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].

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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

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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

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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].

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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.

Davy’s lectures were charismatic and explosive (sometimes literally, see the recreation of his exploding volcano demonstration here). And they were often poetic. Now, as the first edition of the Collected Letters of Humphry Davy is set to be published, it is perhaps time to take another look at one of Britain’s most renowned scientists.

It has been almost six decades since CP Snow famously argued that there were “two cultures” of the arts and sciences. He thought that an unbridgeable chasm divided those who worked in these fields, that they had become so specialised they no longer had the language to talk to each other. Whether you think that this was true then or is true now, Davy – as a poet and a chemist – shows that any such chasm can be bridged.

The Royal Institution, Davy studies became an axis indispensable for the study of the literary romantic generation in the United Kingdom, celebrated worldwide, though certainly not always because of its connection to the scientific profession.

In this way, we elucidate how the possibility of these studies, together with the critical biographical account of Davy's literature, expand the theses on the stereotype of the narrative genre science, poetic production, and scientific nationalism.

Humphry Davy was a pioneer in his professional area for sedimenting this permeability between genres but also for consolidating the profession of the experimental scientist, whose objective became the controlled investigation, under an institutional direction, of the available paradigms and your progress. At least for the public sphere, therefore, Davy had a contribution unique historical context, which involves enlightenment, in the face of an enlightened and moderately prosperous, of a scientific vocation related to the visible progress of technoscience. Likewise, the glorification of this professional function, in view of its persona public, contributed to the ideals of the modern scientist, a possible statement in the face of his original popularity and relationship with the public.

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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).

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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.

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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.

References

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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.

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Introduction: Cervical epidural steroid injections (CESI) have been frequently used since long time for diagnosis and treatment cervical radiculopathies. cervical epidural corticosteroid injection helps in reducing swelling and inflammation of the compressed nerves, hence improving pain for several days to months or longer which leads to help delaying or avoiding the need for surgery.

In this retrospective observational study, we aim to compare clinical efficacy of Dexamethasone vs Triamcinolone in the management of chronic neck, shoulder and arm pain due to herniated intervertebral disc in the cervical region.

Methodology: a retrospective observational study of 1 year follow up was performed in 100 patients of either sex complaining of chronic neck pain with signs of cervical radiculopathy. Patients were divided into 2 groups of 50 each. Those in Group A received Injection Dexamethasone sodium phosphate 12mg and in Group B received Injection Triamcinolone acetonide 40mg in the cervical epidural space under fluoroscopy guidance. All the patients were monitored before the procedure and post-procedure for 4 h following epidural injection and subsequently followed by at the 10 days, 1 month, 3 months, 6 months, 8 months, 10 months and 1 year on telephonic conversation. The primary outcome was to measure the intensity of pain using Visual Analog score (VAS) score of 0-10.

Result: The mean VAS score in both the group A and B pre-procedure was 8.6 and 8.78 respectively and Mean VAS scores were significantly improved to 2.16 and 1.90 respectively post-procedure during 1 year follow up with p value of 0.76. hence from mentioned quantitative data it can be stated that there is no statistically significant difference in the efficacy of both the drugs used in cervical epidural injection.

Conclusion: Based on the results, this retrospective study strengthens the existing evidence that dexamethasone can produce equivalent pain relief to triamcinolone for the treatment of cervical radiculopathy. Though the need for more research studies to prove that Dexamethasone can be used an effective alternative to Triamcinolone continues.

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This is the era of Artificial Intelligence, where AI models are growing fast for making critical decisions for several predictive models. Here AI is giving solution to the medical practices for diagnosis as well as prognosis with its increasing intelligence to simplify the ambiguity and complexity in data to carry out clinical decisions. Several research studies have truly demanded the need of AI-based systems and how to enhancing their capabilities to help medical practitioners. However, instead of giving highest effort for making most accurate AI based models, still now assessing the magnitude and impact of human trust on AI technology demands substantial attention. In the last decade many AI based CAD models were developed which hardly could persuade the experienced medical practitioners to accept the machine-specified decisions. In this research work, it was attempted to interpret and explain a supervised AI model built using XGBoost on Lung cancer detection by using XAI (Explainable AI) tools - two post-hoc methods (LIME and SHAP) and one ante-hoc method, to provide satisfactory explanations to medical practitioners, thereby minimize the AI risk factor in implementation of the model and reinforce the trust to the medical experts and patients in accepting such model. In this paper, the results of all three XAI tools were illustrated using heatmaps to select important input bi- omarkers that contributed more in detection of the benign or malignancy state of the pulmonary nodules. Finally the supervised AI model was rebuilt using only those important input features and it was found out that the metrics like specificity, precision, the AUC of the newer model under the ROC curve were giving better result in prediction of lung cancer nodule state. It is a study to explore how XAI tools highlight the contributions of input features in an AI model and how that AI model’s performance can be fine-tuned based on the outputs of XAI mechanism.

Keywords: AI; LIME; Pulmonary nodules; SHAP; XAI; XGBoost

When KPI is being applied to healthcare organizations, it measures the degree of how much improvement in the outcome of healthcare providers. We all know that what gets measured gets improved. Healthcare leaders should establish a system of quality and performance metrics to control and improve overall healthcare quality; poor quality not only adversely affects patient outcomes, but also affect budget and profits.

For improving healthcare services, indicators should cover healthcare service capability to achieve organization goals and resources with special standards covering patient safety, risk management, and integrated health services, which makes it important to comply with standards and correct performance safely and at an acceptable cost by society, so that it leads to continuous improvement of healthcare outcomes and conformity with the expectations.

We can define healthcare operational excellence as building sustainable competitive standards through operation management, to improve the quality of patient healthcare at different health departments from primary care to intensive care, rehabilitation care and home care. Competitive, visionary healthcare leaders and policy planners are required to transform the daily health dynamics into sustainable, well-established services.

An excellence model in Saudi Arabia has been started for few years now. Due to the importance of sustaining quality and organizational excellence, the role of the government sector is being supported by different governmental and private organizations.

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Item measurement theory - how to measure the unmeasurable?

The components of the quality of life cannot be observed directly. The value of the quality of life can be measured indirectly by asking a series of questions, which are asked to the patient in a different form. Responses are converted to numerical scores which are then combined to obtain "scale scores" or combined to obtain domain scores or other statistically calculated summary scores.

The European urological guideline strongly recommends monitoring the treatment effects of BPH patients using validated questionnaires. The answers received as feedback have a role in the direction in which the further treatment of the patient will take place.

The International Prostate Symptom Score (IPSS) questionnaire is the most used to determine the severity of lower urinary tract symptoms associated with BPH. The first seven questions refer to these symptoms, and the final sum categorizes patients with mild, moderate, and severe LUTS, so further treatment takes place in that direction. The eighth question refers to the quality of life associated with living with those symptoms and is important to ask because it reflects the patient's subjective perception of the symptoms associated with the disease. Often, due to this subjectivity, patients who have mild or moderate LUTS have an extreme impairment of the quality of life and vice versa. Thus, this parameter strongly suggests to us how to direct the therapeutic approach to the patient.

The Benign Prostatic Hyperplasia Impact Index (BII) questionnaire measures the magnitude of change in an individual's BPH-LUTS impact over time. The BII is easy to understand, capturing the clinically relevant impacts of BPH related to urinary problems. It has 4 questions, is easy to understand and validated.

The Overactive Bladder Questionnaire (OAB) - short form (SF) has a total of 19 questions in 2 domains: 6 related to distressing symptoms and 13 related to health quality. Calculated separately, a higher score on the symptom scale indicates greater symptom severity and a higher score on the QoL scale indicates better QoL, so they are inversely related to each other.

The long form of the Male Incontinence Questionnaire has 23 questions on LUTS and related QoL. The short form of 11 questions covers 2 domains: the first one related to micturition - 5 questions and 6 questions related to incontinence. The advantage is in Separate consideration of frequency, nocturia and impact on daily life.

The SF-36 is a generic or general questionnaire in over 10000 items in a PubMed search. It consists of two dimensions - physical and mental. There is no exact balance between the two components’ different approaches in the interpretation of the total result. its validity may be questioned due to the biased amount of data.

The goals in assessing QoL in BPH patients

The latest studies more comprehensively analyze the role of BPH in characterizing the quality of life, but also in relation to the cost-benefit of therapeutic options. For this purpose, combined questionnaires are used, general ones relating to health, disease-specific and general ones analyzing the economic moment.

The QUALIPROST study is of relatively recent date and is a prospective, longitudinal, multicenter, open-label study conducted in outpatient urology clinics to evaluate change in quality of life (QoL) and symptoms in patients with lower urinary tract symptoms/benign prostatic hyperplasia. (LUTS/BPH) in current clinical practice by use of IPSS and BII questionnaires. Improvements in QoL and symptoms were equivalent to the medical treatments most widely used in real-life practice for the treatment of patients with moderate or severe LUTS.

Due to the aging population, the prevalence of BPH is expected to increase dramatically. There is an emerging need to develop and implement effective interventions to improve the QoL and psychological well-being of patients with BPH. A holistic approach in the management of BPH in each individual patient is needed for these goals.

This analytical approach provides additional evidence for current therapeutic options for the management of LUTS/BPH and should help further inform decision-making regarding treatment strategies in this patient population.

