PriMera Scientific Surgical Research and Practice

Change in the lifestyle leads to several types of diseases in which knee OA is leading amongst all. According to global burden of disease published in the year 2000 shows that some specific jobs and occupations which involve physical labor have increased risk to develop OA of knee. Especially the jobs such as farmers, dock workers, mine workers etc. which require heavy weight lifting, squatting and kneeling have high chances to develop knee OA. In 2005, a study named ‘A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis’ shows that females are more prone to knee OA than men. Whereas a study in England, UK shows that reduced BMD and use of oral contraceptive pills may be associated with knee OA. A study conducted in the university of Boston, USA in the year 2010 showed that increase in the age leads to biological changes which reduces joint capabilities to cope with adversity such as oxidative damage, poor proprioception, muscle weakness and thinning of cartilage. Weakness of quadriceps muscle also leads to structural damage to the joint along with painful knee OA shown in the study ‘Is Quadriceps Muscle Weakness a Risk Factor for Incident or Progressive Knee Osteoarthritis?’ in the year 2011.

A study named ‘Lifestyle changes in the management of osteoarthritis’ in the year 2001 reveals that exercise regimes for OA knee consists of both aerobic exercises and strengthening exercises with resistance of quadriceps muscles which helps to improve physical functioning along with pain reduction in the patients. The main aim is to increase balance, ROM, aerobic capacity and strength. A study conducted in 2010 showed that continuous sitting for two hours increases the risk of knee OA.

Lifestyle modification helps to delay or prevent the onset of OA and also prevents many musculoskeletal disabilities. Exercises and weight reduction management are the two lifestyle changes for the management of OA. Several clinical trials support that knee strengthening and aerobic exercises delays disability and reduce pain. Along with this treatment, comorbidities like hypertension and depression also increase the risk of OA knee. So, therefore identifying the risk factors and uplifting the lifestyle could delay the onset of knee OA.

The mechanism of neuroplasticity begins in human intrauterine life and extends until the end of it. This phenomenon is complex, involving many intracellular pathways and has a compensatory and maladaptive outcome. When comparing central and peripheral neuroplasticity, it is possible to identify a difference between both. The peripheral neuroplasticity phenomenon ends up culminating in a successful neuroregeneration process, with pro-regeneration stimuli, while in the central nervous system, the phenomenon ends up being inhibited by neuro-inhibitory stimuli, interrupting the mechanism. Strategies for central neuroplasticity have been developed and are still being developed so that the mechanism is successful and culminates in a functional recovery due to some central nervous system injury. Analyzing both mechanisms, it can be deduced that neuroplasticity is something essentially beneficial that will provide a regeneration of the nervous tissue allowing a functional recovery. However, we must consider its complications that can be observed in the central nervous system after neuroplasticity provides tissue regeneration in the peripheral nervous system. Through this, we can infer some theories on the subject that will be shown at the end of this opinion article.

Understanding Neuroplasticity and The Types That Can Be Evidenced and Stated

First, we must understand the concepts inherent to neuroplasticity and neuroregeneration, as well as their definitions. Neuroplasticity is related to the property of the nervous system to change its function and structure in order to remodel itself to the conditions that are imposed on it, whether physiological or pathological, and can promote functional recovery in a short or medium period of time. Neuroregeneration consists of the ability to generate new neurons, that is, to promote neurogenesis, establishing new connections and promoting long-term functional recovery. Therefore, the process of neuroregeneration must be linked to neurogenesis due to the mechanism of neuronal proliferation [2-6, 17, 18, 34].

Although body tissues have a certain ability to regenerate and restore their previously established functionality, in the nervous system, especially in the central one, this does not occur adequately. Neurons have a finite number of multiplier cycles, which are more exuberant in intrauterine life and in children/young people and less expressive in adults and the elderly, but they can still be found in different regions of the brain, such as the dentate gyrus of the hippocampus. The cell division cycle can be found in two distinct moments, the first one being symmetrical and later, asymmetrical. Symmetric division is when the precursor cell gives rise to two other precursor cells, and so on. This phase is fast and quickly becomes asymmetrical, where the precursor daughter cell continues cycling and the precursor mother cell interrupts the cycle, becoming a young neuron that will go through a process of morphofunctional differentiation in the region where it is found to become in a mature neuron [2, 3, 6, 21, 25]. Axonal development can be evidenced by the expression of a wide range of genes, such as Kruppel-like factor 7 (KLF7) and Sox11, as well as activation of the Rapamycin (mTOR) pathway, which will trigger a series of intracellular signals [2, 3, 6, 22, 24].

Neuroplasticity can be identified at various stages of human development. In the embryonic and postnatal period we have ontogenetic plasticity, an interaction between the genome and the environment capable of promoting an important variety in the human species. Then we have the critical period, when the nervous system is most susceptible to the environment, such as the development of vision in children. Related to the critical period, we can observe the presence of the imprinting mechanism, which can be called the short critical period evidenced by the ethologist Konrad Lorenz when being recognized as a mother by geese chicks, that is, just the gaze mechanism, made the recognition circuit stabilized instantly, without the need for time. An example of a critical period in humans can be seen in the speech development process, which can last until adolescence. In addition to these, neuroplasticity can be didactically divided into three large groups, called: Morphological Neuroplasticity, Functional Neuroplasticity and Synaptic Plasticity. However, success for a successful neuroplasticity that will provide a new connection is directly dependent on three steps and which area of the nervous system was injured. The first step is the distance between the stump proximal and distal to the lesion, the smaller the distance, the greater the success of the mechanism. The second stage is due to synaptic modulations, which can be called metaplasticity, which can be intense or weak and will depend on the stimulus that will be applied. The third step is related to excitatory or inhibitory signals from interneuronal GABAergic circuits that can promote changes in different neuronal firings [1-5].

Studies were published with the aim of highlighting the types of neuroplasticity, explaining its adaptation and development. In the morphological neuroplasticity, dysgenesis of the corpus callosum was evidenced, resulting from a weak molecular stimulation towards the axonal fibers, which culminates in a malformation of the corpus callosum. Another example would be amblyopia after visual deprivation, resulting in a change in the pattern of ocular dominance [4, 5, 7-11]. Synaptic plasticity was reported as responsible for promoting communication and the flow of information in neuronal circuits, with the phenomena of Long-Term Potential (LTP) and Long-Term Depression (LDP) being described and having strong relationships with cyclooxygenase-2 (COX -2) and the p38 MAP kinase (p38 MAPK) [2-5, 11, 19].

However, functional neuroplasticity is what we can use to formulate some theories and thoughts. Within this group, we can highlight the most macroscopically palatable subtypes. It has been demonstrated through experimental studies that functional neuroplasticity can exhibit clinical conditions found in patients. Focal dystonia was evidenced in young patients when compared to more adult patients, where they exhibited cortical increase in the area of representation of the hands. The tactile pattern in blind patients was also different depending on age, whose tactile information ended up being processed in the visual cortex. At this moment, we can observe a maladaptive character of the functional neuroplasticity evidenced by the clinical condition of focal dystonia and confirmed by the phantom limb syndrome of the Ramachandran study, while the processing of tactile information in the visual cortex shows a compensatory character of the functional neuroplasticity. Maladaptive neuroplasticity can be defined as the appearance of symptoms after their appearance, while compensatory neuroplasticity ends up causing the relief of symptoms after their installation in the nervous system [2-4, 7-11, 17, 18].

What Differes the Central Nervous System from the Peripheral in regard to Neuroplasticity and Neuroregeneration?

After understanding the concepts of neuroplasticity and its differentiation from neuroregeneration, it is noteworthy that these two buttons have different behaviors depending on the region of the nervous system, with a higher success rate in the peripheral nervous system (PNS) and a lower one central nervous system (CNS) [2-4, 6, 20-22]. Such behaviors are due to a series of intracellular and molecular signals, reactions triggered by the local inflammatory response, ionic response, physical barriers and genetic response that make the process unfeasible in the CNS and viable in the PNS. However, complications can be evidenced in the CNS and PNS after the onset of neuroplasticity resulting from damage to both systems. In spinal cord trauma, dysfunctions were evidenced after alteration of neuronal circuits, such as autonomic dysreflexia, diaphragmatic dysfunction after degeneration of the frenetic nerve, among others. In the peripheral nervous system, however, it is possible to identify the formation of aberrant circuits, neuropathic pain, allodynia and the phenomenon of preferential motor reinnervation (PMR), in addition to the lack of myelin differentiation that ends up harming the process of peripheral neuroplasticity [1, 4, 6, 22, 28, 34-51].

The neuroregeneration mechanism needs three pillars for the phenomenon to be successful. The first pillar is the genetic response triggered after neuronal injury, which may have a neuro-inhibitory or neuro-stimulatory character. The second pillar is the inflammatory response triggered after the initial injury. The third pillar is the molecular and cellular interactions for the adjustment of neuroregeneration. These three pillars work synchronously and together, providing neuro-inhibition and neurostimulation. In the central nervous system, the mechanism is, in a way, inhibitory and neuroplasticity can have a maladaptive character, while in the peripheral nervous system the phenomenon is stimulatory with a high success rate, however, it can have a maladaptive character in the central nervous system. secondary to peripheral nervous system injury, as previously reported [1-6, 20-22, 28, 50, 51].

In central nervous system injuries, mainly related to mechanical trauma after spinal cord injury, the primary injury is the initial stimulus to trigger the neuroplasticity process in order to repair the injured circuit. However, the mechanism does not work properly. After the primary lesion, there is the appearance of a secondary lesion characterized by an inflammatory and cellular response, in addition to the activation of ion channels and gene expression. The ionic reaction triggered by increased cellular calcium influx increases reactive oxygen species and glutamate species triggering damage to genetic material, proteins and phospholipids, culminating in neurological dysfunction. The ionic response of calcium is responsible for the activation of genes associated with regeneration, however there is a stimulation of Phosphatase Tensin Homolog (PTEN) and Suppressor of Cytokine Signaling 3 (SOCS3) proteins that trigger inhibition of the neuroregeneration process by interfering in signaling pathways Janus Kinase/Signal Transducer and Transcription Activator 3 (JAK/STAT3) and Mammalian Target of Rapamycin Complex 1 (mTORC1). Deficient gene expression may be responsible for not adequately influencing neurogeneration, angiogenesis and cell adhesion/differentiation after vascular disruption and apoptosis after injury, such as the dysregulation of circRNAs. Hub genes, may have a neurotoxic character depending on oxidative stress and ischemia as reported for DNA DamageInducible Transcript 4 (DDIT4), or are responsible for the formation of gliosis through the RhoA pathway by stimulation of Transcription Activator-3 (STAT3), described for the Erzin gene (ERZ). Other physical barriers include the formation of cystic cavities and maturation of the glial scar [1-5, 45, 49, 52-57, 61]. The molecular response also has a great influence on inhibiting the reconstitution of circuits. Lipid peroxidation of oligodendrocytes is responsible for the release of neuro-inhibitory molecules. These cells do not support a long time away from the axons, suffering rapid degeneration, releasing such molecules. In addition, microglia have a lower phagocytic power compared to macrophages, contributing to the formation of gliosis. Chondroitin Sulfate Proteoglycan (CSPG) and Keratan Sulfate Proteoglycan (KSPG) molecules have been reported to inhibit the neuroregeneration process. Acrolein has been reported to cause neuropathic hyperreflexia, in addition to causing mitochondrial damage and triggering apoptosis. The Nogo family (NI250), mainly NogoA, are reported as the main family of neuro-inhibitory stimuli and are capable of interacting with several receptors, such as NgR1 and p75, inhibiting remyelination by activating the RhoA pathway. Myelin-associated glycoprotein (MAG) and oligodendrocyte myelin glycoprotein (OMgp) are also responsible for inhibiting remyelination through the same signaling pathway as NogoA. Versican (GSPG2) also prevents neuroregeneration by interactions between inflammatory leukocytes and inflammatory cells, favoring the recruitment of chemokines. Other molecules are also responsible for inhibiting neuroregeneration such as Ephrins (B3), semaphorins (4D and 3A) and NI-35 [1, 3-5, 47, 49, 54, 58-61].

Arteriosclerosis often does not cause symptoms until the lumen of the affected artery is critically narrowed or is totally blocked. The symptoms of arteriosclerosis are highly variable and can range from no symptoms (in the early stage of the disease) to heart attack or stroke (when the lumen of the artery is critically blocked). Sudden cardiac death can also be the first symptom of coronary heart disease. As a plaque grows along the lining of an artery, it produces a rough area in the artery's normally smooth surface. This rough area can cause a blood clot to form inside the artery, which can totally block blood flow. As a result, the organ supplied by the blocked artery starves for blood and oxygen. The organ's cells may either die or suffer severe damage. Atherosclerosis can narrow the major arteries that supply blood to the legs, especially the femoral and popliteal arteries. These two arteries are affected in 80% to 90% of people with this problem. The reduced blood flow to the legs may result in a crampy leg pain during exercise called intermittent claudication. If blood flow is compromised severely, parts of the leg may become pale or cyanotic (turn blue), feel cold to the touch and eventually develop gangrene. There are various drugs which reduces plasma lipids but with potential side effects. Herbal medication like Green Cardamom has potential to lower bad cholesterol, i.e. LDL-cholesterol and raise good cholesterol, i.e. HDL-cholesterol. In this work we compared hypolipidemic effects of Niacin with Cardamom. Seventy five hyperlipidemic patients were selected for research work. They were divided in three groups. Group-I was on placebo, group-II was given 1.5 grams Niacin, and group-III was advised to use powdered Cardamom thrice daily for the period of two months. Their lipid profile was measured at start of research and then on day-60. After two months therapy group-II reduced total cholesterol 30.8 mg/dl and LDL cholesterol 12.1 mg/dl and increased HDL cholesterol 5.6 mg/dl. In group-III Cardamom decreased total cholesterol 7.2 mg/dl and LDL cholesterol 8.8 mg/dl. HDL cholesterol in this group increased 4.9 mg/dl. When results were compiled and analyzed biostatistically, these changes were significant. We conclude from the research work that Niacin has more effects on total cholesterol but effects of both drugs on LDL cholesterol reduction was almost same.

References

Androulaki M, Frangedaki E and Antoniadis P. “Optimization of public spaces through network potentials of communities”. Procedia Manufacturing 44 (2020): 294-301.
Ferdani D., et al. “3D reconstruction and validation of historical background for immersive VR applications and games: The case study of the Forum of Augustus in Rome”. Journal of Cultural Heritage 43 (2020): 129-143.
Jens K and Gregg JS. “How design shapes space choice behaviors in public urban and shared indoor spaces-A review”. Sustainable Cities and Society 65 (2021).
Lai LW., et al. “Property rights & the perceived health contribution of public open space in Hong Kong”. Land Use Policy 107 (2021).
Lak A., et al. “A framework for elder-friendly public open spaces from the Iranian older adults' perspectives: a mixed-method study”. Urban Forestry & Urban Greening 56 (2020).
Lambe S., et al. “Developing an automated VR cognitive treatment for psychosis: game Change VR therapy”. Journal of Behavioral and Cognitive Therapy 30.1 (2020): 33-40.
Lu X, Wang X and Wu R. “Urban Garden Landscape Design Based on VR Technology and Internet of Things System”. Microprocessors and Microsystems (2020).
Pawlowski CS., et al. “Will the children use it?-A RE-AIM evaluation of a local public open space intervention involving children from a deprived neighbourhood”. Evaluation and program planning 77 (2019): 101706.
Richardson EA., et al. “The role of public and private natural space in children's social, emotional and behavioural development in Scotland: A longitudinal study”. Environmental research 158 (2017): 729-736.
Senda M. “Safety in public spaces for children's play and learning”. IATSS research 38.2 (2015): 103-115.
Timperio A., et al. “Features of public open spaces and physical activity among children: findings from the CLAN study”. Preventive medicine 47.5 (2008): 514-518.
Wei ZHU, Jiejing WANG and Bo QIN. “Quantity or quality? Exploring the association be-tween public open space and mental health in urban China”. Landscape and Urban Planning 213 (2021).
Krasilnikova E. “Integration of therapeutic landscapes into green urban infrastructure”. International Landscape Practical Conference «The comfortable environment - the health of the nation. Creating therapeutic gardens in the urban structure» 248 (2021): 12-18.
Vardanyan K. “Landscape greening as a resourse for hygienization of the medical environment according to the research data of microclimate and noise in children’s hospitals of Yerevan”. International Landscape Practical Conference «The comfortable environment - the health of the nation. Creating therapeutic gardens in the urban structure» 248 (2021):18-23.

