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Oct 2024 DOI 10.14302/issn.2688-5328.ijp-24-5319
Puri NivritiCorresponding author
Chronic pain affects over 30% of the global population, and reliance on external drugs for treatment has led to major issues, including the present opioid epidemic. A healthier option is necessary, which is why music therapy’s analgesic effects have been extensively studied within the last 20 years. Not only is music relatively harmless but given that chronic pain patients require repeated treatment, musical intervention is far more accessible and economical. While the mechanisms underlying music-induced analgesia are relatively unclear, the production of endogenous opioids while listening to music through both the descending pain modulatory circuit and the limbic system, is postulated to play this role. This review describes the brain regions and pathways by which music may trigger the release of endogenous opioids such as enkephalins, endorphins, and dynorphins. More importantly, it discusses the cellular mechanisms through which these neuropeptides are thought to mediate pleasure-induced analgesia in chronic pain patients.
Aug 2023 DOI 10.14302/issn.2688-5328.ijp-23-4624
James AndersonCorresponding author
Periauricular Vagus Nerve Stimulation (pVNS) has been proven safe and effective in reducing chronic pain and related comorbidities in numerous clinical studies. This multicenter, interventional study used a non-randomized, interrupted time-series analysis to test the efficacy of an 8-week treatment protocol using the Stivax neurostimulator device. Subjects (n=33, 15 F, 18 M, age 40-77) were recruited at 3 clinic sites in California and Colorado. All subjects had long-term chronic pain and had failed other treatments. Subjects were treated with the Stivax device 3 times (2 weeks on, 1 week off). Subjective assessments of pain (Visual Analog Scale), disability (Oswestry Disability Index), depression (PHQ-9), and activity (IPAQ-E) were collected at baseline and weekly. Objective blood levels of pain-related cytokines collected at the end of weeks 2 and 8. Most subjects reported reduced pain, disability, and depression, with increased activity levels. At the end of week 8, subjects reported an average reduction in pain by 38.5% (3 subjects reported no pain), depression by 43.6% (2 subjects reported no depression), disability by 38.6% (2 subjects reported no disability), and an average 26.1% increase in activity level (5 subjects doubled their activity level). Levels of the pain-related cytokines IL-1ꞵ, IL-2, IL-3, IL-7, IL-10, IL-15, IL-17α, IL-21, TNF-α, IFN-γ, and FLT3-ligand showed improvement at week 8. pVNS is believed to “reset” central sensitization underlying chronic pain and other central sensitization syndromes, engaging the body’s pain modulation systems. Our results indicate that pVNS can clinically significantly improve chronic pain and associated morbidities without adverse effects.
Jun 2023 DOI 10.14302/issn.2578-2371.jslr-23-4446
Maru Temesgen MinwuyeletCorresponding author
A retrospective study quantifies chronic liver disease burden and trends in Eastern Amhara. It summarizes demographics, etiologies, and outcomes to inform regional planning.
Mar 2023 DOI 10.14302/issn.2641-5518.jcci-23-4506
Partanen AnuCorresponding author
Limited data exist on the mechanisms promoting clonal expression of BCR-ABL1 cells in various myeloproliferative disorders. We present a patient whose Janus Kinase (JAK) 2 V617F-negative idiopathic myelofibrosis (IMF) transformed to Philadelphia-positive chronic myeloid leukemia (CML). A 55-year-old man had anemia and splenomegaly. Trephine biopsy showed excess fibrosis without a JAK2 V617F mutation. Diagnosis of high-risk IMF with t(3;12) and del(16q) was made. Five years later a repeated trephine biopsy showed extensive fibrosis and t(9;22) with der(22)t(9;22). BCR-ABL1 fusion gene with typical p210 fusion transcript was found resulting in the diagnosis of CML. A modest treatment response was achieved with tyrosine kinase inhibitor (TKI) therapies, but the disease eventually progressed to a myeloid blast phase. With AML-based chemotherapy plus azacytidine and a second generation TKI the patient survived for years but succumbed 11 years after the initial diagnosis. Clonal evolution may cause atypical disease characteristics or a poor response to targeted therapy in myeloproliferative disorders.
