise. Typically, they communicate with others using either spoken or written language, which reflects their mental processes. The tone, pitch, and speech patterns used in communication are influenced by genetics, education, medical and social history, environmental factors, and venture. Any evolving medical conditions may also impact how someone communicates with others.
In-person verbal and non-verbal communications and non-in-person oral communications [phone calls] have varying effects on the individual based on subject matter, solicitation degree, and communication skills.
References
The "Healthcare Surveillance of PCOD" study aims to understand the prevalence, symptoms, management strategies, and perceptions of PCOD among patients. Findings indicate that PCOD predominantly affects unmarried women in the age group of 18-25 years, with the most common symptoms being irregular periods, weight gain, acne, hirsutism, hair loss, and infertility. The majority of patients sought medical intervention, with a significant proportion opting for medication and diet and exercise. The perception regarding management of PCOD through lifestyle changes varied, with some believing it to be effective, while others expressed scepticism. Lifestyle changes were adopted by a majority of patients, with varying levels of success reported.
Keyword: PCOD; irregular periods; hair loss
References
Tuberculosis has been one of the leading causes of high morbidity and mortality even in advanced science now a days. Tuberculosis is concerning for resistance pattern and MDR TB. Long term therapy is contravening factors for developing resistance as majority times patient are careless for follow up and discontinue medications after apparent improvement. Gastrointestinal TB accounts for 3% of extrapulmonary TB. The most common site of involvement being the ileocecal region. Vermiform appendix lies in close proximity to ileocecal area. Despite this, incidence of TB in appendix is rarely reported. There are no pathognomic signs and symptoms to prompt preoperative diagnosis of tubercular acute appendicitis. Diagnosis is usually made after histological reports of the appendix. Incidence of appendicular TB in all appendectomies has been reported varying from 0.1 to 0.3%, 1-3. This case report shows a female admitted with features of acute appendicitis and was operated on emergency basis. Her appendix surface was grossly reddened, thick, edematous, short and firmly adhered with cecum. During appendicectomy cecal serosa was injured and repaired. Histopathology reveals appendicular TB. Patient was treated according to anti TB regime.
Keywords: TB; V Appendix; HPR; Anti TB drug
It is a fact, although unknown to many, that the first hospital use of drug that would be named as antibiotic, was the so called pyocyanate prepared by Rudolf Emmerich and Oscar Low, two German physicians, in 1899 from Paeudomonas aeruginosa. However, the accidental discovery of penicillin by Alexander Fleming in 1928 was an event that re-defined treatment of infectious diseases, but was short-lived as it was soon discovered that microbial pathogens amplified their armamaterium to dwarf this very high hope.
Drug companies were very interested in Alexander Flemming’s discovery and started making penicillin for commercial purposes, which was widely used for treating soldiers with battle wounds and pneumonia during World War II. From mid- to late 1940s, it became widely accessible for the general public use. However, in the 1930s, the first commercially available antibacterial agent called Prontosil, a sulfonamide was developed by a German biochemist called Gerhard Domagk. In 1945, penicillin was introduced on a large scale in the treatment of bacterial infections, especially through the work of Howard Florey and Ernst Chain, who efficiently purified penicillin and scaled-up production.
The introduction of penicillin marked the beginning of the’ golden era of antibiotics’ classes for use in medicine, when antibiotics were discovered and introduced to the market between 1940 -1962. Each class contained several antibiotics which were discovered and modified versions of earlier types. Today, very few novel antibiotics are being developed while antimicrobial resistant bacteria that survive antimicrobial treatment are on the increase. These bacteria render most antibiotics ineffective or useless, which has further complicated this global health burden.
The time-line of the discovery of different classes of antibiotics in clinical use, otherwise known as “the discovery void’ refers to the period from 1987 until today, as the last antibiotic class was introduced for treatment of infectious diseases in 1987.
Bacteria use several mechanisms of drug resistance, some of the major ones of which include: 1) Drug inactivation using bacterial enzymes, 2) structural modification of drug’s target site by mutation, 3) reduction of drug intake through lowering of bacterial cell permeability, 4) drug efflux outside the bacterial cell membrane etc.
The AMR crisis due to increasing global incidence of infectious diseases is affecting the human population. This thus threatens human and animal health, and welfare for food and nutrition security, the environment, economic development as well as equity within societies.
Some causes of antibiotic resistance include: 1) over or under-prescription , 2) patients’ inability to complete antibiotic course, 3) overuse of antibiotics in livestock and fish farming, 4) poor sanitation and hygiene, 5) poor access to quality drugs, 6) poor infection and disease prevention and control in healthcare facilities, 7) lack of access to clean water, sanitation, and hygiene (WASH) for both human and animals, 8) self medication and 9) non-application of one health as a preventive strategy.
World Health Organization categorised antibiotic resistant bacteria into 3 groups, as mainly critical, high and medium priority; critical group include Pseudomonas aeruginosa, Acinetobacter baumannii and members of the family Enterobacteriaceae, aetiological agents of pneumonia and blood stream infections, the high and medium priority group include drug resistant bacteria like Salmonella that causes common infections like gastroenteritis, diarrhoea, food poisoning and Neisseria gonorrhoeae, a sexually transmitted pathogen.
The prevalence of drug resistance limits therapeutic options for the treatment of infectious diseases, thus contribute to the specter of “post-antibiotic era" in which most antibiotics are already ineffective.
The consequences of multiple drug resistance is the emergence of the superbugs, which are strains of bacteria, parasites, fungi, and viruses, that are resistant to most of the antibiotics and other medications used in the treatment of their infections. Superbug refers to bacteria which infections cannot be treated with two or more antibiotics. Examples of superbugs include drug resistant bacteria that cause pneumonia, complicated urinary tract infections (cUTI), skin infections etc. Infections by superbugs can however be successfully treated, although, they are much more challenging to treat and manage. A few examples are methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterbacteriaceae (CRE), vancomycin-resistant Enterococcus (VRE), multi-drug resistant Pseudomonas aeruginosa (MRPA) and multi-drug resistant Eshcerichia coli (MREC).
The loss of efficacy by antibiotics surely undermines man’s ability to fight and win the battle against infectious diseases and manage complications among vulnerable patients especially those undergoing chemotherapy, invasive treatment procedures, surgery and organ transplantation.
Various options are applied in the treatment of antimicrobial resistant bacterial infections such as combinatorial drug approaches, antimicrobial polymeric bio-material products, bio- nanotechnology approach, among others.
Therapy against superbugs particularly employ two major methods: 1) pathogen-directed therapeutics approach which decreases bacterial toxicity by alteriing their virulence factors and 2) the host-directed therapeutics approach which limits the superbug by modulating immune cells, enhance host cells’ functions and effectively modify disease pathology. Where the first line and second line antibiotic treatment options are limited by resistance or are unavailable, healthcare providers are compelled to use toxic antibiotics in the treatment of patients, which often result in high treatment cost, definitely less effective treatment characterised by high mortality, longer hospital stay, delayed recuperation and long term disability.
Conerted efforts are required to fight the spread of AMR, some of which are : 1) prevent infections from occurring and preventing resistant bacteria from spreading, 2) minimise the use of broad spectrum antibiotics and promoting the use of narrow spectrum antibiotics, 3) tracking drug resistant bacteria, 4) promoting development of new antibiotics, 5) building on the foundation of proven public health strategies, 6) immunization, 7) infection prevention and control, 8) protecting food supply, antibiotic stewardship and 9) minimizing person-to-person transmission or spread of infections, by screening, diligent treatment and education.
Preventive measures must be taken to minimise the menace of AMR, through rational use of antimicrobial drugs whenever necessary. Healthcare professionals should endeavour to promote drug safety awareness. The proper use of disinfectant must be practiced by both patients and health-workers, so as prevent nosocomial spread of multiple drug resistant bacteria.
In the global attempt at mitigating AMR, nearly 43 new antibiotics are in clinical development by the top 50 pharmaceutical companies with significant antibacterial properties against life-threatening infections, 18 of which have shown potential action against drug resistant Gram negatives and 10 others against Neisseria gonorrhoeae.
While attempts must be made to search for the best treatment strategies against super bugs, as resistance can easily be developed against new and novel antibiotics in the nearest future, rational antibiotic use and proper hygiene practices among patients and health-workers should be compulsory.
Antimicrobial resistance (AMR) is one of the most serious health threats worldwide. Infections from antimicrobial resistant bacteria are now very common as some of these pathogens have shown resistance to multiple types or classes of antimicrobial agents. This has been a very difficult problem the global healthcare sector has to grapple with over the years.
According to World Health Organization in 2019, the total annual deaths due to drug resistance was 4.95 million deaths, out of these, 1.27 million deaths were due to AMR bacteria, which is even more than those from Human immunodeficiency virus (HIV). The WHO lists AMR among ten threats to global health.The economic impact of AMR is enormous as it is estimated at 1.1% of gross domestic product (GDP) reduction, which is projected to exceed US$ one trillion annually across the world. The AMR cost could cost from $300 billion to over $1 trillion annually by 2050 worldwide.
References
Drug and alcohol use is a major public health concern in the United States, as college-aged adults seem to be at the forefront of national statistics due to the commonality on campuses. Research is coming out that determines further understanding of what causes college students to drink and use drugs, but there is a lack of knowledge and literature on the point of view of college athletes. The current study used an online system, the Youth Risk Behavior Survey (YRBS), to address different aspects and consistency of the usage of drugs and consumption of alcohol. The study observed tendencies of college athletes, N=243, M(age)= 19.8, that participated over many sports including baseball, football, men’s basketball, men’s cross country, men’s track, softball, volleyball, women’s basketball, and women’s track. Results of the survey showed that these students had their first sip of alcohol and tried marijuana for the first time at an early age. The survey also showed over half of the participants admitted to binge drinking in the past month, as well as collectively using alcohol and marijuana in the past 30 days as well, among other statistics. Findings and discussion determine that college student athletes are more likely to binge drink, and less likely to engage in drug usage, due to being strictly monitored and regimented with their athletic commitments and having the feeling of missing out on college experiences. These results suggest that more alcohol and marijuana educational programs should further target student-athletes.
Keywords: alcohol; drug use; marijuana; binge drinking; college athletes; college
References
Traditional medicine (TM)/folk medicine (FM) has had a profound impact in Vietnam, with it being a mainstream medical practice, though which has been slowing phasing out, in the country and TM/FM coexisting with modern western medicine. Within Traditional medicinal practices in Vietnam, there are two kinds of Traditional medicine - Thuốc Nam i.e., Southern Herbology/medicine and Thuốc Bắc, i.e., Northern Herbology/medicine. The former is indigenous Vietnamese traditional medicine which developed from Vietnamese folk knowledge, whilst the latter is traditional Chinese medicine introduced from centuries of medical exchanges between various Chinese and Vietnamese dynasties. (Adorisio S, et al., 2016) This will cover both practices as one.
Communication skills with the people in need, as required, make their work different from that in other industries. The evidence in clinical practice shows the benefit of kind-hearted work for all parties: patients, their families, and the medical team. Medical professionals who resonate with people’s suffering are preferred to those who bring down the emotional involvement in care. Kind words, friendly attitudes, respect, generosity, encouragement, and consideration for helpless seniors aid in restoring and improving health, offering a warm, calming, and peaceful light that alleviates distress.
By contrast, disheartened doings disappoint the patient and decrease their loyalty towards their healthcare provider and adherence to the therapy plan. The negative experience during an episode of care may cause the patient and their loved ones to look for another provider from the offerings for future episodes of care. As a result, the provider may experience a decrease in their investment return, affecting their business continuity and growth, professional name, and advancement.
Therefore, how an individual applies the knowledge in practice, interacts with customers, collaborators, and other community members, and shares their presence impacts their reputation and quality of life.
The patient experience reflects the medical professional’s skills in handling their data and communicating with them in various contexts. A provider who carefully examines the medical and social history of the patient and makes alliances with them and their loved ones in managing disorders is likely to have better results in practice. By considering an individual's medical and social history, the provider can correlate past and existing data and make accurate decisions.
Respecting patient preferences in therapy plans is essential; reflecting on their financial situation and time availability, the most beneficial therapy options for them will be selected.
Patient involvement in the therapy plan supposes the art of communication with them, understanding their feelings determined by affected human body functioning, and reducing fears of possible remaining work impairment. Encouragement, lowering pain, and emotional support for them and their dear ones create a model of care for sustaining and advancing life quality, which benefits providers and end-users. As a result, their positive comments can increase the number of new customers, ensuring the healthcare business’ prosperity and continuity.
That’s why kind-hearted work ensures a better life; it should be acknowledged as essential in business development and advancing one's career.
Contrarily, deceptive people’s interactions affect their health and wealth.
The impact of different communication styles on patient’s experience, business continuity, and personal life should be comprehended.
How individuals interact with different parts of society defines their professional and social lives.
People continuously sell and buy products or services as necessary since no one can produce and own everything. To do that, they must interact with each other. Their ability to communicate virtually or in-person can consolidate or deteriorate future relationships. Virtual interaction is preferred because it is low-cost and time-saving, without travel expenses. However, in-person collaboration provides more comprehensive data about an individual, which is necessary for building and extending further connections.
In the healthcare industry, professionals work tirelessly to alleviate suffering and save lives. They must have expertise in a specific area, handle data quickly and efficiently in practice, have excellent interpersonal skills, offer compassionate care, and commit to ethical behaviour. These elements come together to define professionalism in healthcare.
References
The second most prevalent cancer in women globally and the primary disease in Indian women is cervical cancer, which is mostly caused by infection with the Human Papillomavirus (HPV). Although there are a number of ways to prevent cervical cancer, vaccination is now thought to be the most effective strategy due to the availability vaccinations in the market. The efficiency, immunogenicity, and safety of the vaccination have all been the subject of several research. Particularly in the Indian scenario, there are still concerns and disagreements over immunization requirements, the need for booster shots, and cost- effectiveness.
More than one-fourth of malignancies worldwide associated with infection are caused by the human papillomavirus (HPV). In this paper, the high risk types of HPV in India are summarized, with a particular emphasis on rural parts of Odisha.
The spread caused by human papillomavirus (HPV) is diverse and varies from region to region. Given the limited cross protection provided by the current HPV vaccinations, it is crucial to comprehend the distribution of HPV genotypes among the various populations in order to predict the effectiveness of the present vaccine and develop alternative vaccination strategies. The current study focused into the distribution of HPV genotypes in women in Orrisa, in rural parts.
Keywords: Human Papillomavirus (HPV); cervical cancer; vaccinations
References
Background: Self-medication (SM) is practice of using medication without professional guidance which is prevalent across communities worldwide. Without visiting or communicating with a healthcare provider, many people self-diagnose a physical or mental illness in the hopes of alleviating their symptoms. Without seeing a doctor, taking medication can be risky and even result in addiction or dependence.
Methods: This cross-sectional survey was conducted in the chosen wards of Dhangadhi sub-metropolitan city among 291 community people using a pretested and validated questionnaire. The study was conducted from March 2023 to August 2023. Data was analyzed by using SPSS V.25 and presented in tables.
Result: The mean age of the participants was 33.15±12.25 years. Majority of participants (77.7%) practiced self-medication within last three months. Antibiotics, analgesics, and antipyretics were the most common drug classes used in self-medication. The common symptoms/conditions for self-medication were a common cold, headache, and fever. The most frequent justifications for self-medication were minor illness 197 (87.2%), followed by lack of time to visit doctors 92 (40.7%), and due to high fees of doctors 86 (38.1%).
Conclusion: Self-medication was found to be common in Dhangadhi sub-metropolitan city. Government should enhance education and information about the dangers of self-medication if not done appropriately and improve the control of selling prescription drugs in pharmacies.
Keywords: Self-medication; Community-based; Drug use; Practice; Prevalence; Nepal
References
Background and Purpose: Usually resistance training can only be done in the active state. The difficulty of upper limb rehabilitation of stroke patients lies in the inability to complete resistance training on the antagonistic muscle groups with high muscle tension. The vast majority of stroke patients experience upper limb or arm extensor muscle weakness, and many lose the strength of their antagonistic muscle groups, preventing them from performing progressive resistance training, resulting in a large number of stroke patients with long-term upper limb disability. We took the lead in proposing induced passive resistance training to form passive resistance thinking and mode that activated antagonistic muscle groups in the upper limb of stroke, and selected stroke patients who were more than one year old and still had obvious flexion spasm in the upper limb as demonstration objects to observe the intervention effect of this method on abnormal muscle strength.
Methods: Functional acupuncture and passive resistance of upper extremity extensor group induced by Professor Yan Zhi were the main intervention methods. Implementation requirements are as follows: a) Selection of therapeutic positions. b) Selection of intervention site. c) Selection of strength and waveform. d) Real-time evaluation of intervention effects after intervention. e) Multi-task intervention training of upper limb extensor muscle group after treatment.
Results: After 20 minutes of intervention, flexor tension of upper limb, elbow joint, wrist joint and finger joint was improved obviously, extensor function of elbow and wrist joint was recovered obviously, elbow extension resistance function of left upper limb was recovered obviously. After one month of the above intervention treatment, the abnormal muscle tone of the left upper limb of the patient was significantly reduced, the elbow extensor strength score was increased from 0 to 5, and the flexion spasm of the upper limb was significantly improved in multiple scenarios.
Conclusion: The demonstration of this method highlights the significance of three aspects: A) Patients with upper limb flexion spasm more than 1 year after stroke with this method showed obvious intervention effect immediately. b) To confirm that functional acupuncture and medium-frequency induced passive resistance training are the most effective methods for the intervention of abnormal muscle tone in the upper extremity. c) The control of intervention dose and the repetition of precise rehabilitation training have a positive effect on the improvement and continuation of the therapeutic effect.
Keywords: Passive resistance training; Abnormal muscle tone; Stroke
References
Background: Learners continued learning and preparing for their final examinations during COVID-19 pandemic. However, the extent to which the pandemic had affected the mental health status of these learners was largely unknown. We investigated psychological indexes among secondary school pupils in Lusaka, Zambia in the era of the on -going COVID -19 pandemic.
Methodology: A cross-sectional study was conducted among pupils attending secondary schools in Lusaka district between June and September 2020. Five out of sixteen high secondary schools were randomly selected from the list. Insomnia severity Index, a rating instrument for anxiety and a patient health questionnaire for depression were used to collect data. Data analyses were conducted using IBM SPSS®. Statistics 20. Adjusted odds ratios (AOR) and their 95% confidence intervals (CI) are reported.
Results: A total of 1333/1800 (74.1%) pupils participated in the survey. Males were 792 (59.4%). The majority (60.4%) of the pupils were aged between 12-19 years. Age, gender, marital status and religion were associated with anxiety (p < 0.05). Pupils of age 12 - 19 years were 25% (AOR=1.25, 95% CI [1.11, 1.42]) more likely to have anxiety compared to those aged 20 - 25 years. Gender was the only factor that was independently associated with insomnia. Male pupils were 13% (AOR=0.87, 95% CI [0.77, 0.97]) less likely to have insomnia than female pupils.
Conclusion: Insomnia, depression and anxiety were common among learners especially among female students in their final year of their secondary education. The government should develop policy that compel schools to provide psychological services for the learners and more targeted at female students and younger learners.