It has revealed that autonomic innervation represents 85-90% of innervation faced to sympathetic one. The mastery of the unmyelinated C fibers than faster conductors Aδ fibers, gives the eye more sensitivity as only hyperosmolarity or heat. In dry eye disease, even the inability of tear production, the stimulation of receptor neuro-activator as nicotinic acetylcholine receptor, or treatment via nasal route, alleviated this infirmity. In other hand, tear film homeostasis could be repaired via stimulation of parasympathetic fibers of trigeminal nerve.

The surface of eye and lacrimal glands are exposed to air infection, and viruses of hand contact, which increase the risk of infection that land first the tear film. The resilience of tear film protect corneal and conjunctival epithelium, but its lipophilicity increases possibility of viruses to access the ocular surface. The prevalence of vision impairment has taken various origins like exaggeration of electronic surfaces use, some kinds to environment toxicity, chronic diseases and after surgical neuropathies as it could take birth even earlier as preterm birth. As high levels of glucose induced neurotoxicity, glia cells intervenes via glutamate, chemokines and pro-inflammatory cytokines, the retina of diabetic retinopathy is a thickening in retina, and cornea is useful for identifying neuropathy, as shown a deficiency in number of nerve’s fibers. About 57% of people with Down syndrome have visual problems, and analyzing visual acuity considered as the basis of an eye exam. Age-related macular degeneration, glaucoma, uncorrected refractive error, cataract, and diabetic retinopathy are the most abundant eye diseases.

Many studies interested in developing eye drops holding drugs with high solubility in water and high retention on ocular surface, to repair the defects of corneal epithelium; and to prevent surgery laser usually used in high intraocular pressure and ocular pain. In other hand, while treating glaucoma, the drug subsistence remain a discomfort matter for the patients, as it guarantee only a short term eye protection; eye lenses have been proposed due their longer protection referring to higher rates of drug absorption they offered and their substitution into a drug source for the eye’s anterior chamber and the corneal layer.

Between embarrassing health’s conditions of both males and females, males are prone to retinal detachment, and females are subject to inflammation. Dry eye disease is marked with high levels of inflammatory mediators IL-1β, IL-6, IL-10, IFN-γ, TNF-α and ‘matrix metalloproteinase’ MMP-9 mRNA expression in tears. During pregnancy, it has noticed that disorders of ocular as inflammatory demyelination and autoimmune disease provoking disorders of intraocular pressure, and falling blood pressure in cornea. While, thyroid eye disease begins with an inflammation until the fibrotic phase, this autoimmune perturbation when involved the extraocular muscles induce strabismus, the steady progress of the surgery of the horizontal strabismus, estimated with the motor and sensory success accomplished with adjustable suture. The surgery of strabismus with thyroid eye disease expected as successful with eye movements and senses.

Patients practically undergo magnetic resonance imaging (MRI) and computed tomography (CT), to disclose neuro-ophthalmological and orbital conditions of the eye, via assessing orbital mass/malformation, abscess or thyroid eye disease, or identify white matter lesions inducing neuromyelitis optica spectrum disorder. Thyroid hormones as exerted a crucial role on neuro-sensorial development of the eye, the volume of the eye measured via a morphometric and stereological studies of the retina myelination and glial development of the optic nerve, remain crucial in eye diseases diagnosis. Strabismus identified using multiple technics as synaptophore, alternate cover-uncover test with or without prism, and the Krimsky test. Keratoconus, diagnosed by corneal tomography, this disease could aggravated with collagen or genetic alterations.

Recently, doctors’ decision between pharmacological treatments and surgeries became obvious, and its success or failure are prejudged. Strabismus required a surgical intervention, but amblyopia could been corrected pharmacologically. In appropriate cases to surgery, the blind painful and neoplasms, the eye removal is lifesaving, but in other cases as glaucoma, trauma and inflammation surgery remain just a failure of treatment [1]. In some cases, like the pathology of acute angle-closure glaucoma, the doctors should immediately intervene to prevent vision loss and ophthalmology consultations to avoid post-operative complications. During surgery, the vital signs are mainly important to ensure the smooth completion of the operation like blood pressure, pulse rate and respiratory rate. For completing their job, the doctors would better prescribe a convenient treatment after surgery, as wound healing became a main step in surgical; a pH value close to 7, and Polyethylene glyco-lysozyme considered as a tissue adhesive after corneal surgeries with assured biosafety proven by absence of cytotoxic effects on epithelial cells, neither conjunctival epithelial cells.

Interested in the movement of the eye from a departure point to another one, and as the arrangement of the eye identified with three fixations, spatial location, assessment of the saccade, and its landing point. One arrangement succeed in estimation of a shorter saccade amplitudes, and doctors keep as well the gaze necessary in the surgical interface. Recently, the importance of eye tracking use in surgical research has emphasized, spread among surgeons and used as an inspector of surgeon’s cognition, attention and the most abundant use while using laparoscope and the ability of Eye-tracking technology (ET) to precise the appropriate zoom according to the distance between the surgical monitor and the pupil. A study about eye-gaze data indicated the ability of an algorithm with a minimum of information sources and maximum of fault tolerance, to ameliorate the conditions of surgical activities and enrich their methods, while using instruments for tracking signals, which assure the best surgical condition [2]. ET reduces errors in real time of examinations and surgical operations, in a jumbled environment, and supervising key elements utilization accurately as well, during clinical anatomy. ET work as a vigil supervisor while monitoring surgical interfaces, laparoscopic zoom, validity of content, vigilance, fatigue and individual vigilance alike the vigilance of the whole team, and steering them with a feedback. ET technologies adding a mark of specification, limitations confronted by glasses to avoid data loss and algorithms used for assessment of gaze metrics [3]. To resume teams of medical and biological research have been debt to the equipment, and technologies performing their methods of work.

Stress and anxiety of the surgery room, and careless of nurses in some countries, as the eye surgery could been realized with mere local anesthesia, whence the consciousness of the patient aggravated the sensation of fear. In order to earn the trust of patients, doctors work always harder to ameliorate the conditions and performance of their work. Trying to guarantee a safe hospital departure, doctors have developed a new method more secure for eye surgery before healing. To avoid long-term hospital stays and ensure eye protection in case the patient leave the hospital just after the surgery, the orbital rims of the eye have been sutured with a plastic eye shield, which accelerate the healing of operated open globe. Surgeons, to ensure a permanent healing of the injured globe fixed with the plastic eye shield during surgery, which offer extended protection even the patient careless of his health. To sum, fixation of a plastic eye shield during surgery relieves the doctor's conscience.

Surgical teams confirmed that a surgical simulator is required for the performance of residents’ training, the generalization of surgical training of all residents will assure enhancement of competencies between residents, whilst, residents found difficulties in achieving within a time frame the residency program, which lead to a heaped surgical training in the last year. Such problems could only been solved with prolongation of the residency training, and providing simulator early in training to prevent a training end with least operations, which ensure professional teams in eye surgery with minimum errors.

Performance of daily life routines remain the key way to prevent ocular diseases as the healthy nutrition, and exerting sport preserving a healthy lifestyle, which lead to preclude vision deficiency, and constitute a main key to prevent inflammation.

References

Chan SWS., et al. “A decade of surgical eye removals in Ontario: a clinical-pathological study”. Can J Ophthalmol 52.5 (2017): 486-493.
Thiemjarus S, James A and Yang GZ. “An eye–hand data fusion framework for pervasive sensing of surgical activities”. Pattern Recognition 45 (2012): 2855-2867.
Gil AM., et al. “Eye Tracking Use in Surgical Research: A Systematic Review”. Journal of surgical research 279 (2022): 774-787.

What I want to transmit today in this article is that Western medicine is seeing the human being only in parts, and not in its entirety, because it still does not consider the energy part, and only the materialized part of the energy, which are the visible parts that we can see by the naked eye [4, 5].

Therefore, when a patient is brought into the or for any surgical procedure, I often find that "I could still be treated medically instead of being rushed into the or for surgery”.

In various articles I write, I always demonstrate the differences in point of view of Western medicine with traditional Chinese medicine, through the figure of the tree. In this tree, I explain that Western medicine is represented through the part of the tree that is above the earth, which we usually can see with the naked eye. This part is composed of the branches of the tree, which represent the different specialties of Western medicine, and the leaves that come out of each branch, represent each disease treated by each medical specialty [6, 7].

All surgical pathologies that Western medicine is treating are at the “leaf” level of the tree, for example, when a patient has an esophagogastric hernia, Western medicine treats it by performing surgery to contain the contents in the stomach by making a ring so that reflux does not occur [8].

However, if we analyze the figure of the tree, according to traditional Chinese medicine, all the symptoms that appear at the leaf level in the different medical specialties, are caused by alterations in the energy present in the “root” of the tree, which Western medicine still does not recognize its existence and therefore does not study and does not treat [6, 9].

Just today I saw a woman aged around 62 who said she had undergone surgery on her knee and had her meniscus removed, because of she was suffering a lot of knee pain. In these cases, traditional Chinese medicine understands that the cause of knee pain is at the “root” of the tree, which are the energy deficiencies of the Kidney and Liver as I am showing in the article written by myself titled (2020) Why Patients with Knee Pain Still Have Symptoms Despite the Use of Anti-inflammatory Medications [10, 11].

That is why I am saying that patients who are taken for surgery have not yet completed their clinical treatment, where they could still have a cure. Nowadays, we see many cases being taken, and they could still do a clinical treatment and solve the case. The example I can give is surgeries to correct hiatus hernia, where it is known that reflux occurs due to lack of energy in the fifth chakra or the Spleen-pancreas energy (that is responsible for the function of the stomach, breast, spleen, pancreas, thyroid), and when the patient replaces this energy (of the Spleen) and of the whole system that is also without energy (such as the energy of the Lungs, Kidney, Liver, Heart), the patient improves from reflux without having to undergo surgery, which is not entirely innocuous, as I reported in the article written by myself (2021) titled How Can We Treat Gastroesophageal Reflux Without Doing Surgery? In this article, I am demonstrating a patient with hiatal hernia who was submitted to hernia correction using surgery. In the surgery there was an intestinal perforation, leading to septicemia, kidney failure, and vision loss. The patient has been more than 8 years after surgery and she is still dealing with the serious complications caused by this surgery [8].

Patients with any kind of abdominal pain have in common, energy deficiency inside the five internal massive organs causing the formation of internal Fire, that it is the cause of abdominal pain, in the energy level, as I am showing in the article written by myself (2022) titled Energy Alterations in Patients with Abdominal Pain [12].

Even in patients with a brain tumor, there is a chance of avoiding surgery when the doctor pays attention to treating the “root” of the tree and not just the symptoms, which are the tumor itself. I say this because the son of a patient had a brain tumor and blurred vision. As I know that the majority of the world's population is without energy in the five massive internal organs (Liver, Heart, Spleen, Lung, Kidney), I sent the medicines by a friend ( the patient lives in London) so that it would fill the energy of these organs and what happened to this patient was that he improved with the use of highly diluted medications (according to the theory written by me ( 2020), titled Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and also medications made based on crystals). In this theory, I am using Phosphorus to treat Liver, Sulphur to treat Heart, Calcarea Carbonica to treat Spleen, Silicea to treat Lung, Natrum muriaticum to treat Kidney [5, 13, 14].

Even patients with hemorrhoids can be treated clinically without the need for surgery, as they all have in common the lack of energy in the five massive internal organs (Liver, Heart, Spleen, Lungs, and Kidney), and thus, by treating the “root” of the problem and associating some techniques of traditional Chinese medicine, patients improve immediately after the auriculotherapy session without the need for surgery. Usually when the patient with hemorrhoids who was submitted to surgery, they need to stay at home for about two weeks and with a lot of pain in the postoperative period, and cannot work during this period, as I am talking about in the article written by myself (2020) titled Chakras Energy Alterations in Patients with Hemorrhoids and How to Treat it without Surgery [15].

I am saying this because all surgical procedures today are considered high risk, because even if the patients' exams are normal, what is altered in all patients today (even in newborn children), are in the energy level, characterized as this lack of energy in the five massive internal organs (Liver, Heart, Spleen, Lungs, and Kidney), leading to a state of immunodepression, as I am showing in the article written by myself (2022) titled Are Patients Without Surgical Risks Really Without Surgical Risk? in the second article also written by myself (2021) title Are We Vaccinating Immunocompetent or Immunocompromised People for COVID 19? [16-17].

All these energy alterations inside the human body are due to the lack of energy caused by chronic exposure to electromagnetic radiation, due to the modernization of telecommunication globally, and for this reason, all surgical patients are at high risk for complications in the operative period or in the postoperative period, as the anesthetic drugs normally used are all highly concentrates medications. According to the Arndt-Schultz law, created in 1888 by two German researchers, the use of any highly concentrated medication can cause a drop in vital energy and this effect can cause stagnation of Blood inside the blood vessels or other complications such as thrombosis, myocardial infarction, strokes or even death of this patient [16, 18-20].

To minimize all these complications when using highly concentrated medications in all these energy-deficient patients, all patients who went for a surgical procedure should first be submitted to the treatment of the lack of energy of the five massive internal organs, using highly diluted medications according to the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine using Phosphorus to treat the Liver, Sulphur to treat the Heart, Calcarea Carbonica to treat Spleen, Silicea to treat the Lungs and Natrum muriaticum to treat the Kidney, thus maintaining the energy to keep the Blood circulation normally, without causing so much energy drop, when being undergoing an anesthetic procedure [13, 16].

The world population is not the same as in the past, as I am showing in the article written by myself (2021) titled Is the Population in the World the Same as in the Past? So, the clinical measurements used in the diagnosis and treatment of all these patients needs to be careful because of this drop of energy, depending on the type of medication we need to use in the surgical procedure, causing complications or even death of all these patients, independently on the type of diagnosis or the age group, as I am showing in the article also written by myself (2021) titled Energy Alterations and Chakras’ Energy Deficiencies and Propensity to SARS-CoV-2 Infection [21, 22].