Jun 2022 DOI 10.14302/issn.2642-9241.jrd-22-4181
K. Al Miraj A.Corresponding author
Research Assistant, Dept of Vascular Surgery, BSM Medical University Dhaka, Bangladesh
Introduction Worldwide, the Chronic Obstructive Pulmonary Disease (COPD) is a major public health concern; On the basis of epidemiologic data, by 2020, COPD will be the third leading cause of death worldwide. Objective To assess the frequency of Microalbuminuria and the presence of Hypoxemia in patients with COPD. Materials and Methods Study Design Cross-sectional observational study. Place of Study Department of Medicine & Respiratory Medicine in Dhaka Medical College Hospital (DMCH). Study Period Six months after approval of the protocol Study Population Patient suffering from COPD and admitted in Department of Medicine & Respiratory medicine, DMCH, Dhaka, Bangladesh. Total 100 samples were included in this study. COPD usually presents with a history of chronic cough with sputum production or exertional breathlessness which may be associated with relevant clinical findings and a post-bronchodilator FEV1/FVC less than 0.7. In most cases it is associated with smoking Results Total 100 patients of COPD were included in the study. Mean age was 58.16±5.4 years ranging from 50 to 74 years. Out of 100 patients, majority (42%) were from age group 55 to 60 years. Among all, 82% patients were male and 18% were female, of 100 patients, majority (30%) were day laborer. Only 2% were unemployed. The percentage of housewives was 18%. Other 34% were businessman and service holders. COPD severity was assessed using GOLD guideline. Out of 100 COPD patients, 38% had severe COPD (GOLD stage III). 16 % patients were in mild (Stage I) and 32% patients were in moderate stage (Stage II). The condition was very severe for 14% patients (Stage IV). Of 100 COPD patients, 30% had microalbuminuria. Among 100 COPD patients, chance of microalbuminuria increases among COPD patients with the increase of age significantly. There is smoking history of 36 pack year for COPD patients with microalbuminuria. Of 100 patients 26% were hypoxemic. The average forced expiratory volume (FEV1%) was 37.40 with standard deviation 14.48 for patients with microalbuminuria. The PaO2 and PaCO2 is 63.06 with standard deviation 7.09 and 46.09 with standard deviation 2.43 for COPD patients with microalbuminuria respectively. All of these characteristics are significant with p-value 0.00. However, the body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were not found significant. The patients who had PaO2 less than 70 mmHg were considered hypoxemic. The patients who had microalbuminuria among them 87% were hypoxemic. Only 13% patients were free from hypoxemia who had microalbuminuria. Patients without microalbuminuria had no history of hypoxemia. There is significant relation exists between hypoxemia and the presence of microalbuminuria (p<0.5). Conclusion In this study, about one-fourth of the patients have hypoxemia and more than one fourth of the patients have microalbuminuria. Stage III was more frequent among the study population but there was no association between severity grading and presence of microalbuminuria. However, significant relation is found between co-existence of both microalbuminuria and hypoxemia in COPD patients.
Mar 2022 DOI 10.14302/issn.2471-7061.jcrc-22-4139
Wu JianqingCorresponding author
Healthier World (Independent researcher for cause), P. O. Box 689, Beltsville, MD 20704. USA
We examined special roles of the Central Nervous System (CNS) in an attempt to resolve the puzzle that chronic diseases cannot be cured in medicine. By exploring a skill-learning model, we found that the CNS is able to remember certain information reflecting biochemical and cellular (B&C) processes in the body. From the skill-using ability, we found that the CNS is able to control basic B&C processes that drive and power the skill. From the ability to adjust forces and moving direction of body parts, we infer that the CNS is able to adjust B&C processes that control physical acts. From this controlling capability, we inferred that the CNS must also store certain information on the baseline B&C processes, is able to up-regulate or down-regulate the B&C processes, and make comparisons in performing its regulatory functions. We found that chronic diseases are the results of deviated baseline B&C processes, the CNS plays a role in maintaining deviated baseline B&C processes, and protects the body state of a fully developed disease. The three CNS roles can explain that cancer progresses with increasing malignancy, cancer quickly returns after a surgery, cancer cells repopulate after chemotherapy and radiotherapy, cancer patients develop drug resistance inevitably, immune cells rebound after suppression, etc. We further showed that long-term exercises generally can correct part of the departures in B&C processes and thus help to reverse chronic diseases. Finally, we propose strategies for resetting the CNS’ state memory as an essential condition for curing chronic diseases and cancer.