References

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The Biopharmaceutics Classification System (BCS) Guidance, Center for Drug Evaluation and Research (CDER), USFDA.
Benoit JP., et al. “Biodegradabla microspheres: advances in production technology. In: Benita, S. (Ed.), Microencapsulation Methods and Industrial Applications”. Marcel Dekker, New York (1996): 35-72.
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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

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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 that have been so indoctrinated that if something is a vaccine it is safe & effective - end of story - they shut out objective reality at all costs. Even the government’s own VAERS vaccine adverse event reporting system produced a massive death safety signal. VAERS recognized for under reporting adverse events by 99-fold still produced a massive death safety signal, but between the corruption and group think it was ignored.

The response to this inconvenient data was to order people to get more and more worthless injections that would do nothing but cause side-effects. Yet the presence of so many un-injected showed how robust natural immunity is, still promoting natural immunity could put one on a terrorist watch list. They needed as many as possible to be injected as often as possible before the public became aware of the hidden sequalae of the injections. The control group had to be eliminated, or rounded up and terminated - at least that is what they wanted to happen.

Obviously, this story is not over. On their way out the globalists will do whatever they think they can get away with to undermine and collapse civilization, including more bioweapons, they know their future is bleak and would sooner take as many with them as possible. But all stories end sooner or later, and when the story of the New World Order ends, it will look nothing like what its proponents had in mind. So, fight for freedom of knowledge, and in place of deceit, intolerance and prejudice fight for the possibilities of understanding, truth and acceptance. For that is the reality humanity is moving towards no matter how hard those who dish out their cruelties try and stop this change. Change is inevitable - it is the only Universal constant.

Pharmakeia a false hope and deception of false peace, false healing, and a false future.

“The Armenian genocide was not a mistake; Holodomor was not a mistake; the Final Solution was not a mistake; the Killing Fields was not a mistake; the Great Leap Forward was not a mistake. Name your genocide it was not a mistake - that in includes the Great Democide of the 2020’s, to imply otherwise is to give “them” the out they are seeking.

“It was not botched; it was not bungled; it was not a blunder; it was not incompetence; it was not lack of knowledge; it was not spontaneous mass hysteria. The planning occurred in plain sight; the planning is still occurring in plain sight.

“The philanthropaths bought the science; the modelers projected the lies; testers concocted the crisis; the NGOs leased the academics; the scientists fabricated the findings; the mouth-pieces spewed the talking points; the organizations declared the emergency; the governments erected the walls; the departments rewrote the rules; the governors quashed the rights; the politicians passed the laws; the bankers installed the control grid; the stooges ordered the money; the DoD placed the orders; the corporations fulfilled their contracts; the regulators approved the solution; the laws shielded the contractors the agencies ignored the signals; the behemoths consolidated the media; the psychologists crafted the messaging; the propogandists chanted the slogans; the fact-chokers smeared the dissidents; the censors silenced the questioners; jack-boots stomped the dissenters; the tyrants summoned; the puppeteers jerked; the puppets danced; the colluders implemented; the doctors ordered; the hospitals administered; the menticide is scripted; the bamboozled leaded; the totalitarianized bullied; the COVIDians tattled; the parents surrendered; the good citizens believed and forgot.

“This was calculated; this was formulated; this was focused grouped; this was articulated; this was manufactured; this was falsified; this was coerced; this was invective; this was denied.

“We were terrorized; we were isolated; we were gas lite; we were dehumanized; we were wounded; we were killed. Don’t let them get away with it. Don’t let them get away with it. Don’t let them get away with it.”

---- by Margaret Anna Alice.

The world now knows, thanks to 46 Pages FOIA’ed emails between CDC managers, Dr. Fauci, Dr. Collins, and White House, NIH, HHS, that they all knew about vaccine-induced myocarditis and thrombotic thrombocytopenia in early 2021, despite that over 80% of the emails were redacted [1].

Every American citizen must be given access to this complete set of unredacted communications, and the guilty must be prosecuted in a special court arranged by the victims’ families.

We are still in the midst of the greatest worldwide psychological operation (Psy-Op) in the history of man. Not that long ago we were hunter-gatherers where family, purpose, cooperation and community where paramount to survival. We were never wired to withstand the level of psychological manipulation we have been experiencing the purpose of which was to invert reality so we could easily be led to slaughter. It has split our realities, and now we have two separate realities co-existing in the same space-time. The splitting of these two realities is inevitable, the only question is how will it happen.

It takes about 2 years, on average, for citizens in the United States of America (USA) to recognize they are being poisoned, for captured regulatory agencies to make some token inadequate attempt to fix the problem.

Now, who captured most of these agencies that are meant to regulate and protect… well, the obvious answer is Big Pharma - nothing new and no big surprise. Agencies developed mercantile relationships with the very companies they were supposed to be regulating - kind of an economic Stockholm Syndrome. Pharma cares about one thing - profits, and we have let this psychopathic entity run policy in multiple countries. Yet, does someone control Big Pharma like the military? Or is it Big Pharma that is in control of the military?

Maybe they just work hand and hand, because what we saw take place in the last few years is a Globalist military run operation where everyone seemed to be controlled by a central source… “Operation Lockstep?” if you will… even though the population was kept in the dark. After all, you just don’t announce there has been a Bio-Military coup of the US Government (along with many other countries) and expect the population will be ok with that. When it came to COVID, the FDA (Federal Drug Administration) was MIA, the Centers for Disease Control (CDC) was but rubberstamping because on a practical level there was no more CDC - they became the propaganda arm of Pharma prevaricating their dark little hearts out to the public. The FDA existed in name only when it came to COVID… it was all a military operation perhaps in cooperation with China’s 5th Column war to take down the USA. The CDC actually had the Public Relations firm for Pfizer/Moderna embed themselves inside the CDC. The CDC is a regulatory agency it is not supposed to be marketing the very things they are supposed to be regulating. But then they have been doing just that for all vaccines for decades and few complained. You never have the same entity in charge of promoting, distributing (that also owns patents) on vaccines also be in charge of safety - that is a recipe for disaster.

It was an out-in-the-open fact that the NIH was funding Gain-of-Function research at the Wuhan lab [2]. In 2015, a paper was published, A SARS -like cluster of circulation bat coronaviruses shows potential for human emergence. This study clearly states that the authors conducted Gain-of-Function research on bat coronaviruses in order to make them infectious to primary human airway epithelial cells. Ralph Baric (University North Carolina) and colleague, Zhengli-Li Shi were very much engineering the CoV2 virus in Wuhan to make sure that virus was highly infectious to humans. So, literally everything that came out of Fauci’s mouth and the rest of the government was gas-lighting.

Western Civilization, was targeted for destruction and subjected to an intense propaganda campaign to create a permanent global government, but beneath the Psy-Op a spiritual war. Not being tangential here, but one can’t ignore these Macro disease issues - the spiritual sickness component of all this and expect to understand the Micro disease issues, such as how does one deal with the myocarditis the bioweapon causes. Part of this spiritual war is to destroy the experiment called the USA - a Constitutional Republic where rights were given by God. That doesn’t work for the imperialistic New World Order group. The USA was always the thorn in their side and had to be destroyed and they got very far along in doing so, too far it seems. Gates and Zuckerberg have poured in millions upon millions into the public education system in the USA but students have only been getting dumber and dumber, so one has to assume all that money was not to improve education but destroy it. You don’t want your future slaves to be educated - indoctrinated absolutely - but not educated. The dumbing down of Americans was by design.

Nature, the creative spark of life, is an anathema to this group of misanthropes who pretend they care about the environment. We are just useless eaters and bottom-feeders to them to be exploited and killed, but humanity must know the enemy to end this. If we don’t’ face this head-on then Pharma will take over the world and will make sure, for example, you can’t travel if you are over 14 and not taking a statin drug.

It was easy to lose faith in humanity when it was so obvious millions were being encouraged to illegally come to the USA (weaponized immigration) and bring one of the bio-weapons being used to destroy us from the inside. Not CoV2 but Fentanyl. Because journalists (the legacy press), was captured and carried water for these enemies and traitors, the failsafe that would have prevented all this was removed. Without the media CoV2 would have just been another flu like illness that primarily affected the elderly and those with multiple co-morbidities. Remember how the flu completely disappeared in 2020? The media truly was the virus and also made sure you didn’t know the USA was being invaded as policy - globalist United Nations policy.

Yet, the flu never disappeared it was just called COVID to juice the numbers in a case-demic extraordinaire (PCR tests cycled so high clean swabs would be positive). We actually saw our hospitals become de facto euthanasia factories inappropriately putting patients on ventilators and pumping them full of the deadly drug Remdesivir (what nurses called “Run-Your-Death-is Near”). I always wondered if all the videos of dancing nurses was their way of telling the public that hospitals were not being overwhelmed with COVID patients. But there was no science supporting the use of Remdesivir and it was well known as a deadly drug that was killing Ebola victims in a drug trial and its use was halted. But the regulatory gatekeepers were all compromised, fired or had resigned in disgust. The hospitals received a 20% payment bonus if they used the drug. A $500,000 hospital bill would generate an extra $150,000 if Remdesivir was used. Putting a patient on a ventilator earned the hospital $40,000. A lot of money to help hospitals make choices about priorities (wink, wink).

Media organizations played a central role, especially Big Tech IT companies, in stifling anything that wasn’t the approved narrative. Mainstream scientists, many leading experts in their field, working in prestigious institutions, and some medical journal editors themselves were all silenced, while others were paid off. Where was all the billions coming from to create fabricated research critical of effective early interventions such as hydroxychloroquine (HCQ) and Ivermectin? How much did the New England Journal of Medicine and Lancet get from FTX (the criminal crypto group) to publish articles so obviously flawed they would have been the cause of expulsion from any academic center that still had any integrity. FTX was critical in funding the attacks on effective early interventions with the resultant loss of life.