References

Huang Wei Ling. “What Flexner Report did to Our Medicine After 100 Years of Implantation?". Acta Scientific Gastrointestinal Disorders 4.8 (2021) : 01-04.
Conselho Federal de Medicina. CFM.
Acupuncture Legal Status. News Medical Life Sciences. Available in: Acupuncture Legal Status (news-medical.net)
Huang Wei Ling. “Why Are Diabetic Patients Still Having Hyperglycemia Despite Diet Regulation, Antiglycemic Medication and Insulin?”. Int J Diabetes Metab Disord 4.2 (2019): 1-14.
Huang WL. “The Importance of Treating Energy Imbalances and Chakras Replenishment for Prevention and Treatment of Cancer”. Advances in Cancer Research & Clinical Imaging 3.1 (2020).
Huang Wei Ling. “Why Do Patients Still Catch Hospital Infections Despite the Practice of Infection Prevention and Control Programs?”. Acta Scientific Microbiol 1.4 (2018): 34-43.
Huang Wei Ling. “The Importance of Correcting Energy Imbalances and Chakras Energy Deficiencies in the Treatment of Patients with Glaucoma”. Clin Res Ophthalmol 2.2 (2019): 1-9.
Huang Wei Ling. “How Can We Treat Gastroesophageal Reflux Without Doing Surgery?". Acta Scientific Gastrointestinal Disorders 4.9 (2021): 10-11.
Huang Wei Ling. “Chakras’ Energy Deficiencies in Patient with Congestive Heart Failure”. On J Cardio Res & Rep 6.2 2021.
Huang Wei Ling. “Why Patients with Knee Pain Still Have Symptoms Despite the Use of Anti-inflammatory Medications”. International Journal of Orthopaedics Research 2.2 (2020): 21-27.
Huang Wei Ling. “What is Behind All Hernia Formations that We Need to Know?". Acta Scientific Clinical Case Reports 3.3 (2022): 01-03.
Huang WL. “Energy Alterations in Patients with Abdominal Pain". Acta Scientific Gastrointestinal Disorders 5.7 (2022): 38-48.
Huang Wei Ling. “Constitutional Homeopathy of Five Elements Based on Traditional Chinese Medicine”. Acta Scientific Medical Sciences 4.7 (2020): 57-69.
Huang WL. “How Can We Give Hope for Cancer Patients to Cure This Disease?”. TMR Cancer 4.4 (2021): 16.
Huang Wei Ling. “Chakras Energy Alterations in Patients with Hemorrhoids and How to Treat it without Surgery”. Surg Med Open Acc J 3.5 (2020).
Huang WL. “Are Patients Without Surgical Risks Really Without Surgical Risk?”. J, Surgical Case Reports and Images 5.3 (2022).
Huang WL. “Are We Vaccinating Immunocompetent or Immunocompromised People for COVID 19?”. J Vaccines Res Vaccin 7 (2021): 018.
LEESER O. “Support of homeopathy by the Arndt-Schulz law”. National Center for Biotechnology Information (1953).
Huang Wei Ling. “What Is Behind All the Pulmonary Thromboembolism That We Need to Know?”. MAR Pulmonology.
Huang Wei Ling. “What We Need to Know When the Patient has a Stroke with or without COVID-19?". Acta Scientific Neurology 4.8 (2021): 01-05.
Huang Wei Ling. “Is the Population in the World the Same as in the Past?". Acta Scientific Clinical Case Reports 2.6 (2021).
Huang Wei Ling. “Energy Alterations and Chakras’ Energy Deficiencies and Propensity to SARS-CoV-2 Infection". Acta Scientific Microbiology 4.4 (2021): 167-196.

Clinical Case

25-year-old male patient, one-pack-per-week smoker, with no other relevant history. He seeks medical advice for a 1-week left otodynia, associated with scanty yellowish otorrhea in addition to a rapidly growing left temporozygomatic swelling. No antibiotic treatment.

Good condition on physical examination. Apyretic. Left ear: external auditory canal with mucopurulent secretions; dull, congestive tympanic membrane, without luminous shine and with punctiform attic perforation through which little purulent material comes out; no fetidness; no skin flakes. Myringosclerosis plaque (Fig. 3). Instrumental acoumetry with 256 Hz tuning fork; Weber lateralized to the left ear. Bilateral positive Rinne.

Diffuse left temporozygomatic swelling (Fig. 1-2) measuring approximately 8 x 4 cm (A-P) and (L). Its upper limit occupies the entire left supra-auricular region, reaching the tail of the eyebrow and ipsilateral malar region; modified root of the Helix, facial asymmetry and effacement of the retroauricular sulcus, displacement of auricular pavilion. Soft and depressible. Mastoid with mild erythema.

Tomography

Total occupation of mastoid cells on the left, bone erosion with soft tissue involvement. Collection at the level of temporal, zygomatic and left parietal bones. Septations. It measures 80 x 33 x 91 mm L, T and AP (Fig. 4-5). The laboratory study revealed a leukocytosis of 17,000 with neutrophilia (80%). Elevation of C-reactive protein 20 mg/dl, Hemoglobin 12.1 g/dl, Hematocrit 35.8%. Hospitalized patient with medical-surgical treatment. Puncture aspiration (Fig. 6) and surgical drainage. Ampicillin-Sulbactam 3 g every 6 hours, Ketoprofen 100 mg every 8 hours and Hydrocortisone 100 mg every 12 hours were administered. Due to the lack of an emergency block, mastoidectomy was not performed. The infectious process eroded the bone cortex of the temporal bone, dispersing pus between the cortex and the periosteum in the temporozygomatic region (Fig. 5). The causative germ was not isolated; empirical antibiotic therapy was sufficient. Chronic cholesteatomatous otitis media was ruled out; in its evolution, the eardrum was found to be normal with good shine and no collection in the tympanic box. Normal hearing. Control tomography with clear attic (Fig. 7).

References

Acar Z, and Acar P. “Organizational culture types and their effects on organizational performance in Turkish hospitals”. Emerging Markets Journal 3.3 (2014): 1-15.
Anicijevic N. “The mutual impact of organizational culture and structure”. Economy Annals 58.198 (2013): 35-60.
Carreon J. “Human Development: Governance and Social Entrepreneurship”. Mexico: UNAM-ENTS (2016).
Cruz O, Arroyo P and Marmolejo J. “Technological innovations in logistics: inventory management, information systems and outsourcing of operations”. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 165-178.
Dugloborskyte V and Petraite M. “Framework for explaining the formation of knowledge intensive entrepreneurial born global firm: Entrepreneurial, strategic and network based constituents”. Journal of Evolutionary Studies in Business 2.1 (2017): 174-202.
Escobar R. “Neural networks, cognitive processes and behavior analysis”. International Journal of Behaviorism 2.1 (2014): 23-43.
Garcia C. “The knowledge network in a university with a system of professional practices and administrative technological social service”. Foundations in Humanities 14.27 (2013): 135-157.
García C., et al. “Governance of the actors and networks of technological innovation”. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 79-94.
Garcia C, Soto ML and Miranda M. “Knowledge networks around coffee growing in a HEI in central Mexico”. Interconnecting Knowledge 2.4 (2017): 15-32.
Hernandez A and Valencia R. “Innovation instruments: social networks in the internalization of micro, small and medium-sized Mexican companies”. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 47-66.
Huilan C, Liu S and Onderati F. “A knowledge network and mobilization framework for lean supply chain decision in agri -food industry”. International Journal of Decision Support System Technology 9.4 (2017): 1-15.
Jabar M, Sidi F and Selamar H. “Tacit knowledge codification”. Journal of Computer Science 6.10 (2010): 1141-1147.
Mendoza E, Ramírez L and Atriano R. “Use of media and technologies in the creation of an innovation system for the common good”. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 95-114.
Nielsen B. “Synergies in strategies alliances: Motivations and outcomes of complementary and synergistic knowledge networks”. Journal of Knowledge Management Practice, 43, (2002): 1-10.
Omotayo O and Adenike A. “Impact of organizational culture on human resource practices: a study of selected Nigerian private universities”. Journal of Competitiveness 5.4 (2013): 115-133.
Quintero M., et al. “A review of the state of the art on SMEs. What about innovation studies?”. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 31-43.
Robles C., et al. “Culture of quality and innovation in microenterprises”. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 11-30.
Saansongu E and Ngutor D. “The influence of corporate culture of employee commitment to the organization”. International Journal of Business and Management 7.22 (2012): 1-8.
Sales J, Quintero M and Velázquez E. “Adaptation versus innovation: the formation of industrial districts from peasant communities”. Santa Cruz Atizapan and Chiconcuac. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 181-199.
Simpson O. “Motivating learners in open and distance learning: Do we need a new theory of learner support?”. Open learning 23.3 (2008): 159-170.
Storga M, Mostahari A and Stankovic T. “Visualization of the organization knowledge structure evolution”. Journal of Knowledge Management 17.5 (2013): 24-40.
Vázquez C., et al. “Government support for innovation, technology and training for small and medium-sized companies in Mexico”. In M, Quintero., Sales, J. and Velázquez, E. (Coord.). Innovation and technology challenges for its practical application in companies (2016): 67-78.
Wu S, Tuo M and Xiong D. “Network structure detection of analysis and Shanghai stock market”. Journal of Industrial Engineering & Management 8.2 (2015): 383-398.

References

Alberts B., et al. Molecular Biology of the Cell (4th ed.). New York: Garland Science (2002).
Ahlbom A., et al. “Epidemiology of health effects of radiofrequency exposure”. Environ Health Perspect 112.17 (2004): 1741-1754.
American Psychiatric Association. Electroconvulsive Therapy (ECT) (2018).
Adair RB and Guevara MA. “Chronic pain and electrical stimulation: An update”. Neuropsychology Review 29.3 (2019): 279-288.
Babington J. “On the effects produced by the electrical currents on the human body”. The Lancet 98.2517 (1871): 158-159.
Bjordal JM., et al. “Low-level laser therapy in acute pain after wisdom tooth extraction”. Photomedicine and laser surgery 24.2 (2006): 151-157.
Bikson M., et al. “Generalized physiological effects of transcranial electrical stimulation”. In Transcranial electrical stimulation (2013): 69-92.
Bikson M., et al. “Safety of transcranial direct current stimulation: evidence based update 2016”. Brain Stimulation 9.2 (2013): 641-661.
Celik, H., et al. “The effect of transcutaneous electrical nerve stimulation on pain and function in patients with chronic low back pain”. Journal of Physical Therapy Science 29.11 (2017): 1781-1786.
Chou S and Gahukamble DB. “Microcurrent electrical stimulation: a review”. Physical therapy 90.1 (2010): 2-15.
Chen J., et al. “Electrostimulation for wound healing: a review”. BioMed research international (2014): 987390.
Chen X., et al. “High-frequency alternating current exposure affects physiological responses”. Journal of biomedical engineering 1.1 (2016): 18-24.
Chen R, Zhang Z and Cheng X. “The effects of electrical stimulation on muscle strength, endurance, and power”. Journal of Strength and Conditioning Research 22.3 (2008): 823-829.
Di Piazza M, Nitsche MA and Paulus W. “Modulating function and plasticity in the human brain with transcranial electrical stimulation”. Neuropsychologia 76 (2015): 17-25.
Dos Santos JF., et al. “Electrical stimulation of the heart: current state of the art”. Journal of Cardiovascular Electrophysiology 19.9 (2008): 955-963.
Finnerty O., et al. “The effects of electrical stimulation on heart rate and blood pressure”. Journal of Medical Engineering and Technology 37.2 (2013): 102-109.
Geddes LA, Ropper AH and Goldman L. “Principles of electric shock: physiology and management”. Neurocritical care 25.2 (2016): 401-409.
Goldsmith R, Bullard MJ and Kramer LC. “Electric current and the human body: can low-level exposure affect health?”. Environmental health perspectives 115.11 (2007): 1670-1676.
Husain MM and Rush AJ. “Electroconvulsive therapy for depression”. New England Journal of Medicine 364.15 (2011): 1437-1444.
Institute of Electrical and Electronics Engineers. Electromagnetic Interference (EMI) (2015).
Koh S., et al. “Electrical injury-induced oxidative stress and inflammation”. International Journal of Molecular Sciences 20.13 (2019): 3109.
Kong Y, Chen X and Wang X. “Effects of electrical current on the cardiovascular system”. Journal of Electromagnetic Biology and Medicine 38.1 (2019): 5-12.
Lurie KG, Zipes DP and Levine JA. Electrophysiology of the Heart (1st ed.). Philadelphia: Saunders (2006).
Lee YJ., et al. “Effectiveness of transcutaneous electrical nerve stimulation (TENS) for chronic low back pain: a meta-analysis”. Physical therapy in sport 17.2 (2016): 95-102.
Li J, Wang X and Zhang Y. “The effects of electrical stimulation on heart function in patients with heart failure”. BioMed research international (2018): 7402971.
Li Y., et al. “Electromagnetic interference caused by transcutaneous electrical nerve stimulation devices: a review”. Journal of medical systems 40.10 (2016): 321.
Lippold OC and Redfearn JWT. “Changes in cerebral blood flow and electroencephalographic activity during the application of direct current to the human brain”. British Journal of Anaesthesia 36.10 (1964): 875-880.
Miller RE and Wible J. “Electrical current interaction with the human body: A review”. Journal of Electromagnetic Biology and Medicine 36.1 (2017): 1-10.
Nguyen HT Shirazi M and Barnard J. “Transcutaneous electrical nerve stimulation (TENS) for pain management in adults”. Journal of Pain Research 10 (2017): 715-725.
Poreisz C., et al. “Safety aspects of transcranial direct current stimulation concerning healthy subjects and patients”. Brain research bulletin 72.4-6 (2007): 208-214.
Phan ML., et al. “Transcranial direct current stimulation (tDCS) for enhancing cognition in healthy individuals: A systematic review”. Journal of Neural Transmission 119.2 (2012): 121-130.
Pancholi CM., et al. “The effects of electrical stimulation on the human body”. Current Neurology and Neuroscience Reports 15.6 (2015): 47.
Sato A, Radeljic S and Takeo S. “Transcranial electrical stimulation for chronic pain management”. Pain Research and Management 18.2 (2013): 63-68.
Shiozawa P, Fregni F and Boggio PS. “Transcranial direct current stimulation for obsessive-compulsive disorder: a systematic review”. Neuropsychopharmacology 38.4 (2013): 573-586.
Salahuddin A, Ali MN and Shafie AA. “The effects of electrical stimulation on the human body: A review of current knowledge”. BioMed research international (2017): 9194250.
Shen X., et al. “Extremely low-frequency magnetic fields increase oxidative stress and alter gene expression related to the regulation of cell growth and metabolism in human brain cells”. Bioelectromagnetics 31.4 (2010): 291-299.
Saha B., et al. “Transcranial direct current stimulation over the left dorsolateral prefrontal cortex modulates working memory performance: evidence from bi-hemispheric tDCS”. Clinical Neurophysiology 122.11 (2011): 2076-2080.
Tuttle RE. “The electrical properties of the heart”. Physiol Rev 68.3 (1988): 569-592.
Thorne R and Farley J. “Effects of electrical currents on the human body”. Journal of Electrophysiology 23.3 (2015): 231-237.
Wang Y., et al. “Electrical stimulation for pain management: A review of the current state of the literature”. Neural Regeneration Research 12.4 (2017): 619-626.
Wang Y, Zhang J and Cheng X. “The effects of electrical stimulation on pain tolerance and pain symptoms in individuals with chronic pain”. Pain Medicine 14.8 (2013): 1131-1139.
Wang Y, Li X and Zhang Y. “Skin irritation caused by transcutaneous electrical nerve stimulation: a review”. Journal of medical systems 43.12 (2019): 748.
Zhu X., et al. “Transcranial direct current stimulation over left DLPFC modulates the neural activity in the contralateral homologue and visual cortex during working memory tasks”. Neuropsychologia 51.8 (2013): 1557-1564.

Background: Electrical medical devices have become a crucial part of modern healthcare, aiding in diagnosis, treatment, and monitoring of various medical conditions. However, the exposure of the human body to electrical currents produced by these devices can cause adverse effects, ranging from mild tingling sensations to severe injuries, and even death.