Feb 2022 DOI 10.14302/issn.2574-4488.jna-21-4039
K Al Miraj ACorresponding author
Research Assistant, Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU)Dhaka, Bangladesh.
The function of the thyroid gland is one of the most important in the human body as it regulates the majority of the body's physiological actions. The thyroid produces hormones (T3 and T4) that have many actions including metabolism, development, protein synthesis, and the regulation of many other important hormones. There is a lot of interaction between the kidney and thyroid gland during the disease States thyroid hormones have a major role in regulating the glomerular filtration rate through its hormonal actions in normal physiology. But these things are altered in the disease States such as chronic kidney disease. It is a well-known fact that hypothyroidism causes decreased Glomerular filtration rate whereas hyperthyroidism causes increased Glomerular filtration rate leading to renin-angiotensin-aldosterone system activation. In our study we aim to see the prevalence of low T3 syndrome in different stages of CKD which is a state of physiological benefit in preserving the proteins lost through the Kidneys in CKD patients and since CKD is progressed in hyperthyroidism state it is a protective mechanism in restoring the CKD status. Other subclinical hypothyroidism hyperthyroidism. Autoimmune hypothyroidism. Glomerulonephritis are all part of a dynamic endocrine and nephrology sequence. Thorough knowledge of these is required for optimum treatment of thyroid in CKD patients.
May 2020 DOI 10.14302/issn.2575-7881.jdrr-20-3343
Hussen Abdelrhman AmgedCorresponding author
Assis Professor, Department of Hematology and Immunohematology, Omdurman Islamic university / Sudan
Background Anemia of chronic disease is anemia found in certain chronic disease states, is typically marked by the disturbance of iron homeostasis or hypoferremia. Chronic renal failure is currently known as Chronic Kidney Disease (CKD) or Chronic Renal Insufficiency (CRI) implies long-standing, progressive and irreversible renal parenchyma disease resulting in diminished renal function up to 40 to 60%. Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic kidney disease. This disease may also be identified when it leads to one of its recognized complications such as cardiovascular disease, anemia, or pericarditis. Methods Sysmex kx21 used to CBC and the Cobase411 used to iron profile. Enzyme-Linked immunoassay (ELISA) was used to determine the level of serum hepcidin. Sample preparation and PCR detection of HAMP DNA Polymorphisms: Restriction digestion of PCR products was done using Fast Digest. (Figure 1). Results Serum hepcidin levels higher in patients with anemia of chronic kidney disease compared with healthy controls mean. The polymorphisms of the hepcidin gene promoter in Sudanese patients with ACKD showed that the hepcidin HAMP AA genotype 70, AG 23, and GG 7 in 100 patients dialysis-dependent and AA 83, AG 17 and GG 0, and the allele A are more frequent in patients affected by ACKD. Significant statistical association observed between the hepcidin level and end-stage kidney disease. Conclusion This study evaluates for the first time the association between anemia of chronic kidney disease and hepcidin genes promoter polymorphisms and show that the hepcidin HAMP AA genotype and the allele A are more frequent in patients affected by ACKD, further investigation is needed, our data support the hypothesis and hepcidin HAMP are important in the pathophysiology of ACKD.
May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3375
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
The world of chronicity is an area in progressive growth that involves a considerable commitment of resources, requiring continuity of assistance for long periods of time and a strong integration of health services with social ones and those requiring residential and territorial services often not sufficiently designed and developed. The fundamental aim of the treatment of chronic systems is to keep as much as possible the patient at home and prevent or reduce the risk of institutionalization. GP could put their expertise to good use in the Complex of Primary Care Units and Territorial Functional Aggregations, reducing the costs of the health service.
Jan 2020 DOI 10.14302/issn.2474-9273.jbtm-19-3157
Jana SnehasisCorresponding author
Trivedi Science Research Laboratory Pvt. Ltd., Thane (W), Maharashtra, India.