FTX, backed by elite investors like BlackRock (Rockefeller Foundation) and Sequoia Capital, rapidly became one of the biggest crypto exchanges in the world… laundering and stealing investor funds to bankroll the Neo-Con proxy war in Ukraine, and the Democrat party to name two pet projects. Laundering money to the “right” people, Bankman-Fried had Wall Street and the media in his pocket while he practiced effective altruism (aka deceit that makes one look like a moral leader). But it was just another Ponzi scheme that was funding favorite New World Order players. It happened right out in the open. Bankman-Fried’s mother was apparently responsible for running major voter harvesting operations in the 2020 election, so the FTX group was a critical component of a fraudulent government and its fraudulent economy. Yet, maybe FTX’s implosion was all part of a bigger scam to allow a centrally controlled digital currency to come to the fore.

Wonder why it was so important to keep the conflict in Ukraine going with no efforts at peace negotiations? Yeah, it was a money laundering operation and they never wanted it to end even if the end was an all-out nuclear holocaust. Few knew Ukraine was the playground for the dark ones - the local population didn’t know any more than USA citizens knew their country is actually the headquarters of the dark ones and that our Constitutional Republic vanished years ago. Drug trafficking, sex trade, organ harvesting, etc. all taking place in Ukraine without any interference until the Russian invasion. Just an aside… don’t invest with anyone who looks and smells like they can’t afford a bar of soap.

Pandemic/Scamdemic

Decades of pandemic preparedness protocols were trashed so a psychotic, pip-squeak, criminal mastermind could enrich himself, and his loyal following (loyal because he controlled their NIH grants). It seems, based on the FOIA documents Fauci may have been telling the CIA what to do not the other way around. We were literally in the middle of a Godfather movie, but it wasn’t Don Corleone calling the shots but dog torturer, vivisectionist, Don “I am the Science.” There was some truth to that statement though, because this one man literally was the point man for distributing $10’s of billions of dollars to academic and research institutions throughout the world, so he had almost complete control of the “science.” This was a very dark, pernicious situation, for example, if a research team finds out that it is very dangerous to inject vaccines that contain aluminum (80% of vaccines contain aluminum) that research team will be defunded and journals will be told not to print their research papers.

Eighty-six percent of the world was shut down for an infection that had a 0.035% mortality from 0 to 59 years of age, 0.095% mortality for the post 60 set [3]. If you are younger than 20 the fatality rate was 0.0003%. Clearly, this is below fatality rates from the flu and yet this was the emergency that allowed them to bypass safety studies and force/coerce people to get an experimental injections that had never been used before and lie about what they would do. They even lied about saying the “vaccine” would prevent transmission and infection and of course was safe and effective as they say all vaccines are…safe and effective became an indoctrination mantra. Most vaccines do not have adequate safety studies despite what we have all been led to believe. This was not just regulatory maleficence - this was about trashing the U.S. Constitution and murdering as many as possible in the process.

The median/mean age of death from COVID holds steady at 82 years of age. Seventy percent of the mortality in the USA were in the elderly with six or more underlying medical conditions. If it were not going to be COVID it would have been something else as they were already beyond the average life expectancy. Over the last three years no healthy child in the USA died from a CoV2 infection… not a single healthy child.

Well, we weren’t supposed to be alive to discuss any of this, but the criminal “reset” plan failed out of the starting gate because CoV2 was supposed to have killed billions and the jab was supposed to finish off as many survivors as possible. Too many people were left alive asking inconvenient questions. One of the few true responsibilities of a government is to protect the integrity of the nation’s border, but the so-called “open border” was intended to bring in a replacement population, because the rest of us were supposed to be already dead or dying.

If you can’t define the enemy you can’t defeat your enemy

One of the things that makes fleshing out these events important is medicine as we have known it will not survive - the population is losing and will soon lose completely any trust in Public Health institutions and modern medicine in general, and that trust won’t be coming back any time soon nor should it. Evidence Based Medicine (EBM) was destroyed during the last few years and public health decisions were being made on plausibility, as in how much money is it plausible to make if we force deadly injections on the public that don’t even work and lock them down?

Modern medicine decided to follow a dark agenda and became a dark influence. While COVID may have been a Hail Mary for the dying paradigm of the Bio-Military-Pharmaceutical complex to maintain control it still caused a lot of death and suffering. They will try and regroup if we don’t all wake-up. I will assume that post financial collapse the money to fund many of these shenanigans just won’t be there to fuel the murder. The lockdown fetishism imposed on us was an import from China as part of their 5^th column attack to destroy our economy, but it was also the agenda of the NWO/WEF set.

Human history has been replete with invasions, attacks, trade wars, etc. It seems like raging war on each other was chosen to be the primary operational paradigm on this planet. For the most part they were driven by the need to eat, have land to grow food, trade routes, etc. I am not assigning blame and after all it was the crucible of our modern civilization, which I have to say has not turned out so well. Today, war is machine - unending on anything and everything be it COVID, drugs, terrorism, Afghanistan - it doesn’t matter. The population is never told the real reasons for war, which is to wash money out of our hands and into the hands of this group of dark elites. So, war is never over, there is always another and it never stops.

Alexander the Great wanted to take over the world, but even he wouldn’t recognize modern war even though he was a one-man wrecking crew. Even the Roman Empire was less about cruelty, power and greed than what human kind now experiences. In the 1200s CE, the Mongol hoard pieced together the largest contagious empire the world had ever seen and unlike the plethora of wars that preceded it, this was being driven by power, cruelty, brutality without honor and greed. Energetically, Earth was being beset upon by a dark energy that was not home grown, it was only present because there were enough humans who held these negative traits for this energy to become interested in feeding off of them and the havoc they could reap. The generation of fear is key to its survival or presence on this planet - fear (the opposite of love) is the gasoline this dark force runs on.

What does any of this ancient esoterica have to do with what we are experiencing today where the USA government, the largest empire in modern times, has become vicious, incompetent, utterly corrupt and under the control of agendas pushed from elsewhere.

They know they are lying; we know they are lying; they know we know they are lying

The Southern border of the USA was in full operational control by traitors inside the USA and that control was to keep the boarder wide open and lie about it - it is a weaponized invasion. The American people didn’t understand their country had been taken over. Since it seems politicians lie and can’t stop themselves from lying, the public lost the ability to know big lies from small lies - call it some kind of desensitization but it produced an apathy that only empowered the cabal. Institutionalized lying is a major factor that enables LIERS-IN-CHIEF to carry out their illegal, immoral and criminal practices of institutionalized discrimination, retaliation, defamation, and intellectual harassment.

Deception is the modus operandi of the dark ones, which is why free speech had to be eliminated in their playbook. Puppets are never told the true reasons for doing what they are doing, only the upper tier of puppets are made privy to some of this information. For example, the CIA hitman who murdered Marylin Monroe was told she was sleeping with Castro and leaking to him things JFK had whispered to her under the sheets. Normand Hodges said he carried out 37 assassinations for the USA between 1959-1972.

Follow the Money

Jumping ahead in this story to address one of the top puppets, Peter Daszak, who is a perfect example of how this dark energy turns the like-minded into its puppets. Can you believe that a scientist funded by the U.S. government could possibly create a virus on purpose to release it and then hype up a resulting infectious disease crisis all for profit and power? Daszak’s Eco-Health Alliance was essentially a front group for a faction of the CIA.

“Daszak reiterated that, until an infectious disease crisis is very real, present, and at an emergency threshold, it is often largely ignored. To sustain the funding base beyond the crisis, he said, we need to increase public understanding of the need for MCMs (medical countermeasures) such as a pan-influenza or pan-coronavirus vaccine. A key driver is the media, and the economics follow the hype. We need to use that hype to our advantage to get to the real issues. Investors will respond if they see profit at the end of process, Daszak stated.”

The above paragraph is from page 73 of Rapid Medical Countermeasure Response to Infectious Diseases: Enabling Sustainable Capabilities Through Ongoing Public and Private-Sector Partnerships - published by the National Academy of Sciences in 2016 [4].

How did we get here?

We know so little about the true history of mankind on this planet - the great civilizations that have waxed and waned long before recorded modern history [5]. Regardless of the time or place, oligarchs of the civilizations that we do know about have been obsessed with over-population going back to at least the days of Plato (Plato [De republica, V] and Aristotle [De republica, II, vi]). While, there are some areas on the planet that have too many humans in the same space or in the wrong place, over-population itself is a myth perpetuated to help the ruling class maintain control - it is about wealth transfer. Even though most of humanity is not aware of the full extent of what has been going on, open war has been declared by those who want to repress and command with the purpose of keeping the rest of us unconscious, keep us from being inquiring beings, keep us from knowing how strong the human spirit is or exploring what we are capable of becoming. This is the emotional grid they want to impose. They want to keep us small, controlled so they can feed off of our assets and energies. They are literally deranged fools whose minds have been warped by their greed and the covenant they have made with forces that have always lied to them and continue to lie to them. This struggle is not new and is addressed in fable and parable by many of the world’s ancient texts, but this is not speculation of what has happened in the far past, this is about what is happening now and why.