Aim and objective: This systematic review aims to investigate the effect of exposure to electrical current produced by medical equipment on the human body.

Material and Method: The review included studies which investigated the effects of exposure to electric current in healthcare workers, patients, and the general public. The search was conducted using the following keywords: “medical equipment”, “electrical current”, “exposure”, “health hazards”, and “assessment”. The studies were identified through searches of electronic databases, including PubMed, Embase, and Scopus, using a predefined search strategy. After screening 1240 studies, 43 studies were included in the review. The studies evaluated a range of medical equipment, including electrosurgical devices, defibrillators, electrocardiographs, and magnetic resonance imaging machines.

Result and Discussion: The results of this systematic review indicate that exposure to electrical current produced by medical equipment can lead to a range of adverse effects. These effects include burns, tissue damage, nerve damage, cardiac arrhythmias, and even death. The severity of the effects was found to depend on the duration and intensity of the electrical current, the pathway of the current through the body, the electrical resistance of the body tissues, and the individual’s health status. Furthermore, the review identified several risk factors associated with electrical injuries, such as the presence of moisture or conductive materials on the skin, the use of metallic implants, and the proximity of the equipment to vital organs. The review also revealed that various safety measures, including proper equipment insulation, grounding, and the use of safety protocols, can minimize the risk of electrical injuries associated with medical equipment.

Conclusion: The study found that exposure to electric current can cause a range of health effects, including burns, cardiac arrhythmias, nerve damage, and even death. The review also found that the level of risk associated with exposure to electric current varies depending on the type of equipment and the individual’s susceptibility. Exposure to electrical current produced by medical equipment can have significant adverse effects on the human body. Therefore, healthcare providers and medical personnel must be aware of the risks associated with electrical medical devices and implement appropriate safety measures to prevent such injuries. Healthcare workers and patients with pre-existing medical conditions may be at higher risk of adverse health effects. Overall, the review highlights the need for improved safety measures and training programs to reduce the risk of exposure to electric current in healthcare settings. Further research is needed to better understand the mechanisms of injury and to develop more effective prevention strategies.

Telemedicine is now widely used in surgery from performing operations to teaching and can be divided into three main components; telesurgery, tele-mentoring and teleconsultation. Developments across these fields have led to remarkable achievements such as intercontinental telesurgery and tele-mentoring [3].

Due to the limitation of special regions and unbalanced development of medical technology, many patients lost the best opportunity for operation. The idea of telesurgery robot was proposed for the first time to quickly and safely treat trauma patients in the rear hospital in the wartime. With the development of medical and remote communication technology, the demand of telesurgery has increased. Laparoscopic and endoscopic technology changed the previous operation mode that operated under direct vision. By presenting the operation vision through video images, tele-present surgery came into reality, and it was early used for remote surgery guidance and education of complex operation and emergency trauma cases [4].

Patients far away from hospital, can consult with their doctors easily with teleconsultation and can reduce the number of hospital visits. Patients can have teleconsultation for follow-up.

During the covid error, surgeons need to take care of surgical patients, and operate on covid-positive patients. Surgeons also take care of covid-positive non-surgical patients as the medical staffs are not enough to take care of the rising number of patients. Health-care personnel have to attend patients both personally and on-line. Many patients consult with medical professionals via tele-consultation, video-calling by using viber, messenger, etc...

Doctors with busy schedule can have multidisciplinary meeting via online. Doctors perform continue medical educations in the form of webinars.

Surgeons can also use video-calling to discuss about the patients during ward-round and also during operation. Surgeons from different places can collaborate without long travel.

Surgeons can perform surgery and broadcast so that doctors from remote areas can view the live surgery on-line and can do questions and answers in real time.

Senior surgeons can supervise the operations of juniors by video-call. Seniors can see both the intraoperative findings and the skills and handicrafts of juniors. Seniors can also do the tele-mentoring.

There are many advances and benefits, due to improvement of communication media.

The biggest challenge of telepresence system at present is not to compromise the optimal balance of remote operation process due to excessive occupancy of available bandwidth when meeting the quality requirement of real-time medical image and video [4].

Telesurgery benefits not only the developed countries but also the low and middle-income countries by facilitating in the areas of patient consultation, pre-operative preparation, operation and follow-up. It also aids in training of juniors, supervision of juniors, mentoring the juniors and collaboration between doctors. Doctors should make the best use of telesurgery to get quality care in medical practice.

References

Acosta J. “Leadership and innovative entrepreneurship in new technology-based companies. A case study based on a knowledge management approach”. Journal of Advanced Leadership Studies 1.1 (2012): 5-13.
Adams S. “Academic framework of public security policies”. Journal of Transdisciplinary Social Work 50.1 (2020): 1-8.
Ardevol A. “Framing theory in communication research. Origins, development and current situation in Spain”. Latina Magazine of Social Communication 70 (2015): 423-450.
Carreon J. “Models of fixed effects of diffuse variables in the formation of intellectual capital”. International Journal of Engineering Research & Development 5.9 (2019): 1-7.
Carreón J., et al. “Specification of a digital entrepreneurship model for human development through the intensive use of information and communication technologies”. Rural Perspectives 13.25 (2015): 123-155.
Clark S. “Specification a model of intellectual capital”. International Journal of Economics and Management Studies 10.3 (2020): 1-3.
Datta B. “Assessing the effectiveness of authentic leaderships”. International Journal of Leaderships Styles 9.1 (2015): 62-75.
De la Fuente J, Vera M and Cardelle M. “Contributions of the psychology of innovation and entrepreneurship to education in the knowledge society”. Electronic Journal of Research in Educational Psychology 10.28 (2012): 941-966.
Duarte T and Ruíz M. “Entrepreneurship: an option for development”. Scientia 15.43 (2009): 326-331.
Garcia C. “Specification a model for study of entrepreneurship”. Advances Research Journal of Multidisciplinary Discoveries 49.1 (2020): 1-4.
Godson O. “The influence media ownership and control on media agenda in Nigeria”. IJHSSE 1.7 (2014): 36-65.
Harper S. “The leader coach: a model of multi style leaderships”. Journal of Practical Consulting 4.1 (2012): 22-31.
Korstanje ME. “Academic framework of knowledge management”. International Journal of Engineering Technology and Management Research 7.2 (2020): 1-6.
Kumar M and Jain S. “Leadership’s management: principles, models and theories”. Global Journal of Management and Business Studies 3 (2013): 309-318.
McCleskey A. “Situational, transformational and transactional leaderships and leadership’s development”. Journal of Business Study Quaterly 5.4 (2014): 117-130.
McCombs M and Valenzuela S. “The agenda setting theory”. Information Notebooks 20 (2007): 44-50.
Melchar D and Bosco S. “Achieving high organization performance through servant leaderships”. Journal of Business Inquiry 9.1 (2010): 74-88.
Meru O and Ogbonna I. “Transformational vs transactional leadership’s theories: evidence in literature”. International Review of Management and Business Research 2.2 (2013): 355-361.
Organization for Economic and Cooperation Development. Statistic for coronavirus SARS CoV-2 and COVID-18 disease in the country (2022).
Panamerican Health Organization. Statistic for coronavirus SARS CoV-2 and COVID-19 disease in the Americas. New York: PAHO (2022).
Rivera D, Punin M and Calvo D. “Agenda setting in the Ecuadorian press: The Universe, The Mercury, The Commerce and The Telegraph”. Latina Magazine of Social Communication 68 (2013): 209-244.
Secretaria de Salud. “Statistic for coronavirus SARS CoV-2 and COVID-19 disease in Mexico”. CDMX: SSA (2022).
Sánchez J, Cagiano V and Hernández V. “Entrepreneurship competencies in university education”. International Journal of Developmental and Educational Psychology 1.2 (2011): 19-28.
Villegas E. “Specification a model of intellectual capital”. International Journal of Economics & management Studies 10.1 (2018): 1-2.
Weaver D. “Thoughts on agenda setting, framing and priming”. Journal of Communication 57 (2007): 142-147.
Wepner F. “Entrepreneurship as a factor of social mobilization”. Nómadas 36 (2012): 1-6.
World Health Organization. Statistic for coronavirus SARS CoV-2 and COVID-19 era in the world. Gynevra: WHO (2022).

References

Xu Yifan. “Design and Implementation of Middle School Physics Simulation Experiment Based on Virtual Reality (in chinese)”. Hunan University (2014).
Benesha J., et al. “Are You for Real? Engineering a Virtual Lab for the Sports Sciences Using Wearables and IoT”. Proceedings 49.1 (2020): 110.
Elfakki AO, Sghaier S and Alotaibi AA. “An Efficient System Based on Experimental Laboratory in 3D Virtual Environment for Students with Learning Disabilities”. Electronics 12.4 (2023): 989.
Wang Liang and Liu Dongfeng. “Interface design and implementation of 3D virtual physics experiment simulation platform (in chinese)”. Computer Technology and Development 24.09 (2014): 238-240.
Zhang Wenmiaoyun and Chen Zhaoxi. “Optical experiment simulation based on Python and its application in medical physics teaching (in chinese)”. Modern Computer 718.10 (2021): 134-136.
Cao Fujun and Wang Dayong. “Simulation of physical experiments with EWB software (in chinese)”. Journal of Tangshan Normal University 02 (2005): 42-43+69.
Mystakidis S and Lympouridis V. “Immersive Learning”. Encyclopedia 3.2 (2023): 396-405.
Guo Tiezheng, Zheng Yifeng, Chen Wei, et al. “Simulation experiment construction and teaching of cricket system based on Unity3D (in chinese)”. Laboratory Research and Exploration 41.03 (2022): 187-192.
Xiong Yanfan and He Xiwu. “Research on the Application of VR Technology in the Practical Teaching of Industrial Network Technology Specialty (in chinese)”. Electronic Components and Information Technology 4.02 (2020): 167-168.
Feng Jiao., et al. “Design of flight simulation system based on Three JS (in chinese)”. Computer Measurement and Control 28 .02 (2020): 216-219.
Ge Yan, Feng Wanting and Liu Hongyan. “Design and development of virtual experiment based on Unity3d (in chinese)”. Heilongjiang Science 9.24 (2018): 30-31.
Ferrão J., et al. “Environment-Aware Rendering and Interaction in Web-Based Augmented Reality”. Journal of Imaging 9.3 (2023): 63.
Minopoulos GM., et al. “A Medical Image Visualization Technique Assisted with AI-Based Haptic Feedback for Robotic Surgery and Healthcare”. Applied Sciences 13.6 (2023): 3592.
Song Xiaopeng., et al. “Fluid Mechanics Simulation Experiment Based on WebGL (in chinese)”. Physics Experiment 40.08 (2020): 36-39.
You Liang Huang and Ming Quan Zhou. "Design and Development of the Virtual Acupuncture Training Using WebGL". Advanced Materials Research 2534 (2013): 756-759.
Jin Xing., et al. “Construction of virtual simulation workshop based on Three JS (in chinese)”. Automation Appl 09 (2021): 78-80+83.
Joon Yun, Jin Zhongxian and Joongheon Kim. “3D modeling and WebVR implementation using Azure Kinect, Open 3D, and Three.js (in Korea)”. Proceedings of the Korean Communication Society Academic Conference (2020).
Zhong Shuheshan., et al. “Study on the sinking time of Saxon bowl (in chinese)”. Physical Experiment 41.02 (2021): 37-42.
Wang Jianxing. “Research on virtual 3D display based on Three JS (in chinese)”. Science and Technology Horizon 205.19 (2017): 68+80.
Yu Yuefan and Zhou Xiaoyun. “Development of virtual simulation experiment system for space teaching based on VR technology (in chinese)”. Laboratory Research and Exploration 41.08 (2022): 123-127.

Nowadays Simulation Training technology has developed much and I can help in designing cost effective "Simulation Training Centre." Simulation has many advantages, for it results in highly trained medical graduates who are less likely to make life-threatening or costly medical errors. Some of the advantages of simulation are listed in Employing medical simulation techniques can help move medical training from the old “See One, Do One, Teach One” method into a “See One, Practice Many, Do One” model of success. Virtual simulation can be used for clinical judgement training to students. Simulation-based teaching has proved to reduce risks to both patients and learners. It has also proved to be effective in both undergraduate and post graduate education as well as faculty development. Simulation can be used in the primary health care setting to improve confidence in performing life-saving skills, clinical skills, communication skills, and the quality of care for patients with chronic diseases such as diabetes mellitus and bronchial asthma. Such simulators as part task trainers, computer-based systems, virtual reality and the haptic system, simulated patients, simulated environment, and integrated simulators have been also used effectively to assess and evaluate clinical skills. Virtual simulation for Nursing provides students with a realistic, true-to-life clinical experience. The immersive virtual scenarios allow students to engage with 3D patients, testing their ability to recognize and analyse cues through unfolding visual and audio responses and by experiencing lifelike reactions. Students decide what actions to take for Nursing with the system adapting to student-driven decisions so they can see immediate cause and effect, strengthening their clinical judgment skills.

There has been changes from time to time in medical education teaching methodology. Both Clinical Theory and Clinical Rotations is a must for learning students so that they can practice without compromising patient safety. Most of the medical institutions do not have simulation technology. Simulation teaching can be of two types one for teaching Communication, hands on skills and the other is to make clinical judgement. Simulation approach has to be customized as per project or training objectives. In developed medical institutions around the globe the healthcare providers candidates have to complete clinical rotations and simulation learning as well. How many Nursing colleges and medical colleges does have simulation curriculum? For example, In Paramedicine the paramedic licensing exam includes an integrated out-of-hospital simulation scenario where a candidate is required to effectively manage a simulated patient for 15 to 20 minutes. After initial licensing recurring competency assessments are often conducted through simulation activities. These assessments are meant to capture continued competence of providers. Drawing a quality standard on EMS simulation activities is vital since simulation-based assessments are utilized for determining provider competence and workforce readiness. Shortcutting this level of quality can negatively impact providers and ultimately patient safety.

During emergencies, being READY is critical and can save lives. “IMMAST” Institute of Medical and Minimal Access Surgery Training (Mumbai, India) is providing simulation training on surgeries and allied health sectors. It is the only center of its kind in India that offers hands-on training on close to life models, using in-vivo and ex-vivo animal tissue, which perfectly mimic a live patient, in a re-created OT setting with top-of-the-line equipment. The hand-picked faculty at IMMAST enjoys national and international recognition in their respective surgical disciplines, and are bound by their passion for teaching. The center offers a plethora of surgical and medical education courses, spanning 16 surgical super-specialties, with hands-on practice, live transmissions, didactic lectures, and operative videos constituting basic as well as advanced levels of training." Sandor Medicaids Pvt Ltd (India, SARRC Countries) is committed to providing durable, affordable and comprehensive training Manikins and Turnkey Projects for Medical Intuitions that help our Physicians, Nurses and Paramedics to provide worldclass care. Pirogov Anatomy has introduced 3D virtual anatomy with case study for medical students and allied health sciences which is very important for any medical students to make clinical judgement. NMC policy in India makes mandatory that each medical institutions must have 3D anatomy dissection table in every medical college. The decision makers of Medical Institutions and Nursing Institutions need to understand that this is the time not to waste anymore. This is the time to get the resources for better training of Physicians, Nurses and Paramedics for the country. Then only we can hope for better care and patient safety.

Geriatric care has to be popularized

Life in geriatric care institutions and services is not very popular in India. This is not encouraged for a variety of reasons. Lack of social and family support is also a factor. The community needs to understand the need for care for the elderly. The rates of dependence on geriatric centers are increasing in India. The situation may arise where the children are abroad and the parents are at home. When relying on nursing homes, we need to think about whether our parents will get better care like home. Otherwise the situation of our parents will be miserable. Facilities and quality of care and maintenance should be ensured.