Keywords: COVID-19 pandemic; High school, Pupils, Adolescents; Insomnia; Anxiety; Depression
References
Primary adrenal insufficiency is a disorder of adrenal cortex characterized by deficiency of glucocorticoid and mineralocorticoid. It has various causes which includes infective, autoimmune, neoplastic, congenital, iatrogenic and others. Autoimmune etiology is the commonest cause of adrenal insufficiency in developed country where as in developing country it is the infection which is the leading cause. Prompt diagnosis is necessary in this case as delay in initiation of treatment might cause fatal outcome. This is a cause of primary adrenal insufficiency in a young boy due to rare genetic cause.
Vaginal Microbiome and RPL
The vaginal microbiome plays a crucial role in women's reproductive health, particularly during pregnancy and the postpartum period. Research has shown that substantial changes occur in the composition of the vaginal microbiome following the end of pregnancy Nunn et al. (2021). These changes are associated with hormonal fluctuations, menstrual flow, cervical and vaginal secretions, and sexual activity (Walther-Antonio et al., 2014). Disruption of the vaginal microbiome has been linked to various pregnancy complications, including recurrent miscarriages, preterm birth, intrauterine infection, and stillbirth. Moreover, the maintenance of vaginal microbiota has been highlighted as an important factor in achieving ideal pregnancy outcomes (Celik et al., 2022). Furthermore, the vaginal microbiome has been studied in the context of premature ovarian insufficiency, recurrent implantation failure, and unexplained infertility, highlighting its potential role in RPL (Rezende et al., 2023; Patel et al., 2022; Lk et al., 2019). The vaginal microbiome undergoes significant changes during pregnancy, characterized by reduced diversity and increased stability, with a dominance of Lactobacillus species (MacIntyre et al., 2015; Serrano et al., 2019; Freitas et al., 2017; Walther-Antonio et al., 2014; Morselli et al., 2022; Nunn et al., 2021). Studies have identified specific microbial species that are commonly found in the vaginal microbiome, including Lactobacillus crispatus, Lactobacillus iners, Lactobacillus gasseri, and Lactobacillus jensenii, which are known to dominate the vaginal microbiome in healthy individuals (Doyle et al., 2018; Chang et al., 2020). The presence of other microbial species, such as Gardnerella vaginalis, Prevotella, and Megasphaera, has been associated with alterations in the vaginal microbiome and gynecological conditions (Putonti et al., 2021; Mu et al., 2019). Additionally, Grewal et al. (2022) reported low co-occurrence of L. crispatus, a species associated with vaginal bacterial stability, with other microbial species in RPL cases. Moreover, the association between gut dysbacteriosis and an imbalanced cytokine network in women with unexplained miscarriage has been identified, highlighting the potential role of gut microbiome dysbiosis in adverse pregnancy outcomes, including RPL (Liu et al., 2020). The microbiome in the female reproductive tract, including the endometrial and vaginal microbiota, has been associated with RPL, suggesting that microbiota composition may play a role in the etiology of RPL (Peuranpää, 2021; Peuranpää, 2022).
Need for studies in RPL and vaginal microbiome
Conducting studies on the relationship between the vaginal microbiome and recurrent pregnancy loss (RPL) is crucial for several reasons. Firstly, for investigating the vaginal microbiome in individuals experiencing recurrent pregnancy loss can help identify specific microbial factors or dysbiosis patterns associated with increased risk. This knowledge is essential for understanding the root causes of RPL. Secondly, these studies can lead to discovery of novel microbial biomarkers associated with recurrent pregnancy loss. Establishing such biomarkers could facilitate the development of diagnostic tools that help identify individuals at risk of RPL, enabling early intervention and personalized care. In addition, it can also contribute to the development of targeted therapeutic interventions based on the modulation of the vaginal microbiome. Understanding how specific microbial profiles influence pregnancy outcomes may lead to novel treatments or preventive measures. Studies can help in categorizing individuals into risk groups based on their vaginal microbiome composition. This risk stratification can guide healthcare providers in tailoring interventions and monitoring strategies for those at higher risk of recurrent pregnancy loss. Insights into the role of the vaginal microbiome in recurrent pregnancy loss can enhance the success rates of assisted reproductive technologies. Optimizing the microbiome environment may improve outcomes for individuals undergoing procedures like in vitro fertilization (IVF). Understanding the interplay between individual variations in the vaginal microbiome and recurrent pregnancy loss allows for personalized medical approaches. Tailoring interventions based on a person's unique microbial profile can enhance treatment effectiveness. As recurrent pregnancy loss has significant emotional and economic implications, studies on the vaginal microbiome can have a broader public health impact. Insights gained may lead to interventions that reduce the overall burden of RPL on individuals and healthcare systems. In summary, studies on the vaginal microbiome and recurrent pregnancy loss are essential for advancing our understanding of the underlying mechanisms, improving diagnostic capabilities, and developing targeted interventions to enhance reproductive outcomes for individuals experiencing RPL.
Recurrent pregnancy loss (RPL) is a significant reproductive health issue, particularly in India, where the prevalence and risk factors associated with RPL are of particular interest Patki & Chauhan (2015). RPL is defined as the spontaneous loss of two or more consecutive pregnancies before 20 weeks of gestation (Kashyap et al., 2023). Research has explored chromosomal abnormalities among cases of recurrent spontaneous abortions in India, indicating the importance of cytogenetic analysis in investigating the causes of RPL (Janani et al., 2016). Furthermore, the association between diminished ovarian reserve and RPL has been studied, emphasizing the need for a comprehensive understanding of the factors contributing to RPL in the Indian population (Abohashim et al., 2022). Understanding the prevalence and etiology of RPL is crucial for developing targeted interventions and improving reproductive outcomes for couples affected by this condition. Recent research has focused on understanding the relationship between the vaginal microbiome and RPL.
References
This study investigates the influence of hospitals built with conventional architecture compared to those built using neuroarchitecture which is a branch of architecture that considers the impact of design on cognitive and emotional responses, particularly in relation to stress reduction. A device sensitive to skin impedance was used to measure symptoms of stress. A total of 28 participants were shown two videos, one featuring conventional architecture and the other showcasing neuroarchitecture. Additionally, the Depression, Anxiety and Stress Scale - 21 Items (DASS-21) questionnaire was administered to assess the symptomatology of stress, depression, and anxiety. Significant differences in skin impedance were found between subjects exposed to Neuroarchitecture and Conventional Architecture environments. In the Tococirugía data, Neuroarchitecture showed an average impedance of 355 kΩ compared to 287 kΩ in the conventional environment. Similarly, in the UCIN data, Neuroarchitecture had an average impedance of 302 kΩ while the conventional environment had 230 kΩ. For the UTIN data, Neuroarchitecture exhibited an average impedance of 377 kΩ, whereas the conventional environment had 235 kΩ. The DASS-21 questionnaire results indicated higher levels of moderate stress (53.5%) compared to mild anxiety (46.4%) and mild depression (50%) among medical personnel in the evaluated clinical services.
References
Road traffic accidents are on the increase despite interventions implemented by states, stakeholders and partners. World Health Organization (2018) has reported that more than 1.35 million people die every year on the world’s roads, making road traffic injuries a leading cause of death globally. Most of these deaths occur in low- and middle-income countries where rapid economic growth has been witnessed in recent years, in spite of COVID 19 pandemic, which interfered with global health and economies. In Kenya 3500 people die each year due to road crashes, while nearly 1000 are left with life threatening disabilities.
The purpose of this study was: To investigate major determinants that are associated with road traffic accidents which have also been identified by other researchers that have directly or indirectly contributed to accidents causation both in developed and in developing countries, particularly in Asia and Africa including Kenya. A systematic review was used to review the most current researches that have been conducted on road traffic accidents that caused deaths and injuries to significant road users. Literature search was conducted, using Google-scholar and Pub med. The review used 58 most current studies from a total of 120.
The study findings: Revealed that there is an increase in the number of vehicles praying on the roads, coupled with an increase of population and especially those using vehicles, and motorcycles. Intentional violation of traffic rules was reported. Poor implementation of road safety network, poor planning and design of road infrastructures were identified. Poor mechanical conditions of vehicles, over speeding, overloading, uncontrolled and mixed traffic environment were equally cited. Again, road “users” and drivers’ behavior, have significantly contributed to the increase of road traffic accidents, contributing to mortalities and morbidities. The commonly affected people are pedestrians and passengers who are between 15-29 years of age.
Conclusion: Factors contributing to accidents causation include; increased vehicles and vehicular use and human factor leading to intentional violation of traffic rules; bad roads, over-speeding and over-loading was identified to be associated with road traffic accidents. Likewise, use of unroadworthy vehicles, errors of other significant road users, poor implementation of road safety measures and poor planning and design of road infrastructures were also identified.
Recommendations: Sustainable road safety to be based on individual road user’s decision, geared towards personal responsibility, tailoring traffic environment to human characteristics by training and education, improving road network, control of speed, direction and mass to vulnerable road users.
Keywords: road traffic accidents; traffic injuries; morbidities and mortalities; sustainable safety
The WHO defined palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual” [1]. In other words, it is a holistic care that improves the quality of life of the patients as well as their families. Evidence from various studies reveal that more than 90% of the cancer patients spend most of their time in hospital during their terminal period and about 70% of them die in hospital settings without their nears and dears in front of them. These patients often get a curative care only and are usually devoid of the “total care’ that includes physical, social, psychological and spiritual support.
India is a resource poor country; with shortage of manpower, money and materials in healthcare. Therefore, to deliver palliative care at the grassroot level for the rural poor population of India, it should be delivered by a multidisciplinary team comprising of family members, community volunteers, social workers, spiritual leaders in addition to the doctors and nurses who can provide symptomatic care to the patient. A good example of this is the Neighbourhood Network of Palliative Care (NNPC) in Kerala which is the first WHO Collaborating Centre for Community Participation in palliative care.
Though with limited awareness and coverage, history of palliative care in india dates back to 20 years or mid- 1980s when people used to think that palliative care is for cancer patients only. So, the first facilities to deliver palliative care in India were within cancer centres at places like Ahmedabad, Bangalore, Mumbai, Trivandrum, and Delhi. Another milestone in the history of palliative care development in India was establishment of Indian Association of Palliative Care (IAPC). The first hospice in India, Shanti Avedna Ashram, in Mumbai, Maharashtra, was opened by Professor D’Souza in 1986. Can Support in Delhi was established in 1997 which was the first centre in North India to deliver home care palliative care services. The availability of morphine was again a big hurdle in India. The Narcotic Substances and Psychotropic Substances (NDPS) act of India in 1985 further added to the difficulty in the procurement of morphine leading to a remarkable drop in its use in the subsequent years. In 1998 Indian government gave instructions to all state governments to amend their narcotic regulations, but the response was not good. Various workshops were held in lot of states regarding this issue and among them Kerala showed a significant improvement in access to opioids. Two important events that contributed to the progress of palliative care were designation of the Institute of Palliative Medicine at Calicut, Kerala, as a WHO Collaborating Centre for Community Participation in Palliative Care and Long-Term Care in 2010 and of Pallium India’s Trivandrum Institute of Palliative Sciences (TIPS) as a WHO Collaborating Centre for Training and Policy on Access to Pain Relief in 2012 [2].
But inspite of increasing progress in the field of palliative care in India, only 1% of Indian population has access to it. India is rated lowest among all countries in the use of opioids. National programme for palliative care was formulated in 2012 but it is lost under lack of funds [3]. Need of an hour is to include palliative care in the primary health care so that it is accessible and affordable to all rich and poor. Not only the health care professionals but the general community should be made aware that palliative care is the continuum of care that should be started with the diagnosis of any long term or life limiting illness. Volunteers with leadership qualities should be included in the programme to enhance community participation and make the general community more receptive. The emphasis needs to be shifted from the quantity of life to the quality of life. Efforts have been started by the government and a lot of barriers have been overcome but still lot is needed to be done. The policies and programmes that are made need to be implemented stringently to bring about a change.
References
According to The UN's State of World Population Report 2023 India will become the world's most populous country by mid-2023, surpassing China's 1.425 billion people by about 3 million. India is a developing country and presently facing a big demographic transition in terms of rising population size, population growth and increase in life expectancy. Though the working population is increasing (demographic dividend) but at the same time elderly population is also rising. Also, our country is facing the dual burden of diseases both communicable and non-communicable or lifestyle diseases. Keeping in view of the above scenario, inclusion of palliative care in the primary health care is the need of an hour.
References
The most prevalent modifiable cause of atherosclerotic cardiovascular disease is hyperlipidemia. The notion of the inverse link between the onset of a major adverse cardiovascular event and non- high-density lipoprotein (non-HDL) and low-density lipoprotein (LDL-C) cholesterol has emerged from our understanding of controlling hyperlipidemia. An overview of lipids and their metabolism will be given in this review. It will also address hyperlipidemia and therapeutic strategies for it.
Keywords: low density lipoprotein-cholesterol; statin-induced myopathy; lipid metabolism
References
This study determined if social support and parental stress as factors could predict resilience among caregivers of autistic spectrum disorder. The study further examined if gender, age, and religion of caregiver will predict resilience among caregivers of autistic spectrum disorder as well. Participants for this study include 34 caregivers from the Child and Adolescent Mental Health Services Centre (CAMHSC) of the Federal Neuropsychiatric Hospital, Yaba, and Lagos State. Caregivers’ age ranged between 20-66 including both males and females, across different religions and ethnic groups. Social support was assessed through Multidimensional scale of perceived social support, Parental stress was assessed through the parental stress scale, while Resilience was measured through the Brief resilience scale. The result revealed that social support did not significantly predict resilience B= -.16, t= -.98, P> .05. Stress has a significant influence on resilience B= .40, t= 2.46, P< .05. It further revealed that both social support and parental stress jointly significantly predict resilience R= .209, F (2, 31)= 4.09, P<.05. There is significant influence of gender on resilience t(32) = -2.842, P<.01. Similarly, there was significant interaction influence of age and religion on resilience F(2,27) =19.33; P<.01. It is suggested that mental health awareness campaigns should be raised about autism and the challenges faced by caregivers among religious and community leaders.
Inhalational/smoke burn is most fatal one in terms of acute laryngeal edema, acute lung injury, ARDS. This all are survival priority in time dealing matters and sometimes difficult to manage even in dedicated higher centre.
Skin and soft tissues burn has space to contribute by medical professionals, as ensuring time fashioned critical care services can maximize the survivability and reduce the morbidity and mortality. More than 40-50% burn are the major priorities of critical care.
Ideal Burn care management starts from zero hours of occurrence. ECF - ICF fluid, ions disequillibrium are starts just after burn which is very rare about the onset of physiological imbalace in any sort of injury/ diseases. Starling law of forces are the key factors for maintaining Ph, acid base balace and homeostasis which is disrupt just after burn within seconds. Parkland formula is very much useful for burn care. In recent burn care guidelines crystalloids and colloids (FFP, Albumin, plasma expander, Blood and blood products) are needed even in 1st 24 hrs of burn injury. Crystalloid induced dilutional coagulopathy are concerning factors in definitive care and recent guidelines practicing 2ml fluid instead of 4ml for initial regime of fluid. 1st 24 hrs focused care are the pivotal factors for recovery of burn patients. After 48-72 hrs of good urinary balance (0.5 ml/kg/ hr) and early prediction of sequential (Mechanical ventilation, pain care, sepsis control, lung care, partial parenteral nutrition, stomach and gut care) morbidity during the recovery process are important factors for good outcome.
Sometimes burn patients delays time to reach the proper care unit and got some mixed treatment and fluid care. This patients should manage by proper history taking of receiving fluids, consumption of time after incidence, percentage of burn, body wt, co morbidity, age of patient and respective physicians clinical eyes.
Good burn care by bottom way of top (patient care attendant, Nurse, paramedics, physiotherapy, attending duty doctor, administrator, consultant and patients legal guardian) is the ultimate hope for survival of whatever the percentage of burn. 20% burn can kill a patient by sepsis and more than 80% burn can survive with team care.
Acute care services is most important part in advancing health care development. Medical professionals are very much enthusiastic to overcome the gap of acute care and for upgradation of medical services emergency care should be in widely practiced.
Burn is the most disastrous event in casualty and mass casualty. Acute burn care is the Most challenging clinical events for health care professionals, as round the clock nursing and vigilance is the key point in medical management. ensuring utmost critical care contributes a lot to the outcome of burn patients.
Histopathologic Implications of Transgender Surgeries
The gender transition process for many transgender individuals usually involves gender-affirming surgeries, such as phalloplasty, vaginoplasty and mastectomy. Thus, anatomical pathologists will find themselves interpreting more unique anatomical changes because of the increasing demand for these surgeries.
As far as the gender transition process is concerned, the field of anatomical pathology will continue to play a crucial role in the pre-operative assessment, intraoperative evaluation, and post-operative examination of specimens obtained from transgender surgeries. Histopathological analyses of tissue specimens are crucial for confirming successful surgical outcomes and diagnosing complications. Thus, Pathologists must be aware of the diverse anatomical variations emanating from gender-affirming surgeries and adapt their diagnostic approaches accordingly.
Standard diagnostic breast pathology criteria may not be completely applicable to mastectomy specimens from transgender surgeries; therefore, anatomic pathologists will need to collaborate with surgeons to establish comprehensive guidelines considering both diagnostic accuracy and the unique needs of transgender patients.
The creation of neo-vaginal and neo-phallic tissues in transgender surgeries introduces new considerations for anatomical pathology practice. Evaluating these reconstructed anatomical structures requires a good understanding of the surgical procedure and the ability to recognize and separate normal histological features from surgically induced changes. Standardized reporting systems will have to be developed to ensure communication between surgeons and pathologists, ensuring accurate interpretation of pathological findings.
Patient-Centered Approach to care
Transgender, individuals often face unique healthcare challenges such as stigmatization and discrimination; so it becomes imperative that anatomical pathologists should prioritize cultural competence and sensitivity in their interactions with transgender patients, ensuring that pathology reports and discussions are conducted with empathy, respect and confidentiality.
Suggestions for Education and Training
To navigate these evolving challenges, continuous education and training initiatives are essential for anatomical pathologists in the realm of transgender medicine. Pathology residency training programs and professional development courses should introduce transgender healthcare considerations that will enhance the skills and awareness of pathologists, to foster a more inclusive and competent pathology workforce.
Conclusion
The increasing prevalence of transgender surgeries requires a thoughtful evaluation and consideration of their impact on the practice of anatomical pathology. Pathologists must adapt their diagnostic approaches to accommodate the unique anatomical changes resulting from gender-affirming surgeries while maintaining a patient-centered focus. Collaboration between surgeons, pathologists, and educators is important to develop guidelines that ensure the delivery of accurate and culturally competent anatomical pathology services for transgender individuals.
References
Background
The landscape of medical practice and healthcare is gradually evolving, and with it, the field of anatomical pathology is experiencing transformational changes. These changes are noteworthy in the field of transgender medicine and gender-affirming surgeries. This editorial piece seeks to explore the impact, implications and challenges that transgender surgeries pose to anatomical pathology practices and to emphasize the need for adaptation and sensitivity in pathology services to cater to the diverse needs of transgender patients.