Lose your Spirit and you have lost everything … Lionel Richi (singer/song writer)

It is problematic that humans think they are nothing more than evolved mammalian primates (apes). Yes, those are the bodies we use, but we are spiritual beings having a human experience, not just naked apes that aspire to be spiritual. Spirit is not the enthusiasm you have for your local high school football team. It would behoove us all to try and understand what spirit is because there have been those trying to kill you for having one. There are juicy energies and powers connected with being human - a subject humans are almost completely unaware; however, there are those who know about these hidden features of the human experience and want those energies and powers for themselves. Without belaboring the point, tyranny can only be imposed if the population believes they are nothing more than their animal bodies limited to their five senses. Tyranny runs on fear and it is much harder to scare someone who is not completely tied to what their five senses tell them reality is all about. Tyranny cannot exist where there is freedom of speech so it is really easy to tell who the “bad” guys are…they censor and don’t want freedom of speech.

Where this Timeline starts

In a timeline that starts in 1933, although the darkness got its foothold long before that, a group of bankers hatched a plot to replace U.S. President Franklin Roosevelt with someone who was more in line with these entrenched institutions and the systemic ideologies that do not want democracies to exist. These dark ones were still drunk on their success from being able to create the Federal Reserve. There was no coup d’état because their point man, retired Marine Corps General Smedley Butler, betrayed them. So, the banking cabal shifted all their attention to Germany.

That same year the Public Health Service of the USA began its infamous Tuskegee Experiment on poor black males in Alabama. An experiment that lasted 40 years, and only ended in 1972 because of a leak to the press. Under the guise of receiving free health care, the victims were watched to see what the ravages of syphilis would do to them and their families. No Nuremberg trial held, no accountability - but if you are an American apparently, it’s okay to say you were just following orders if caught and it’s all mea culpa and asking for amnesty.

The lessons of the last century have not been completely understood, and now humanity is in that awkward place where there is a reckoning with these poorly understood experiences that have been swept under the rug. However, the rug is now gone and it would behoove the world to recognize the players of our immediate past for who they really were. For example, Adolf Hitler was probably the greatest teacher of hate the 20^th century had ever seen. Intolerance was intense in the western world a century ago, and he filled the calling others had prepared for someone with this intention and influence. He had other options for his life, which he closed down early.

Bringing up Hitler or suggesting we are unduly influenced by energies we can’t perceive - many will just tune out, but that is merely a reflection of how indoctrinated we have all become. Indoctrinated by negative energies that have kept us trapped for millennia in deception, delusion, fear and wars, and part of that indoctrination was to convince us we were powerless to change any of this. Rather sad that the megalomanic leading this was again a German national, Klaus Schwab. One would have thought we were done with that part of our history.

In one sentence this is what WW II was about…Hitler, like Schwab, was merely a tool for large international corporations and banks that were funding him to implement a top-down feudal economy in Europe that would hopefully expand worldwide and reign for a 1000 years or as long as they had the slaves to feed into the system. Yet, their tool became too unstable, too unpredictable and too uncontrollable as he tried to take over the entire planet. The globalists were still able to use him as a pretext for the NATO/European Union (EU) paradigm to control Europe. Now, with both the inspiration for Hitler and much of his financial support coming from inside the USA, it was no surprise that Operation Paperclip brought so many Nazi scientists and technocrats to the USA after the kinetic war was completed (~30,000 Nazis). The American Nazis; although, they did not call themselves Nazis, brought their assets back while Hitler himself, a deletant compared to the fools who have made war against us today, was allowed to retire to South America [6].

The eugenicists in America (and to some extent England) were a great influence and inspiration to the Nazi regime and in fact it was a part of the defense used in the Nuremberg trials to justify the programs they implemented. But there were other influencers as well, and they may still be present today. The upper tier of Nazidom were deeply into the dark side of occult esoterica. The swastika itself was an ancient symbol of the universe so what the Nazi’s did was use that symbol rotating to the left or counter-clockwise - a symbol of a devolving universe, not an evolving universe shown when it rotates to the right [7].

This symbol drew in those worldwide who knew what it meant (rotating counter clockwise), which is why, for example, dead Tibetans were reported to have been found among the casualties in WW II… sorcerers perhaps enlisted to help with dark rituals. Rituals are really important to the puppets of darkness as it provides them with a sense of power. They are now flaunting some of their rituals in the open, just to name three - the weird closing Olympic ceremony in London 2012, which heralded a plague that would put many in hospital [8]. In late 2021, the rapper Travis Scott’s Astroworld performance was not only overtly satanic but murders (human sacrifices?) took place during the performance. In 2022, the overtly satanic advertisements of Balenciaga.

It would surprise many to find out just who these puppets of darkness have been and currently are. For example, Madeleine Albright, former Secretary of State, was celebrated when she passed in 2022, despite being a mass murderer. She publicly announced the sanctions that were imposed on Iraq that killed over half a million children were worth it. Research who has attended the ceremonies at Bohemian Grove (Northern California) where they worship the false deity Molech, and you may be surprised [9]. Then there is the Bilderberg/Davos group and their High Priests (that is literally what they call themselves) - a smarmier group of international corporate scum and villainy you will never find. The World Economic Forum (WEF) is just a front group for these power crazed psychopaths who draw into their circle those who are in synch with them (the Law of Attraction), and they may not all be human, which is almost a guarantee.

Consider the possibility that we are part of a universe replete with life and intelligences of all types and strips be they seen or unseen - trillions upon trillions of conscious beings to a greater or lesser degree. It is regrettable that humans are so unaware, and so misinformed about our participation in the cosmos and we are even less aware of non-humans in the affairs of our lives and our planet. Some seem to be divinely angelic; some are more like predatory parasites.

As questionable as the influence of these low vibrational “others” might be, they probably weren’t responsible for the descent of certain governments into satanic, murderous, pedophile networks used to control and manipulate those that entered the halls of power. Pedophilia is the sick glue that holds their system together. The dark ones know children, especially young children, are closer to Source and by defiling them, by being brutal and cruel one is showing God that you are a counterion - an angry counterion. Why would you want to show God you are an angry counterion? Seems counter-intuitive, but foolish humans believed the promises made to them about personal power and wealth, so for the weak minded… that apparently is all it takes, an unfortunately there are many with weak minds.

This is beyond mere corruption; world governments had been bled out from the inside by these global predators. In fact, international banks, working with Pfizer, successfully executed a planetary coup against the nation-state. Pfizer is the most criminally fined corporation in America that admitted in front of the EU that they never tested the COVID injection to see if it would stop transmission or infection. Of course now we know it doesn’t.

Understanding Biomedical Waste

Biomedical waste encompasses various materials generated during healthcare activities, including hospitals, clinics, laboratories, and research facilities. These waste materials can include sharps (needles, scalpels), pathological waste, pharmaceuticals, chemicals, and contaminated materials. It is essential to segregate and handle these wastes appropriately to minimize risks.

Hazards of Improper Biomedical Waste Management

When biomedical waste is improperly handled, it can lead to infections and diseases spreading among healthcare workers, waste handlers, and the general public. As a result, untreated biomedical waste can pollute water, soil, and air, posing long-term health hazards and environmental pollution.

Segregation and Collection

Effective waste management begins with proper segregation at the source. Healthcare facilities should implement color-coded containers for different types of waste to ensure correct segregation. This includes separate bins for sharps, infectious waste, pharmaceutical waste, and general non-hazardous waste. Trained staff should collect and transport these segregated wastes to designated storage areas.

Safe Handling and Storage

Biomedical waste should be handled with caution to minimize the risk of injuries and infections. Healthcare workers and waste handlers must utilize personal protective equipment (PPE) such as gloves, masks, and goggles while handling potentially hazardous waste. Secure and labelled storage areas with restricted access should be in place to prevent unauthorized handling and ensure proper containment.

Treatment and Disposal Methods

Biomedical waste requires appropriate treatment before final disposal to neutralize any potential hazards. Common treatment methods include incineration, autoclaving, microwaving, and chemical disinfection. The choice of treatment method depends on the type and volume of waste. After treatment, the waste can be safely disposed of in designated landfill sites or through authorized waste management services.

Training and Education

Proper biomedical waste management relies on the knowledge and commitment of healthcare professionals, waste handlers, and support staff. Regular training sessions and educational programs should be conducted to raise awareness about the importance of waste segregation, handling protocols, and safety measures. This helps ensure compliance with regulations and fosters a culture of responsible waste management.

Conclusion

Effective biomedical waste management is vital for protecting public health, minimizing environmental pollution, and ensuring the safety of healthcare workers and waste handlers. By implementing proper segregation, safe handling practices, and appropriate treatment and disposal methods, we can mitigate the risks associated with biomedical waste. It is a collective responsibility of healthcare institutions, government bodies, and individuals to prioritize and invest in comprehensive biomedical waste management systems, thereby creating a safer and healthier environment for all.

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More scientific validation today indicates that most cancer patients have experienced some sort of trauma. Any kind of trauma, subtle or strong, average or accentuated, puts us on the path of fight and flight response. The body becomes reactive, and the body becomes a chemical factory, reacting. Such development of reaction is what we call cancer.

This has been backed by the tremendous work of a German doctor, Dr. Hamer. His belief was that when an unexpected, distressing event / trauma occurs, the biological program, called cancer is triggered.

Being sensitive to emotions and psychology, disappointments, depression, hurt, pain, suffering, resentments, and harbored hatred, all such emotional and psychological toxins and imbalances influence and impact our wellness.

The body's defense mechanism primarily goes out of hand, ungoverned, and instead of protection, it can kill, if not checked, well in time.

All kinds of such influences on us disturb our immunity, immunoglobulins, T-cells, our B-cell secretion, they disturb our digestion, process of absorption of nutrients, and elimination of toxins.

All this becomes a force multiplier effect and of course, then that develops into cysts, lumps, and knots which then keep growing, crowding the organ, and then of course begin to migrate and spread within the body.