Sleep biomarkers in brain such as melatonin, BDNF (Brain-derived neurotrophic factor), PGD2 (Prostaglandin D2), leptin, orexin-A, and acetylcholine were evaluated in the unpredictable chronic stress (UCS) rodent model in the presence of Consciousness Energy Healing Treated (the Trivedi Effect®) novel test formulation in male Sprague Dawley (SD) rats using ELISA assay. The test formulation was consisted of minerals (Zn, Fe, Cu, Se, Ca, Mg), vitamins (C, E, B6, B12, D3), β-carotene, ginseng, and cannabidiol isolate. The test formulation constituents were divided into two parts, one part of each ingredient was distinct as the untreated test formulation, while the other portion of the test formulation and a group of animals received Biofield Energy Healing Treatment by a renowned Biofield Energy Healer, Mr. Mahendra Kumar Trivedi. The level of melatonin in groups viz. G5 (Biofield Energy Treated Test formulation) and G7 (15-days pre-treatment of Biofield Energy Treated Test formulation) was significantly increased by 17.6% (p≤0.01) and 16%, respectively as compared with the disease control group (G2). Brain-derived neurotrophic factor (BDNF) level in brain was increased by 5.2% in G7 group as compared with the G4. Prostaglandins D2 (PGD2) level was significantly (p≤0.001) increased by 12.7%, 18.1%, 23.7%, and 30.7% in the G6, G7, G8 (15 days pre-treatment of Biofield Energy Treated Test formulation to the Biofield Energy Treatment per se rats), and G9 (untreated test formulation to the Biofield Energy Treatment per se to the rats) groups, respectively as compared with the G2. The level of leptin after Biofield Energy Treatment and with the test formulation was altered. However, orexin-A level was significantly decreased by 37.1% (p≤0.05), 32.6%, 40.5% (p≤0.05), 44.4% (p≤0.05), and 28.2% in the G5, G6, G7, G8, and G9 groups respectively, as compared with the G2. Similarly, acetylcholine (Ach) level was significantly (p≤0.001) decreased by 42.5%, 49.2%, 40.1%, 47.9%, and 45% in the G5, G6, G7, G8, and G9 groups, respectively as compared with the G2. Overall, the results showed the significant slowdown the stress-related disease progression and its complications/symptoms in the preventive in the Biofield Energy Treatment group per se and/or Biofield Energy Treated Test formulation groups (viz. G6, G7, G8, and G9) comparatively with the disease group. The Trivedi Effect® showed increased level of melatonin and decreased levels of insomnia related brain biomarkers which might be helpful to induce better sleep in human.
Jan 2020
Jalal Al Mosawi AamirCorresponding author
Children Teaching Hospital, Baghdad Medical City, Bab Al Muadham, Baghdad, Iraq
A new dietary approach used to lower urea levels in chronic renal failure, and thus simulating dialysis has been recently described. This approach has been increasingly called intestinal or dietary dialysis. The aim of this paper is to describe the emerging evidence, principles, and concepts related to intestinal dialysis.
Oct 2019 DOI 10.14302/issn.2641-5518.jcci-19-3039
Sanikidze TamarCorresponding author
Tbilisi State Medical University, Tbilisi, Georgia
Chronic total occlusion (CTO) of the left main coronary artery (LMCA) is rare on the angiograms; Coronary Artery Bypass Grafting is the standard method of its revascularization. To demonstrate that PCI may in some cases be a safe option for patients with a high-risk surgical category, we report a complex clinical case of revascularization of chronic total occlusion of the LMCA, left anterior descending artery (LAD), and circumflex artery (CX). Methods Recanalization of the occluded LMCA and LAD was performed by utilizing the support-balloon technique, and CTO wires (Miracle 3™ wire, Abbott Vascular; Runthrough® NS Intermediate wire, Terumo); LAD, CX, LMCA, and its bifurcation, were stented with 3 drug-eluting stents (Resolute Integrity DES, Medtronic); the "Culotte Stenting " technique was used for bifurcation stenting, followed by "Kissing Balloon" post-dilatation technique; proximal optimization technique was performed in the LMCA. Results The intervention ended without complications. 2 months after stenting, the ejection fraction increased from 20% to 38%, improved almost all parameters of the heart, Congestive Heart Failure functional class decreased to class I. Conclusions It should be considered that LMCA CTO lesions can be successfully revascularized with PCI in case of the selection of the suitable patient and appropriate revascularization technique.