References
Ageratum conyzoides (billygoat-weed, chickweed, goatweed, whiteweed, mentrasto) is native to Tropical America, particularly Brazil, but has become an invasive weed in many other parts of the world. It is a 0.5-1 m tall herb with ovate leaves 2-6 cm long and white to mauve flowers. The dichloromethane extract of Ageratum conyzoides aerial parts. (Aster-aceae), a plant widely used in folk medicine for a variety of diseases including sleeping sickness, was recently discovered to have strong activity (IC50 = 0.78 g/mL) against bloodstream forms of Trypanosoma brucei rhodesiense.
This study set out to assess the haemostatic potential of an aqueous extract of Ageratum conyzoides leaves in order to support or refute the plant's traditional use as a hemostatic agent. According to the ability of the extract to reduce bleeding time in experimental animals, Ageratum conyzoides leaf aqueous extract seems to have hemostatic properties. Although the extract prevented whole blood coagulation, it did cause blood material precipitation. Because of their ability to (a) cause vasoconstriction, (b) precipitate proteins at bleeding sites, and (c) promote the natural process of blood coagulation, various substances can be used to control local bleeding. The extract's ability to stop bleeding may be due to a confluence of two mechanisms. According to the findings of the current experiments, these mechanisms include the precipitation of blood constituents (as evidenced by the heavy precipitation), forming a bung to plug the blood vessel cut.
Keywords: Ageratum conyzoides; Haemostatic effect; Blood coagulation
References
Purpose: The aim of the article is to outline the frequency of occurrence, course, diagnosis, possible treatment of spinal cord ischemia (SCI) on the basis of literature overview and to raise awareness of this rare yet devastating condition.
Views: SCI compared to cerebral stroke is a relatively rare disease. It is diagnosed 100 times less often than a cerebral stroke. The root causes of its origin, proper treatment and long-term prognosis are still inconclusive. Magnetic resonance imaging (MRI) with DWI is a main tool to confirm the SCI and rule out broad spectrum of possible alternative diagnoses. SCI is a medical condition, in which prompt recognition, accurate diagnostic steps, and reperfusion therapy are essential to ensure desirable functional outcome and reduce mortality and disability. Although there are no specific guidelines regarding treatment, administration of recombinant tissue plasminogen activator (rt-PA) might be an effective therapy for acute ischemic stroke preventing permanent spinal dysfunction. In surgical causes, close cooperation between neurologist and neurosurgeon is necessary to provide combined appropriate management promptly.
Conclusions: Due to the relative rarity of SCI, the multi-center studies of ischemia of a spinal cord and its treatment would be advisable in neurological practice to enhance current knowledge. Fast diagnosis is crucial for appropriate care and desirable long-term outcomes.
Keywords: ischemic myelopathy; spinal cord ischemia; spinal cord infraction
Data about an individual social history and accomplishments circulate online rapidly. This makes potential collaborators anticipate the effects of cooperation with them on their business advancement and make informed decisions when needed.
People are interested in selling their products and services and buying others as necessary since no one can produce, own, or know everything. To do that, they select from the offerings of their providers. The professional must convey their actions in an enjoyable interaction with customers and partners, presenting the quality of their products and fulfilling customers’ needs. The customers quantify the worth of the offering and interaction with providers. Suppose they are delighted by this exchange of goods and services. In that case, they will maintain the relationship with those providers and talk with friends, loved ones, and other community members about their joyful collaboration. Provider reputation attracts new customers, determining the provider’s business continuity and expansion, ensuring a successful professional and social life.
An increase in investment return validates the client’s positive experience and predicts their loyalty.
No one wishes to collaborate with providers offering inferior services or products with deceptive interactions because that alters their emotional health and financial status. In these circumstances, the client looks for other contributors from the present, and that decreases provider investment return, which affects their business stability.
So, customer loyalty reflects the provider’s professionalism in creating, presenting, and selling products. The quality of offerings and interactions with collaborators and clients influences an individual work-life value in the community.
Provider professionalism is a key to attaining excellence in the virtual and real world. Expertise in a selected field, fast and effective handling of data in practice, communication skills with collaborators, and acting in line with social norms define professionalism.
In healthcare, emotional care investment for people suffering differentiates their work from others.
Insensitivity to people’s altered health dissatisfies the patient, his family, and other dear ones. It determines a low adherence to the therapy plan and poor clinical outcomes, making them look for another provider for the next episode of care. This action frustrates the medical team and decreases investment return, affecting business continuity and growth.
By contrast, kind-hearted work improves patient adherence to the therapy plan and clinical outcomes and maintains a pleasant collaboration that benefits providers and end users.
Customer loyalty reflects their preference to continue collaboration with a provider based on their experience and provider reputation that fast circulates online.
Client experience anticipates devotion or disloyalty to a provider. Each can be an esteemed professional in the community they serve or refused by the clients, according to their product quality and interaction with them.
Patient sentiment analysis using AI to integrate their touch points predicts the evolution of return on investment, which defines a business trajectory in a new, highly competitive digital medical market.
In this new era of digitalization, people’s way of interacting with each other has changed. Nowadays, virtual interaction seems to be the preferred method for collaborative work rather than the traditional model of working in person. This is because it offers the comfort of communication at a low cost, saving time and travel expenses. Even if in-person face-to-face interaction is more beneficial for building and extending further relationships, online verbal and non-verbal communication provides essential information about an individual in various circumstances. Therefore, virtual interaction remains a favoured selection for many.
AI in Early Diagnosis and Predictive Analytics
Artificial intelligence's capacity to aid in early diagnosis and predictive analytics is among its most notable contributions to critical care. To detect trends and patterns that could indicate the start of serious illnesses, machine learning algorithms can sift through mountains of patient data, including imaging scans, laboratory results, and vital signs. Artificial intelligence systems can improve patient outcomes by detecting tiny changes in a patient's health status and alerting healthcare providers to probable issues. this enables early intervention and keeps patients well.
Furthermore, predictive analytics powered by AI can forecast patient deterioration, allowing healthcare teams to proactively allocate resources and tailor treatment plans to individual patient needs. This proactive method may lead to fewer adverse events and unnecessary treatment escalations, which could improve patient safety and satisfaction.
Personalized treatment and care coordination
AI technologies are also empowering healthcare providers to deliver personalized treatment and optimize care coordination in critical care settings. Algorithms powered by artificial intelligence may analyze data relevant to each patient, taking in to account their traits, medical history, and therapeutic response, to provide personalized treatment suggestions.in addition to better clinical outcomes, this individualized approach to therapy reduces the likelihood of side effects and superfluous interventions.
Moreover, AI-driven care coordination tools facilitate seamless communication and information sharing among multidisciplinary care teams, ensuring that all providers are equipped with up-to-date patient information and treatment plans. This enhanced coordination promotes continuity of care, reduces medical errors, and fosters a collaborative approach to critical care management.
Remote monitoring and telemedicine
The integration of AI in critical care extends beyond the hospital walls, enabling remote monitoring and telemedicine solutions that enhance access to specialized care and support patients in diverse geographical locations powered remote monitoring systems can continuously track vital signs and physiological parameters, providing real-time data to health care providers and triggering alerts in case of abnormal findings. this capability not only enables early intervention but also reduces the burden on in-person critical care facilities, particularly in underserved areas.
Furthermore, AI-driven telemedicine platforms facilitate virtual consultations, enabling critical care specialties to remotely assess and advise on complex cases, this approach expands access to expert care, promotes timely interventions, and improves patient outcomes, particularly in regions with limited access to critical care expertise.
Challenges and considerations
While the potential of AI in critical care is vast, there are significant factors and obstacles to consider. serious thought must be given to data security and privacy, the ethical consequences of making decisions with AI, and the necessity of rigorously validating AI algorithms. To fully realize AI promise in health care, it is vital to eliminate gaps in access to critical care solutions enabled by AI and to ensure fair deployment across varied patient groups.
Conclusion
To conclude Artificial intelligence is poised to revolutionize critical care by enhancing early diagnosis, enabling personalized treatment, facilitating remote monitoring, and optimizing care coordination Patient safety, privacy, and equity must be the priorities when healthcare organizations apply AI solutions, and the problems that come with this adoption must be addressed. with thoughtful integration and ongoing advancements in artificial intelligence. finally, We must ensure that the promise of AI in healthcare is used responsibly and ethically as we move into this improved future by acting as watchful stewards of ethical practice.
In recent years artificial intelligence (AI) has been a game changer in the field of critical care, Reshaping the practice of medicine. Artificial intelligence can improve healthcare delivery, resource utilization, and patient outcomes in intensive care units, where swift and accurate decision-making is of the utmost importance. this article delves into the serval ways AI is changing the health care landscape, specifically in critical care, and the ways it applies to different tasks.
The recent epidemiological transition from Communicable Diseases (CD) to Non Communicable Diseases (NCD) has reiterated the theory that NCDS which was prevalent among the rich are no longer restricted to the rich only [4]. The NCDs have gripped the poor as well. The progress in reducing poverty in India from 2013-14 to 2022-2023 is highly encouraging. During this 9 period, in our nation, about 25 crores or 250 millions of individuals have exited from Multi Dimensional Poverty (MPI) [5, 6].
The basic strategy to reduce the impact of poverty on health is to reduce the Out of Pocket Expenditure (OOPE) on health expenses. The Ayushman Bharat Jan Arogya Yojana (AB-JAY) fulfills the criteria of this strategy. The second large scale intervention is the Ayushman Arogya Mandir (AAM) where the basic health units like sub centres are converted to Health & Wellness Centers (HWCs). These HWCs provide comprehensive services & AYUSH services are also an integral part of this intervention [7, 8].
Out of the components of AYUSH, the most cost effective, therapeutically active system of medicine with zero side effects is Homoeopathy of AYUSH. Masses can be covered easily with homoeopathy while benefiting from these three properties. Integration of this system while linking the public through the existing public health system of homoeopathy will reduce their family’s OOPE. This reduction will lead to reduction in poverty of the household [9].
Integration of this system will lead to a process in the body that addresses food security. Govern of India is currently distributing free food grains through the Public Distribution System, Pradhan Mantri Garib Kalyan Yojana & Antodaya Yojana. Whenever these households receive the free food grains, the homoeopathic medicines will help to optimize the benefits of these schemes through optimum utilization in the body. This way the trio of Availability, Accessibility & Utilization (AAU) the concept of food security will be complete [10, 11].
Consumption of these varieties of cereals, pulses by the poor households will also help to address nutrition security as reduction in OOPE on health will help them to purchase & consume locally produced green vegetables, green leafy vegetables & fruits. Currently, 10% of the total 130 million use Homoeopathy & hence, 10 million people in India can benefit from this integration [12].
References
In terms of epidemiology, poverty is a state of health. The state of health that is embedded in poverty is not mentioned in a death certificate but for the families living below poverty line the actual cause is poverty [1, 2]. The vicious cycle of poverty & health proposed by Wagstaff illustrated that ill health affects individual’s financial status through loss of income & increased susceptibility to catastrophic health care cost where as poverty causes ill health as the poor suffer from different kinds of health [3].
References
Mpox disease, caused by Mpox virus, a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae has an incubation period of 6 to 13 days but can range from 5 to 21 days. The symptoms are quite diverse and this makes a number of rash-associated illnesses close differential diagnosis. This study aims to review the common symptoms associated with the disease during outbreaks in Imo State between 2017 and 2023 and the implications for surveillance.
Surveillance data from the Surveillance Outbreak Response Management and Analysis System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS ® version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance.
Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0-4 (32.5%). About one-fifth (21.2%, n = 49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%), (p>0.05). Modal age group was 20-24 (22.4%, n=11), 18% (9) were children under 14 years, p>0.05.
Fever was a constant presentation with 68.4% (n=158) and 65.3% (n=32) of suspected and confirmed cases respectively presented with varying degrees of fever. Other modes of presentation among the confirmed cases are conjunctivitis (12.2%, n=6), cough (16.3%, n=8), photosensitivity (14.3%, n=7), fatigue (36.7, n=18 and headache (45%, n=22). Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. Only 12.2% (n=6) presented with one form of lymphadenopathy contrary to literature. This might be associated with the clinical skills of the cadre of health workers who are responsible for surveillance activities at the LGA (district) level in the State. This study has been able to describe the symptomatology of Mpox during outbreaks between 2017 and 2023 Imo State. The findings have significant implications for capacity building of surveillance actors in order to improve early case detection and response.
Keywords: Mpox; Symptomatology; Outbreak; Surveillance
References
Fixed prosthodontics has seen a rapid technological advance over the last several years.
The computerized engineering technology seems to offer efficient means of treatment planning.
However, clinical investigations do not deliver consistent data about the accuracy and treatment outcomes of the digital workflow.
Therefore, the aim of this article is to compare the performance of digitalized workflow to conventional one.
Keywords: Digital; workflow; cast; Scanning; accuracy
References
Introduction: The purpose of the present study is to test the hypothesis that an innovative Hallux Valgus [HAV] sock reduces HAV angle and restores a more normal foot function in persons living with Hallux Valgus.
Methodology: A prospective, same-subject, pre-post experimental study was conducted on twelve participants presenting with HAV. Laboratory tests utilizing electromyography in order to investigate foot function during gait with and without wearing the HV sock, lab tests utilizing foot pressure mapping in order to investigate plantar pressure distribution during gait with and without wearing the HV sock and laboratory photographic measurement of hallux valgus angle were taken.
Results: The innovative hallux valgus sock reduced the peak plantar pressure on most anatomical landmarks, including the first toe/hallux, first metatarsal head, second to fourth metatarsal head, however, no significant difference in pressure was noted on the fifth metatarsal head in both right and left foot. Hallux valgus angle reduction was evident in both left and right angle for all subjects. Finally, EMG results show that 50% of the patients showed an increase in the muscle function during walking.
Conclusion: The innovative hallux valgus sock reduced the peak plantar pressure on most anatomical landmarks, it reduced the hallux valgus angle and muscle function during walking was also increased. Apart from being user-friendly and low-cost, this sock is especially designed to be easy to use and unobtrusive to ensure patients daily compliance. The HAV sock is innovative in nature, since no other sock with such properties exist to date. This offers a novel alternative to clinicians and patients in the management of HAV.
Keywords: Hallux valgus; medical devices; conservative treatment; hallux valgus sock
Reference
A 26 year old male patient complained of appearance of itching, painful white plaque like lesion over right sole prescribed all antipsychotic medications (fluoxetine (60mg), lithium (450 mg), aripiprazole(2mg) and propranolol for last 3months); adding clozapine (5mg) in place of aripiprazole. Then he was prescribed all the medications instead of olanzapine (10 mg) in place of clozapine and fluvoxamine (100 mg) in place of fluoxetine. After 3months, he developed existing itching and painful plaque like lesions with urinary hesitancy, tremor and insomnia. Then he was advised to withdraw all the medications for at least 1month and somatic disorders were treated with combined tab pregabalin and methylcobalamine, multivitamin. Psoriatic lesion was treated by topical corticosteroid and oral cyclosporine (100mg once weekly for 1months).
Naranjo causality assessment score was 5 and it was scored as probable in WHO-UMC scale. These type of effects were minimized by dechallenging of the culprit drugs and symptomatic management.
Keywords: Antipsychotic; Plaque like lesion; tremor; insomnia; psoriatic lesion; Naranjo; WHO-UMC; dechallenging
Lesson two (2). The acute phase is followed by a chronic process that we call "POSTCOVID SYNDROME". This phase of the disease has a duration of 18-24 months, and sometimes more. And it is the main danger for those who have had a mild, moderate or severe form of the course. For some patients, it has the appearance of mild discomfort.
Lesson three (3). "POSTCOVID SYNDROME" is dangerous for the sudden development of thrombosis and related complications. As shown by the analysis of the development of the pandemic in many countries, 80-85% of patients suffer this infection in mild to moderate severity. And only 15-20% of patients due to concomitant diseases require hospitalization and round-the-clock monitoring by medical personnel. During this period of the chronic phase of the disease, it is necessary to monitor the most informative markers of the possible development of thrombosis: the dynamics of D-dimers, prothrombin time, fibrinogen levels, and the number of platelets in the blood of those who have been ill.
In practice, such large-scale monitoring is not possible. As you know, the recommended treatment to prevent thrombosis is oral anticoagulants. And for detoxification, it is recommended to use plasmapheresis. However, both of these recommended treatments have a number of significant drawbacks and contraindications, especially with their long-term use.
Lesson Four (4). We offer an alternative method - "SYSTEM METHOD OF LEECHING” (SML). The proposed method is based on 30 years of experience in the use of SML in elderly people with multiple organ pathology and children treated at the Academy of Hirudotherapy in St. - Petersburg.
Our experience in the treatment of "POSTCOVID SYNDROME" in the period 2020-2023 has shown the high effectiveness of SML.
Lesson Five (5). There are convincing statistics on the high morbidity and mortality of doctors who worked in the "Red Zone" during the pandemic. First of all, we are talking about nurses and surgeons, that is, about medical personnel who have to contact the bodies of sick people for the longest time. At first glance, it seems that this is due to the violation of the epidemic regime by medical personnel.
However, the author argues that in this case, the factor of remote interaction of the "Aquasystem of a Sick Person" with the "Aquasystem of a Healthy Person" by means of wave radiation may play a role. As evidence, the author cites the discovery of Academician Kaznacheev V.P. and co-authors entitled: "The phenomenon of intercellular distant electromagnetic interactions in the system of two tissue cultures" (Number and date of priority: 122, dated 15.02.1966) and supplements this discovery with his own experimental results on humans, using ultraviolet irradiation of volunteers as a model.
Lesson six (6). Many of our patients note that during the pandemic they were sick 2-3 times.
This suggests that having been ill with one strain of coronavirus, the human immune system is not able to protect against other antigenic variants (strains) of coronavirus. These facts make you wonder, against which strains of coronavirus do you need to prepare a vaccine for the population?.
In addition, many materials have been proven and published on severe post-vaccination complications, including deaths or stillbirths in pregnant women who were vaccinated during pregnancy. In the author's article (Krashenyuk A.I. Pandemic "COVID-19 - POSTCOVID SYNDROME": A System Method of Leeching is a New and Effective Treatment. Journal of Virology Research & Reports, 2023, volume 4(2):1-12).
This problem is being discussed. And this topic is described in even more detail in the author's recently published book "COVID-19 - POSTCOVID SYNDROME". Ed. "ASTERION". SPb, 220p.
Lesson Seven (7) The problem of rehabilitation of convalescents. Since this is a long process that takes 18-24 months or more, the question arises, what to do, how to rehabilitate people? Our experience shows that the safest and most effective method is the use of the "SYSTEM METHOD OF LEECHING” (SML).
References
During the coronavirus pandemic, the author of this message was engaged in the treatment of patients, training doctors in treatment technology, analyzing scientific information from around the world and writing his own scientific articles on the topic: "COVID-19 - POSTCOVID SYNDROME". OBSERVATIONS AND CONCLUSIONS. EXPERIENCE OF LEECH TREATMENT". Ed. "ASTERION". SPb, 220p.
The author of this message owns a series of publications for 2020-2023, in which this pandemic was called "COVID-19 - POSTCOVID SYNDROME". The editors of 6 major authoritative and specialized online magazines agreed with this name of the coronavirus pandemic. As a result, the book was born: PANDEMIC “COVID-19 - POSTCOVID SYNDROME”.
Lesson one (1). None of the antiviral drugs known to date have shown the ability to stop the development of the acute viral phase of the process. This phase lasts 2-3 weeks, and we can call it "COVID-19".