Even while stressful life events are challenging to predict or prepare for, their potential connection to breast cancer development could give new perspectives into the disease's prevention and therapy.

Our bodies release the hormone cortisol when we are under stress. The stress hormone cortisol has been associated with an increased risk of breast cancer.

Additionally, stress can hinder our bodies' ability to combat cancerous cells. Neurotransmitters like norepinephrine are released when the body is under stress, which stimulates cancer cells.

Chronic stress exposure has been associated with adverse adjustments in the body's homeostasis. Telomere shortening caused by stress may affect cellular aging and have negative effects on health. This is how stress can cause cancer of the breast.

Controlling stress factors using a variety of self-learned coping mechanisms or seeking professional help to deal with unpleasant emotions early on should undoubtedly have a positive impact on women's health.

So drop your anxieties, dissolve your fears, let your insecurities get dwindled.

The emotional and psychological catharsis of screaming, crying, recreation, laughing, dancing, joy, reminiscing happiness, the joy of the past along with lots of rhythmic, calming, tranquilizing and regulated breaths, optimal movement and clean green nutrition, can certainly begin to heal and harmonize.

Among the medical fraternity, a famous scientist, Bruce Lipton, who has won many coveted awards, has mentioned in his popular book, The Biology of Belief, that “Your belief can change your Biology”.

Reportedly, many patients who suffered, benefitted by this understanding and simply by applying mental attitude, optimism, affirmations and faith. No wonder, Dr. Bruce Lipton has gained a lot of credibility.

Dr. Mickey Mehta says, your faith can change your physiology, breath can change your hormonology, meditation and prayers can change your emotion and psychology.

With optimism, faith and belief, begin to believe that you are whole, and healing and you will become whole and healed.

This faith elevates the mood and so turns the biochemistry, which in turn secretes happy hormones. Therefore, we can say, that Faith is happiness.

Your intentions, emotions, energy translates amavish (poison) to amruta (nectar).

Maintaining a general healthy pH balance in the body is fundamental for overall health. pH disturbances, defined as considerable deviations from the normal pH range, can have a variety of effects on the body's restoration and homeostasis. Mood conditions, emotional make up and your psychological ill effects can keep your body in the acidic zone and this can increase chances and be a cause of cancer.

This can lead to a disturbance in the circadian rhythm. The circadian rhythm is a natural, endogenous process that regulates the sleep-wake cycle and occurs approximately once every 24 hours. This internal clock is regulated by external cues like as light and darkness and is critical in regulating a variety of physiological functions such as hormone secretion, metabolism, and immunological function.

The circadian rhythm affects the release of hormones like cortisol, which regulates metabolism and the immune system. Circadian rhythm disruptions may have a direct impact on hormone balance, potentially influencing systems related to cancer development.

Maintaining a regular sleep-wake cycle, limiting light exposure at night, and adopting healthy sleep habits are all techniques that may assist sustain a healthy circadian rhythm.

The relationship between attitude, optimism, and food biochemistry involves the interaction of psychological and physiological components.

While the impact of attitude and optimism on food biochemistry is complex, there are a number of ways in which mental and emotional states can influence eating behaviour and, thus, the body's response to food.

Mind - body connection - The notion of the mind-body connection acknowledges the interaction of psychological and physiological variables.

Dr. Hamer has indicated achieving high success rates in last stage cancer patients with a form of mind - body healing.

Positive attitudes and optimism have been related to overall well-being, including enhanced mental health. A good attitude may influence healthy lifestyle choices, including eating choices, which can have a positive impact on biological processes.

Stress and cortisol level - Stress levels can be influenced by one's attitude and optimism. Chronic stress is linked to higher cortisol levels, a hormone involved in metabolism and energy management. Changes in eating patterns caused by stress may contribute to changes in blood sugar levels and metabolic processes.

Dopamine release - Dopamine is a neurotransmitter that has been linked to pleasure and reward. Dopamine release can be enhanced by positive experiences and attitudes. Food selection and eating, particularly delicious and fulfilling foods, can also cause dopamine release, altering the biochemistry of reward and satisfaction.

Emotional eating - Eating habits can be influenced by one's attitude and emotions. Some people may indulge in emotional eating, which is when they utilize food as a coping method for stress or bad feelings. Emotional eating can lead to the consumption of certain foods, which can have a variety of impacts on biochemistry, including changes in neurotransmitters and hormones.

Nutrient absorption - Chronic stress, for example, has been linked to alterations in gastrointestinal function and may impact nutrient absorption.

Inflammation and immune system - Reduced inflammation and improved immune function have been linked to positive attitude and optimism. Chronic inflammation has been linked to a variety of health problems, including metabolic abnormalities. Positive emotional states may help to balance the inflammatory response and improve overall immunological function.

Promoting longevity, immunity, and vitality can contribute to overall well-being and may play a role in prevention of cancer and other fatal diseases.

There have been a lot of studies conducted by the likes of Deepak Chopra, Baba Ramdev's Patanjali Research Foundation and findings of Sadhguru and Sri Sri Ravi Shankar Ji, Maharishi Mahesh Yogiji and other scientists of the world which includes Elizabeth Blackburn's findings on telomeres which state that good mood, faith and optimism are the causes of longevity, immunity and vitality.

Here are some broad principles that may contribute to longevity, immunity, and vitality, with a focus on cancer prevention:

Include Food For Gods - Healthy, wholesome and well balanced food supplies critical nutrients for energy, immunological function, and tissue repair.

This can be attained better with the use of plant-based foods. VEGETARIANISM is the ideal way to great health and well-being.

Consuming sattvik foods that are high in vital nutrients with a variety of seasonal and regional fruits and vegetables. These foods are high in antioxidants, vitamins, and minerals, which promote overall health and may protect against certain cancers.

It is important to be instinctive and eat only when hungry. Following the circadian rhythm and going by the cycle of eating is good for health.

The father of medicine, Hippocrates, has said, “Let thy food be thy medicine and thy medicine be thy food”.

Food can neutralize stress because food is an agent, a healing agent.

VEGETABLES cleanse you; FRUITS heal you; NUTS, SEEDS AND DRY FRUITS fortify you; and HERBS regulate you.

Arjun ni chaal, Giloy, Dashamula, Punarnava, Guggulu are the suggested and recommended herbs where a lot of research has been done for their curative properties. They have zero side effects if you take pure herbs and use them.

Adjuvants like cinnamon, nutmeg, cardamom, turmeric, black pepper, cloves and kadhas also have anti inflammatory and curative effect. They aid in repair, restoration, regeneration, revival and rejuvenation.

Weight management is important as being overweight or obese puts one at risk for a variety of malignancies. Adopting a nutritious sattvik dietary intake and engaging in regular physical activity can help with weight management.

Optimal movement therapy and postures in poetry on a regular basis with the right breathwork has been linked to a lower risk of several types of cancer.

Prioritising sleep routine and getting a good night’s sleep is ideal for balancing our unit rhythm. It determines the rhythm of our heart or it's better to say that the heartbeat determines that rhythm too.

So our unit rhythm when gets synchronised with the universal rhythm, the cosmic rhythm, our circadian rhythm remains harmonised and hormones behave well.

The most important factor for the same is rest. Rest, generally, we address it as sleep but sleep need not be restful. Sleep also is an art. It's a matter of a way of life, where you can literally breathe out, the moment the hour, the day, the days, the week, the weeks, the month, the months, the year, the years, the life and the lives lived till date. So breathing it all out and sleeping like a baby and waking up like a daisy is when maximum healing happens.

Sleep deprivation or poor sleep quality might have an impact on the immune system.

On the other hand, good sleep helps to restore other body clocks, like biological clocks, restoration, repair, rejuvenation.

Different brain neurons are activated by deep breathing, signaling the body to relax. Being stressed out and erratic, irregular breath, impacts breath management. Better breath management can neutralize stress.

Calming down, getting collected, slowing down, stopping, and stilling the mind with yoga, breath or meditation are other ways to signal body to relax.

Keeping in touch with a mental health professional for controlling stress and having a MD vaidya supervision would be beneficial as all this can aid in the creation of healthy coping strategies and a plan to lessen stress which helps in releasing endorphins, dopamine, serotonin, and oxytocin.

This life is an ocean that keeps moving, there will be high tides, there will be low tides, there will never be any steadiness. This unsteadiness causes stress.

The art of surfing this ocean is so important so that we can cope with the stress, meet the stress, re-create ourselves, and break the pattern of stress.

Being calm in the storm is an art, it's not easy, yet it can be achieved. So, we have to learn to be happy within and be fulfilled within.

Observe silence and meditation because these are the things that can bring back order. Make sure that we laugh with our friends and family, and make sure that we share a strong bond with our beloveds including parents and grandparents.

Dr Joe Dispenza has said that your mind can heal the body. The mismanagement of emotions and the hormones of stress is what begins to create their condition. That constant state of panic and stress is an imbalance that happens in our brains. It’s what causes our diseases.

If we learn how to change our thoughts, the mind can heal the body. It happens all the time — it’s called “spontaneous remission,” and even people with stage 4 cancer can be totally cured - Dr. Joe Dispenza.

When your mind and brain functions become coherent, they create an electromagnetic field for cleansing the environment, harmonising the environment and vitalizing the inner and outer environment.

Today, every leading hospital chain of the world, especially in the first world countries, have introduced lifestyle functional medicine, life coaching, integrating complementary medicine, because the findings of the last two decades and more says that all the pillars of lifestyle, which means nutrition, movement, breath, meditation, sleep, laughter, sports, outdoor environmental engagement and social engagements don’t just prevent but cure and heal all diseases.