Good service and quality care are the focus of aging care. Elderly routines, diets, current health status and previous knowledge, functional capacity, strengths and weaknesses are allessential for the smooth functioning of rehabilitation. Adverse conditions are such as sudden depression, uncontrolled functioning of the internal organs, ulcers, weight loss, etc. This will reduce the risk of future complications. The family should be informed at regular intervals about the care and if there are any significant problems. The Resident Assessment Form is an effective tool for valuing things in geriatric care centers.

Serve the elderly

Policies are currently formulated by the National Policy of Older Persons and the National Program for the Elderly. However, there are no specific restrictions or guidelines for institutional managers on what to do in geriatric care facilities. This needs to be changed. However, the Standard Wise International India Association, a subsidiary of Standard Wise International, has launched a new initiative to evaluate and recognize geriatric care centers in India. This will lead to a broader vision of the elderly living in the country and new policy formulations. Special training Gerontology education and the number of people in need of long-term care are very limited in the country. Errors occur in areas where the elderly are cared for due to lack of education. We need to be trained to care for each other as we care for our parents. Once we all have to be there in any of the old age home because our culture is in a ongoing process of change. If there are hundred people in an old age home, instead of looking at a hundred people as one, they should take care of the needs of each one. Education is essential for this. Before ending I am just visualizing the concept of family it will be extolled in the pages of the history books from where the new generation will read and learn. We just try to foresee a better society then our vision will be clear and precise.

Findings and analysis

Majority of the respondents are from the age of 40-45. This is a newly invented information by this research because the most of the middle aged women are affected psychos somatic disorder in the ages of 40-45. The reason is that the stated age is the initial stage of occurrence of the psycho somatic symptoms. There will not be any chances of misinterpreting on the basis of aging difficulties.

The second major finding which is obtained in the type of the family, the type of nuclear and joint family is significant factors while dealing with psychosomatic disorder in middle aged women. The social interaction and family sharing are the important role in reducing the levels of stress in middle aged women because after 40 ages they will be more vulnerable to stress and social isolation within the family.

The third aspect must be taken into account is that the marital status of the respondent. The majority of the respondents are married women because comparatively the married women are undergoing various stresses and worse life situations than unmarried women. It depends on the stress level through which each woman is facing in their day to day life.

Another important thing is regarding the symptoms which are mostly affected with middle aged women. The back pain and joint pains are the initial symptoms in the psychosomatic disorder. The reason why is that pain is attributed to get relief from the stressful situations. The age will be negatively conceptualized by the middle aged women since they all have children those who are trying to settle themselves.

There is another most visible symptom is that low energy and trouble in sleeping. The fact is that both of these symptoms are quite similar in its effect. Initially it will be started with sleeping disturbance which will direct to energy loss in day time. If the brain is not able to manage with stress then automatically brain shuts down the activity so mind and its function will be collapsed which will be affected the sleeping stimulation in human body.

The anxiety and depression are the major cause of the psycho somatic disorder in middle aged women. The research mainly focused on the ratio of anxiety and depression which causes the possibility of the psycho somatic disorder. The important thing is that most of the respondents are affected with mixed anxiety and depression which gives high possibility of psycho somatic disorder especially in middle aged women due to the hormonal changes and menopause circle.

As per the collected data 78% of respondents are having drastic improvements by the help of medication. The changes which is visible in the hospital where researcher has taken for the study, it is a categorical result of effectiveness of medication for the respondents.

The family care and support are low approximately 70% of the respondent. The low family support and care for the women will be loosening their emotional well being from the family itself. The stress which comes from the family itself because the majority of them is married and house wives, the stress in the family easily affects the women those who are mid life. So if there is stress factors in the family there will be chances likely to affect middle aged women with psycho somatic disorder.

Interventions

The therapies and counseling can change their thoughts and consciousness in a better way. The majority of the respondents are benefited by the counseling and therapies in the hospital. If the therapies and counseling should be taken as a serious part in their life then which will be useful so here in the hospital this will be ensured in a right way. There are drastic improvements in patients for middle aged women those who come with psycho somatic disorder which will help to refresh and purify their distress into positive way.

The last major finding is an unresolved question whether the psychiatric medicine is having any side effects or not. Here researcher has no valid answer to question because there may be chances of side effect but not that much dangerous thing. Another typical situation of self treatment of the respondents will cause serious psychiatric issues in the future life.

Rising suggestions

Barriers to middle-aged women?s mental health fell into two main themes including increased life concerns and physical and psychological tensions. The two sub-categories of the first theme included having mental concerns and increased burden of roles. The second main theme also consisted of two categories including perceived undesirable physical changes and perceived undesirable psychological changes. So here researcher would like to write aside some suggestion to the respondents and the people those are in the psycho somatic condition.

To the middle aged women

Try to increase the social interaction which will help to reduce the stress level.
Mediation, breathing exercises and yoga will help the middle aged women to concentrate the concrete life situations and they can remove the negativities and can lead a stress free life.
The spirituality plays an important role which will help the women to relocate themselves in a comfortable place and they become more reflective which will reduce the stress factors in life.
The self care techniques can be used which will give new realm of life pattern that will nourish positive mental health and stress free life. the self care techniques are following as love pets, listening music, gathering with friends etc. these all will give positive feedback in the life and will give relaxation from the family stresses.

To the Family

The family care and the support are the inevitable factors that give remarkable changes in middle aged women which will balance the stress level in the menopause period of the women. the hormonal changes can be easily controlled by the love and care from the partner and family members.
To attend a family counseling which will help to cope up with the patient those who are having difficulties of adjustment in the family.

Conclusion

Menopause and the postmenopausal period are very important landmarks in a woman?s life since she will spend more than a third of her life during these periods without significant endogenous estrogen production. Menopause is a physiological process, which takes place universally in all women who reach midlife. Midlife is a period of transition for both men and women. It brings about changes in women and it has an implication on women?s health. Menopause may be viewed as a transition of women from middle age to old age. Menopause is not just cessation of menstruation it is depletion of ovarian follicles leading to decrease in ovarian hormones. Natural menopause occurs after 40 years of age and has no underlying pathologic cause. Menopause is considered premature or late when it occurs before 40 years and after 55 years, respectively. The commonest age range is at which women experience menopause after 40 to 50 years. Though menopause is a normal physiological phenomenon, but women at menopausal and postmenopausal age get a variety of symptoms like irritability, lethargy, depression, forgetfulness, weight gain, insomnia, joint and muscle pain and constipation. The most of the psychosomatic symptoms are similar as the menopausal period of the women. Another important thing is that unbalanced stress level of the women which are contributing to psycho somatic condition.

The study findings revealed that majority of the postmenopausal women had one or more of the psychosomatic problems with the most common being fatigue, muscle and joint pain, irritability, anxiety and depression. Women experience such problems due to reduction of the ovarian function. Thus, women need to recognize these symptoms early and seek timely medical care. It is the dilemma that every middle aged women are vulnerable to psycho somatic disorder. After the completion of the research I would say “NO” because when over stress and menopausal difficulties are come together where there is a high possibility of psychosomatic disorder. The environment of the middle aged women has a vital role of leading a mentally free and happy life with family.

As the result of entire study on psycho somatic disorder in middle aged women come to a one word of conclusion is that menopausal period of women should be treated well and supported physically and mentally by the family members and it is the social concern to women because being a mother is the most challenging and most rewarding position so respect women when they come in the midlife through which we will love our mother then we all become the most beautiful person in the world.

Reference

Ahuja Niraj. “A Short Text Book of Psychiatry”. 7th edition, Jaypee Brothers Medical Publishers Pvt. LTD (2011).
Bahman To?ghi. “A Study of the Relationship Between Stress and Psychosomatic Disorders”. Department of Consulting, Bushehr Branch, Islamic Azad University (1990).
Chandrashekhar CR and Math SB. “Psychosomatic disorders in developing countries; current issues and future challenges, current opinion in Psychiatry”. RELX Group Publishers 19.2 (2006): 201-6.
Engel GL. “The concept of psychosomatic disorder”. J Psychosom Res (1967).
Fava GA. “The psychosomatic spirit”. Lipowski’s legacy, Psychother Psychosom (1999).
Hunter MS. “Psychological and somatic experience of menopause: A prospective study”. The London journal 52.3 (1990): 357-67.
Kaplan. “Comprehensive Text Book of Psychiatry”. Seventh edition, Lippincott Williamsand Wilkins (2000).
Lipowski ZJ. “Psychosomatic medicine Past and present”. Can J Psychiatry 31.1 (1986): 2-7.
Miller JB. “Towards new psychology of women”. 4th edition, Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association (1990).
Nagabhushana D., et al. “Stress related disorders – A review”. ed., Jiaomr, Pearson Publications (2004).
Pert CB, Drehert HE and Ruff MR. “The psychosomatic network: Foundations of mind-body medicine”. Alternative Ther Health Me 4.4 (1998): 30-41.
CB Pert, HE Dreher and MR Ruff. “The Psychosomatic Network: Foundations of Mind-Body Medicine”. Cornell university 4.4 (1998): 30-41.
Shekar K, Prameela Rajaram and Rameela sheakhar. “Women and Mental Health”. ed., Mubarak A.R, National Institute of Mental Health and Neuroscience (2004).
Sweeting HN. “Explanations for Female Excess Psychosomatic Symptoms in Middle Aged Women”. West PB, Der GJ. BMC Public Health 7 (2007): 298.
Wittkower ED. “Historical perspective of contemporary psychosomatic medicine”. INT J Psychiatry Med 5.4 (1974): 309-19.

References

AMA passes first policy recommendations on augmented intelligence.
An introduction to explainable AI with Shapley values.
The Global Burden of Disease 2004 Update, WHO.
Hancock, M., Pylidc , MIT.
Rathe A. Random Forest vs XGBoost vs Deep Neural Network, Kaggle.
Zhu P and Ogino M. “Guideline-based additive explanation for computer-aided diagnosis of lung nodules”. In Interpretability of Machine Intelligence in Medical Image Computing and Multimodal Learning for Clinical Decision Support (2019): 39-47.
Singh A, Sengupta S and Lakshminarayanan V. “Explainable deep learning models in medical image analysis”. Journal of Imaging 6.6 (2020): 52.
Lucieri A., et al. “Achievements and Challenges in Explaining Deep Learning based Computer-Aided Diagnosis Systems”. arXiv preprint (2020).
Ahmed ZU., et al. “Explainable artificial intelligence (XAI) for exploring spatial variability of lung and bronchus cancer (LBC) mortality rates in the contiguous USA”. Scientific reports 11.1 (2021): 1-15.
Siddhartha M, Maity P and Nath R. “Explanatory artificial intelligence (XAI) in the prediction of post-operative life expectancy in lung cancer patients”. Int J Sci Res 8 (2020).
Bartczak M and Partyka M. Chapter 8 Story Lungs: eXplainable predictions for post operational risks.
Venugopal VK., et al. “Unboxing AI-radiological insights into a deep neural network for lung nodule characterization”. Academic radiology 27.1 (2020): 88-95.
Zhou B., et al. “Learning deep features for discriminative localization”. In Proceedings of the IEEE conference on computer vision and pattern recognition (2016): 2921-2929.
Selvaraju RR., et al. “Grad-cam: Visual explanations from deep networks via gradient-based localization”. In Proceedings of the IEEE international conference on computer vision (2017): 618-626.
Lundberg SM and Lee SI. “A unified approach to interpreting model predictions”. In Proceedings of the 31st international conference on neural information processing systems (2017): 4768-4777.
Shrikumar A, Greenside P and Kundaje A. “Learning important features through propagating activation differences”. In International Conference on Machine Learning (2017): 3145-3153.
The Cancer Imaging Archive (TCIA) Public Access, LIDC-IDRI.
Tulio Ribeiro M, Singh S and Guestrin C. "Why Should I Trust You?": Explain- ing the Predictions of Any Classifier. arXiv e-prints (2016): arXiv-1602.
He H., et al. “ADASYN: Adaptive synthetic sampling approach for imbalanced learning”. In 2008 IEEE international joint conference on neural networks (IEEE world congress on computational intelligence) (2008): 1322-1328.

Introduction

Electronic Medical Records (EMRs) have become widely adopted across healthcare systems in both the United States and Latin America. These digital repositories contain comprehensive patient data, including medical history, diagnoses, laboratory results, medication records, and demographic information. Extracting this vast amount of data and integrating it with advanced technologies such as neural networks presents an opportunity to derive actionable insights for improving prognostic care.

Scope of Extracting Vital Patient Informatics
Improved Treatment Decision-Making

Extracting EMR data and feeding it into neural networks enables healthcare providers to analyze large datasets and identify patterns that may be crucial for accurate prognostic care. By utilizing machine learning algorithms, physicians can gain access to predictive models capable of assisting in treatment decisions, risk assessment, and prognosis evaluation.

These models can provide evidence-based recommendations tailored to individual patients, optimizing clinical outcomes.

Personalized Interventions

The extraction of EMR data allows for the identification of specific patient characteristics, such as genetic predispositions, lifestyle factors, and comorbidities. Neural networks can integrate these factors with clinical data to create personalized intervention strategies for disease management. This individualized approach enhances patient engagement, adherence to treatment plans, and overall therapeutic efficacy.

Enhanced Healthcare Outcomes

Utilizing EMR data with neural networks promotes population health management by analyzing large-scale patient data to identify disease patterns, risk factors, and potential outbreaks. By leveraging this information, healthcare systems can develop preventive strategies, optimize resource allocation, and improve patient outcomes on a broader scale.

Challenges and Considerations
Data Privacy and Security

When dealing with sensitive patient data, ensuring privacy and security is of utmost importance. Adequate measures must be implemented to protect patient information and comply with existing regulations and ethical guidelines.

Data Quality and Standardization

EMR data extraction relies on accurate and standardized data entry. Inconsistent or incomplete data may lead to biased results and inaccurate prognostic models. Efforts should be made to improve data quality and establish standardized protocols for data collection and storage.

Health Inequality and Accessibility

While extracting EMR data for neural networks shows promising potential, it is essential to consider health inequalities and accessibility issues prevalent in both the United States and Latin America.

Efforts should be made to bridge the digital divide and ensure equitable access to technology and healthcare services.

Conclusion

Extracting EMR data and leveraging neural networks hold significant potential for enhancing prognostic care in the United States and Latin America. By utilizing machine learning algorithms, healthcare providers can improve treatment decision-making, develop personalized interventions, and achieve enhanced healthcare outcomes. However, challenges such as data privacy, quality, and accessibility must be addressed to fully harness the potential benefits of this approach. Further research, collaboration, and investment are necessary to optimize the utilization of EMR data for neural networks in clinical care in both regions.

References

Bates DW., et al. “Big data in health care: using analytics to identify and manage high-risk and high-cost patients”. Health affairs 33.7 (2014): 1123-1131.
Denny JC and Spickard A. “Mining electronic health records: towards better research applications and clinical care”. Nature Reviews Genetics 14.6 (2013): 395-405.
Haque SN and Ali NM. “Leveraging electronic medical records for improving healthcare: a systematic review”. Journal of Medical Systems 44.12 (2020): 1-14.
Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. National Academies Press (US) (2001).
Panch T, Mattie H and Celi LA. “The "inconvenient truth" about AI in healthcare”. NPJ Digital Medicine 2 (2019): 77.
Weng SF., et al. “Can machine-learning improve cardiovascular risk prediction using routine clinical data?”. PLoS One 12.4 (2017): e0174944.
World Health Organization. Health in the Americas: regional outlook, country profiles. Pan American Health Organization (2013).