Can we have another suitable choice instead of cake in different delicious events, or can we at least use cakes that are less harmful? We have some suggestions in this regard: 1) Natural sugar sources obtained from fruit juices may be used instead of crystal sugar in cake formulations [3]. 2) Pawpaw Fruit Puree may be used in cake formulations as fat replacement [4]. 3) Cowpea (Vigna unguiculata) flour may be used instead of wheat flour [5]. 4) Vegetable and apple pomace which are rich of fibers may be used. Pumpkin is an essential vegetable and is a rich source of protein, vitamin A and C, antioxidant, beta carotenes, carbohydrates, minerals, flavonoids and phenols though low in fat and calories [6]. 5) Using cakes in smaller sizes, for example, using cupcakes instead of cakes in large size. 6) Mixing the fruits together and putting them in cake molds and then adding a substance like gelatin and making them like a cake and using them as birthday fruits instead of birthday cake. 7) Making cake-free boxes special for birthday, having places for candles. People can throw away these boxes after blowing out their birthday candles.
More other routes may be introduced in order to change birthday habits to healthier and happier ones. It is enough to test some of these routes in birthdays, ceremonies, etc. Let’s begin.
References
Nowadays, obesity is increasing in the world. The amount of calories that people receive in their food is more than the amount the body’s needs. Lifestyle is one of the main causes of obesity. A ubiquitous lifestyle is the use of high calorie sweets such as cakes during various events like birthdays and graduation parties. One piece of cake has a high amount of calorie [1].
The main ingredients in cake baking are sugar, flour, and fat, all of which cause weight gain. If we replace these main ingredients with better nutritional alternatives, we can produce delicious, healthier cakes [2].
Faith can provide us with stability and wealth when we follow the rules given to us by the teachings of God and his chosen disciples. Living in a clean environment and being fair, respectful, trustworthy, and honest can lead to a prosperous and fulfilling life. When we maintain our wholesome nature, we become closer to divine energy, which can significantly and positively influence our existence. Being mindful in our work and caring for ourselves and others reward us with better inner workings; its energy can align with the Universe’s positive energy and resonate with it, improving well-being. We must strive to create positive outcomes in all our endeavors.
Individuals must emphasize the benefits of reasonable work and a healthy lifestyle in a suitable environment to maintain and improve their welfare. When feeling unwell, taking the time to reflect on past actions and attitudes in daily interactions with others can help identify any harm caused and allow steps to be taken to rectify the situation. This can be a small step towards restoring the body’s functioning, as mental health is essential in governing all bodily functions.
God invites us not to make more mistakes. Errors cause harm to both the receiver and the person who created the error. The negative energy of the thoughts and emotions associated with these errors can also disturb the contributor’s mental and energetic state, leading to more or less clinically expressive disorders.
Healing human disorders means dealing with darkness and restoring light to the affected area; to do that, we need assistance with thought power. Considering divinity as an indefinite spring, our thinking expects support in troubled times; to receive this help, we must be diligent in our daily lives and struggle to align ourselves with the Universe’s positive energy. By doing so, we can refine our microcosm and achieve overall welfare.
People aspire to perfection but must have an appropriate configuration to achieve it. With dirty life arrangements, you can never be bright. By cleaning up our surroundings, purifying our thoughts, and engaging in proper work, we can attain a peaceful inner life that interrelates with divine energy.
Human sweethearts are changeable over time, and they want another one - a stable adoration that can support them through life’s ups and downs. God continuously sustains and reinforces them when they follow Its principles.
In today’s digital age, it has become increasingly important to have a basic understanding of different religions across the globe due to the rising movement of people. When managing medical disorders, it is necessary to approach discussions with patients regarding their religious beliefs appropriately. Medical teams must honour people's opinions on divine creation and human life. Furthermore, their relationship with the patients and their families should facilitate patients’ involvement in decision-making concerning their viewpoints and practices relating to the existing divine.
The holiness approach varies among people; its perception and integration into life value differentiate people, making them connected at variance, following differing disputes with consequences on human life.
Static and dynamic life forms are perpetually transient on the planet and put in front of humans the creation problem: who, why, what, and to whom necessitate all - that is deciphered partially, much of it remaining a mystery. God could never be understood since the divine’s magnified and bright work blinds all when they come to explore its interrelated nuances. Humans can control various life forms on Earth but cannot comprehend or control divinity.
References
The global health crisis of the novel coronavirus (COVID-19) pandemic unfolded in public view, affecting millions of people worldwide. The virus, arising in late 2019, spread quickly, leading to enormous morbidity and mortality. Essentially, India, with its congested population and varied healthcare system, encountered an uneven road in grappling with the illness. Multiple surges occurred in the country, resulting in a multi-faceted catastrophe with lasting public health and economic repercussions (Sardar et al. 2020). Many segments of Indian society healthcare, economy, socially - are impacted by the pandemic to various degrees. Knowing the Indian leg of COVID-19, from inception to the present day, is essential to interpret the overall narrative. This backdrop further examines India’s response mechanisms, public health interventions, and socioeconomic consequences amid the calls for a global answer.
References
Tuberculosis (TB) is a major health issue in underdeveloped nations, with India having the largest TB burden. The disease is caused by the bacteria Mycobacterium tuberculosis and has been a leading cause of death in India. The search for anti-TB agents has received extensive study, and the immune mechanisms and hereditary risk factors for TB-related lung injury are being explored. The history of TB treatment has seen remarkable advancements since the invention of streptomycin in 1947. In 2015, the World Health Organization recorded 9.6 million new cases of tuberculosis (TB) and 1.5 million fatalities related to the disease. Amongst these cases, 5% were expected to be multidrug-resistant TB. The disease has a long history, with evidence of spinal caries and TB in ancient times. The document provides information on the diagnosis and treatment of tuberculosis. It discusses various diagnostic methods such as microscopy, antigen detection, and tuberculin skin testing. Additionally, it outlines the treatment intentions for tuberculosis and the WHO’s standardized DOTS/cease TB program. The document also details the metabolism, route of elimination, and toxicity of anti-tuberculosis drugs like Ethambutol and Ethionamide. Various methods for the extraction and quantitative analysis of artemisinin, a compound with potential medicinal properties has been discussed. These methods include liquid chromatography-mass spectrometry, ultrasonic-assisted maceration, Soxhlet extraction, microwave-assisted extraction, and supercritical fluid extraction. The challenges of quantifying artemisinin due to its low concentration and thermolability are also highlighted.
Keywords: Tuberculosis; Mycobacterium; WHO; Artemisinin; Taxus; Vetiveria; Propolis
References
Health as we define is the cumulative result of mental, physical, social, economic and spiritual well being: not merely the absence of disease or infirmity. But as we move ahead in the chronology of diseases, the infections fade off, the spate of non-communicable diseases is on rise. Similar change is seen in the fabric of management of the ailments- shift from biomedical approach to biopsychosocial approach.
This piece of research searches for ways to redefine the way we aim to solve the pain management jigsaw. Sports medicine lab will be a revolutionary step in management of injuries. From traditional method of immobilization of the injured part to selective mobilization of group of muscles, the specialist technicians now aim to improve the status of the patient before time. This intervention not only helps the patient and relatives see a healthier and better transformation but also improved stress levels and better cognitive functions. The planning and designing of Sports medicine Lab will prove to be a guiding path to many in the fraternity.
References
Clostridioides difficile infection (CDI) is a major cause of hospital-acquired diarrhea, with significant morbidity and mortality. In the past decade, the incidence rates of community-acquired CDI are increasing worldwide. Antibiotic therapy which alters the normal colonic microbiota is the greatest risk factor for the development of these infections. The number of effective antibiotics for the treatment of CDI is limited, so it is necessary to explore alternative approaches in therapy. One of the approaches to solving this medical and public health problem is the use of plants and their products.
The aim of the present work is to explore the antimicrobial activity of herbal products against C. difficile in order to point out which herbal products are the most promising for the treatment and prevention of CDI.
We searched JSTOR, PubMed, ScienceDirect, Scopus, Springer Link and Web of Science databases for articles identifying herbal products targets or antimicrobial treatments for C. difficile. While searching certain keywords were used to find the publications that would be relevant in this review.
The study indicates that several essential oils, plant extracts, and their pure compounds exhibit a great antimicrobial potential against C. difficile, suggesting their possible use as an alternative to antibiotics or in combination with conventional antibiotics for the treatment of CDI.
Keywords: essential oils; plant extracts; pure component; Clostridioides difficile; antimicrobial activity
Saffron (Crocus sativus L.) is an aromatic plant with 3500 years of age. Saffron is often known as the most expensive medicinal plant. Iran currently produces one of the best saffron. Countries such as Australia, Canada, the United States of America, China, and some Central African countries also produce this plant [3].
Clinical research suggests that Saffron may be used as a preventive and therapeutic anti-inflammatory and antioxidant agent, regenerator of unsaturated fatty acids in the body, a free radical absorber and an anti- oxidative stress. Therefore, researchers recommend the consumption of saffron and its compounds in the diet [4, 5].
It is worth noting that one of the most important factors which increases alcoholism is the feeling of euphoria caused by the release of dopamine neurotransmitter in the brain after drinking alcohol. On the other hand, interest to ethanol consumption may be related to factors such as price, availability, and shape and beauty of glasses [6].
Based on abovementioned points, we recommend using healthy non-alcoholic drinks that can create the same happiness as alcohol. We specially offer saffron containing drinks that have beneficial therapeutic properties as well. Saffron aqueous extract has been able to increase dopamine in the brain of mice [7] and also it has been shown that saffron in young men increase the dopamine [8].
We suggest that producing saffron beverage in proper volumes and beautiful packages may be a good way to decrease alcohol consumption disadvantages as well as maintaining the happiness of drinking cool delicious drinks.
References
Increased global alcohol consumption annually causes death or diseases including liver problems in many societies. Alcohol is causally related with more than sixty different diseases. The risk of premature death and disability caused by alcohol consumption is classified as the seventh cause of death [1].
Alcohol use disorders (AUDs) are significant psychological conditions that often cause serious and dangerous problems. A 2018 World Health Organization (WHO) report on alcohol and health found that in 2016, around 3 million people (5.3% of all deaths) died as a result of alcohol consumption. This number of deaths is more than the number of people who died due to high blood pressure and diabetes. The World Health Organization has indicated in this report that about 5.1% of the global burden of diseases and injuries is caused by alcohol consumption. Also in 2016, there were about 2.3 billion people who consumed alcohol, and 283 million of them had AUD. Moreover, alcohol consumption accounts for 1% of the gross income of a middle-income country [2].
Mental health is essential for work efficiency; processing data speed and rational response differentiate people. They must interact to sell their products and buy others’ goods since no one can own everything. Communication reflects an individual’s energetic mental state, influencing energy transmission through thoughts and words. Their power in the functioning of the human body was observed in clinical practice. Individual attitudes can inform us about rational or irrational data processing and the vibrational model of interrelated actions. Cool or kind-hearted work, adaptability, flexibility, and the ability to overcome barriers are some metrics for evaluating mental activity. Perception, analysis, and response to data tell apart people’s genetics, education, and networking. Usually, emotional distress results from unsafe interaction with others or one’s surroundings; it can manifest in mental health variances following functional abnormalities in fragile areas of the human body since the mind’s activity governs bodily functions. People’s vulnerability to deceptive interactions with others varies. The impact of such communications on mental activity is observed in their subsequent actions. Attenuated or explosive reactions toward others in different situations, uncontrolled emotions often accompanied by irregularities in heart function, a decrease in accomplishments, and social isolation are some common clinical manifestations of altered mental health. Poor sleep that frequently follows and exacerbates the disturbed mental health must be accounted for.
Words used, attitudes, and surroundings depict individual views; cultivating good habits enhances work and facilitates social acceptance. It is essential to advise individuals about the negative consequences of their exposure to improper collaborative work, working in an unhealthy environment, and adopting unsafe habits that may harm their health. By pondering all the factors influencing us, we can care for ourselves and others.
The relationship between stimulus intensity, duration, and response is sometimes linear in impacted regions. Variability in individual responses to the same stimulus characteristics predicts uncertainty, and doubt may limit coping with creativity.
In today’s digital age, artificial intelligence can detect mental disorders rapidly and provide suggestions for corrective actions promptly. By focusing on improving mental well-being, promoting self-care practices, and maintaining clean surroundings, individuals and communities can experience positive impacts on health and overall societal progress.
IT devices provide a variety of on-demand programs for education and entertainment. Discussions with loved ones, listening to preferred musical programs, watching movies, viewing art from famous artists, and exploring nature images relax and stimulate different brain areas, helping in recovery.
People’s actions illustrate their thinking; when it is not working correctly, it must be restored, and continuous efforts should be made to improve it. Their actions illuminate the thoughts and words’ power to change around and in the inner area, with outcomes that can surprise or sometimes prove anticipatory facts.
Human creation is a fascinating construction with the capacity to remodel its structure as many times as necessary to achieve its original performance. If the damaged area is not substantial, a disrupted configuration is quickly repaired without help from others.
Regularly, overwhelming conditions alter human equilibrium, leading to disorders. Affected areas caused by intrinsic or extrinsic factors’ abnormalities hurt the individual’s work and generate feelings of varied discomfort. Individuals can generally cope with their irregularities, but excessive distress requires attentiveness to remedy.
References
Cardiovascular diseases (CVDs) pose a serious global threat as they are a significant cause of morbidity and mortality claiming a large number of lives. Increased incidences of cardiovascular events are often associated with an increased uptake of unbalanced dietary high-saturated lipids, salt and sugar. A sedentary lifestyle as well as obesity contribute to other potential factors leading to cardiovascular diseases. Demerits of limited applications in the diagnosis and treatment strategy of CVDs have led to the further exploration of nanoparticles in medicine. The field of Nanomedicine based on employing nanoparticles has revolutionized the diagnostic and therapeutic landscape by playing an important role in identifying their targets, signaling process and efficient drug delivery. These nanotechnology-driven methods can serve as efficient biomarkers in the early detection of CVDs thereby helping in their therapeutic and future prevention of cardiovascular events.
Keywords: Nanomedicine; Cardiovascular Diseases; Drug delivery; Biomarker
References
Dental caries is a multifactorial disease that happens by the combination of dietary sugars, dental biofilm, and the dental tissue of the human. It happens from the periodic changes of demineralization and remineralization at the junction of tooth surface and biofilm.
There are two types of carious dentin-infected dentin and inner caries-affected dentin. The dentin-impacted by caries has a varied mineral distribution and the depth of the caries can extend a few hundred of micrometers. The ground substance of the dentin affected by caries is physiologically remineralizable and is not biochemically or physically different from that of sound dentin, in contrast to denatured caries-infected dentin.
References
Critical illness myopathy is a significant neuromuscular complication in critically ill patients, characterized by early proximal muscle weakness. It has varying incidences, significantly impacting mortality and morbidity among critically ill patients. This article aims to discuss the pathophysiology and evidence-based management strategies, which may help to improve patient outcomes in critically ill individuals.
Keywords: Critical Illness Myopathy; Early Mobilisation; Sedation
References
Chronic pain impacts the quality of life of older adults and their informal caregivers physiologically, psychologically, and financially. Therefore, this paper examines the challenges of pain management among older adults and their informal caregivers. Moreover, the Dyadic Pain Management Program (DPMP), an alternative approach that empowers older adults and their caregivers to provide friendly care, has proven effective. The DPMP aligns with various dominant welfare ideologies in different regions around the globe, which can potentially reduce social expenditure by emphasizing the role of families. Therefore, this paper advocates for the broader implementation of DPMP and reviews the existing policies managing older adults' chronic pain by addressing its advantages at the micro- and macro levels of the DPMP.
Keywords: chronic pain management; dyadic pain management program; informal caregivers; aging population; public health costs
Migraine is defined as an episodic headache associated with certain features, such as sensitivity to light, sound, or movement or “a recurring syndrome of headache associated with other symptoms of neurologic dysfunction in varying admixtures” [6]. The symptoms of migraine are recurrent severe headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound. It affects millions of people worldwide, making it one of the most common and disabling conditions worldwide [7]. There are different phases, including a premonitory phase, transient neurological symptoms (i.e., migraine aura), an intense headache attack, and a postdrome phase [8].
Pathophysiology
The pathophysiology of migraine is still not well understood. Few of the proposed mechanisms surrounding the onset of migraine headaches are given below:-
Genetic Studies
The genetic or the inherited component plays a very important role in the pathophysiology of Migraine. Studies have shown that individuals with a family history of migraines are more likely to experience migraines themselves, indicating a genetic predisposition to the disorder. Various genes and genetic factors have been implicated in migraine susceptibility, including those related to neuronal excitability, neurotransmitter function, and vascular regulation [9]. There is an unexplained but epidemiologically well-established predisposition that relates to methyl tetrahydrofolate reductase gene mutation C677T that is certainly overrepresented in migraine with aura [10]. The presence of aura seems to be associated, in rarer inherited cases, such as CADASIL or autosomal-dominant retinal vasculopathy with cerebral leukodystrophy, with structural protein dysfunction [11]. and perhaps with an embryonic syndrome that includes patent foramen ovale [12].
Neuropeptide studies
Activation of the trigeminal nerve triggers the release of signaling molecules including calcitonin gene-relate d peptide (CGRP), resulting in secondary cerebral vasodilation, plasma protein extravasation and mast cell degranulation, all contributing to symptoms of migraine. Although, this theory does not explain the pathophysiology of migraine, CGRP can be considered as the initial trigger of trigeminal nerve stimulation causing migraine headaches [10]. It is also apparent that the dilatation of blood vessels is the result of neuronal inflammation, not the cause of migraine headaches. The roles of 5-HT and CGRP have been well documented. CGRP is a potent vasodilator that causes pooling of blood in the cerebral vasculature parallel to decreased levels of 5-HT [11, 12].
5-HT receptors, especially 5-HT1B, 5-HT1D and 5-HT1F receptors play a crucial role in migraine [13]. 5-HT1F receptors are expressed in the CNS, including major regions of migraine pathophysiology such as cortex, hypothalamus, the trigeminal ganglia, trigeminal nucleus caudalis (TNC) and in low concentrations on the cerebral blood vessels like the Middle Cerebral Artery without vasoconstrictive properties [14-16]. Additionally, 5-HT1B, 5-HT1D, but not 5-HT1F, receptors were found on cerebral microvascular smooth muscles and all three subtypes were expressed on astrocytes. These findings, along with pharmacological evidence that selective 5-HT1F receptor agonists lack vasoconstrictive effect, prompted Cohen et al. to hypothesis that the function of this receptor subtype may be related to blood-brain barrier physiology rather than vascular contractility [17]. Triptans have been the drug of choice for migraine over the last three decades. These 5-HT1B and 5-HT1D receptor agonists act on the blood vessels and nerve endings in the brain to inhibit the release of vasoactive neuropeptides (CGRP and Substance P) by trigeminal nerve innervating the intracranial vessels and dura mater [18, 19]. But triptans are not recommended for individuals with history of cardiac and cerebrovascular diseases and those who are at risk for developing such diseases because of their vasoconstrictive action [20]. Besides having limited efficacy, triptans are contraindicated in pregnancy and breastfeeding women [21-23].
Thus, there arose a need to develop more selective treatment for migraines that lack any cardiovascular and cerebrovascular side effects. Drugs targeting neurons (trigeminal pathway) were suggested and 5-HT1F receptors were considered as a contemplated victim for it.