Resistance to diseases certainly grows with recreation. So dance, music therapy, poetry, and singing are also extremely important to aid the healing process.

These are all healing quotients and they uplift, upregulate, and upscale our immunity to a big extent. So kindly restore, repair, revive, and rejuvenate using different therapies. Cancer neutralized… creativity Mickeymized!!

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Objective: To determine the role of aggravating factors in the development of destructive pulmonary tuberculosis and to develop a model for predicting the probability of closure of decay cavities in patients with destructive forms of pulmonary tuberculosis.

A prospective study was conducted cohort study. Patients admitted to the hospital of the Grodno Regional Clinical Center “Phthisiology”, as well as to the Republican Tuberculosis Hospital “Novoelnya” were examined. Depending on the prevailing aggravating factor, patients are divided into 10 groups. In addition, 2 more groups of patients with XDR MBT were formed. The results obtained indicate a significant negative impact of aggravating factors on the formation of destructive processes in the lungs. Patients with TB accompanied by diabetes mellitus, ADS, CNRD, patients arriving from places of detention and with the presence of several factors simultaneously should be considered more significant for this factor.

The results obtained indicate that the frequency of formation of destructive forms of tuberculosis in MDR-TB depends on a number of aggravating factors. The most significant in this regard: diabetes mellitus, several factors at the same time, ADS, patients arriving from places of detention, CNRD. Factors such as contact and gastrointestinal morbidity do not have a significant impact on the formation of destruction in the lungs in MDR-TB.

In the presence of XDR-TB, the highest frequency of destructive forms is observed (over 70%), reaching 76.0% in patients with XDR-TB in combination with ADS.

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When Z ≥ -1.304, closure of the decay cavity is predicted within 6 months of chemotherapy. If Z< -1.304 - the decay cavity does not close within a given period, the risk of developing gross morphological, sometimes irreversible changes increases.

Keywords: destructive tuberculosis, risk factors for tuberculosis, multiple and extensive drug resistance of Mycobacterium tuberculosis, long-term results, prognosis

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This was a contributing factor to the continuation of the calls that accompanied the Arab feminist struggle through multiple stages, to expand women’s and gender studies, as educational curricula and academic research multiplied in the region. The beginning was in Palestine through the Women’s Studies Program in 1994, then the program was transformed in 1988 into The institute grants a master’s degree in gender and development, and starting in 2014 it became the first institute to offer a bachelor’s-level program in women’s studies.

As a result of this first Arab experience; Several Arab universities have offered various programs offering diplomas and master's programs in women's and gender studies, and this reflects an optimistic idea about some Arab universities, and the extent of their interest in women's issues and developing them academically and scientifically.

Despite the importance of the scientific content provided by Arab academic institutions on women’s and gender studies, they continued to face challenges represented by the nature of the negative social and political environments, limited resources, inequality at the institutional or development and training levels, and security unrest in some countries.

In addition to the need for these studies to be further supported and developed on a quantitative and objective level, after the fragility of some established research centers led to the production of research dealing with women and gender, which would be accepted by governments and some influential and controlling parties in them, such as women’s rights in religion, or the influence of Enlightenment ideas on the role of women in the public sphere, or by focusing on the role of women in social protection programs, or refraining from teaching feminist movements locally and not paying attention to them as they deserve, and being content with teaching their models in the West or in the regions of Southeast Asia.

Developing Arab research centers concerned with gender studies after diagnosing the strengths and weaknesses and in a way that is consistent with women’s needs across multiple stages, especially in Arab countries that are witnessing political and social transformations, will help provide a solid scientific description of the reality and problems of Arab women, as well as provide scientific solutions, through research. Solid academic studies reflect the quality of research effort produced by both women and men.

It will also make Arab universities think tanks that provide scientific advice to decision-makers in the region to improve the situation of women in light of their priorities and needs, especially with regard to the conditions of women who are victims of armed conflicts, women (refugees and displaced women), marginalized women in the countryside and slums and non-urban areas, women who are victims of terrorism and extremism, as well as issues Related to the reality of women locally in light of the specificity of each Arab country, as well as the larger issue; The issue of cultural and societal reform and the rejection of discriminatory religious discourse.

Thus, it remains relaxed and enjoys a false cognitive peace. Therefore, there is no protection against the roaring current of thought except by taking refuge in the cognitive ruptures.

Hence, this hypothesis starts from a basic principle, which is that the moon witnesses a phased state of absence, darkness, and eclipse in its aspects, and it may extend to all its aspects during a period of its life, and just as the matter applies to modern administrative institutions, a leader may decide an organizational decision regarding an administrative issue, and that decision may be correct, but conclusively, we find that there is a dark side in that decision, so the next leader comes to remove that darkness, which may surround an aspect of communication or decision-making. Or attention to employees or incentives and rewards.

However, a rivalry may arise whose origin is undesirable organizational jealousy between the leaders who assume the leadership of the institution, based on the fact that each leader tries hard to prove his capabilities and the effectiveness of his capabilities, burning everything green and dry in order to obtain the loyalty of his employees, forgetting or ignoring the interest of the public institution under which he works and breathes in its achievements. Which may fade and the flame of its fire may be extinguished at the nearest crossroads.

The full moon hypothesis in leadership confirms that leadership based on the influence that enchants and attracts employees to work willingly with the leader and his ideas, constitutes the basis that guarantees the success and effectiveness of the administrative institution and its efficiency by keeping the leadership axes subject to criticism and doubt and a constant feeling of inadequacy and weakness, thus making the institution’s employees, especially those who are At the middle management level, they live in a state of brainstorming and constant thinking about solving emerging problems that the human will cannot restrain.

But good management, management, and work within the state of group dynamics may help in achieving the desired goals within a leadership characterized by the perfection of its axes, the quality of its performance, and the implementation of its tasks and duties to the fullest extent.

I go back to saying that the full moon hypothesis in leadership is suitable to be extended to the rest of the things through which we live, so that this hypothesis does not remain limited only to administrative institutions, but rather extends to include the individual, the family, and society as a whole, so as to ensure a state of creative interaction between its components.

Many pharmaceutical interventions do more than advertised. For example, one can’t wean cold-turkey off of SSRI’s even when substituting a serotonin analog, such as saffron, because SSRI’s do more than what they claim to do - they do far more than just inhibit serotonin reuptake. SSRIs such as Prozac, seem to hijack dopamine receptors to name one [3].

While the public is/was told mRNA is ephemeral in the body, a truth, what was not told was billions were being injected not with mRNA but modRNA, which is not ephemeral and it is no secret that it is programmed to make more than just the spike protein as per Pfizer’s own documentation:

“Self-amplifying mRNA (saRNA): saRNA is a platform that uses a much larger molecule because not only does it encode the antigen of interest, but four additional proteins. These extra proteins allow the cell to make more copies of the mRNA, resulting in more protein being expressed from a smaller dose” [4].

This bears repeating... these injections do not deliver natural mRNA but a modified version with extended stability which causes the cells of the body to produce unnatural proteins in addition to the spike protein but the true purpose of these proteins and what they are creating is unknown and on a practical level their presence is undisclosed. Be that as it may, the injection is clearly a gene-therapy and should have been labeled and regulated as such.

In the spring of 2020, the definition of vaccine was changed from something that would reduce infection and transmission to something that would reduce hospitalization, or the severity of the disease after receiving multiple injections - that violated the CDC’s own published rules on what a vaccine is supposed to be [5]. The public was lied to by saying it was a vaccine when it was an “experimental gene-therapy“ as per Moderna and BioNTech’s own filings - at least until April of 2020. They called it a vaccine so people would take it, because vaccines are the sacred cows of conventional medicine and everyone is preprogrammed to believe they are all “safe & effective,” because an authority figure told them it was and most in the First World have been carefully conditioned to concede our common sense or discernment to authority figures.

The manufacturers could legally lie about safety because in 2018 the legal definition of an adverse event was changed to being only something the medical literature or medical consensus had previously noted was an untoward sequelae of that injection. It would not have mattered if the injection gave every recipient myocarditis if that was not previously delineated - it would not be an adverse event.

While few are aware the injections are making multiple proteins this fact is clearly spelled out by Pfizer itself. Granted Pfizer has zero to no credibility for anything they write or say, but they seem to be very transparent about revealing the injection is making “these extra proteins.” They are admitting to four additional proteins; however, there may be many more unintended, and undisclosed proteins being made. Pfizer very much wanted to keep their clinical data sealed for 75 years, so they had a lot to hide.

What are these extra proteins and what are they doing in the human body and what could go wrong? How about death?

Note the words “self-amplifying,” because one might correctly assume that these other proteins are critical to self-amplification. Is there a connection between, for example, these never-seen-before massive clots found in so many deceased jab victims and these self-amplifying bio-nano machines?

War on humanity became fully operational but not recognized as such because there were no helmets, guns, bombs or bullets. Need proof? A systematic review of autopsy findings in deaths after Covid-19 injections revealed that 73.9% of those deaths were caused by or significantly contributed to by the Covid-19 injections [6].

Perusing the Moderna patent issued in April of 2023 (US patent number 11,622,972 B2) entitled: Lipid nanoparticle compositions and methods for formulating same, you can see that that these stealth nanoparticles are chock full of plastic polymers many of which are carcinogenic and toxic Phthalates. Phthalates are most often used as plasticizers that allow plastics to be more flexible, durable and long lasting. If the COVID injection were actually a vaccine these chemicals would be (and should have been) labeled as adjuvants or excipients, and subjected to safety evaluations.