The recommendation issued by the World Health Organization in 1981 and the resolutions regulating the subsequent merchandising code for breast milk substitutes aim at standardizing the rules for advertising and inappropriate promotion of these products, including: infant formula, baby bottles, pacifiers, and supplementary food products.

Despite the efforts to bring forward these regulations at national levels, it has been very difficult for most countries to create legal bodies enabling actions to be taken in defense of the rights of mothers, fathers, and families to access reliable information about infant nutrition. This information must be free from the influence of aggressive marketing campaigns and merchandising for these substitute products. These campaign strategies continue to influence the decisions on food and nutrition of babies, reducing or even causing an early halt of breastfeeding, which would otherwise widely benefit babies and their mothers’ health and nutrition in the short and long term.

Commercial influence in decisions about infants’ nutrition

In contrast to the aforementioned breastfeeding figures, the state of the baby formula industry shows its increasing profit worldwide. In 2019, this market achieved a total worldwide income of 70.6 billion USD.

The 2023 Lancet series on the topic of breastfeeding, describe the multilayered and highly effective strategies of baby formula manufacturers to address the parents, health professionals, and policymakers. These include:

Presenting their products – with little or no supporting evidence – as answers to common infant health and developmental challenges in ways that systematically undermine breastfeeding;
Using digital platforms to substantially extend the reach and influence of marketing; and
Lobbying governments in an effort to prevent the strengthening of breastfeeding protection laws and to challenge food standard regulations.

Code dissemination and further action

After more than 40 years since the promulgation of the international code for commercialization of breast milk substitutes, the WHO with the support of civil societies like the IBFAN network (International baby food action network), held the first world congress on the code in Geneve in June 2023. They proposed several goals, such as: the creation of policies and strengthening mechanisms to coordinate and manage these policies. Thereof, countries would finally acknowledge the mandatory character of the code making it into legislation. Thereafter, it is possible to subdue the conflicts of interest created by the food industry within the health system through health professionals and the ongoing advertising broadcasted across mass media, social networks, and other communication platforms on the internet.

IBFAN is committed to continue supporting breastfeeding and overseeing the observance of the code as we continue to advocate for the unobstructed advancement of the implementation of the code. Likewise, we seek to promote public policies that favor breastfeeding. We overall seek to work in accordance with the conclusions and recommendations expressed by the countries participating in the Geneve forum which became a milestone in policymaking to support breastfeeding.

To conclude, the way to achieve dissemination and promotion of breastfeeding is still complex. Nevertheless, there are more foreseen actions and awareness by many to get the necessary support of governments, the civil society, and health professionals to gain the needed knowledge on this subject and its successful implementation in the public and private areas.

Similarly, we need to bear in mind that it is also relevant to address individuals, a key factor to foster breastfeeding aiming to overcome the fear and lack of confidence experienced by mothers in their own capacity to breastfeed. These limitations are induced by baby food campaigns that seem to take advantage from their doubts and also attempt to convince mothers of the impossibility to breastfeed bringing forth ideas like an alleged failure in milk production. Actually, such events are absolutely possible to reverse and many of them are merely untrue. These beliefs prevent achieving successful breastfeeding, and totally surmountable and essential to SAVING MORE BREASTFEEDING as well. Therefore, we will continue to support mothers and their babies in this life period of utmost importance for nutrition, both at public and individual levels.

Value intelligence is defined as; The ability to engage in a range of behaviors that call for the use of specific skills such as language and social skills, It possesses a set of characteristics that enable it to communicate and adapt to the values and attitudes of individuals from different cultures. Value intelligence is also defined as; The ability that allows individuals to understand and interact positively with a wide range of values, It can be said that value intelligence is the ability to find a new useful product, or to develop a valuable service for the value system in which the individual lives, and it includes a number of skills that enable its owner to solve problems facing him, in addition to being a biological possibility that interacts with environmental factors. Here it must be noted that value intelligence does not only mean cognitive understanding of value differences, but it includes several components: motivation, behavior, In addition to knowledge, therefore, we find that individuals who have value intelligence have effectiveness regarding new value situations related to value differences, and this is what is known as behavioral value intelligence. Which determines the totality of practices, actions and behaviors that the individual performs in relation to life situations, especially those related to the value side, and we also find those who enjoy intelligence and have the motivation and ability to interact with new value concepts. This is what is known as the value-motivational intelligence, which constitutes the main engine for the individual's practice of the intelligent side and uses it to identify the total value attitudes surrounding him and interacts with the incubating environment with all its cultural variables. They are also more capable of adapting and interacting with people of different cultures, and they have a desire to ask many questions, to be constantly exposed to new situations, and to feel pleasure when communicating with individuals from different cultures and to increase their value experiences. This is what is known as the value-cognitive intelligence that is based on the love of exploration, inquiring and diving into an ocean of questions that may not end at times, as they express depth in the levels of intelligence related to individuals within the framework of different cultural systems. Over the ages, human societies have been concerned with the development of their institutions in all economic, social and value fields, and the development of their intellectual and value skills, which has led to a kind of mixing of values. Educational institutions such as schools and universities are a meeting point for individuals from different backgrounds, especially since the educational institution as a whole is the first organizational entity in the educational process. It has occupied great interest in all countries of the world, especially as it is an effective tool that contributes to the progress and development of nations. Therefore, many countries have paid great attention to improving the level of universities by improving educational programs and their curricula, as well as paying attention to the academic aspect and faculty members, developing their personal experiences and knowledge in learning strategies in general, and drawing inspiration from renewable knowledge in particular. The success of the educational process in universities has been largely linked to the success of the faculty member, who is the leader in the educational process and is responsible for implementing the educational mission and educational policies within the walls of the educational institution. By making decisions and applying educational laws with the help of educational specialists, including administrators and educational leaders, and following up students in their academic achievement and urging them to be knowledgeable and knowledgeable and research in order to achieve educational goals with their correct goals, As well as his role in cooperating with his colleagues in exchanging educational experiences. The university environment may consist of diverse cultures and the culture of the majority prevails, which may affect the sub-cultures of students. Therefore, the faculty member’s possession of value intelligence is an effective factor in the success of the educational process, through his ability to Communication and adaptation with people from different cultures.

Today, the world is witnessing major changes in all areas of economic, social, political, intellectual and educational life, especially in the field of information and communication, which has facilitated friction between different cultures. Intelligence is an important factor in successfully dealing with modern developments brought about by globalization and the communications and information revolution, which in turn; It has multidimensional effects on the content of the value framework surrounding man. New mechanisms were developed for patterns of human behavioral interaction, as well as new perceptual values and judgments that shook the value legacies, which in turn embraced human thought, awareness and culture throughout contemporary history. The concept of intelligence is one of the most controversial concepts due to the multiplicity of its topics and definitions. This concept has been associated with the necessities of success in life, especially since individuals differ in the percentage of each type of these intelligences they have. One of the most important types of intelligences that scholars and researchers in management science and social psychology have paid attention to is value intelligence. Which appeared as an inevitable necessity as a result of the convergence of civilizations and the diversity of values that took many patterns in our societies as a result of the great technological development that we are witnessing in the current century. Culture is also the thread that connects a person to himself and others, and that the interactions and behavior of individuals involve, in essence, a cultural relationship. In light of the different cultures, we find that there are similarities and differences in light of these multiple cultures, which culture in turn works to create a suitable environment for living together in light of the diversity of values. Therefore, culture is responsible for shaping the value structure of each human society. It is what shapes the economy and determines the political system. It is also developed and has a dynamic interaction. Value intelligence refers to a group of abilities related to situations that are characterized by value diversity Value intelligence also comes as a form of intelligence that focuses on understanding, management, and behavior in situations characterized by value diversity There is no doubt that individuals from multiple environments and cultures differ in their intelligence, and they can develop types of these intelligences to an appropriate level through the availability of adequate support from the environment or culture in which they live.

The Importance of Rational Antibiotic Use

Nosocomial and community-based ease of infection is a serious consideration in the postoperative management of patients in this region. Likewise, CS deliveries carry an increased risk of complications associated with infection compared to vaginal deliveries [2]. SSIs, endometritis, and urinary tract infections are common post-operative complications that can lead to increased morbidity, healthcare costs, and antibiotic resistance [3]. To mitigate these risks, the rational use of antibiotics is essential. Rational antibiotic use involves selecting the appropriate antibiotic, optimizing the dosage regimen, and considering factors such as the patient's health status, local resistance patterns, and cost-effectiveness [4].

Pattern of antibiotics prophylaxis

Currently, International guidelines provide recommendations for antibiotic prophylaxis in CS. These guidelines emphasize the importance of selecting antibiotics with appropriate spectra of activity against common pathogens, administering the antibiotics at the optimal time, and limiting the duration of prophylaxis. However, adherence to these guidelines can vary, and it is essential to evaluate the compliance with international guidelines in different healthcare settings [4].

This variation in compliance may result in varied patients’ outcome that may be positive or negative. In Nigeria, some hospitals in the federal capital give 2g single dose intravenous ceftriaxone or other potent cephalosporin intra-operatively as its sole prophylactic measure, without any other complications in the theatre, no further antibiotics are given. Whereas, while the intra-operative prophylactic ceftriaxone is given, routine intravenous antibiotics are continued for 24 hours post-operatively and then orals subsequently for 7-10 days, in Bauchi State, Nigeria. Sadly, at the moment, there are no comparative studies between these two states in Nigeria. However, a study conducted in Sudan at Elquatainah Teaching Hospital where similar practices as those of Abuja and Bauchi State were compared. Cost wise and pharmaceutically speaking, not prescribing post-CS antibiotics were found to reduce expenditure and general work load. But the medical repercussion was not examined in that study [5].

That notwithstanding, several studies have investigated the adherence to international guidelines for antibiotic prophylaxis in CS in various African countries. For example, a study conducted at Mulago National Referral Hospital in Uganda implemented a randomized clinical trial to assess the timing of antibiotic administration in CS. The study found that administering antibiotics before the skin incision significantly reduced the risk of postoperative infections. This research highlights the importance of following evidence-based guidelines to optimize patient outcomes [6].

Another study conducted in Lusaka, Zambia, examined the antibiotic prescribing patterns and prevalence of SSIs in CS deliveries. The study found that the most commonly prescribed antibiotics were the third-generation cephalosporin, ceftriaxone, and a triple combination therapy of benzylpenicillin, gentamicin, and metronidazole. The prevalence of SSIs was 6.0%, with factors such as the level of education, type of CS, and oral antibiotics post-CS influencing the risk of infection. These findings highlight the need for targeted interventions to improve antibiotic prescribing practices and reduce the prevalence of SSIs [7].

As regards targeted interventions, another study conducted at AL Ain Hospital in UAE amongst 807 women; found that there was a significantly low rate (1.4%) of SSI following CS. All women diagnosed with SSI had wound discharges within 30 days of the operation. More important, was the common denominator they identified amongst these women. That’s, they all had prolonged pregnancies. This was thus now tabled as a targeted risk for SSI after CS, and as thus subsequent patients fitting this profile ought to be on longer antibiotics regimens [8].

Implementing Guidelines for Rational Antibiotic Use

Like earlier mentioned, about the variation in approach in Abuja and Bauchi state in Nigeria, there are also intra-hospital variations in antibiotics utilization in CS. A study conducted at Elqutainah Teaching Hospital in Sudan implemented a hospital guideline for the rational use of prophylactic antibiotics in ECS. The intervention involved withdrawing metronidazole dosage forms from prophylactic antibiotics according to international guidelines. The study found that this intervention significantly reduced the overuse of antibiotics and medication costs while maintaining patient safety [5].

While this approach has been found to be effective in this hospital in Sudan, there are no searchable evidences for its implementation or trial in other areas in Sudan, north Africa or in the Africa region as a whole. Similar tales can be told about many other rational approaches. Also, the study also went on to show the vital role of clinical pharmacists in the development of rationale guidelines for antibiotics in obstetrics and gynaecological clinical practice, in this case, prevention of SSIs following CS.

Furthermore, when selecting antibiotics for prophylaxis in CS, several factors need to be considered. These factors include the local epidemiology of pathogens and their antibiotic resistance patterns, the patient's individual risk factors, the surgical procedure's specific characteristics, and the available resources and infrastructure. Adapting international guidelines to the local context is crucial to ensure the effective prevention of postoperative infections.

Understanding the local epidemiology of pathogens and their antibiotic resistance patterns is essential for selecting appropriate antibiotics. Studies have shown variations in pathogen profiles and resistance patterns across different African regions. For example, a study conducted in Nigeria found that Staphylococcus aureus and Escherichia coli were the most common pathogens isolated from SSIs in CS, with high rates of resistance to commonly used antibiotics. These findings emphasize the need for local surveillance and tailored antibiotic recommendations.

However, it is worth of note that individual patient risk factors, such as obesity, diabetes, and immunosuppression, should be considered when selecting antibiotics for prophylaxis. These risk factors can increase the likelihood of postoperative infections and may require broader-spectrum antibiotics or extended prophylaxis durations. Integrating patient-specific risk stratification into antibiotic prescribing practices can help optimize outcomes and reduce unnecessary antibiotic use.

Surgical Procedure Characteristics

The type of CS procedure, whether elective or emergency, can influence the choice and duration of antibiotic prophylaxis. Elective CS procedures are considered clean surgeries with lower infection risks, while emergency CS procedures carry a higher risk due to potential contamination. Tailoring the antibiotic prophylaxis regimen based on the specific surgical procedure characteristics can help ensure adequate coverage while minimizing unnecessary antibiotic exposure.

Resource Constraints and Infrastructure

Resource constraints and infrastructure limitations pose challenges to antibiotic selection and administration in many African healthcare settings. Limited access to certain antibiotics, inadequate laboratory facilities for culture and sensitivity testing, and suboptimal healthcare infrastructure can impact the choice and availability of antibiotics. It is crucial to consider these factors when implementing guidelines for rational antibiotic use and explore strategies for optimizing antibiotic stewardship in resource-limited settings.

Strategies for Optimizing Antibiotic Use

To promote rational antibiotic use after CS in Africa, several strategies can be implemented at various levels of healthcare delivery.

Education and Training

Education and training programs targeting healthcare professionals involved in CS deliveries can enhance their knowledge and awareness of rational antibiotic use. Providing evidence-based guidelines, conducting workshops, and promoting continuous medical education can help improve antibiotic prescribing practices and increase adherence to guidelines.

Antibiotic Stewardship Programs

Formulating antibiotic stewardship programs specific to CS deliveries can be an effective approach to optimize antibiotic use. These programs can involve multidisciplinary teams, including clinical pharmacists, infectious disease specialists, obstetricians, and microbiologists. The programs can focus on implementing guidelines, monitoring antibiotic prescribing patterns, providing feedback to healthcare providers, and promoting appropriate antibiotic use.

Surveillance and Monitoring Systems

Establishing surveillance and monitoring systems for SSIs and antibiotic resistance can provide valuable data for guiding antibiotic prescribing practices. These systems can help identify trends, detect outbreaks, and evaluate the effectiveness of interventions. Regular monitoring and feedback to healthcare providers can facilitate continuous improvement in rational antibiotic use.

Collaboration and Partnerships

Collaboration and partnerships between healthcare facilities, professional organizations, and policymakers are crucial for promoting rational antibiotic use. Sharing best practices, implementing standardized protocols, and advocating for policies that support evidence-based antibiotic prescribing can contribute to reducing the burden of SSIs and antibiotic resistance after CS.