Sep 2019 DOI 10.14302/issn.2574-4488.jna-19-3008
Aydin ZekiCorresponding author
Darica Farabi Training and Research Hospital, Department of Nephrology, Kocaeli, Turkey
Introduction Hypertension is a major cardiovascular risk factor. There is a strong relationship between blood pressure (BP) elevation and stroke, myocardial infarction, heart failure and mortality due to kidney disease. It is known that the loss of the dipping pattern in hypertension is associated with increased target organ damage. In our study, we aimed to investigate the prevalence of dipper hypertension (DHT) and nondipper hypertension (NDHT) and related factors in patients with stage 1 and 2 chronic kidney disease (CKD). Materials and Methods A total of 158 patients diagnosed with stage 1 or stage 2 CKD were included in the study. Demographic characteristics, anthropometric measurements, physical examination findings and laboratory results of the patients were recorded. Ambulatory BP monitoring was performed in all patients. Results Of the 158 patients (female n: 98), 78 (49%) were in the stage 1 CKD group and 80 (51%) were in the stage 2 CKD group. No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The rate of NDHT was 59.5% (94/158 patients). Female patients had more DHT in the general population and in the stage 1 group than male patients (p=0.05, p=0.01, respectively). Conclusion No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The prevalence of DHT in female patients was significantly higher in both groups than in men in both groups, but especially in the stage 1 CKD group.
Aug 2019 DOI 10.14302/issn.2372-6601.jhor-19-2982
Padaro EssohanaCorresponding author
Hematology Department, Campus Teaching Hospital, University of Lome.
Objective Rosenthal's disease (RD) is a rare constitutional hemorrhagic disorder defined by factor XI deficiency. It is clinically characterized by the presence of minimal haemorrhage. We report the first observation of RD in Togo. Observation Mrs. G. A., 45 years old with no particular pathological antecedents, was referred for anemia in a context of chronic epistaxis. It was a spontaneous anterior exteriorization epistaxis often of great abundance, rocking and which evolved episodically. The patient received several transfusions for anemia. The ear-nose-throat examination was normal and a sinus CT scan found only an inflammatory process of the right maxillary sinus. The blood count showed microcytic severe anemia (2,2g/dl). Hemostasis tests showed a prolonged aPTT (57,9 seconds). Clinical examination documented an anemic syndrome with dry skin. Iron deficiency was found. The hemostasis balance confirmed aPTT elongation. Coagulation factors activity showed normal VIII and IX level, but moderate decrease of factor XI (32%). The family survey was not possible (orphan patient). It is recommended the setting under fresh frozen plasma (FFP) in case of a new episode. Follow-up is in progress. Conclusion In the event of any hemorrhagic syndrome, the isolated elongation of the aPTT must lead to a systematic analysis of intrinsic pathway factors
Jun 2019 DOI 10.14302/issn.2688-5328.ijp-19-2731
Wei XiangCorresponding author
Hospital of Suzhou University, Suzhou, China
The rise of epigenetics provides a new idea for studying the regulation of chronic pain-related genes and synaptic plasticity. External environmental stimuli can regulate BDNF genes through different epigenetic modifications. The epigenetic changes of the BDNF gene can affect the expression of its mRNA and protein and participate in the development of chronic pain. By reviewing the literature, this paper reviews the mechanism of epigenetic regulation of brain-derived neurotrophic factor (BDNF) in chronic pain, which provides some new directions and targets for the treatment of chronic pain.