Of course, safety gets side-stepped when no one even bothers to look or evaluate for same, and this is by design. It was already known many Phthalates are toxic endocrine disrupters, and should never have been allowed in these injections without adequate safety considerations, but ipso facto…safety is not a consideration in today’s captured regulator environment. Phthalate exposure alone is responsible for 100,000 deaths in America every year with a societal cost of almost $40 billion a year [7]. Why do you think testosterone levels have been crashing to use but one example?

Hydrogels

Complex organic polymers are called Hydrogels. Hydrogel-forming natural polymers include recognizable proteins such as fibrin and collagen. The Pfizer Lipid nanoparticles [8] are the constituents of hydrogels and again the question is what is being made by these constituents?

Remember the spike protein is a pathogen. So, it is of interest that the CoV-2 spike protein S1 alone induces fibrin(ogen) resistance to fibrinolysis. So, just the massive production of the spike protein alone by the cells of the human body could be causing these massive clots being seen today in those who have experienced post-injection thrombi that the body cannot destroy [9]. We have all heard the reassurances that mRNA does not affect DNA so not to worry your genome is safe, and indeed mRNA does not affect DNA, but modRNA has a direct effect on DNA [10].

At the very least injected breastfeeding mothers and organ donors who underwent the COVID-19 injection almost certainly transfer worrisome modRNA, adenoviral DNA, spike protein, and or anti-platelet factor-4 antibodies (vaccine induced thrombotic thrombocytopenia or VITT) to their close contacts [11].

VITT are these weird elongated clots pulled from the vaccinated dead. Platelets are activated in a novel and deadly manner to create an immune complex hydrogel. This is accomplished by platelet-activating anti-platelet factor 4 (PF4) antibodies. It is still a mystery as to what sets this off. No one is accusing the spike protein, but if not the spike protein could it be one of the many additional proteins the modRNA is instructing the cells to create? Or is it the undisclosed presence of Graphene oxide (GO) known to self-assemble?

Injecting modRNA, which does not seem to degrade in many - i.e. it is not ephemeral - could have serious repercussions on over-all mortality post injection, to say the least, by the pernicious disruption of the human genome. To believe, and this is about faith not science, that biopolymer particle (BP) vaccine technology is a benign intervention ready for prime time for a whole host of potential conditions is the height of arrogance and hubris in the face of the mounting death toll in the countries most heavily Injected.

Fear is the Mind Killer

Providing some additional background context, the Gain-of-Function work that created CoV2 was funded by the United States Government and approved by Anthony Fauci. The bagman was Peter Daszak of Eco-Health Alliance, who as of this writing is still getting millions in NIH grants. Yet, the apparent deliberate release of the CoV2 virus must have been big disappointment as it was hoped it would have killed billions and the injection, called a vaccine, was only meant to do clean-up. Since CoV2 didn’t perform as hoped the roll-out of the injection had to be moderated as not to draw too much attention to the death toll or those asking too many questions given there were too many still alive to ask those questions, so certain batches were not as problematic as others. Never evaluated to see if it would stop transmission or infection, because that was never the intention of the jab - the intention was democide. One need look no further than Canada to prove that point - those with vaccine injuries are being offered free euthanasia. Now, we all know the jab neither stopped transmission nor infection. The mass indiscriminate use of the modRNA vaccine was catastrophic but then wasn’t it meant to be?

It was also imperative any options for early treatment be extinguished lest that interfere with the injection roll-out, so hydroxychloroquine and ivermectin were demonized, while hospitals were being incentivized to literally murder COVID patients by intubation and the use of the ineffective and deadly drug Remdesivir. Unsupportable medical protocols were strictly enforced. Admitting a patient and labeling them a COVID patient was worth $11K to the hospital, $39K if they were intubated. Using Remdesivir and Versed as the only pharmaceutical protocol gave hospitals a 10 percent bonus on the total bill, so by using Remdesivir a typical $500K hospital bill would garner an extra $150K for the hospital. That is why all other treatments were forbidden.

Truly, this was probably the single greatest crime against humanity in the modern history of mankind. The world was told what they were going to do in 2015, but the world was asleep. At the end of February 2024, Russia submitted a 2,000-page report to the United Nations documenting the bio-security deep state and pharma manufactured the COVID event naming influential figures within the US political landscape who orchestrated the Covid-19 pandemic as part of a global domination strategy. Among those named as participants in this scheme are Hillary Clinton, Barack Obama, Joe Biden, and George Soros, implying their involvement in a conspiracy against humanity. This is really the overlooked big picture, there were a colluding set of conspirators both in industry and in the public sector that orchestrated the plandemic, and well planned it was. No one was allowed to question anything because it had been decided everyone would get the injection.

These individuals must be exposed lest they take matters into their own hands to hide their crimes in the chaos they are still very much capable of creating. For example, thousands of foreign military or para-military combatants were brought through the open boarder into the United States just waiting for the word to activate and pillage, rape and destroy United States citizens inside their own country. Then again, it could just be that new and improved infectious bio-weapon Bill Gates seems to be so anxious to unleash. The crime was not committed solely by Big Pharma, they were just the arms dealers - the crime is what allowed them to be arms dealers - this ongoing war on humanity itself - that is the crime. This is beyond the scope of this perspective but the elites want a return to feudalism with a vastly reduced planetary population -an 80 to 90 percent reduction. These individuals are detached from reality, but have never suffered the consequences.

The first patent [12] on CoV2 was back in 2002, but in 2019 Moderna filed four patents that had previously been rejected, “Because of concern for the reemergence or a deliberate release of the SARS coronavirus, vaccine development was initiated.” That is only something you say because you know what the plan is - no different than when Fauci announced in 2017 that Trump would face a surprise infectious disease outbreak...surprise? If anyone announced their local bank would experience a surprise robbery don’t you think that person would be a prime suspect?

In the fall of 2019, the WHO announced it would conduct a worldwide exercise to be ready for the release of a “rapidly spreading pandemic due to a lethal respiratory virus…which would impose additional preparedness requirements”. The “criminals” announced in advance what they were going to do and no one seemed to care but for literally a handful of individuals that were dismissed as conspiracy theorists. Did the lethal respiratory virus exercise also include distributing the virus to multiple locations around the world? Because it is clear this infection did not come from a wet-market in December of 2019. CoV2 circulating for months before that. Release implies intention and distribution; it does not imply an accident of happenstance. One could infer the WHO was actually involved in its release and the so-called exercise may have been far more than just an exercise.

Then came the diabolically dishonest cover-up. The distrust in government and public health edicts has grown exponentially as a result. More dangerous than CoV2 was the shutdown of free-speech, and of course self-righteous politicians and technocrats who knew nothing about the actual science were eager to censor, terminate, or delicense anyone who didn’t agree with the narrative they were pushing. The government used proxies to silence those asking inconvenient questions or had information that would expose the narrative. The FBI and DHS were meeting weekly with the high-tech platforms to make sure those platforms took down or suppressed information they disagreed with. Meanwhile, “I am the Science” Anthony Fauci’s emails from January 2020 showed he was well aware the NIH was funding Gain-of-Function research in Wuhan; nevertheless, the public was told the opposite (the least of his crimes). It is doubtful he will ever be prosecuted for anything, because in the United States there is now a two-tier system of justice where what is called lawfare is used to minimize anyone who threatens the elite’s plan for world dominance. If this is allowed to continue the judicial system in the United States will collapse and take the rest of the country with it.

Physicians could have stopped this tragedy but in the United States 85 percent of physicians work for institutions and those that knew better still feared more about their employment than doing the right thing. This is what happens when you have the corporate practice of medicine. So, modern conventional medicine went down a very dark path created 100 years ago by the Rockefeller Foundation. There was a pernicious turn from science to scientism, which is a non-evidence-based mix of scientific dogma and magical thinking that is meant to serve those in control or wanting to be in control.

Considering the rush is on to completely bypass informed consent and aerosolize this technology [13] it is critical to understand and expose the insanity of how this democide was carried out - an understanding that has yet to happen, so its instigators are still at it and are desperate for the next wave of infectious disease genocide they have up their sleeves if for no other purpose than to cover their tracks from their crimes related to COVID.

The public has been bombarded with distractions, from UFO’s, Drag Queen Story Time, George Floyd, January 6^th, the drug and slave trade on the deliberately open southern border, DEI, men having babies, the climate change hoax, and unending wars in multiple locations. This was all orchestrated to invert reality so that the real crime would not be noticed - that a colluding set of misanthropes caused this all to happen. These conspirators knew the plandemic was coming and played their roles to make sure it took place. This information has been in the public domain now for over a decade, as per Peter Daszak’s 2015 presentation to the National Academy of Science:

“Daszak reiterated that, until an infectious disease crisis is very real, present, and at an emergency threshold, it is often largely ignored. To sustain the funding base beyond the crisis, he said, we need to increase public understanding of the need for MCMs (medical counter- measures) such as a pan-influenza or pan-coronavirus vaccine. A key driver is the media, and the economics follow the hype. We need to use that hype to our advantage to get to the real issues. Investors will respond if they see profit at the end of process, Daszak stated” [14].

But it goes back farther to 2005 when Ralph Baric gave the DARPA lecture: “Synthetic Coronaviruses. Biohacking: Biological Warfare Enabling Technologies. June 2005 Washington DC: DARPA/MITRE sponsored event”.

Why are we still debating where the virus came from?

Ralph Baric, the scientist who made the weaponized CoV2 virus, at the University of North Carolina, actually published the treatment for the bioweapon in 2010: Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture [15].