Conclusion

The rational use of antibiotics after CS in Africa is essential to mitigate the risk of postoperative infections and combat antibiotic resistance. Adhering to international guidelines, considering local epidemiology and resistance patterns, individual patient risk factors, surgical procedure characteristics, and resource limitations are key factors in optimizing antibiotic use. Implementing strategies such as education and training, antibiotic stewardship programs, surveillance systems, and collaboration can contribute to improving antibiotic prescribing practices and ultimately improving patient outcomes. By prioritizing rational antibiotic use, Africa can address the unique challenges associated with CS deliveries and pave the way for sustainable healthcare practices.

Recommendations

Africa faces unique challenges in the rational use of antibiotics after CS, including variations in pathogen profiles, limited resources, and infrastructure constraints. As such, Africa should conduct more internal studies and develop more locally adapted strategies.
Adapting international guidelines to the local context is crucial for effective prevention of postoperative infections.
Multidisciplinary collaboration and partnerships are essential for promoting evidence-based antibiotic prescribing practices.
Education and training programs, antibiotic stewardship initiatives, and surveillance systems can contribute to optimizing antibiotic use after CS in Africa.
Rational antibiotic use after CS plays a vital role in reducing the burden of SSIs and combatting antibiotic resistance in the region. As such, the utilization of antibiotics should not be unfairly played down in bids to rationalize its use, instead this should be evidence based and more strategic.

References

Sway A., et al. “Burden of Surgical Site Infection Following Cesarean Section in Sub-Saharan Africa: A Narrative Review”. International Journal of Women’s Health 11 (2019): 309-318.
Gelaw KA., et al. “Surgical Site Infection and Its Associated Factors Following Cesarean Section: A Cross-Sectional Study from a Public Hospital in Ethiopia”. Patient Safety in Surgery 11 (2017): 18.
Jasim HH., et al. “Incidence and Risk Factors of Surgical Site Infection among Patients Undergoing Cesarean Section”. BMC Infectious Diseases 12.46 (2017): 113-6.
Azizi M., et al. “Comparing the Effectiveness of Broad-Spectrum Antibiotic Prophylaxis with Single Agent Antibiotic Prophylaxis to Prevent Post-Cesarean Section Infection”. Hormozgan Medical Journal 20 (2017): 287-292.
Suliman SM, Yousef BA and Hamadelnil AA. “Impact of guidelines implementation for the rational use of prophylactic antibiotics in elective cesarean sections at Elqutainah Teaching Hospital”. J Family Med Prim Care 9.1 (2020): 162-167.
Dlamini LD., et al. “Antibiotic prophylaxis for caesarean section at a Ugandan hospital: a randomised clinical trial evaluating the effect of administration time on the incidence of postoperative infections”. BMC Pregnancy Childbirth 15 (2015): 91.
Kasanga M., et al. “Antibiotic Prescribing Patterns and Prevalence of Surgical Site Infections in Caesarean Section Deliveries at Two Tertiary Hospitals in Lusaka, Zambia”. Pharmacology & Pharmacy 13 (2022): 313-330.
Alnajjar MS and Alashker DA. “Surgical site infections following caesarean sections at Emirati teaching hospital: Incidence and implicated factors”. Sci Rep 10.1 (2020): 18702.

One of the predators, who actually was and may never have stopped being a Nazi is global financier and convicted felon George Soros [10]. His plan, which is shared by many in these elite circles, was to shut down every part of the economy in the first world, and de-industrialize the USA. The collapsing borders, super-inflation, total elimination of fossil fuels (unless it comes from perhaps British Petroleum or those in league with the globalists), and collapse of the world food supply (mass starvation). All this so a corporate UN coordinated world government can come in and act as saviors. It is a decarbonizing agenda, an anti-terraforming religion where carbon dioxide will be removed from the atmosphere in the name of being Green. Green was intended to be the new anti-human, anti-science religion used to isolate, control and eventually eliminate as much as 80% of the human population on the planet, for the carbon they really want to remove is us. If Green were really “Green” why are we outsourcing our energy needs to China where slaves are many and human rights are few. Those batteries for electric cars require cobalt mined by exploited African children. Who do you think are making all those Chinese solar panels (yes, they make most of them)? How about a million Uyghur Muslim slaves incarcerated because of their religion - at least until someone with money needs an organ that matches one of the slaves, be they Muslim or Fallon Gong practitioners. It’s called Green Washing or environmental virtue signaling.

By 2026, there will be more than three Chinese males for every female aged 15-29, thanks to their policy of sex-selective abortion. The Chinese gender gap is fueling the trafficking of poor women, who are being kidnapped or lured into China and forced to be prostitutes or slave-brides. This is an unspoken driver of Chinese policy.

A massive global death cult has been lurking for decades for the moment to strike. They actually believe(d) they could transcend carbon-based life and have their consciousness transferred to some silicon-based life-form. In the short term, their plan is to neutralize the USA with a civil war/economic collapse while China takes over the South China Sea including Taiwan.

Whether you personally believe in malevolence, Satan [11] or nasty inter-dimensionals is your choice, but the globalists believe in them and most have sold their proverbial souls [12] for something they already had and now they have created a covenant with the losing team. The weird thing is on some level they know it, but can’t stop themselves so they push forward with their deranged game plans to create a transhuman world where most humans have been eliminated and they want this all to happen by 2030 according to their own published agenda [13].

A world that will be free of poverty and hunger because we won’t be in it, but those who remain will own nothing, be happy and eat bugs - again, this plan has been cooking for the last century. The globalists’ desire to be top dogs on a prison planet is so intense their wish may actually be granted, but not on this Earth. That seems to be the way a benevolent universe works, you get what you want, eventually, but it may not be exactly how you planned it out. Be that as it may, there also seems to be a lot of malevolence tolerated at certain levels and layers of our reality undoubtedly to stir the evolutionary pot for the benefit of all. Nevertheless, what goes around comes around, so if true, you don’t trade your future for temporary misuse of power as seductive as it may be. It is a poor choice, but some insist on learning the hard way, yet even in their insanity, the lessons they offer benefit the whole.

Medical Tyranny and Soft Kill weapons

Fluoride seems to have been the first foray into medical tyranny to control populations. The historical use of fluoride for behavior control probably started in the Soviet gulags in the 1930’s but Nazi Germany was quick to apply same in their prison camps as the mineral makes humans apathetic and easy to dominate - stupid and docile. The propaganda campaign in the USA was so convincing that fluoride was essential for preventing tooth decay that anyone who questioned its use in the water supply, even though fluoride is more poisonous than lead, was considered a nut case. The book The Fluoride Deception is well researched and goes over this in detail [14].

The practice and paradigm of fluoridating municipal drinking water demonstrated that the public would accept drinking poison if the government insisted it was a public health measure being done for the benefit of citizen’s well-being - “Fur Ihre Sicherheit” - it’s for your safety a common Nazi reframe. This poison is still universally defended by the dentists who will willingly put the most poisonous non-radioactive element on the periodic table in your mouth, mercury amalgam fillings, and call it silver. The mercury is constantly leeching out and you breathe it in and swallow it too.

During WW II, the biowarfare activities of the Japanese were particularly atrocious. As many as 3000 allied troops lost their lives in places such as the infamous Unit 731 testing biologics and untold number of civilians when these agents were released in Asia. The USA covertly granted the scientists involved immunity not unlike Operation Paper Clip [15].

Blame it on the fluoridated water, but we have allowed ourselves to be experimented on far too easily and without holding anyone accountable. There is no freedom without accountability. In 1950, the U.S. Army sprayed the bacteria serratia marcescens in San Francisco from a boat(s) in the bay - Operation Sea Spray and continued till 1969. There was at least one documented death from the infections that followed.

Infantile paralysis or polio didn’t exist until the heavy use of various pesticides the most notable being DDT, which is required to weaken the immune system so a previously benign stomach virus could start causing paralysis. But the government had encouraged and required the liberal use of DDT, and it was used everywhere and on almost everything (still is in certain parts of the world). Nevertheless, a virus and only a virus would be blamed for what was actually an illness caused by a pesticide or else there would be great liability to both the government and industry. So fear of a virus was ginned up - sound familiar? The mass vaccination campaign (Polio) initially gave 98 million Americans a retrovirus infection, a simian virus (SV40), now known to be causally related to several types of cancer. Now it seems genetic sequences from SV40 are in the mRNA bioweapon for COVID.

Don’t misunderstand what is written here… an enterovirus causes the illness but it needs a toxic co-factor in most cases. If the truth of the toxic cause of polio was known, and the government held accountable for infecting millions with a cancer-causing retrovirus, we would not be where we are today. The first mass vaccination program for polio in the USA, now called the Cutter Incident, gave 200,000 children polio. To convince the public the polio vaccine program was working, the definition of polio was changed so that one had to be paralyzed for at least 60 days to be classified as polio - most cases resolved before 60 days and of course they knew that. It made the vaccine look very effective. Today, the definition of what is a vaccine has been redefined to accommodate a hard to sell, problematic gene-transfer therapy that makes the human body create a pathogenic protein (forever in some people), potentially sterilize [16] many recipients and inflame their hearts [17]. Make the human body produce a pathogenic spike protein - what could go wrong?

Oh, and the definition of “Gain-of-Function” was changed as well, so the reader can decide if that made Dr. Fauci look any more credible. Especially, when it was found he wanted EcoHealth Alliance to spray more virulent corona virus in Wuhan caves to infect the local population (the Pentagon refused to fund the project - maybe because it was an act of war?) [18].

Made in the USA

By masking biowarfare programs as public health measure producing vaccines these fools were able to get around restrictions. The Department of Defense (DoD)/DARPA admitted to operating 46 biolabs in Ukraine, for public health of course - but pay no attention to the fact we operate these labs all over the world…. “we are the good guys.” In 2012, DARPA developed their ADEPT:PROTECT project that would use gene-encoded vaccines to stop a pandemic (they would create?). There was no WARP speed program - they had already been working on this for ten years before Trump announced WARP speed. Moderna got its first contract in 2013, but it was the DoD that came up with the idea of mRNA vaccines - this whole thing has been a military operation from the get go. By 2015, the peer reviewed literature had articles announcing the enhanced CoV2 was ready to be used (on the human population). It was never a China-virus, the Wuhan lab was just enhancing what was created in the USA. With the first week thousands of pregnant women were taking this vaccine. Never have we given experimental vaccines to pregnant women and in the past medicine went out of its way to protect pregnant women from as much as possible and certainly not interventions that would upset their immune systems, but medicine was now neutered - only Pharmakeia existed and was in full control.

The polio outbreak showed that you could herd the sheep (humans in this case) into a slaughter house if there was an invisible enemy and a virus is perfect for that because one can use fear to get populations to turn to their government to protect them from this invisible enemy. If you have control of the media, you can also implement a divide & conquer strategy, so if you can turn men against women, blacks against whites, heterosexuals against the LGBQTs, established populations against imported immigrants by the millions - all of that causes people to turn to their governments for interventions. Do you think those funding Critical Race Theory to Drag Queen Story-Time want harmony? No, they want culture wars and civil wars.

In the USA, if one disagreed with the narrative the media, the Department of Justice or FBI would label that individual either a domestic terrorist or white supremacist/racist regardless of their skin color. It was part of the plan to blame the destruction of the USA on white supremacists, but ponder this one example - the City of Oakland California is deeply beset with crime and violence, but I would challenge you to find even one white supremist in Oakland. Those behind the tyrannical cult we have been subjected to are not super-intelligent, but few realize they get their power from public acquiescence whose perceptions they have to control. Yes, the cult has a lot of financial resources and many deluded minions who will blindly do their bidding, but they are weak - only the weak censor. The censorship was a desperate move to control perceptions. But the censorship surrounding COVID killed tens of thousands.

So, with a virus, you can stop people from gathering, organizing and if you can digitize a population, you can control who is talking to whom and where. If you can get people to school online or do their work online the government can listen to everything everyone is saying and writing and buying. The excuse is that it is Fur Ihre Sicherheit to protect against the invisible enemy. It also keeps people lonely, isolated, and depressed. People will buy into solutions before they know anything about the consequences of that solution, so you can mandate lockdowns without proper science supporting same, injections that have not been adequately tested, or vaccines that are known to cause harm for the greater good of someone’s bottom-line.

Infectious Disease Skullduggery

This is not a comprehensive tome of infectious disease skullduggery, but in 1955 it has been reported that the CIA conducted an open-air biological warfare experiment near Tampa, Florida and environs with the Pertussis bacteria. It was alleged that the nasty endeavor tripled the whooping cough infections in Florida to over one-thousand cases and caused whooping cough deaths in the state to increase 12-fold over the previous year [19].

In 1966, the U.S. Army released Bacillus globigii into the tunnels of the New York City Subway system, as part of a field experiment called A Study of the Vulnerability of Subway Passengers in New York City to Covert Attack with Biological Agents. The Chicago subway system was also subject to a similar experiment by the Army [20].

Bacillus globigii was used to simulate an attack with anthrax, but as it turned out, now we know this bacteria is a human pathogen [21].

The USA government conducted many radiation experiments on the unwary, MKULTRA drug experiments on the unknowing, torture experiments on the incarcerated, but again…this is not meant to be a comprehensive list. By the time U.S. President Eisenhower left office with his infamous speech beware the “military-industrial-complex” we were being lead into unending military conflicts, often initiated by false flag events such as the Gulf of Tonkin incident that was used to start the Vietnam war.

Men in Black

In the 1950s, the CIA had split into two factions. The western faction was almost exclusively in control of anything that had to do with ETs - I don’t mention this to be sensational. In the years that followed the military-industrial paradigm evolved and became inclusive of many multinational corporations, investment houses and banks, which benefited from this arrangement leading to where we have massive corporate interests, such as Black Rock/Vanguard, which span the globe and whose shareholder-ships are networked among a very small oligarch class.

While President Roosevelt avoided a coup, President John F Kennedy did not, and was assassinated (1963) in a coordinated plot managed by the CIA’s E. Howard Hunt. Lyndon B. Johnson was Vice-President and was fully aware of the planned elimination of JFK as was the infamous director of the FBI, J Edgar Hoover. Apparently, America decided to explore the dark side and so begin unending wars and skullduggery around the globe. But I doubt this could have been possible without the cooperation of the press in covering up the facts of the event. Why was Kennedy assassinated?

Kennedy wanted the USA back on the gold standard, he wanted the CIA dismantled, he never wanted the USA to get entangled in Viet Nam. Unbeknownst to Kennedy, the CIA had become far more than the “CIA” they were literally the Men in Black in matters extraterrestrial and if the CIA was threatened it also threatened the cover being used in such matters and the monopoly of information the CIA had on this information. Kennedy had a vision for the space program, but his vison was not shared by those using NASA as a front organization for their secret space program (they were back engineering crashed vehicles probably with the help of low-vibrational ETs, but that is speculation). Just days before his murder, Kennedy signed an agreement with Kurschev to cooperate on moon exploration and signed an executive order requesting the CIA share what they knew about UFO’s to make sure there were no accidents from confusing UFOs with an aggressive act by either side. The CIA had no intention of sharing anything with anyone and certainly wasn’t going to let the chief executive tell them what to do even if that meant making him “wet.”

Meanwhile, the secret biowarfare facility located on Plum Island off the coast of Connecticut was developing an enhanced version of the Borrelia bacteria (Lyme disease) under the directorship of former German SS-officer and microbiologist Eric Traub - Gain of Function research. This organism with increased virulence now infects 20% of the world’s population. Be that as it may, the virulence of the organism was not robust enough for the globalists.