Pharmacology
Lasmiditan is the first of a new group of headache medicines that are being called the "ditans." Lasmiditan is unique as it is the only drug in its class which works specifically on the 5-HT1F receptor as compared to triptans that primarily act via 5HT1B/1D agonism. They do not cause vasoconstriction in contrast to triptans. It contains a pyridinoyl- piperidine scaffold instead of an indole group [24]. The mention of offsite interaction with the 5HT1F receptor suggests that there may be other mechanisms through which the triptans exert their therapeutic effects. The exact role of 5HT1F receptors in the context of migraines and triptan therapy is an area of ongoing research, and understanding these interactions may contribute to the development of more effective migraine treatments. It is important to note that while triptans can be effective for many people with migraines, they are not suitable for everyone, and their use should be discussed with a healthcare professional to ensure proper diagnosis and appropriate treatment [25]. The precise mechanism of action is not fully understood, but there are several proposed ways in which 5HT1F receptor activation may contribute to its activity in migraine treatment. Some of the effects associated with 5 HT 1F receptor agonist include decreased plasma protein extravasation, decreased c-fos expression, suppressed neuronal firing within the trigeminal nucleus caudalis, inhibition of CGRP release from perivascular fibres, direct anti nociceptive action.
While these proposed mechanisms provide insights into how Lasmiditan may work in treating migraines, it's important to note that the exact interplay of these effects and the overall mechanism of action are still subjects of ongoing research. As with any medication, individuals should consult with their healthcare providers for a thorough understanding of its benefits, potential side effects, and suitability for their specific condition [25, 26]. Lasmiditan is highly lipophilic and hence crosses the blood brain barrier which leads to central nervous system abnormalities [27].
Pharmacokinetics
Lasmiditan is administered orally with bioavailability of about 40 % [27]. Lasmiditan can be taken with or without food as the co-administration of drug and a high fat meal was not found to produce a clinically significant difference in exposure [28]. The median peak time to peak plasma concentration is 1.8 hours and the onset of action is 30 to 60 mins post ingestion [29]. The fact that Lasmiditan is primarily metabolized by non- CYP enzymes suggests that the influence of CYP inhibitors or inducers on its pharmacokinetics is unlikely. This can be advantageous in terms of drug interactions, as it reduces the risk of significant alterations in Lasmiditan levels when co-administered with medications that affect CYP enzymes. On the other hand, the “gepant” class of medications which includes Ubrogepant and Rimegepant, is metabolized by CYP3A4 enzymes. CYP3A4 is a major hepatic enzyme involved in the metabolism of various drugs, and its activity can be influenced by inhibitors or inducers. Therefore, when these “gepant” medications are used concurrently with strong CYP3A4 inhibitors or inducers, it can lead to significant changes in plasma concentrations, potentially affecting their efficacy and safety. In summary, the difference in the metabolic pathways of Lasmiditan and the “gepant” competitors contributes to variations in their susceptibility to drug interactions with CYP inhibitors or inducers. It is essential for health care professionals to be aware of these differences when prescribing or adjusting medication regimens to minimize the risk of adverse effects and ensure optimal therapeutic outcomes. Lasmiditan undergoes oxidation on the piperidine ring to form metabolites M7 and M18, as you mentioned, is a combination of M7 and M8 pathways. These metabolites are considered pharmacologically inactive, meaning they do not contribute significantly to the therapeutic effects of the drug. Regarding excretion, a small portion of the active drug of around 3% is excreted in the urine unchanged. This indicates that a minor fraction of the administered Lasmiditan is eliminated from the body without undergoing significant metabolism [30]. The majority of Lasmiditan is excreted in the urine as the metabolite S-M8, accounting approximately 66% of the total excretion. S-M8 is likely a metabolite formed through some specific metabolic pathway, and while it may be inactive, the elimination of the drug through this pathway contributes to its overall clearance from the body. Understanding the metabolism and excretion of the drug excretion of a drug is crucial for assessing its pharmacokinetic profile, potential drug interactions, and overall safety. It also provides insights into how the body processes and eliminates the drug, which can be important for dose adjustments and considerations in specific patient populations [30].
Adverse effects
Lasmiditan, being a CNS (central nervous system) depressant, can lead to significant adverse events when co-administered with other CNS depressants, such as alcohol. The potential for serious driving impairment is noted, and it's emphasized that patients should refrain from driving a motor vehicle for at least 8 hours after each dose of lasmiditan. This caution is crucial for patient safety, as impaired driving can pose risks to both the individuals taking the medication and others on road [31]. Alternative therapies such as rimegepant and ubrogepant are considered to have a high safety profile with relatively low adverse effects. Dizziness, a common adverse event reported in lasmiditan trials (16% to 18% of participants), is mentioned to occur at less than 2% for both ubrogepant and rimegepant. This suggests that these alternative medications may be associated with a lower incidence of dizziness, making them potentially more tolerable for some individuals [32]. Considering the potential for CNS adverse effects and driving impairment with Lasmiditan, healthcare providers may need to carefully assess individual patient profiles, consider alternative therapies, and provide appropriate guidance on driving restrictions and potential risks.
Abuse Potential
Lasmiditan is a schedule V controlled substance. This classification is determined based on its potential for abuse and the perceived risks associated with its use. In abuse potential studies, lasmiditan was compared with alprazolam, a Schedule IV controlled substance. The "drug liking" scores for lasmiditan were higher than placebo but lower than alprazolam, indicating a lower abuse potential compared to alprazolam. As a result, lasmiditan was classified as a Schedule V controlled substance, while alprazolam remained in the higher Schedule IV category. It's worth noting that the classification of a drug as a controlled substance is influenced by various factors, including its pharmacological properties, abuse potential, and safety profile. The Schedule V classification suggests a lower potential for abuse relative to substances in higher schedules. Drugs like, rimegepant and ubrogepant, are not controlled substances. This difference in regulatory classification may be attributed to variations in their pharmacological profiles and abuse potential.
Understanding the controlled substance status of medications is important for healthcare providers, as it affects prescribing practices, dispensing regulations, and patient education on the responsible use of these substances to mitigate potential risks associated with abuse or misuse [33].
Dosage and Administration
Lasmiditan is available in 50 mg and 100 mg tablets, and the recommended dosing is 50 mg, 100 mg, or 200 mg taken orally as needed for the acute treatment of migraine attacks. It's important to note that a second dose of lasmiditan has not been shown to be effective in clinical studies [34].
Comparison of Ditans with Triptans
Triptans, act primarily on 5HT1B receptor, exert their effects through vasoconstriction. However, their use is contradicted in patients with cardiovascular or cerebrovascular diseases due to this mechanism. Triptans’ efficacy varies, and approximately 40% of migraine attacks do not respond to them adequately. It is uncertain if there is significant CNS component to their efficacy, and the ability of some triptans to penetrate the blood brain barrier is limited. Lasmiditan provides a different mechanism of action compared to triptans.
It is highly lipophilic and capable of crossing the BBB, potentially acting in the central nervous system. This property distinguishes Lasmiditan from triptans and may contribute to its efficacy in migraine treatment. It's important to note that while the CNS effects of lasmiditan are observed, they don't necessarily prove that its efficacy against migraines is solely mediated in the CNS. There is preclinical and ex vivo evidence suggesting that lasmiditan may inhibit both PNS and CNS pain pathways, including the trigeminal nerve, through the modulation of neuropeptides and neurotransmitters such as CGRP and glutamate. The distinct pharmacokinetic and mechanistic features of lasmiditan make it an intriguing alternative for migraine treatment, especially in cases where triptans may not be suitable or effective. The ability to penetrate the BBB and potentially modulate both PNS and CNS pathways adds to the understanding of how lasmiditan may provide relief for migraine sufferers [35].
Drug Interactions
Lasmiditan administration is associated with mean decreases in heart rate, ranging from 5 to 10 beats per minute, which is higher than the decreases observed with a placebo (2 to 5 beats per minute). This indicates a cardiovascular impact of Lasmiditan [36]. Participants in phase III trials who reported taking concomitant heart rate-lowering medications, such as β-blockers, did not experience adverse reactions compared to other treatment participants. This suggests that, in clinical studies, the use of lasmiditan in combination with heart rate-lowering medications was generally well-tolerated [37]. Given its classification as a CNS depressant, caution is advised when using lasmiditan in conjunction with alcohol or other CNS depressant medications, including antiepileptic medications like valproic acid and topiramate used for migraine prophylaxis [38]. As with all drugs interacting with serotonin, there is a theoretical risk of serotonin syndrome with lasmiditan. Caution is recommended when using lasmiditan concomitantly with serotonergic drugs. A medical review of data from phase III studies assessed the risk of serotonin syndrome, and while five possible cases were identified, none were severe or serious, and they did not meet the Hunter Serotonin Toxicity Criteria. The risk of serotonin syndrome with lasmiditan is considered somewhat theoretical, and warnings are included out of caution. It's noted that alternative therapies, such as rimegepant and ubrogepant, do not carry the serotonergic risk associated with lasmiditan. The mechanism of action for rimegepant and ubrogepant involves CGRP signaling rather than serotonin agonism.
Understanding the cardiovascular effects and potential risks associated with lasmiditan is crucial for healthcare providers when making treatment decisions and counseling patients. Individual patient characteristics, medical history, and concurrent medications should be carefully considered to ensure the safe and effective use of lasmiditan for migraine treatment [30].
References
Headaches are a universal experience that can affect individuals at any point in their lives [1]. It is painful and can disable a person to perform normal functions of their day today’s life. Migraines can significantly impact productivity and daily functioning, affecting individuals across a wide age range. Headaches not only impact individuals but also create a financial strain on society due to healthcare expenses, lost workdays, and decreased productivity. 1.7-4% of the world’s adult population suffer from prolonged headaches for 15 or more days a month [2]. One in ten patients seeks care from general practitioners [3], one in five requires emergency admissions [4], and one-third patient population is referred to neurology [5]. This underscores the importance of addressing migraine management comprehensively to improve patient outcomes. It’s concerning to see such a substantial increase in the prevalence of migraine among children and adolescents over the years. A study done by WHO assessed the global prevalence of conditions and disability life years among children below 20 years of age from 1990 to 2019. Understanding these prevalence trends can help in developing targeted interventions and healthcare policies to improve the wellbeing of young populations [2].
The social media channels have absolutely changed our communication mode and have facilitated us with sharing our life with our friends, family, and any other community situated at any part of the world. But such pressure of living up to a digitized perfect life, coupled with the fear of missing out (FOMO), in turn creates inadequacy, loneliness, and anxiety.
One of the major concerns with digital talk is the mistreatment of users through cyberbullying or online harassment. The power of being anonymous online may send some into the online space to be mean and hurtful, with some serious psychological effects on the victim. More so, the virality associated with such cyberbullying or online harassment may elevate the negative, thereby elevating feelings of shame and isolation.
This, in fact, has been fueled by the advent of social media sites, which encourage one to base their life against others' highlight reels. This induces a cycle of comparison that grates at self-esteem and fosters a warped sense of reality in which everyone seems to be living a more glamorous and fulfilling life than you.
Furthermore, misinformation happens in digital dialogues with viral rumors and online conspiracy theories flowing across social media platforms like wildfire. Together, they serve to not only spread suspicion about reliable sources of information but be responsible for increasing states of anxiety and uncertainty about the world that surrounds us.
However, social media carries the potential to promote mental health and form supportive communities during these hard times. A positive shift in a digital dialogue might foster a healthier online habitat where empathy, authenticity, and meaningful connections can be established.
Some proactive approaches to digital well-being include setting time slots to go off the grid or to allow a balance between online and offline life, filtering our online social circles, and paying attention to the quality of content. Other steps include fixing screen time limits, curating digital social circles with positive vibes, and appraising content critically. Furthermore, the promotion of digital and media literacy skills will assist in navigating the online realm and sifting fact from fiction.
This is why, as users, we have to put more emphasis on self-care and taking care of our mental health in the digital space. This might mean taking breaks from social media platforms, ensuring plenty of offline activities for fun and fulfillment, and reaching out to trusted friends or family members—or even mental health professionals—for support whenever necessary.
Besides, it is upon these social media companies to focus their efforts on well-being by including protective measures against cyberbullying, promoting digital literacy, and fostering cultures of kindness and respect online. This can be done through a concerted effort involving all parties, and that is when success is likely to be achieved in maximizing the good that social media can offer and minimizing the harm that can be implicated on the mental health of each. In short, the mental health impact of social media seems complicated and asks for an approach that may work only when it is comprehensive. Create digital well-being: be mindful in your use, utilize it well, and act together to harness the power of digital discourse so that the world has a more inclusive, empathetic, and supportive global village.
It can be said without argument that, at present, social media has found itself at the heart of digital life, centrally and crucially affecting communication and connection, even to the effect of perception with the world around. Such platforms extend social interaction opportunities and information sharing to unprecedented levels but are a huge challenge to our mental well-being. It seems only wise to navigate this complex digital discourse with a nuanced understanding of its impact on mental health and proactive strategies pursued toward fostering digital well-being.
References
In this era, there is a promising path toward halting the HIV pandemic. It underscores the vital importance of spreading accurate HIV information and educating the public. Understanding these facts enables people to grasp the historical, present, and future aspects of HIV, determining the current position and trajectory. While significant progress has been made in combating HIV, there is still much work to be done, emphasizing the need to sustain ongoing efforts. This review aims to raise public awareness of HIV and urges for compassion, insight, and proactive measures. It calls for strength not only in laboratories but also in community engagement and policymaking. As we move forward, let us embrace a renewed sense of optimism and determination. Through collective action, we can relegate HIV to history, turning it from a persistent threat into a defeated adversary. Just a few decades ago, halting HIV seemed improbable. Today, reducing new HIV cases is within reach, exemplified by campaigns like "Let’s Stop HIV Together," which targets a 90% reduction in new cases by 2030. Together, progress has been made, and together, it will continue. Increasing public awareness of HIV and ongoing efforts further strengthens the fight against HIV.
Reference
Vaccination remains a cornerstone of public health, yet persistent pockets of vaccine hesitancy challenge its widespread acceptance. This review explores the intricate interplay between the COVID-19 pandemic and vaccine hesitancy, examining how the introduction of the COVID-19 vaccine has influenced broader attitudes towards vaccination. A systematic review of literature spanning 2021 to 2023 elucidates the multifaceted factors influencing vaccine acceptance and hesitancy, including socio-demographic disparities, misinformation, and healthcare access. Findings reveal a nuanced landscape, where sociodemographic variables significantly impact vaccine acceptance, while misinformation from media sources exacerbates hesitancy. Promising interventions, such as immersive virtual reality experiences, financial incentives, and political endorsements, offer avenues to mitigate hesitancy and enhance vaccine uptake. Furthermore, the pivotal role of healthcare professionals in promoting vaccination and combatting misinformation underscores the importance of leveraging trust and expertise to shape public perceptions. Employer recommendations and tailored educational initiatives emerge as practical strategies to encourage vaccine acceptance within communities. This review underscores the imperative for targeted interventions grounded in evidence-based practices to address vaccine hesitancy effectively and safeguard public health in the face of evolving challenges.
References
This study examines the 1mP1 method, an innovative hypnosis technique that prioritizes direct suggestion and the concept of organic biolocalization. In comparison to contemporary approaches of indirect suggestion, the 1mP1 method stands out for its emphasis on precision and detail during suggestion. It is theorized that the effectiveness rate of 1mP1 significantly surpasses conventional methods, aiming not only to influence the individual's mind but also to explore the possibility of structurally or functionally modifying organs and tissues. Potential applications include pain relief, immune system modulation, tissue regeneration, and anti-aging procedures. This method introduces a revolutionary approach in hypnosis, opening new perspectives in the treatment of various medical conditions.
Keywords: 1mP1 Method; Hypnosis; Hypnotherapy; Biolocalization; Direct Suggestion; Neurosciences; Clinical Hypnosis; Mind-Body Interaction; Psychophysiological Effects; Mind-Body Medicine
Reference
Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has caused a complete upheaval of healthcare systems across the world. As children with cancer are considered to be at greater risk, the organization of oncological care had to be adapted.
Objective: We report our strategy in the face of the Delta wave of COVID-19 within our establishment, describing the measures put in place to limit its transmission while ensuring the continuation of anti-cancer treatments. We also present the main epidemiological, clinical and para-clinical characteristics as well as the outcome of our patients.
Materials and methods: This is a prospective study descriptive spread over three months from August 1, 2021 to October 31, 2021, concerning all children with cancer and diagnosed positive for SARS-CoV-2 infection, hospitalized or followed in the day hospital of the pediatric hemato-oncology department of the Hospital Center University of Marrakech. We collected 15 patients.
Results: The average age of our patients was 6 and 6 years. The underlying cancer was acute lymphoblastic leukemia in 5 cases (33.3%), neuroblastoma in 4 cases (26.7%), osteosarcoma and lymphoma in 2 patients (13.3%). Patients were symptomatic in 68.75% of cases. The main clinical signs were fever in 67% of cases, cough and rhinorrhea in 34%. The inflammatory syndrome was present in two thirds of cases, there was lymphopenia in 38.46%, and anemia in half of the cases. Severe forms represented 6.6% of cases. All of our patients benefited from geographic isolation with application of hygienic rules. Azithromycin was used in all our patients for 5 days. The Chemotherapy was postponed with a delay of 1 week in patients with cytopenia (53.3 The evolution was favorable in 14 children and we noted the death of a single case presenting post-chemotherapy aplasia.
Conclusion: Children with cancer are more vulnerable to pandemic infectious diseases. Therefore, we must take all preventive measures to ensure adequate care.
Keywords: Child; Cancer; Chemotherapy; COVID-19; PCR; Prevention
People’s illusion of independence provides them joy, but they all depend on each other to sell and buy their products, as necessary, since no one can own or know everything.
Being respectful, honest, and friendly in relationships leads to a good reputation, a successful professional and social life, and a better inner life – core elements for a healthy existence.
Disappointment in relationships with animate or inanimate surroundings grants the darkness to come into your inner life, disturbing personal health and interaction with others. In such circumstances, unhealthy eating habits, more alcohol use, and improper communication are often noticed, and they do not represent a good solution. Route cause analysis of the problem, balancing stressors with other beneficial habits that provide well-being, such as lectures of interest, selected musical programs, the comfort of virtual or real communication with friends and loved ones, walking, painting, and writing must be considered. Favoured and exciting things and actions and professional support from loyal friends, dear ones, and experts in this field can alleviate depression. Sadness and frustration bring sleep disturbance, which can be the starting point for many dysfunctions in the human body; quickly repaired, we provide a light way for life in this perceptible, temporary world.
When a relationship fails, the inner voice can guide personal advancement and creativity for remediation to attain a peaceful inner life.
Doubts and emotional involvement frequently make us oscillate in decisions; each verdict has its way of predicting life’s hazardous game.
Standing trustworthy, kind, and polite usually protects us from disillusionment and extends our relationships.
Life’s ups and downs continuously appear, preferable to making us more robust, more prudent, and wiser in breaking barriers.
Choosing a positive work environment, having loyal collaborators, being honest and respectful, having friendly connections with others, and aligning with social norms contribute to a successful personal, professional, and social life. This, in turn, leads to a peaceful inner life and overall well-being.