Sep 2018 DOI 10.14302/issn.2641-9181.ijnr-18-2226
V.I.PetukhovCorresponding author
Vladimir State University, Vladimir, Russia
The authors analyze the results of atomic emission spectrometry of hair samples for Al, Cd, Fe, Cr, Cu, Li, Pb, V, and Zn in 952 healthy subjects and 952 liquidators of the Chernobyl nuclear power plant accident. Using correlation analysis (Pearson) of the obtained data, the authors have found pair correlations between metal concentration values. According to the authors, criticality or synchronization (as a particular case of the critical state of the system) can be inherent in all ATP-dependent membrane pumps (P-type) controlling metal-ligand homeostasis in epidermal cells. A quantitative criterion (synchronization index) is proposed to measure the level of criticality (synchronization) in the functioning of membrane ATPases.
Aug 2018
Sh. Badawy M.Corresponding author
Chest Department, Qena Faculty of medicine, South Valley University, Egypt
Background: Co-morbidities are associated with increasing risk of mortality, hospitalizations and costs of treatment in Chronic Obstructive Pulmonary Disease patients. Identification of Co- morbidities related to COPD phenotypes may guide individualized therapies and achieve better prognosis. Methods: A prospective study of one hundred ten patients of confirmed COPD diagnosis were carried out and divided into five different phenotypes with related co-morbidities. History taking, clinical examination, Chest X-ray, Computed chest Tomography, laboratory investigations, arterial blood gas, Echocardiography and Electrocardiography were done for all patients. St. George’s Respiratory Questionnaire, COPD assessment test (CAT score) and BODEx (BMI, FEV1, dyspnea and exacerbations) were used for assessment of disease impact on quality of life, severity, and exacerbation respectively. Results: Emphysema group were 31% among all cases with mean age 61.8±9.1, frequent exacerbator group and Chronic bronchitis phenotype were 18% with mean age 64.4±11.3, and 48.8±9 respectively. COPD with bronchiectasis group were 19% with mean age 60.3±6 and Asthma COPD Overlap Syndrome (ACOS) were 12% with mean age 62.8±15.8. There was significant difference as regards age between different group of phenotypes P- value <0.001. There was significance difference in BODEx index and in (CAT) score among different COPD phenotypes P-value 0.020, 0.001 respectively. There was significant difference in all items of SGRQ among different COPD phenotypes P–value 0.001. Diabetes was commonly presented in 50 % ACOS cases, Ischemic heart disease was present more in Emphysema 22.9%, Osteoporosis was more in COPD with bronchiectasis 28.6%, Cor-pulmonale was more present in frequent excerbator 65%, and Anemia more common in COPD with bronchiectasis 23.8%. Depression was more common in frequent excerbator phenotype (45.0 %). Gastro-esophageal reflux was the most common co-morbidities (58 %) then cor-pulmonale 41.8%, systemic hypertension 40 % and pulmonary hypertension 28%. Conclusion: The presence of significant co-morbidities is important modifying risk factors for severity in COPD. They contribute to the overall severity in individual patients, have a major impact on quality of life, and major causes of hospitalization. Co-morbidities can be associated with any clinical phenotype.
Dec 2017 DOI 10.14302/issn.2640-6403.jtrr-17-1818
Manuela BesserCorresponding author
University Witten/Herdecke, Centre for Biomedical Education and Research (ZBAF), Dpt. Of Translational Wound Research
If a wound progressively heals or the healing process is impaired is basically influenced by the surrounding milieu. This is reflected by the wound fluid. Its specific composition triggers the migration, proliferation and differentiation of dermal and epidermal cells which so far was not sufficiently examined in 2D cell culture models. The influence of the different wound entities was analyzed on a newly implemented three dimensional in-vitro model, which improved the transferability to the in-vivo situation. The influence of pooled wound fluids from patients suffering from acute or chronic wounds were investigated within a time period of 10 days after wound application. Histological and immunohistochemical analyses were performed addressing the impact of AWF and CWF on regeneration, such as cell proliferation, fibroblast activity and cell migration. AWF slightly stimulated fibroblast migration while CWF inhibited their activation and migration. The CXCR4- immunopositive population was continuously decreased compared to the control and AWF treatment. The expression of FAP was enhanced under AWF and medium. In keratinocytes CWF massively stimulated cell proliferation initiating on day six after injury. The presence of 10% CWF inhibited fibroblast activation and migration and induced the degradation of the collagen matrix. Keratinocytes were stimulated to proliferate, resulting in healing inhibiting hyperplasia. Transferred to human wounds, no effective wound closure would be achieved because of the de-regulation of pro-proliferative and migration-stimulating factors and a degraded extracellular matrix. This newly implemented 3D study model represents a novel appropriate in-vitro system for studying healing mechanisms and potential therapeutic applications.