The fall-guy set-up to take the blame for the JFK assassination was CIA asset Lee Harvey Oswald, who strangely enough was mixed up in a virus gain-of-function program for the purpose of developing a weapon that would kill Fidel Castro. Oswald knew too much and was expendable, so he was a convenient “patsy.” Mary Sherman, the scientist running the program, was murdered. It is still speculation whether there was a link to this apparent effort to create a deadly virus and the subsequent identification and possible enhancement of the HIV virus.

Maurice Hillerman, one of the world’s most prominent virologists of his time and a Vice President of Merck, was recorded boasting, “So we brought African Greens in and I didn't know we were importing the AIDS virus at the time.” Merck switched from Indian rhesus to green monkeys because the rhesus monkey were full of retroviruses including SV40. Was HIV just due to sloppy virology, or was HIV, once identified, manipulated and chosen as a bioweapon. A weapon that must have been a big disappointment as it took far too long to kill its victims. Intentional or not, in all likelihood it was introduced in the USA via the Hepatitis B vaccine trials that exclusively recruited gay men in New York, San Francisco and Los Angeles. The bottom-line is that vaccineologists in the 20th century were creating invasive medical interventions with no clue as to what they were doing and as a result murdered many. Or did they know what they were doing?

The situation in Africa is a little less clear, starting in 1957 [22], oral polio vaccines were administered by the Wistar Institute and given to “hundreds of thousands of Africans.” As with almost all vaccines there was no follow-up. The FDA has archived vaccines from that period and if they forensically looked at them to see if HIV was present, they have not told anyone. That would eliminate the conspiracy theories, but it would also implicate the whole vaccine program as a very problematic, unethical and sloppy endeavor to say the least.

Big Pharma, in the USA, was able to get unconditional liability protection from lawsuits related to adverse events from their vaccines in 1986. Safety was no longer their concern as the responsibility of vaccine safety was now the responsibility of the U.S. Government. So, there was an explosion of vaccines required for children, and a mysterious increase in sudden infant death syndrome, chronic health conditions and a formerly rare neurological disorder called autism. Autism is a post-vaccination encephalitis but the connection between vaccines, mercury, aluminum (found in ~ 80% of vaccines at toxic levels), acetaminophen and autism was deliberately covered up by agencies of the U.S. Government. When the CDC had the objective data the vaccines were connected to autism their response was to shred the data. A high-level whistleblower came forward and disclosed this but no one in government did anything - no hearings, no investigation - nothing. This was the subject of the documentary “Vaxxed.”

Big Pharma was already well on their way to capturing regulatory agencies and politicians. No one in the upper echelons of government would dare reveal what they knew, and they never did; however, that silence empowered the eugenics cult. The U.S. Government never met their obligations under the 1986 Vaccine Act and ignored all safety issues even as they pushed the mantra, “Safe & Effective” so that by the time CoV2 showed up the population was good and indoctrinated. Health & Human Services (HHS) already had decades of blowing off their responsibilities for vaccine safety and few seemed to care.

SARS -1, the predecessor to SARS-2 (CoV2) arrived on the scene in 2002, and in all likelihood was a test run. The reason one does not here about it anymore is that is has no natural host, and therefore not in circulation. If there is no natural host, then where did it come from? Is there wet market in the Wuhan virology lab? CoV2 was a made in the USA, but was sent to the Wuhan Virology Lab for enhancements that became illegal to do in the U.S.

There is strong circumstantial evidence that A/H1N1, the so-called novel Mexican Swine flu event of 2009 was neither Mexican nor novel, but a genetically engineered creation from the USA. The virus included genetic bits of North American human, avian and swine flus and Eurasian swine flu —the virus had not been detected in any pigs except those in a single herd in Canada [23]. A variant of A/H1N1 broke out in India in 2015, but has apparently not been a player since. No natural host.

Had there been a sincere and honest attempt to flesh out the origins of these viruses, again we would not be where we are today. While A/H1N1 was very infectious, the virus was no more problematic than the normal flu virus and has vanished. It may have just been a test run for a future release.

The destruction of the World Trade Center on 9/11, was another coup d’état this time by the NeoCon faction of the New World Order set. It greatly empowered them to have been able to get away with that event. Firing a missile into the Pentagon, but telling everyone it was a 757 jet, the overt demolishing of WTC 7 (no plane hit this building), and clear evidence WTC 1 & 2 were demolished. It was carried off by traitors within the USA in conjunction with several middle eastern countries. Much could be said here about the horrors unleashed post-coup d’état, but no one in officialdom would dare speak the obvious truths. It really set the stage for what would be coming soon enough. And what was that?… the continued NeoCon agenda to take over Eastern Europe (in violation of the agreement made with Gorbachev that there would be no expansion into Eastern Europe [by NATO] if the Warsaw Pact was dissolved).

The attempt to scare the world with the Zika virus was a really big flop. They would not make that mistake again. So quick to blame a relatively benign virus for the clusters of microcephaly in Brazil. However, too many found out fairly quickly that the pocket of mothers in Brazil who gave birth to children with microcephaly were vaccinated with DTP while pregnant and while drinking larvicide laden tap water at the same time. So, that attempt to scare the world had to be shut down immediately because a vaccine was clearly implicated. At the same time a sentinel paper was published - a retrospective look (using matched controls) at 30 years of DPT use in Africa showing in increased overall mortality 10-fold, so it was very important to shut down any interest in looking at the safety and efficacy of the DPT [24].

Which brings us to CoV2, and the announcement by Dr. Fauci in 2017, that a surprise outbreak was imminent. The plot was apparently hatched as far back as 1999, at the University of North Carolina. In the subsequent years numerous white papers, such as SARS 2025-2028, [25] the pandemic war games, such as Event 201, [26] which were priming both the media and the public. Finally, they would have the event that would allow them to bring in their great reset of the world economy and cull the population at the same time. Key players in multiple governments had already been compromised, regulatory agencies had been captured, and Big Pharma along with Big Tech were in total control of conventional media outlets.

Yet, CoV2 virus was not an infectious disease hellion. It took out the old and the infirm just like influenza does every year, so the hype had to go into overdrive, which the PCR tests accomplished cycled so high clean swabs would test positive. It was critical the number of deaths for CoV2 to be very high in order to generate the fear to justify what would come next. So, despite long standing rules for data collection and reporting, successfully used for years by all hospitals, medical examiners, coroners, and physicians, suddenly CDC changed the way they wanted deaths reported. Had they used the normal criteria the mortality figures would have had to be revised down 90%. The very people within government who might have sounded the alarm that we were being manipulated into a bio-security state based on false information were compromised as many of them would be able to earn millions of dollars from the licensing of the mRNA technology. It has been determined that almost half of all PCR results were false positives, which if nothing else calls into question the clinical trials used to validate the “vaccine.” [27] As an aside, we have never had a vaccine that makes the human body create a pathogen in a controlled way for an uncontrolled duration. The Spike protein is a significant pathogen - a loaded weapon if you will with no assurance it would control the outbreak.

What happened next was 50 countries panicked and were cajoled into signing secret agreements with Pfizer essentially putting them into receivership in exchange for the injections and monetary assistance from the World Bank and the International Monetary Fund [28]. An agreement to remain secret for 50 years. Any criticism of the injections or of Pfizer would be forbidden, Pfizer would not only direct the global response but also the response individual countries would have so a worldwide extermination system could be initiated. The Federal Drug Administration (FDA) now under operational control of the Department of Defense (DoD) even asked a federal court to allow them 55 years to hold onto the data they relied on to give Emergency Use Authorization for the Pfizer injection. There can only be one reason for this request, and that is the FDA/DoD didn’t want anyone to see that the Pfizer data showed that at best, one would have to inject 22,000 people to potentially prevent one death. No need to point out the Wuhan A strain was no longer in circulation. I am also sure they didn’t want anyone to see that there were more deaths in the injected group than in the control group.

The lack of early prevention and treatment protocols, and the persecution of anyone trying to treat COVID patients prior to hospitalization was not a form of treatment nihilism, it was a well-organized, well-funded conspiracy to make sure nothing would interfere with an injection rollout. Never have sick patients been turned away from hospitals and told to come back when their lips were blue.

All the big players were deeply, corruptly and maliciously in bed with Pharma, so would lose billions if it were found off-patent drugs could treat COVID. The FDA, under the direction of the Department of Defense (DoD), illegally exercised emergency use powers, and was a willing ally in the suppression of treatments known to be effective against the virus, such as something as benign as vitamin D. In some countries physicians were arrested for prescribing Ivermectin. Then injections were illegally marketed to children as well after the FDA advisory panelist said "We're never gonna learn about how safe the vaccine is until we start giving it," said panel member Dr. Eric Rubin. "That's just the way it goes." No Dr. Rubin… that is not the way it goes [29]. When you ignore safety, you tend to ignore whether the injection even works, and while the “science” is moving forward, unfortunately deluded technocrats were not [30]. The FDA stopped being a regulatory agency and became part of the other alphabet agencies to promote the “vaccine.” They saw their role was to get a needle in every arm, in everyone in every country - it was choreography to dance to the edicts of the DoD.

Pfizer now had the power to silence governments, maximize profits and power. Military bases, National Parks - just a few of the items signed over [31]. Big Tech and Pharma had bled out multiple governments to create this giant one world government monster with Pfizer calling the shots - literally. The human infestation would be eliminated with the silent, obedient consent of governments around the world.

Original Antigenic Sin

But there were problems. The injection was going to kill too many too fast (as intended) even though many of the injections were expired and ineffective (they were thawed for too long) and many blanks were shipped to many locations to mitigate the number of adverse events anticipated. Nevertheless, the body count increased as well hidden as those bodies may have been. They had to buffer the rollout of the injection because again it was supposed to have come on the scene after billions were already dead from CoV2 and few would be left to ask important questions.

One question was why give a non-sterilizing vaccine to everyone possible in the middle of a pandemic…all that would do is prolong the length of illness by pumping out a multitude of variants, which is exactly what took place. They were called variants because they had a different spike protein than the one the injection was having the human body manufacture, and so the efficacy of the injections started falling into the single digits [32]. This was all predicted well in advance, but the injections were rushed for socio-political reasons not medical/scientific reasons. Compare and contrast what took place in Gibraltar vs. Africa.

Africa, a heavy user of hydroxychloroquine (HCQ) - taken by millions - by the end 2021, the vaccination rates in 20 African countries wasn’t even close to coming out of the single digits.

Overall the African vaccination rate was around 6%, but for some reason the “experts” were mystified as to why there is so little COVID in Africa [33]. On the other hand, perhaps the most vaccinated country on the planet was Gibraltar where there is a 100%+ vaccination rate and yet cases of COVID were so high Christmas 2021, was canceled. Unintentionally, they proved boosters don’t work. In Singapore, with at 94% vaccination rate, cases and mortality spiked to record levels, and in Ireland, where 92% of the adult population is vaccinated, cases and mortality doubled [34]. England was the only country, worldwide, that seemed to keep accurate records of its deaths by vaccination status (at least for a while). The COVID vaccines used in England (mRNA & DNA vector vaccines Pfizer, Moderna, and Astrazenica) do not significantly reduce COVID mortality, but did result in greatly increased all-cause mortality [35]. Specifically in England, if you are under 60 and you get injected, you are twice as likely to die. As the months went by the mortality of the injected only increased.

The mortality from COVID in an African country, such as Zaire was 0.6 per 100,000. Almost no one received the injection. In the USA the mortality was 1000 per 100,000. There should be no need to read one more word if you understand the obvious implications of that last sentence. Even before President Trump announced he had taken HCQ, the drug was disappearing and countries were removing it from over-the-counter status and requiring prescriptions. Someone didn’t want HCQ to be around, and studies were being conducted with near lethal doses of HCQ in late-stage patients (no zinc, no azithromycin) - it was as if someone deliberately wanted to destroy any chance HCQ might have to help treat COVID patients. Then perhaps one of the most momentous medical frauds in history took place - both the New England Journal of Medicine and the Lancet simultaneously published completely fabricated, fictional articles that concluded HCQ was not efficacious. What someone(s) had the power to fund fraudulent studies, compromise the world’s top medical journals, and then get the Federal Drug Administration (FDA) to pull the emergency use authorization (EUA) for HCQ? Apparently, that was the FTX group. Even after the papers were retracted the FDA did not reinstate the EUA. This brings up the problem that there is no FDA - the DoD took over the FDA regarding all things COVID.

However, those who successfully destroyed the possibility of using HCQ for COVID weren’t done - they went after Ivermectin, but not with the same success. First and foremost, data from 19 countries that participated in the World Health Organization (WHO) sponsored African Programmed for Onchocerciasis Control (APOC), from 1995 until 2015, were compared with thirty-five (Non-APOC) - in other words, APOC countries are on Ivermectin. That may be why they had almost a 30% lower mortality from COVID than non-APOC countries [36]. But what took place in India was even better. Two provinces took opposite stands. Tamal Nadu followed WHO recommendations and had the same dismal stats that the USA had, but Uttar Pradesh supplied Ivermectin to its population and 97% of the cases were eliminated. Uttar Pradesh has 2/3rds the population of the USA.

Despite the data on Ivermectin, leaders from Australia to Austria actually believed the COVID injections worked and the unvaccinated were spreading CoV2 - they probably still believe it. Ignore the fact there are no unvaccinated in Gibraltar. Are these leaders psychotic or, following orders from the Fauci/Francis Collins/Gates/Bio-Pharmaceutical-Military complex? They wanted us to panic with each new variant, so they could continue to lock-down, take people to camps, and have the ability to inject humanity multiple times a year forever [37] …that was always the plan.

This was not the greatest public health disaster the USA had ever seen; this was done on purpose but when events deviated from what was projected the cabal scrambled to salvage the situation as best they could. So, insane medical rituals that had no foundation in science or medicine were pushed - the less than worthless cloth masks, the quarantining of health asymptomatic adults and children, the meaningless six feet social distancing (the pulled that out of their rear-ends).

Remember, those that expired were very old, fat and had multiple medical problems. There was never any credible reason to keep children from attending school and most lost two full years of education they will never be able to make up. Suicides increased, along with obesity and delays in treatment for medical problems that cost lives. The burden was on the poor who didn’t have jobs where they could work from home, while the elite rich got richer.

It doesn’t take a degree in immunology to understand that if you occupy the body’s immune system making a spike protein that is no longer connected to the circulating variant, not only is the vaccine worthless, it perniciously lowers one’s ability to deal with the actual viral infection one may get in the real world, because one’s immune system is busy making antibodies to something that is not present and may be oblivious to an actual virus invading the body. The CoV2 infection has a very low risk of myocarditis, but it is there. The injection had the body make massive amounts of spike protein, and the amounts the injection was having the body make caused significant myopericarditis. The FDA actually asked that prospective studies be done but they were never done by manufacturers. One such study has the actual risk is about 2.8% or about 3 people out of every 100. Conservative estimates have the risk at 1:<2000 (for context the Swine flu vaccine from the late ‘70’s was pulled when it was found the risk of a neurological disorder Guillain-Barre was 1:100,000).

The population continued to be told “Safe & Effective” and the usual “one in a million (side-effects).” There was 20 years of data showing corona viruses can cause heart disease, so one case of myocarditis should have shut the “vaccine” program down. But instead of pulling the vaccine the CDC went to work pushing the idea that the “vaccine” induced myocarditis was mild. It is just there is no such thing as mild myocarditis, in fact 20% of those that die within a day of receiving the “vaccine” have myocarditis [38]. There is only one solution…immediately end the worldwide vaccination program and try to help people repair their immune systems. But compromised, well-paid “experts” will never acknowledge this solution. There is just too much money to be made giving everyone more “vaccines.”

Then there is this insane group-think that needs to be overcome, because there are people in government, medicine and academia

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