Taking time to think about our role, accomplishments, and pitfalls, identifying our weaknesses and strengths, working to overcome obstacles, helping the creators of errors repair their inaccuracy, and being careful in choosing partners/collaborators benefit us by offering a shining inside private and holy room - a peaceful light for relaxation and meditation.
Cherishing and delightful moments in this natural and ephemeral world are essential to a prosperous and healthy existence.
Inner life reflects the effects of animate and inanimate surroundings on individuals and their attitudes toward them; self-awareness defines the power to anticipate difficulties, avoid them when possible, and overcome barriers to a successful existence.
External life is connected with inner life, and people’s introspection can generate actions for better changes in their interests.
The inner self defines life’s principles, reasons, and desires; quick, constructive reflection is necessary when these are not aligned.
Enjoying yourself and others, as a preference, ensures a better inner life, learning from each lifetime’s corner.
Others analyse and decide who you are, but your inner voice can tell you that better. Your feelings, emotions, ideas, and perspectives interchange with those of others in various circumstances, finally depicting your health and life trajectory.
References
Aim: Prostate cancer, one of the most common cancer among men and a cancer that can vary significantly in its aggressiveness, will cause more deaths in the future with its increasing incidence. Gleason score has been defined as the most reliable and autonomous predictor of prostate cancer outcomes. The study aim to determine the variables affecting Gleason score and indirectly to establish prognostic indicators for prostate cancer.
Material and methods: The variables in the data set were analyzed according to the dependent variable categories Independent sample test and Mann Whitney U test were used in statistical analyses and p<0.05 was considered significant. Analyses were performed with IBM SPSS 26.0. In the modeling phase, the relationship between the grouped form of Gleason score and other variables was examined with Multilayer Perceptron and Radial Basis Function Neural Network methods. The dataset was divided into training and test datasets in a 70:30 ratio. The results are reported using accuracy, balanced accuracy, sensitivity, specificity, PPV, NPV and F1 score as performance metrics.
Results: The data set used in the study consists of variables belonging to 97 patients. The mean age of the patients was 63.87 years. Patients were divided into two groups: those with a Gleason value of 7 and above and those with a Gleason value below 7. There were 35 patients with a Gleason value below 7 and 62 patients with a Gleason value above 7. According to the results obtained from the modeling, the best result was obtained from the Multilayer Perceptron model. accuracy, balanced accuracy, sensitivity, specificity, positive predictive value, negative predictive value and F1 score were 96%, 100%, 93.3%, 90.9%, 100%, 95.2%, respectively.
Conclusion: The study obtained highly accurate classification results when modeling with Gelason score categories and other independent variables. This shows that machine learning models can be used effectively and successfully in medical data. Furthermore, important variables were identified and their indirect associations with prostate cancer were revealed. In the future, more detailed research on prostate cancer can be conducted by focusing on these variables.
Keywords: Prostate cancer; Gleason score; modelling; classification
References
Background: Retaining children in care still remains a real challenge in Africa. In Cameroon, the retention rate among children under 15 years of age remains low. Some reported factors found to be associated with low retention rates were late initiation of antiretroviral therapy (ART) and poor adherence. Our objective was therefore to assess retention at 36 months of paediatric patients on antiretroviral treatment at the day unit of the Mother and Child centre of the Chantal Biya Foundation.
Methodology: We conducted a cross-sectional study with a case-control component targeting children aged 0-15 years. Data were collected exhaustively from the 2017 and 2018 cohort follow-up registers, diagnosed positive after the first PCR. Children who had died, been lost to follow-up and transferred to an outpatient department were considered as cases, and any child who was on treatment at the end of the study period was considered as a control. Patient follow-up and the association between independent variables and the occurrence of attrition were estimated.
Results: Data were collected from 260 children (117 from 2017 and 143 from 2018). The prevalence of retention varied according to the relationship with the nursing and patient characteristics. Orphans [OR=9.75 IC95%=(4.06-10.37) P=0.01], mothers poor adherence with therapeutic education [2.52, IC95%=(1.78-3.37) P=0.001] and immunosuppression [OR=9.10 IC95%=(4.06-10.37) ;P=0.03] were found to be significantly associated with poor retention of the childs. The main reasons given by caregiver for poor adherence to therapeutic education were discrimination 10 (27.78%),the child’s schooling 8 (22.22%) , puberty 9 (25%) and self-transfers 9 (25%).
Conclusion: The retention rate of children put on ARV remains worrying, at more than a third of patients. The factors associated with poor retention were mothers poor adherence with therapeutic education, immunosuppression and orphanhood.
Keywords: Retention; Children 0-15 years; Mother and Child Centre; Chantal Biya Foundation; Yaounde
References
Background: The recent results published in the annual report HOLOGIC GLOBAL WOMEN’S HEALTH INDEX have shown that Italian women are among the least involved in cancer prevention programs: in fact, only 11% have undergone an organised screening pathway in the last 12 months, while the average in Europe is 20%.
Aim: Through an active call, a path of proactive medicine has been realized by attracting all women between 40 and 74 whose computerized medical records did not show the execution of a mammography in the last two years.
Material and Methods: Starting from MilleWin medical records management software, MilleGPG search engine has been used to extract from the total number of patients (1630) all women between 40 and 74 years who had not performed a mammography in the last two years. The women were contacted by telephone by the clinic nurse, who ascertained that the mammogram had not been performed during the previous two years and, in compliance with the regional guidelines of breast cancer screening, short motivational counselling was carried out to highlight the importance of prevention and achieve individual empowerment in order to increase adherence to screening. In detail, for the achievement of the goal, a dematerialized prescription was sent to women aged between 40 and 44, those aged 44 to 49 were sent a dematerialised prescription with an exemption code, while women aged 50 to 74 were redirected to organised regional screening. Women with a previous diagnosis of breast cancer were excluded from the active call.
Results: In a group of 874 women, out of a total of 1630: 53 were in the 40-44 age group, 72 in the 45-49 age group, 313 in the 50-74 age group, and 36 (4%) had had a breast cancer. The extrapolation of the data from the medical records showed that there were no results of mammography performed in the previous two years in: 24 out of 53 in the 40-44 age range, 37 out of 72 in the 45- 49 age range and in 156 out of 313 in the 50-74 age range.
All these patients were contacted by phone with a confirmation of not having performed a mammography in 11 out of 24 women in the 40-44 age group; in the 45-49 age group 4 out of 37 women had performed one more than 2 years ago and 10 had never performed one; in the 50-74 age group 60 out of 156 women had performed a breast screening more than 2 years ago while 5 had never performed one. 37 patients never answered the active call. The total analysis showed that 217 women were not reported in the folder, 37 of these did not respond, 90 had performed the test without declaring it and 90 other were redirected to screening.
Conclusions: Our study project confirmed that Italian women adhere less to cancer screening than women in other European states, the reasons are multiple but the prevailing cause is the workload and the same dedication to the family that characterizes the Italian woman as the caregiver of the whole family. Despite the many reasons, the numerous organizational obstacles and the different strategies between the Regions, the structuring of a proactive medical path allows to increase the adhesion to cancer screening by realizing without additional costs a support and a strengthening in Primary Care to the network of organized screening. This project shows that proximity medicine also serves to produce health and not only to provide social and health care, and that the “microteam” of the Primary Care Physician can be a valid territorial unit in cancer screening.
Keyword: cancer screening; proactive medicine; proximity health services; motivational; counselling
References
Tobacco consumption is widely recognized as the single most preventable cause of death and disability worldwide. The impact of tobacco use on global health is substantial and well-documented, affecting millions of people and leading to numerous health complications. Tobacco dependence is indeed a chronic condition characterized by a persistent and recurring nature, which often leads to relapse even after periods of abstinence. The chronicity of tobacco dependence can be attributed to both physiological and psychological factors. Nicotine, the primary addictive component in tobacco, creates dependency by altering brain chemistry, leading to withdrawal symptoms and cravings when not consumed. These physiological dependencies are compounded by behavioral and social habits formed around smoking, making it a challenging addiction to overcome. Addressing tobacco consumption is crucial for improving global health outcomes. The role of dental professionals in managing tobacco dependence is vital due to their frequent and often long-term interactions with patients. By implementing comprehensive tobacco control measures, societies can significantly reduce the burden of tobacco-related diseases and enhance the quality of life for millions of individuals.
Keywords: tobacco; tobacco cessation; tobacco-cessation centers; dental surgeons
The major industrialised countries have significantly contributed to global warming with unprecedented magnitude. It is worth noting that the major polluters are; China, India, and United States of America including Brazil. These countries have many industries which emit their affluence to the atmosphere, inform of ‘black carbon dioxide and methane gases’. This has led to global warming and climate change. Melting of junks of ice in North Pole and Alaska increased the volume of water in seas and oceans of the world thus causing unprecedented floods. Again, the widespread use of fossil fuel, and episodes of wild fire has significantly damaged the environment and contributed to global warming and climate change.
The world’s energy systems are still dominated by fossil fuels. However, it is imperative that countries scale down the use of fossil fuel usage to save the planet earth. Again, carbon dioxide usage should be taken out of the power sector by phasing out coal facilities. There is a dire need to increase the uptake of renewable energy around the world. Limit global warming to 1.50C and reduce greenhouse emissions. The said countries have promised to reduce fossil fuel and industrial pollution by 25 to 30 percent by 2030. It is easier to say but are we likely to witness tangible action?
Global actors need to institute actions to limit climate change, and avoid unacceptable risks to global health. Fund initiatives for climate change and implementation public health measures to reduce number of deaths from cancer, respiratory and cardiovascular diseases that are caused by air pollution, risks from extreme weather events, infectious disease, diminishing water supplies, and food insecurity. Public health specialists have a fundamental role in leading by example, primarily by: a) Raising awareness of the health effects of climate change and the potential health co-benefits of low carbon pathways. b) Contributing to the development and implementation of measures to limit climate change and protect people in workplaces, and communities; c) Working to minimize the environmental impacts on health systems, while improving health services.
There have been many global summits regarding climate change and global warming. Which started in 1992 in Rio de Janeiro in Brazil, then Montreal protocol, Kyoto protocol (Japan) and COP-21(Paris). The efforts advanced by world leaders in addressing the problem have been futile, hence, follow-up summits. Even the subsequent summit recommendations reached may not bear fruits but will likewise be mere rhetorics. The global dilemma shouldn’t be where it is if concerted and collective measure were implemented in a spirit of collective responsibility.
References
Introduction: This study shows into the technological revolution of connected medical devices, which are redefining the landscape of disease monitoring, diagnosis, and treatment. It explores how the integration of cutting-edge technologies is propelling personalized and remote healthcare services.
Objectives: The primary aim is to evaluate recent advancements in connected medical devices and their impact on enhancing disease monitoring and diagnostic accuracy. The research explores how these technologies are reshaping healthcare dynamics and identifies associated challenges and opportunities.
Methodology: A qualitative approach anchors the research, linking investigative questions with theoretical frameworks and empirical findings. The study scrutinizes wearable devices and implantable systems, integrating a comprehensive literature review with expert interviews and data analysis. This methodological framework enables an in-depth understanding of the interplay between technological innovation and medical practice.
Results: Findings highlight that connected medical devices significantly enhance precision and efficiency in healthcare delivery, enabling real-time patient monitoring and improved clinical decision-making. While technical, ethical, and regulatory challenges are identified, the study also underscores innovative solutions to address these hurdles effectively.
Conclusions: The research emphasizes the importance of qualitative methodologies in examining the realm of connected medical devices. It stresses the need for a robust methodological framework to assess both technological advances and associated challenges thoroughly. This study contributes to a deeper understanding of how connected medical devices are transforming healthcare, highlighting the need for integrated and multidisciplinary approaches to maximize their benefits and mitigate risks. The analysis concludes that connected medical devices could be the key to a future where digital health is at the core of a more inclusive and resilient healthcare system. This study acts as a catalyst in the debate on the digitization of healthcare, proposing strategic directions for future research and policies.
Keywords: Connected medical devices; Remote monitoring; Digital diagnosis; Health technology; Hyperconnectivity
References
Aim: To define and evaluate the role of Apulian General Practitioners in regarding the prescribing appropriateness of antibiotics and the importance of counseling for patients, to identify and manage the problem of ABR, particularly in the context of upper respiratory tract infections.
Materials and methods: the survey was conducted through the administration of a questionnaire consisting of 10 items addressed to the GPs of the Apulian territory, in the period from January to April 2024, by email, instant messaging and social media.
Results: 180 General Practitioners were interviewed, (58% women 42% men) of which 45% GPs with >1500 patients, 32% urgent care doctors, 16% GPs with 1200-1500 patients, 3% GPs with 1000- 1200 patients and 5% GPs with 800-1000 patients.
65% of GPs (n:117) prescribe an average of 5 antibiotics per week, 22% of GPs (n:39) prescribe 6-10 antibiotics and 13% (n:24) more than 10 antibiotics. Patients ask for antibiotics for the following reasons: pharyngitis (68%), urinary tract infections (69%), cough (40%), acute bronchitis (44%), otitis (23%), sinusitis (18%), cold (16%), other flu symptoms (15%). General Practitioners report that every day on average at least one patient requires a prescription for an antibiotic for a pharyngitis. In 33% of cases it is a woman (33%), very insistent (52%), arguing the need to resume her work activity as soon as possible (34%), for self-diagnosis (32%) for comparison with family members with similar symptoms who would have been prescribed an antibiotic (32%), for having started home therapies, residues of previous therapies.
GPs report a patients’ poor awareness about side effects, compared to the deep-rooted belief that the antibiotic guarantees a quicker and better resolution of symptoms.The proposals to stem the phenomenon from the GPs interviewed suggest patient education to limit improper requests (79%), counseling not to use antibiotics in viral infections (77%), information on individual adverse events linked to abuse (56%), empowerment regarding the impact on the global health of the planet and the growing difficulty in treating infections caused by resistant germs (52%), synergistic action with pharmacists (48%), greater diffusion and training for the application of treatment guidelines in primary care (19%) and more frequent updating on the issue of AMR (15%).
Regarding the use of diagnostic tests such as the rapid test for beta hemolytic streptococcus, although little used in general practice, the majority of participants (80%) consider it strategic to avoid inappropriate antibiotic therapies and guide the patient towards its use of symptomatic. 83% of GPs recommend the use of anti- inflammatory-analgesics for the management of "sore throats" and confirm the need to combat the abuse of antibiotic therapy requests.
Conclusions: Antibiotic resistance is a multifactorial public health issue that requires urgent prevention and control actions at global and cross-sectoral. General Practitioners in Apuglia have a fundamental role on the correct use of antibiotics. It is necessary to promote health education and patient counseling, citizen empowerment about good hygiene practices (use of DPI, hand washing, etc.), attention to environmental contamination (e.g. waste disposal); to encourage adherence to vaccination and the appropriate use of antibiotic or symptomatic therapies for themselves and for the community; to reduce the tendency to self- prescribe antibiotics and the adverse events related to it, such as the percentage of treatment failures and healthcare costs; to apply the guidelines in pharmaceutical prescriptions; to join collaborative, research and innovation initiatives to combat ABR.
A possible helpful tool may be the use of rapid diagnostic tests to reduce the inappropriate prescription of antibiotics. We need to move from a simple idea of appropriateness in prescription to an overall cultural appropriateness of a healthcare nature.
In fact, General Practitioners can act effectively only with other stakeholders, to trigger virtuous processes, respecting the skills and responsibilities of each individual, in order to always be able to operate for the best clinical outcome, in the absence of ethical conflicts. At the same time, we hope for more training opportunities for healthcare workers, pharmacists and veterinarians, in integrated multi-sectoral events, according to the principles of One Health.
Keywords: antibiotic resistance; General Practitioners; sore throat
References
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, Hubei, China, and has resulted in an ongoing pandemic. As of September 25, 2020, more than 32.1 million cases have been reported across 188 countries and territories, with more than 981,000 deaths; more than 22.1 million people have recovered. The data was obtained from the media bulletin released by the Ministry of Health and Family Welfare Department, Karnataka. The study included total cases of 13168; in that total discharges were 9438, and deaths were 235; the prevalence of attack rate in the month of September was 260 per lakh population; in the previous month of April it was less than 1 per lakh population; the case fatality rate in April rose to 40; in May it was zero; in September it became 1.14; the recovery rate in April was less than 20; in September it was 76.
Keywords: Case fatality rate (CFR); Recovery rate (RR); complete case fatality rate (CCFR); Attack rate (AR)
References
There is lack of information on the use of Gongronema latifilium and Luffa aegyptiaca leafy vegetables decoction in the management of diabetes. The study investigated the effect of G. latifilium and L. aegyptiaca leafy vegetable decoction on blood glucose level, lipid profile and liver enzymes of alloxan-induced diabetic wistar rats. Experimental design was adopted to randomly assign 30 rats of 5 treatment groups and 1 untreated group each. The leafy vegetables were purchased, picked separately and washed with deionized water. The vegetables were separately boiled for 10.3minutes in 3.5L and 4.5L of water, respectively. The decoctions were sieved out separately and stored in the refrigerator for further study. Alloxan was used to induce diabetes in the rats, while treatment lasted for 21days. Phytochemicals, acute toxicity test, blood glucose and liver function test were done using standard methods. Pair-sample t-test (p < 0.05) was used to determine the effect of the decoctions and percentage difference was calculated. There were 69.64% and 68.88% decreases in the blood glucose level of diabetic rats treated with 3mL/kg bodyweight of G. latifilium and L. aegyptiaca decoctions, respectively. There was significant increase (p < 0.05) in the HDL-C level of diabetic rats after treatment with 3mL/kg bodyweight of G. latifilium and L. aegyptiaca decoctions. Significant decrease (p < 0.05) was observed in the liver enzymes activity of the diabetic rats after treatment with 3mL/kg bodyweight of G. latifilium and L. aegyptiaca decoctions. The leafy vegetables decoction had potentials to reduce high blood glucose level, dyslipidemia and, for normal liver function.
Keywords: Gongronema latifilium; Luffa aegyptiaca; decoction; blood glucose; diabetic rats; liver enzymes; dyslipidemia
References
The study was conducted at farm of Animal Production Department, Faculty of Natural Resources and Environmental Studies, University of Kordofan, El-Obied, North Kordofan State, Sudan. During June 2021 to April 2022. The study was designed to investigate the effect of sesame waste feeding on growth performance, carcass characteristics and external body measurements of male Desert kids. Sixty male Desert kids aged 4-5 months and weighed 12.0Kg were used in this study. The experimental kids were divided randomly into three groups; 20 males for each group. Group one was fed on pastures and supplemented diet (waste sesame diet) which consist of 38% waste sesame diet, at a rate of 0.5Kg/head/day. Group two was fed on pastures and supplemented (wheat bran diet) which consist of 38% wheat bran, at a rate of 0.5Kg/head/day. Third group was fed on pastures only (control) with one week adaptation period in randomized complete design experiment; data was analyzed by [1]. The results revealed that there were significant (p<0.05) differences in daily weight gain, where as daily weight was 4, 19.4 and 14.3g for control, wheat bran and sesame waste respectively, there was no significant (p>0.05) differences in daily feed intake, where as daily feed intake was 269 and 202g for wheat bran and sesame waste respectively, there was no significant (p>0.05) differences in slaughter, empty body, hot carcass weights and dressing %, final heart girth belly girth, height at wither and body length. Highest profits were recorded sesame waste diet compared with wheat bran diet pasture.