Nov 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1787
Allison WilliamsCorresponding author
This paper discusses the challenges in recruiting a diverse sample of caregivers of older adults with multiple chronic conditions in two Canadian provinces – Ontario and Alberta, as well as the successful strategies to overcome these challenges. Four strategies were employed to overcome the recruitment challenges experienced. These included: (1) using a multi-pronged recruitment strategy with persistence; (2) knowing the location of the sample in the community; (3) weekly reporting by team members primarily responsible for recruitment and data collection, and; (4) regular team meetings to build on successful recruitment strategies while troubleshooting new approaches. These four strategies complemented one another. The most effective strategies in Alberta (recruiting over 50% of participants) were newspaper advertisements and working with the Alberta Caregivers Association and the Alzheimer Society of Alberta/NWT. In Ontario, the most effective strategy was door to door flyers (recruiting 61.5% of participants).
Nov 2017 DOI 10.14302/issn.2372-6601.jhor-17-1761
Lee Mortensen GitteCorresponding author
AnthroConsult, Fynsgade 24, 8000 Aarhus C, Denmark
With the introduction of tyrosine kinase inhibitors (TKI), patients with chronic myeloid leukemia (CML) have obtained survival rates close to normal. It may appear paradoxical, then, that medication adherence is suboptimal in some health care settings. As the first of its kind, this study aimed to explore drivers and barriers to TKI treatment adherence in Danish CML patients. A literature study informed the design of qualitative interviews with 20 patients, individually and in focus groups, focusing on their disease perceptions of CML, their health-related quality of life (QoL) and medication adherence. The study showed that many participants had previously switched treatment due to lacking efficacy or intolerance but most felt their current disease burden was tolerable. Anxiety might, however, resurface if treatment stopped working or with the occurrence of infections or side effects, creating a state of ‘fragile peace’. To these patients, their role functioning – as professionals, spouses, parents and grandparents – was crucial to uphold a positive self-image and meaningful life. Whether treatment enabled or hindered this was thus decisive to their QoL and medication adherence. Our participants expressed high adherence rates with only one having intentionally non-adhered due to side effects and poor QoL. Most participants felt well-informed about CML and treatment and privileged to receive specialised personal care from the public health care system acting to motivate their medication adherence. As a novel finding, this study indicates that the prospect of treatment-free remission may positively affect ‘adherence’ suggest this should be explored in future studies.
Sep 2017 DOI 10.14302/issn.2474-7785.jarh-17-1727
Akazawa ManabuCorresponding author
Public Health and Epidemiology, Meiji Pharmaceutical University
Background: Healthcare services provided to patients should vary depending on disease severity. However, disease severity bias, a type of selection bias, is a commonly encountered problem in administrative database studies. Herein, we selected chronic obstructive pulmonary disease (COPD), which commonly affects elderly Japanese citizens, for the development and validation of a severity classification system based on a health insurance claims database. Methods: Patients who received COPD-related diagnostic codes in 2011 were selected from a commercially based health insurance claims database. COPD patients were randomly divided into two groups to develop and validate severity scores. A principal component analysis was used to estimate factor loadings used to weight calculations of COPD severity scores. Score validity was evaluated using a linear trend test to predict COPD treatment costs and acute exacerbation events. Results: Using records from 880 patients, ten variables were created: acute exacerbation events, emphysema diagnoses, laboratory test and oxygen therapy procedures, prescribed anticholinergic, inhaled corticosteroid (ICS), short acting beta-agonist, and long acting bronchodilator (LABA) agents, asthma diagnosis and patient birth years. Factor loadings from LABA and ICS prescriptions had the strongest impacts on estimated severity scores (0.50 and 0.49, respectively). Among 300 validation group patients, scores were found to associate with increasing trends of median costs and exacerbation risks (p for trend < 0.05). Conclusions: Estimatedseverity scores would help to predict COPD-related medical costs and exacerbation events. For further clinical implementation, this classification system should be re-evaluated using clinical lung functions information indicative COPD severity and treatment choices.