No surprise that the creator of the Gain-of-Function virus would have a countermeasure if for no other reason than his own protection. The public has been conditioned for years to accept fear-based narratives without questioning them and to surrender their own discernment for whatever the authority says is going on and what should be done. Combine that with the assault on our I.Q.’s with toxins, such as fluoridated water, pesticides, and a poor educational system to the point where we couldn’t see the information under our noses - the elites were fearless in their ability to pull off this great democide and will try again if they are not exposed.

References

Yuyang Lei., et al. “SARS-CoV-2 Spike Protein Impairs Endothelial Function via Downregulation of ACE 2”. Circulation Research 128 (2021): 1323-1326.
The release of CoV2 did not cause a pandemic as planned, but a criminal cabal decided to run with it nevertheless. It affected the very old with multiple co-morbidities, the obese and the medically compromised just like the flu does every year. The flu itself mysteriously vanished during this plandemic, because the cabal needed to count flu victims as COVID victims - essentially almost anyone dying of anything was counted as a COVID victim. The planning component of the plandemic was out in the open in both the medical literature and in plenary sessions, such as Event 201. The script of Event 201 (October 19, 2019) was the exact script run 3 months later in December of 2019 and later in 2020, including the lockdowns and other restrictions, which caused far more morbidity and mortality than the virus itself. No healthy child succumbed to COVID, which was almost non-existent on the continent of Africa where millions take ivermectin and hydroxychloroquine as part of their routine malaria prophylaxis or iverm ctin as part of the African Programme for Onchocerciasis Control (APOC).
Fu-Ming Zhou., et al. "Corelease of Dopamine and Serotonin from Striatal Dopamine Terminals". Publishing in Neuron 46.1 (2005): 65-74.
https://www.pfizer.com/science/innovation/mrna-technology
There was no evidence the “experimental gene-therapy” would either make one less ill or reduce hospitalizations. Further, the FDA said one would not be counted as immunized until 2 weeks after the second injection. So, one was counted as unvaccinated until 2 weeks post the second injection. One did not have an adverse event post vaccination unless the medical literature already listed that adverse event as a risk from that injection.
Hulscher N., et al. “A Systematic Review of Autopsy Findings in Deaths after COVID-19 Vaccination”. Lancet preprints SSRN.
Trasande L., et al. “Phthalates and attributable mortality: A population-based longitudinal cohort study and cost analysis”. Environmental Pollution 292.Pt A (2022): 118021.
Nonclinical Evaluation Report BNT162b2 [mRNA] COVID-19 vaccine (COMIRNATYTM) Submission No: PM-2020-05461-1-2 Sponsor: Pfizer Australia Pty Ltd (2021).
Grobbelaar LM. “SARS-CoV-2 spike protein S1 induces fibrin(ogen) resistant to fibrinolysis: implications for microclot formation in COVID-19”. Biosci Rep 41.8 (2021): BSR20210611.
Aline Marnef and Gaëlle Legube. “m6A RNA modification as a new player in R-loop regulation”. Nature Genetics 52.1 (2020): 27-28.
Halma M, Rose J and McCullough P. “Inadvertent Exposure to Pharmacologically Designed Lipid Nanoparticles Via Bodily Fluids: Biologic Plausibility and Potential Consequences”. Preprints (2024): 2024021267.
The timeline of the various patents going back two decades is well detailed in: Covid 19 and Anthony Fauci Dossier by David Martin.
Suberi A., et al. “Polymer Nanoparticles Deliver Mrna to The Lung for Mucosal Vaccination”. Science Translational Medicine 15.709 (2023): eabq0603.
From page 73 of Rapid Medical Countermeasure Response to Infectious Diseases: Enabling Sustainable Capabilities Through Ongoing Public and Private-Sector Partnerships - published by the National Academy of Sciences in (2016).
Aartjan J. “Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture”. PLoS Pathog. Nove 6.11 (2010): e1001176.

Introduction: Curcumin, is a natural polyphenol product found in turmeric, and it has primary anti-inflammatory and antioxidative properties. It modulates several molecules in the cell signal transduction pathway to exert the therapeutic benefits. It is widely used to treat multiple medical illnesses and has shown many health advantages. Bromelain, an enzyme obtained from pineapple is shown to promote tendon healing through anti-oxidant and immunosuppressive effects. This study is conducted to assess the effectiveness of Fortend, a drug consisting of MicroActive Curcumin, Epigallocatechin gallatoe Bromelina with Coenzyme Q10, Manganase and Selenium in treating Lateral Epicondylitis (LE).

Materials and Methods: This was a non-controlled, non-randomized retrospective observational clinical study. Records of all patients that were treated for LE in multiple centres between 1st April 2022 to 30th June 2023 with elbow disorders were assessed for eligibility. The inclusion criteria of the study are patients who have been diagnosed clinically to have LE through history, physical examinations and special tests and have been offered at least one course of Fortend. The exclusion criteria include patients with connective tissue disorders, previous history of surgery to the elbow, incomplete follow-up records and/ or without consent. One course of treatment consists of taking one tablet of Fortend per day for 20 days consecutively and a maximum 2 courses are offered based on clinical response. Patients were followed up at 1 month, 3 months and 6 months after initiating Fortend. The outcomes were assessed using Visual Analog Score (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) score.

Results: A total of 260 patients that fulfilled the inclusion and exclusion criteria were selected for the study. VAS were 6.9±1.0 at first baseline, 5.6±0.8 at 1month (p=0.03), 3.8±0.6 at 3 months (p<0.001) and 1.7±0.7 at 6 months (p<0.001). DASH scores were 57.8±3.8 at baseline, 41.5±5.8 at 1 month (p<0.001), 26.5±4.6 at 3 months (p<0.001) and 14.6±3.2 at 6 months (p<0.001).

Discussion: Fortend has anti-inflammatory and anti-oxidative properties. It is being used widely in the world to treat many medical illnesses and can be used to treat tendinopathy. This study has shown that the use of Fortend in lateral epicondylitis yields promising results with fast recovery and minimal tolerable side effects. In addition, patients also can avoid any form of injections or surgery for lateral epicondylitis which has inconsistent results.

Conclusion: Fortend is a safe and effective adjunct to conservative treatment of lateral epicondylitis to relieve pain and improving function.

Keywords: Fortend; Tennis Elbow; Anti-inflammatory; Anti-oxidative; Pain

References

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Real Delor RE., et al. “Quality of life and sarcopenia in adult patients with chronic renal failure”. Rev. Nac. (Itauguá) 14.1 (2022): 30-45.
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López Catalán., et al. “Relationship between health-related quality of life and sociodemographic determinants in adults from Cuenca, Ecuador”. Economy and Politics Magazine, Epub 29 (2019): 62-84.
Dantas Jales R., et al. “Auriculotherapy in the control of anxiety and stress”. Sick global 20.62 (2021): 345-389.
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León Martínez CA., et al. “Music therapy as a therapeutic modality that regulates emotions in pre-retirees”. Electronic Medicenter 25.1 (2021): 92-106.
Saldías Fernández M Angélica., et al. “Between physical activity and quality of life: National Health Survey”. Public health Mex 64.2 (2022): 157-168.
Rodríguez Medina DA., et al. “Is the Psychophysiological Stress-Relaxation Response the same in all Cancer Survivor Patients?”. Psychological investigation report 12.3 (2022): 86-101.
Lorca P Luz A., et al. “Functional results of a prehabilitation program in elective colorectal cancer surgery”. Rev. cir 74.3 (2022): 276-282.
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Martínez GG, Guerra DE and Pérez MD. “Chronic kidney disease, some current considerations”. Multimed 24.2 (2020): 464-469.
Díaz Armas MT., et al. “Epidemiological behavior in patients with terminal chronic kidney disease in Ecuador”. CCM 22.2 (2018): 312-324.
Marín Prada MC., et al. “Mortality of chronic kidney patients of working age in Cuba”. Cuban Med Rev 60.2 (2021): e1530.

The major industrialised countries have significantly contributed to global warming with unprecedented magnitude. It is worth noting that the major polluters are; China, India, and United States of America including Brazil. These countries have many industries which emit their affluence to the atmosphere, inform of ‘black carbon dioxide and methane gases’. This has led to global warming and climate change. Melting of junks of ice in North Pole and Alaska increased the volume of water in seas and oceans of the world thus causing unprecedented floods. Again, the widespread use of fossil fuel, and episodes of wild fire has significantly damaged the environment and contributed to global warming and climate change.

The world’s energy systems are still dominated by fossil fuels. However, it is imperative that countries scale down the use of fossil fuel usage to save the planet earth. Again, carbon dioxide usage should be taken out of the power sector by phasing out coal facilities. There is a dire need to increase the uptake of renewable energy around the world. Limit global warming to 1.50C and reduce greenhouse emissions. The said countries have promised to reduce fossil fuel and industrial pollution by 25 to 30 percent by 2030. It is easier to say but are we likely to witness tangible action?

Global actors need to institute actions to limit climate change, and avoid unacceptable risks to global health. Fund initiatives for climate change and implementation public health measures to reduce number of deaths from cancer, respiratory and cardiovascular diseases that are caused by air pollution, risks from extreme weather events, infectious disease, diminishing water supplies, and food insecurity. Public health specialists have a fundamental role in leading by example, primarily by: a) Raising awareness of the health effects of climate change and the potential health co-benefits of low carbon pathways. b) Contributing to the development and implementation of measures to limit climate change and protect people in workplaces, and communities; c) Working to minimize the environmental impacts on health systems, while improving health services.

PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

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