Keyword: Desert goat; growth performance; external body measurements
Health system designers often fail to consider the overwhelming nature of the tasks they assign to the average individual in modern society. This exhaustion leads individuals to disregard health and treatment advice and lack the willingness to carry out these actions.
It is necessary to execute many of these acts using various and pleasurable approaches. Enjoyment and reinforcement play a crucial role in driving motivation, facilitating learning, experiencing emotions, and maintaining physiological balance (allostasis) [1]. As an alternative, individuals are encouraged to engage in enjoyable physical activities, such as swimming, rather than engaging in monotonous and tedious repetitive movements.
Meanwhile, one approach to administering certain compounds to the digestive system involves the consumption of appetising foods or specialised chewing gums.
Here are some items that can be made using chewing gum: A chewing gum that includes vitamin B6 and ginger is designed to prevent car sickness and aeroplane sickness. Another option is mint chewing gum, which has basic properties that help avoid bloating or refluxing. Edibles or saffron gums can be used to energise, while herbal gums with therapeutic effects, such as those containing turmeric, can help reduce joint inflammation. So, based on the advantages of using chewing gum as an innovative method of delivering drugs, such as its ability to simultaneously provide local and systemic delivery, protect against acids and enzymes, have low first pass metabolism, enhance alertness and cognitive function, and maintain good stability, it can be inferred that chewing gum will become increasingly popular among patients and in the market in the coming years. Some examples are: remedies for motion sickness, pain, smoking, dental caries, tooth decay, various mouth diseases, otitis media, gastrointestinal problems, oral fungi, and inflammatory issues [2, 3].
Chewing gum is an effective oral delivery system that offers increased effectiveness, the ability to remove gum at any time, reduced risk of overdosing, and no water requirement. It provides protection against chemical or enzymatic attacks in the gastrointestinal tract, making it popular among children and teenagers. Chewing gum has a low first-pass effect. It is suitable for rapid delivery and has fewer side effects. It also has good stability against light, oxygen, and moisture. Chewing gum can help alleviate xerostomia, improve work performance, and reduce pain and swallowing difficulties after tonsillectomy. It also stimulates alertness and reduces food cravings [2, 4, 5].
Chewing sugar-free gum (SFG) decreases the amount of Streptococcus mutans bacteria in the mouth compared to individuals who do not chew gum. Given the extent of variation in the impact and the moderate quality of the trials analysed, further study is necessary to investigate the potential of sugar-free gum as a preventive intervention for reducing the presence of cariogenic oral bacteria [6].
Paying attention to subtle details, such as suggesting that industrial drugs and supplement producers create different types of chewing gum and various foods, is a seemingly straightforward approach that can enhance the efficacy of health recommendations and facilitate the delivery of specific substances. The technology required to introduce chewing gum as a viable substitute for various types of tablets in the healthcare system is not yet developed and comprehensively understood. This is due to the need for further exploration and acquisition of information and knowledge on the manufacturing of chewing gums.
References
A typical person should take a very long list of steps in a 24-hour period to maintain the health of himself and his family such as: brushing the teeth, managing blood sugar levels by adjusting the intake of substances into the digestive system, consuming specific chemicals to aid in digestion, utilizing mouthwashes to improve oral odour, taking medications like Probiotic supplements and vitamins, increasing physical activity and maintaining a healthy body weight, strengthening muscles to prevent joint and bone disorders, regulating sleep patterns through the consumption of beverages like coffee, reducing stress and inducing relaxation through the use of certain medications, etc.
References
The increasing development of digital technologies in recent years has led to a concomitant increase in the availability of data in ICUs. For this vast amount of information to be useful, it must be processed and analyzed to extract meaningful information. However, its size and complexity often exceed the capabilities of traditional tools, motivating ongoing research efforts to develop new analytical techniques better able to address these challenges. This effort has resulted in the maturation of disciplines such as artificial intelligence, machine learning (ML), data mining (LLM), parallel computing, and many others. Despite these advances, countless challenges of modern computing remain unaddressed and strategies to extract knowledge from complex data will undoubtedly persist as an active area of research in the years to come.
Real-time risk estimation of isolated pathologies provides interpretable information to understand the different risks of patients with multiple pathologies using electronic health records (EHRs) in an ICU patient; However, in this case there are fundamental problems when formulating hypotheses such as sample selection bias, imprecise variable definitions, implementation limitations, frequency of variable measurement, subjective treatment assignment and model overfitting.
Decision-making and predictive models (CDSS), on the other hand, are not yet widely developed with the current known health systems. However, their potential based on massive data sources, allows with the structured data of data lakes, to perform artificial intelligence (AI) to improve training and control for algorithms according to the different requirements and security that we must carry out and that we will build for the different syndromes. Here we present an CDSS model that captures data from public ICUs and we show in our report the potential data mining, for later analysis with different predictive models.
We highlight that with the current results of a public ICU, through a Smart ICU there is 0.003% that corresponds to EHR data and only 3.97% is structured data in data lakes that are susceptible to useful algorithms -at the present time- for an CDSS system.
Keywords: Data sources; Intensive Care Units; CDSS; Artificial Intelligence; Interoperability; EHR
References
Pancreatitis, marked by inflammation of the exocrine gland of the pancreas, poses significant therapeutic challenges with conventional treatments often failing to provide long-term relief. This study investigates the efficacy of a Neo-Ayurvedic treatment protocol, which includes herbal supplements and dietary modifications, in the management of chronic pancreatitis. The case study of a 23-year-old male patient with a three-year history of chronic pancreatitis demonstrates significant symptomatic relief and normalization of pancreatic enzyme levels within a short period after initiating the Neo-Ayurvedic treatment. This novel approach highlights the potential of integrative medicine in treating complex gastrointestinal disorders and restoring overall health without headaches and abdominal pain, allowing normal digestion of all types of food.
Keywords: Pancreatitis; Neo-Ayurvedic treatment; cell regeneration; herbal supplements; integrative medicine
References
Introduction: In December 2019, in the city of Wuhan, Hubei province, Covid 19 appeared and spread rapidly around the world. This syndrome is associated with failure and damage to several organs; or even a disruption of cellular metabolism.
Materials and Methods: This is a prospective, descriptive and analytical study of patients infected with SARS-Cov2. For each patient, the determination of certain biochemical parameters (albumin, creatinine, urea, sodium, potassium) was carried out with the ARCHITECT plus Ci4100 PLC.
Results: Our study population consisted of 153 subjects with covid-19 with a mean age of 55 ± 19 years. Male sex represented 53.8% of the study population, with a sex ratio of 1.15. We noted that 45.1% of patients had a severe form of the disease and 50.3% had a comorbidity. The disturbances noted are hypoalbuminemia, hypercreatininemia, hyperuremia, hyponatremia and hyperkalemia.
Conclusion: The incidence of death was significantly high in patients with disruption of biochemical parameters.
References
A recent study has indicated that 70 million people are estimated to suffer from epilepsy. Despite the increase in education and health care, some health professionals continue to linger in darkness about the cause and treatment options of the disease. The main objective was to study the nurses within the Asutifi North District to understand their subjective experiences of epilepsy in a socio-cultural context and how their knowledge shaped their practice towards people with epilepsy. The exploratory descriptive cross-sectional study design was used. The study participants were selected using a multistage sampling technique to arrive at a sample size of 102 using a standard statistical formula. Data analysis was done using STATA version 12. Findings indicated that 45.1% of nurses have had theory lessons only, 29.4% clinical demonstrations only, and 25.5% of participants said they have had both theory and clinical demonstrations. The bivariate logistic analysis proved a significant difference in knowledge of epilepsy and demographic factors as observed among religion (p=0.017), speciality area (p=0.045), and close family relationship with epilepsy (p=0.001). When the socio-demographic characteristics were cross-tabulated with practice on epilepsy, the area of speciality (RMN) (p=0.001) appeared statistically significant. Nurses in the Asutifi North District of the Ahafo Region of Ghana tended to have low knowledge and poor practice on epilepsy. Therefore, enhancing nursing education and training on epilepsy is imperative to improving health care delivery for people living with epilepsy.
Keywords: Knowledge; Practice; Epilepsy; Nurses; Asutifi North District
References
Thyroid hormones are regulators of various physiological processes within the human body, which become particularly evident in case of imbalance. Autoimmune thyroid disease affects about 10% of the population worldwide with an increased incidence in women (Hayter, 2012). The aim is to analyze the reference values of thyroid anti-peroxidase (anti-TPO) and evaluate the relationship between mood disorders such as anxiety, depression and autoimmune thyroid diseases. The correlation of autoimmune thyroid disease with anxiety disorders is significant because it is also the most prevalent mental health problem in women (Rector, 2006), followed by depression. The research was carried out in digestive health institutions in the municipality of Pristina, namely in the American-Kosovar AmeriKos polyclinic and the Vital Group clinic in Pristina with a total sample of N-80 female respondents, of which 40 patients with a positive result of Anti-TPO and 40 with a negative Anti-TPO result. The research was carried out based on the qualitative method and the instruments that were used consisted of questionnaires related to anxiety and depression that were determined using the HADS assessment (Zigmond, 1983). The research results show that anxiety and depression have a significant negative strong correlation with people with autoimmune thyroid disease: (alpha = 0.05, P= .002), A -0.4398 and D -0.4608. Based on this research, we can conclude that individuals in the community with autoimmune thyroid disease with positive Anti-TPO may be at high risk for mood disorders, depression and anxiety, the basic factors in normal functioning in life.
Keywords: Hypothyroidism; Autoimmune disease; Anti-peroxidase; anxiety disorders; Autoimmune thyroiditis; Depression; Gills; Hashimoto's thyroiditis
Whether in-person or virtual transactions, effectiveness requires three essential elements for the benefit of producers and buyers:
The quality of product exchange depends on expertise in the domain prepared for and the production process. Nobody wants to buy goods or services of inferior quality, as it leads to unsatisfactory usage, affects their finances, and wastes time. This disappoints buyers and drives them to seek other suppliers for future transactions, ultimately reducing the provider’s return on investment and negatively impacting their business stability and growth.
Skills in presenting and selling products involve effectively communicating the value of preferred products at a lower cost than the competitor while showcasing higher quality.
Trustful and respectful relationships among collaborators provide them with the comfort of communication. The pricing decisions made by providers reflect their fairness in business. If the producers overestimate their goods and set an inflated price, the buyers will be disappointed when compared with their competitors’ offerings. They will consider them as disrespectful and untrustworthy providers and avoid further relationships with them.
If a buyer is unaware of the prices of a particular product in the market and the provider overcharges them, this can also negatively impact the buyer and may lead them to seek similar products elsewhere later. The buyer is likely to share their dissatisfaction with others, causing a negative ripple effect on the provider's reputation. This can result in decreased investment returns and instability for the provider's business.
Hence, a disrespectful relationship impacts all parties involved in exchanging products.
People must recognize the importance of being fair in all dealings. Unfair practices in selling products or services can harm consumers’ inner lives and discouragement disrupts their overall balance.
By contrast, product quality offerings, price adjustments to the customer’s financial capabilities in a given area, philanthropic activities when required, and providing necessary goods to help those in need are essential for a better life.
In summary, the way we treat others when selling our products reflects our reputation in the community; it provides information about how we establish and maintain relationships with those interested in our products. This, in turn, impacts our social and professional life trajectory in a constantly changing virtual and real world.
Each selects their path for advancement according to personal preferences and being informed.
No one can live alone in the community since they do not own or know everything. Usually, people must interact with each other to exchange their products or services to provide comfort for themselves and their loved ones.
Financial power ensures a successful existence if the money is wisely invested and spent in one’s interest.
Continuously importing/exporting goods and services means collaborating with other providers/buyers. The connection between parties implied in this product exchange is essential. Nowadays, this happens in the virtual and real world. Even though traditional in-person collaborative work is a more accurate and practical model, many people prefer virtual connections to save travel costs, time, and tiredness.
References
Purpose: This research paper aims to analyze a project-based learning method and its positive effects on building emotional competencies in Gen Z students. In its initial part, the paper outlines project-based learning as a long-established teaching practice, whose origins can be traced back to antiquity. The paper then narrows its focus onto a method of project-based learning occurring outside of the classroom settings, namely the one adopting the form of community service projects. At its core, the paper concentrates on the effects of community service projects on the development of emotional competencies in project participants, with an added focus on self-regulation, motivation, and social skills in leadership and conflict management.
Design/methodology/approach: This quantitative research paper uses a descriptive research design, centered on a survey developed in line with the related literature. The research data was collected through a self-administered questionnaire, delivered in paper-and-pen format in November and December 2023. In total, 221 full-time university students, aged 17-20, participated in the survey.
Findings: Based on the findings, the paper contends that community service projects not only provide Gen Z students with ample opportunities for social and emotional learning, but more crucially, project implementation proves to have positive effects on students’ emotional competencies, which include self-regulation, motivation, leadership, and conflict management.
Originality/value/implications: In its conclusion, the paper argues that project-based learning is an effective teaching method that allows project participants to acknowledge and cultivate feelings about themselves, their peers, or the communities they serve. When considering its maximum potential, project-based learning can also be viewed as a vital tool in combating those social and emotional deficiencies that may prevent members of this recently emerged demographic cohort from realizing their full potential.
Keywords: project-based learning; gen Z students; self-regulation; motivation; social skills; leadership; conflict management
References
CAD/CAM milling and direct metal laser sintering (DMLS) methods, have brought significant advancements to prosthodontics.
In recent years, additive manufacturing techniques have gained popularity for fabricating metal substructures, particularly cobalt-chromium (Co-Cr) components.
These technologies have reduced manufacturing costs and time, while also minimizing human errors such as wax pattern distortion and casting irregularities, leading to improved fitting accuracy compared to traditional casting techniques.
Although milling techniques achieves greater accuracy, its high fabrication costs limit its practicality for daily use. In contrast, DMLS is a more cost-effective and faster technique with a slightly lower precision.
This paper briefly provides an in-depth exploration of the fundamental principles, clinical applications benefits and considerations associated with direct metal laser selective (DMLS) technology in fixed prosthodontics.
References
A prospective cross-sectional study of diabetic patients registered at Eye department of Tobruk medical center in Tobruk-Libya between (01.06.2023 to 29.02.2024). Data was collected using self-administered questionnaire. Grading of DR was done by slit-lamp examination and Fundoscopy by ophthalmologist. Descriptive analysis included percentage and mean, median, and p-value by using SPSS 25. There were 85 diabetic patients, ages ranged between 30 and 90 years, with a mean of 58, the majority (97.6%) were Libyan nationality living in Tobruk (98.3 %). There were 86 females. that patients with duration of diabetes ranging between 11 and 15 years were at almost five-folded risk of developing DR compared to those with duration <10years. Most of advanced complicated diabetic retinopathy cases had diabetes more than fifteen years, and no advanced disease in the cases with duration less than 10 years.
The patients with poor controlled blood sugar and HbA1c >9 throughout the disease were at almost five-folded risk of developing DR compared to those with moderate controlled diabetes cases were HbA1c between (7.5 -9), patient with poor control of diabetes HbA1c>9 was 25-folded risk of developing PRP than cases with good control HbA1c <7.5. The majority of advanced diabetic retinopathy cases were correlated with non-controlled diabetes mellitus HbA1c > 9%, were no advanced complication recorded in good controlled cases.
The objective of this study to estimate the prevalence and identify the correlation between risk factors like age of patients, type of DM, duration, no control of diabetes mellitus patients with blindness due to progression of DR attending the Eye Department at Tobruk medical in Tobruk-Libya.
References
Senescence is the age-dependent end of the life span. In plants, it can be visualized by yellowing of leaves that accompanies the mobilization of leaf nutrients to the reproductive structures. The yellowing of senescing leaves is correlated with a series of biochemical changes such as loss of chlorophyll contents, degradation of proteins, RNA and a decline in photosynthetic activity. Senescence limits crop yields in annual crops like maize, rice and wheat. Delayed leaf senescence is a desirable agronomic trait to improve crop yield. In this study the combination of AlCl3 and Gibberellic acid reduced the loss of pigments, proteins, spectral properties, electron transport activities in wheat primary leaves under incubated dark conditions. The restoration of whole chain electron transport activity by the combination of AlCl3 and GA was closely associated with the restoration of PS II activity when compared with PS I. The combination of Gibberellic acid and AlCl3 treated leaf thylakoid membranes showed an increase in absorption at 680 nm moderate increases at 480 nm and 440 nm at 72 h during dark incubation. The AlCl3 and Gibberellic acid protected the degradation of water oxidation complex polypeptides (33, 23, 17 KDa) of PS II and slightly protected the 68 kDa of PS I polypeptides.
Keywords: Senescence retardation; PSII and PS I activity; water oxidation complex polypeptides
References
The aim of the study: To conduct a medical and sociological survey among doctors in 4 Commonwealth of Independent States (CIS) countries for the effectiveness of the implementation of secondary prevention of noncommunicable diseases (NCDs) in outpatient healthcare.
Material and methods: Outpatient doctors from 6 cities in 4 CIS countries participated in the simultaneous study. A total of 210 doctors of therapeutic profile took part in the survey: Bishkek (Kyrgyzstan) - 42 doctors, Minsk (Belarus) - 37 doctors, Astana, Shymkent, Aktobe (Kazakhstan) - 55, 30, 10 doctors, Baku (Azerbaijan) - 36 doctors. The survey was carried out according to a questionnaire previously prepared by the National Research Center for Therapy and Preventive Medicine, which consisted of 11 blocks of questions. Answers to each question were offered in several gradations.
Results: In three countries, patients in the age range of 50-59 years prevailed among men who applied to the primary health care unit, whereas in Azerbaijan, men aged 60-65 years were dominant. In the CIS countries, patients most often go to the polyclinic for chronic forms of CHD. In Azerbaijan, Kazakhstan and Belarus, the incidence of type 2 diabetes with or without complications is more than 20%. Doctors in large cities of the CIS countries do not recommend non-drug treatment methods in up to 10% of cases. Preferential drug provision differs slightly between the analyzed cities. In Kazakhstan and Belarus, doctors note about 70% of cases when 75% of the target level is reached. In Kyrgyzstan and Azerbaijan, the same level is reached 2-3 times less often. In Kazakhstan, Belarus and Kyrgyzstan, there is a relatively high frequency (satisfaction in 75% of cases), while Azerbaijani doctors claim that 52% are not satisfied and 44% of cases are partially satisfied with interaction with specialized hospital doctors. In Azerbaijan and Belarus, 75% of the staffing of outpatient clinics prevails. In Kyrgyzstan, in 84% of cases, 100% staffing is detected. At the same time, in Kazakhstan, 50% and 75% staffing levels have a comparable frequency. In these countries, a similar pattern is being monitored for the provision of secondary medical staff at the polyclinic level.
Conclusion: Patients with CHD and type 2 diabetes mellitus predominate among patients with NCDs observed in polyclinics. Adherence to therapy is insufficient in every second case. Coverage of preferential drugs and achievement of target levels of the main risk factors among patients.
Keywords: secondary prevention; non-communicable chronic diseases; medical and sociological survey; doctors; CIS countries
By contrast, gaps in instruction, inadvertent communication with those implied in relationships, inflated prices, not sharing the presence well, and not aligning with social norms attract the provider’s lousy name, which in turn leads to their business decline and negatively impacts the provider’s career and social life.
The clients, collaborators, and providers must all make the same effort to maintain and strengthen their relationships. Disrespectful interactions can negatively impact their inner life, leading to conditions such as depression, arterial hypertension, type 2 diabetes, and even brain hemorrhage or tumors in vulnerable individuals.
Maintaining truthful and well-mannered relationships is crucial for sustaining and advancing practice. In the present digital age, individuals can block unsafe communications by using specific functions of IT devices. The offenders can reflect on their past improper attitudes or words toward the blockers and try to correct their unprofessional behavior.
Overtiredness reduces work efficiency, following common mistakes; when they exceed limits, they amplify the adverse effects on both the receiver and the sender. Preferably, we should avoid errors rather than deal with their negative impact on people’s lives.
Depressed providers do not offer quality services, which decreases the client’s desire to participate in collaborative work and consequently devalues their work.
By contrast, joyful providers deliver services of quality increase and delight the end users.
AI is used to score the sentiments of people implied in relationships, gaining insights about their work efficiency and continuity and how each variable can be modified in the best direction to their advantage in a constantly evolving world.
Nowadays, conversational AI, chatbots, virtual assistants, and AI/ML [machine learning] for business operations are the top investment areas, with leaders like Qualtrics and Verint. AI offers a new method to generate and communicate knowledge, benefiting clinicians and patients and enabling them to make better-informed decisions. AI tools complement, not replace, the healthcare providers’ decisions and autonomy.
Humans’ high aspirations lie in their physically perceptible existence. Loved ones, friends, and other connected community members want to interact virtually or in person as long as possible for the beauty of the mind and soul, and our mission is to support this.
Artificial and human intelligence may embrace people’s wishes for a better life and continuity.
A professional in the healthcare industry spends a long time in education to attain expertise in a specific field. Continuously updated information availability requires financial resources and time to possess or access instruction tools. These efforts are to improve people’s health, their life quality, and their expectancy.
The delivery of healthcare services benefits all players: the patients and their families, the medical team, and society as a whole. Each implied in a relationship has a contribution, valued according to their efforts.
The individual should combine expertise with communication skills in daily practice. Effectively handling data, showing consideration for people in distress, maintaining a friendly attitude, and using kind words benefit both the provider and the receiver of help. These elements ensure the provider’s good reputation with their practice standing and advancing and data quickly circulating online.
References
Public health surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in taking public health action geared towards the reduction of morbidity and mortality associated with the disease or health-related event [1].
Data disseminated by a public health surveillance system can be used for immediate public health action, program planning and evaluation, and formulating research hypotheses [1]. Periodic evaluation of public health surveillance systems ensures that problems of public health importance are being monitored efficiently and effectively [1].
Human Mpox is a zoonotic smallpox-like illness caused by the Mpox virus [2, 3]. The Mpox disease (formerly monkeypox) is caused by the Mpox virus (MPXV), an enveloped double-stranded DNA virus of the Orthopoxvirus genus in the Poxviridae family, with two genetic clades, clades I and II [3].
References
This review explores the therapeutic potential of African antitussive plants by examining their traditional uses, phytochemical properties, and pharmacological evidence. It highlights the historical and cultural significance of these plants in African medicine and provides an overview of the key phytochemicals associated with their antitussive effects. The review also evaluates scientific studies that support the efficacy of these plants, including in vitro, in vivo, and clinical research. Additionally, it addresses challenges in standardizing and conserving these valuable resources while discussing opportunities for integrating traditional knowledge with modern healthcare practices. This comprehensive analysis aims to advance the understanding of African antitussive plants and their potential contributions to global health.
Keywords: Antitussive plants; African traditional medicine; Phytochemicals; Pharmacological evidence; Ethnopharmacology
References
Pancreatic cancer represents a formidable challenge in modern oncology due to its dismal prognosis and substantial global burden. This comprehensive review examines the epidemiology, risk factors, pathophysiology, clinical presentation, diagnosis, treatment modalities, prognosis, and emerging therapies in pancreatic cancer. Epidemiological data reveal a concerning rise in incidence rates, particularly among younger cohorts and certain demographic groups. Known risk factors such as smoking, obesity, and family history are explored alongside emerging associations including changes in gut microbiota and metabolic disorders. Molecular pathways implicated in pancreatic carcinogenesis, including DNA adduct formation and genetic mutations such as KRAS, p53, and BRCA, are elucidated. The complex tumor microenvironment and stromal interactions are discussed, emphasizing their role in disease progression and therapeutic resistance. Clinical presentation, diagnostic modalities, staging systems, and challenges in early detection are outlined, followed by an overview of current treatment modalities including surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, and palliative care. Prognostic factors and survival rates based on stage and treatment are analyzed, along with predictive biomarkers for prognosis and treatment response. Emerging therapies and research directions, including precision medicine and immunotherapy, are explored, alongside considerations for quality of life, survivorship, and psychosocial support. The article concludes with a summary of key findings, implications for clinical practice and research, and future perspectives for pancreatic cancer management and treatment.
References
Background: Polycystic ovarian syndrome (PCOS) is a complicated reproductive, metabolic, hormonal, and endocrine disorder that affects one in every five (20%) Indian women. As a result, detecting PCOS at a young age is critical. Currently, limited diagnostic tool exists to evaluate the risk and severity of PCOS in women of reproductive age. As a result, the focus of our research is on developing and evaluating the 'Novel PCOS diagnostic questionnaire', which will help both healthy people and PCOS patients determine their risk of getting PCOS and the severity of their illness respectively.
Method: Novel PCOS questionnaire was developed with questions related to demography, co-morbidity, symptoms, diet, and menstrual pattern. It was evaluated through theoretical validation, empirical validation, and reliability tests.
Results: The ‘Novel PCOS diagnostic questionnaire’ passes all the validation tests and it can be utilised further as diagnostic tool.
Conclusion: The preliminary development and validation of the Novel PCOS diagnostic questionnaire is highly relevant to be useful in the real-world. The validation of this questionnaire at a comprehensive spectrum is furtherly focussed.
Keywords: PCOS; validation study; questionnaire; risk and severity assessment
References
Blended diets (BD) have gained popularity as an alternative to commercially available enteral formulas in children requiring tube feeding. Caregivers increasingly favor blended diets for their perceived benefits, including improved gastrointestinal tolerance and psychosocial benefits. However, questions remain about the safety, nutritional adequacy, and long-term impact of BD. This review synthesizes the latest literature from 2023 and 2024 to provide a comprehensive overview of the benefits, challenges, and clinical considerations of BD in pediatric patients. We explore the evidence on gastrointestinal outcomes, growth, safety issues, and the psychosocial effects of BD.
Keywords: Blended-diet; gastrostomy; food
Systematic documentation of traditional medicinal knowledge along with uses of herbs and dose administration play a pioneering role in the research and development of modern medicine. Worldwide more than 4,20,000 flowering plants are reported to date and more than 50,000 plants are used as medicine for kinds of ailments. In the context of the Indian traditional medicine system, more than 43% of the total flowering plants are recognized as medicinal values.
Much research has proven that the Indian traditional medicine system includes one of the oldest and finest medical sciences in the world. Collectively this medical system consists of AYUSH, which means Ayurveda, Yoga, Unani, Siddha, and Homeopathy. The treatment of any health issues with AYUSH can include Drug therapy, Acupuncture massage, Psychotherapy, Yoga, and Surgical techniques. According to the Sushruta Samhita, there are eight kinds of surgical methods mentioned under the surgical techniques viz., Resection, Incision, Stab, Puncture, Extraction, Puncture and collaterals, Suturing, and bandaging.
Ayurveda has been a fascinating subject since back to two decades among health and medicine researchers. It is the oldest collection and documentation of medical systems that originated back to 5000 B.C. In Ayurveda, there are eight divisions found i.e., Kayacikitsa (Internal medicine), Salya Tantra (Surgery), Salakya (Otolaryngology), Kaumarabhrtya (Gynecology and Pediatrics), Bhutavida (Psychiatry), Agada Tantra (Toxicology), Rasayana Tantra (Gerontology) and Vajikarana (Eugenics and Expediting). Ayurvedic treatments developed a close relationship between body and mind which makes them holistic therapy.
On the other side, Chinese herbal medicine (CHM) is a major part of the Chinese traditional medicine system. CHM is significantly used as an important source in new drug discovery. A Nobel Prize awarded You-you Tu (2015) discovered a therapeutic drug Artemisinin from the Chinese herbal plant Artemisia annua L. Artemisinin is used as a drug to treat malaria. According to the literature, one-third of the clinical drugs are extracted from CHM in China. For thousands of years, CHM has been the main source of treatment and prevention traditionally for various health issues in China. CHM not only provides a drug but also gives food flavors, pigments, and cosmetics ingredients. The CHM market recognized globally in recent years. According to the statistical data, CHM consumption is boosted by 400000 tons annually. These data support the importance of the Chinese traditional medicine system.
In conclusion, both the Indian traditional medicinal system and the Chinese traditional medicine system are still recognized as primary healthcare treatment for the majority of the people. Many drugs are discovered from natural resources and plants due to their traditional use in many parts of the world. The ethnic knowledge of herbal drugs navigating to the new drug discoveries at the labs. There are need for effective documentation of the traditional knowledge of herbal drugs. It may help the scientific community to achieve drug development for untreatable ailments.
Traditional medicine system consists with two elements first, spiritual practice and second, natural drug-based treatment methods. Where natural drug either plant derived or animal based. The spiritual healing are basically some rituals doing by the communities to treat ailment initially. Traditional medicine having holistic and dynamic characteristics. Both spiritual practices and natural drug-based treatment also known as complementary therapies and herbal medicine. They are recognized globally in both developed and developing countries. According to the World Health Organization (WHO) reports, nearly 80% of the global population still chooses traditional medicine as their first choice of healthcare. This huge chunk of the population has a great interest in traditional medicine because of its cost-effectiveness, easy accessibility, acceptability, minimum side effects and spiritual mythology. For two decades there has been a progressive demand for traditional medicine worldwide. An inadequate provision of modern medicine causes to move toward traditional medicine system to peoples. The huge research database indicates that traditional medicine research gets significant attention within the scientific community.
No one can be perfect in every situation; human imperfection is a common trait.
Each person is a unique construction that evolves differently in varied environments. A suitable workplace, loyal and friendly collaborators, lovely persons or animals around, and healthy habits facilitate the development and use of an individual's full potential. By contrast, excessive envy, lack of interest or support in personal advancement, and interaction with uneducated people with inappropriate behaviour decline creativity and work efficiency.
A professional in the healthcare industry spends many years, even decades, gaining expertise in the specific field and continuously updating knowledge. More new information makes us realize that the oceanic body of data is partly available for use and understanding. So far, no one may be proud of knowing and perfectly operating them.
Humility: 'Be like the bamboo: the higher you grow, the deeper you bow' - Chinese proverb.
There is a work hierarchy, and each practice has its work value. Being professional in relations with others is mandatory.
Handling data quickly and efficiently ensures you can maintain the equilibrium between the production process and relaxation. Experts in the domain who accumulate fatigue can make errors in practice, which harm both the receiver and the creator of the error. In those moments, they realize they are worthless. Saying sorry when you make an error is necessary – be professional. You must recognize your failure and do your best to repair the fault. Intense adverse reactions from offended people may destroy the vulnerable construction of the offender. Therefore, a professional approach to such conditions is required.
Passion can cause an individual to deviate from norms in daily life, and errors in social life can cause grief for others. Consequently, the individual realizes they aren't perfect, and their ignorance and arrogance decline.
Even having the best intentions and selecting the best way for the best doings, unexpected barriers may arise to fail. Failure confirms your weakness in checking, avoiding, blocking, and getting rid of them.
Vigilance decreases at the end of life since time slowly undermines everything. Sometimes, this happens early, originating in medical conditions. As a result, your capabilities change, making you aware of your limits in the community.
Each can best do a specific work, as instructed. Achieving a high position with a low education is inadvertent. Inappropriate self-importance follows failure, provoking distress around. Self-regarding your power and adjusting when it does not fit the requirements is essential. Friends, loved ones, and specialists in a specific area make you aware of your misunderstanding and act to take a good path. When your desires exceed realities, more self-reflection on your limits validates your imperfection, experiencing humility.
Like in a beehive, there is an order in life and the world. We must respect and be respected by each contributor empowered by God.
The Bible: 'Do not think of yourself more highly than you ought to think'.
God’s supremacy is eternal.
Being aware of your strengths and weaknesses is essential in daily activities. You evaluate yourself and compare yourself with others; the inner voice tells you the truth better. Analysing yourself and others' values validates the idea that people are more or less powerless in interrelating with God’s will.
References
Introduction: The objective of this study was to determine the prevalence of diarrhea as well as the conditions of water supply and management in households with a view to preparing a diarrhea control intervention.
Methods: An analytical cross-sectional study was carried out on an exhaustive sample of 237 households from two villages in the Tshopo province of the DRC, during the period from July 16 to 23, 2023. Statistics were performed using Pearson Chi-square, Fisher Exact, t-Student and Wilcoxon Mann Whitney tests, according to their conditions of application.
Results: The prevalence of diarrhoea in children aged 0-59 months was 21% (95% CI: 17%-25%). Unimproved sources (93%) were the main source of water supply. The population was aware of poor water quality (73%), believed that it was possible to treat water (90%) and were in favour of treating it (97%). However, only 3% of the population actually treated it. Storing water in unhygienic containers (43%), storing water on the ground (100%) and keeping it for more than 24 hours (51%) were common practices. All variables of sample characteristics, knowledge and observed practices were not statistically different between the two study villages (p>0.05).
Conclusion: The prevalence of diarrhoea is high in both villages surveyed. The population is aware of the poor quality of source water and is willing to treat this water. Intervention is expected on water treatment and safe management to reduce the high incidence of diarrhoea.
Keywords: diarrhea; water treatment; secure management; Tshopo; DRC
References
Introduction: Consumption of unsafe water is the cause of many diseases, leading to significant morbidity and mortality, particularly among children under five years of age. This situation represents a considerable burden for humanity. Household water treatment appears to be a practical and effective solution to ensure water security for populations, while reducing contamination and microbiological risks in communities without reliable access to safe drinking water. This article presents a study protocol aimed at assessing household drinking water treatment practices and identifying factors associated with these methods in the peri-urban environment of Bumba, Democratic Republic of Congo.
Material and method: A cross-sectional study with analytical aim will be carried out among 422 households during a period from July 1 to November 30, 2023. The data will be collected on the basis of an administered questionnaire and an observation guide. The frequencies and odds ratios (OR) and their 95% confidence interval will be estimated, then the logistic regression by stepwise descending approach will be calculated to analyze the influencing factors.
Expected results: Expected outcomes include a better understanding of households' practices and knowledge regarding drinking water, as well as the determining factors for their treatment behavior.
Conclusion: The findings of this study will highlight the role of knowledge and perceptions in the adoption of water treatment practices, thus contributing to the Sustainable Development Goals for 2030.
Keywords: Treatment; drinking water; peri-urban environment; Bumba
References
Introduction: Biomedical waste from healthcare facilities poses a serious threat to humans and the environment. Thus, this study aims to assess the level of knowledge, attitudes and practices of healthcare providers in Kisangani regarding the management of this waste.
Materials and methods: A descriptive cross-sectional study conducted among 422 professionals and managers of secondary and tertiary health care establishments in Kisangani, from June 15 to August 15, 2024. Data were collected through structured interviews and observations. Categorical variables are expressed as percentages, and quantitative variables according to their distribution (mean ± standard deviation or median and interquartile range).
Results: The study shows that 64.5% of providers have never been trained in biomedical waste management or on infection prevention and control, and 68.7% of those trained were trained more than 36 months ago.
In addition, 93.6% of providers had little knowledge of the definition of biomedical waste management, 82.7% had little understanding of its steps, and 55.2% recognized its importance. In practice, 69.7% did not sort waste, 78.2% did not use coded garbage bags, and 66.8% lacked containers for sharp objects. Furthermore, 65.2% of establishments did not have a storage area and 74.6% considered waste management unsatisfactory. In addition, 71.8% reported a lack of functional incinerators, and 77% the lack of suitable means of transport. Finally, 68.7% reported a lack of water tanks, and 79.6% the lack of a dedicated budget.
Conclusion: The study reveals insufficient management of biomedical waste in health care facilities in Kisangani. There is a need to strengthen staff capacities and invest in infrastructure to ensure health safety and protect the environment.
Keywords: Management; biomedical waste; health care establishments; knowledge; attitudes; practices; City of Kisangani
References
Background: Excessive Smartphone Use (ESU) is associated with mental disorders among University students in most developed countries. The aim of this study was to determine the distribution of ESU and its association with mental disorder among students of the University of Dschang.
Method: We conducted a cross-sectional study at the University of Dschang in which randomly selected students completed a survey comprised of a SAS-SV (10 items questionnaire), PHQ-7 (7 items questionnaire), PHQ-9 (9 items questionnaire), to screen for ESU, depression and anxiety respectively. Sleep quality was assessed using a three-item questionnaire. Multiple logistic regression was used to determine the association between ESU and mental disorder. Mental disorder was considered as the presence of one or more of the following disorders; depression, anxiety and/or sleep disorder.
Results: A total of 636 participants were included in this study. The prevalence of excessive smartphone use was 38.4% [95%CI: 34.6-42.3], and the prevalence of mental disorder was 35.8% [95%CI: 32.2-39.6]. The odds for mental disorder were 2.23 times greater among ESU [aOR =2.33, 5% CI: 1.58-3.16, p< 0.001] than in normal users.
Conclusion: There is a high prevalence of ESU among university students and a strong association with mental disorders. There is urgent need for interventions to control ESU among students for optimal academic performance and general wellbeing.
Limitations And Recommendations: This study was a transversal study; A longitudinal study and the use of a mental health specialist to confirm all cases of Mental health disorders could reveal better results.
Keywords: Excessive smartphone use; Mental health; Addiction; Students
References
Jewelry and body piercings are widely practiced cultural and fashion expressions, particularly in areas such as the ears, nose, and eyebrows. However, a significant number of individuals experience adverse reactions, including inflammation and persistent discomfort, commonly referred to as jewelry allergies. These allergic reactions are frequently triggered by exposure to metals like nickel, cobalt, and chromium, known allergens that can induce skin sensitivity. Ayurveda, an ancient Indian system of medicine, offers a holistic approach for managing such allergies. Ayurvedic treatment emphasizes the use of herbal remedies, dietary adjustments, and topical applications to alleviate inflammation and promote tissue repair. Commonly employed herbs such as *Azadirachta indica* (Neem), *Curcuma longa* (Turmeric), and *Aloe barbadensis* (Aloe Vera) are renowned for their anti-inflammatory, antimicrobial, and skin-soothing properties. Furthermore, Ayurveda advocates the use of hypoallergenic metals like gold and silver, which are traditionally recognized for their therapeutic benefits, to prevent allergic reactions.
This paper explores Ayurvedic strategies for managing jewelry-related allergies and complications arising from body piercings. It examines the therapeutic efficacy of natural remedies, preventative approaches, and the role of lifestyle and dietary interventions. The integration of Ayurvedic principles with modern insights into allergic responses offers a comprehensive framework for the effective management of jewelry-induced allergies and complications.