Aug 2017 DOI 10.14302/issn.2578-2371.jslr-17-1669
Bagny AklessoCorresponding author
Departement of gastroenterology, University Teaching hospital Campus of Lomé
Aims: To describe the clinical, biological and evolutionary features of mono infected patients treated with tenofovir in Togo. Method: It is a descriptive, prospective study. Patients were treated with Tenofovir Disoproxil Fumarate (TDF). The inclusion criteria were: active chronic HBV (HBs Ag-positive for more than 6 months, high aminotransferases, the HBV –DNA ≥ 2000 IU / ml for HBeAg negative or ≥ 20 000 IU / ml for HBeAg positive and significant fibrosis) and absence of HCV, HDV, or co-infection HIV. Results: Among patients with HBV in our department, only 10.68% were treated with TDF. The mean age of patients was 33.01±9.81years. There was male predominance (68%). The circumstances of discovery were mainly during blood donation (65.3%) and a routine checkup (14.7%). Clinical examination was normal in most of cases (86.7%) apart from hepatomegaly (9.3%) and icterus (4%).) The HBeAg was negative in 89.3%; the average DNA was 7.56 ±8.01 log10 IU/ml. Abdominal ultrasonography was performed in all patients and we found hepatomegaly (18.67%), splenomegaly (10.67%), and ascites (5.3%). The assessment of fibrosis and activity had enabled to find a fibrosis higher or equal to 2 in 12 cases (48%) and an activity higher or equal to 2 in 9 cases (36%). The clinical and virologic outcome was marked by an undetectable viral load (HBV-DNA˂10 IU/l) in 89.3% of the patients after 1 year of treatment. Conclusion: TDF had helped to find out an undetectable viral load in in 89.3% of the patients after one year of treatment.
Aug 2017 DOI 10.14302/issn.2688-5328.ijp-17-1581
Gustorff B.Corresponding author
Department of Anesthesia, Intensive Care and Pain Medicine & Vienna Human Pain Research Group, Wilhelminenspital, Vienna, Austria, teaching hospital of the Medical University of Vienna
Background Capsaicin 8% patch reduces peripheral neuropathic pain. Based on the concept of neuropathic pain (NeP) in mixed low back pain (LBP) it is hypothesized, that an exclusively lumbar capsaicin 8% patch is an effective treatment of mixed LBP. The aim is a proof of this concept and to identify predictors of responsiveness. Methods This prospective stratified study included 54 chronic, mixed, LBP patients with spontaneous pain >3/10 on the NRS (0-10) and a painDETECT Questionnaire (PDQ) score >12 meaning possible or likely (>18) NeP. Pain intensity, PDQ, and quantitative sensory testing (QST) were assessed at baseline. After a one-hour capsaicin 8% treatment on the low back, follow-up was carried out regularly over three months. Response was determined at one month (≥30% pain reduction) and predictors were compared accordingly. Results The average change in pain intensity at week four was -1.1 (-0.50;-1.71, 95%CI, p < 0.001). Twenty-one (39%) patients responded at one month with a mean pain reduction of -3.1 (-4.0;-2.3, 95%CI) and even 10 of the 21 responders showed a ≥ 50% pain reduction. No pain reduction was seen in 33 (61%) patients (p = 0.42). Responders and non-responders did not differ at any baseline parameter: NRS (p = 0.85), PDQ score (p = 0.47), duration of pain (median of 48 and 36 months) nor QST profiles. Conclusions Lumbar capsaicin 8% patch is an effective treatment in about 40% of chronic patients with mixed neuropathic LBP. However, predictors for response could not be identified.
Jun 2017 DOI 10.14302/issn.2474-3585.jpmc-17-1506
Drenowatz ClemensCorresponding author
Department of Exercise Science, University of South Carolina, Columbia, SC 29208
Despite the generally accepted benefits of exercise on sleep there remains limited research on potential differential effects by exercise type. The purpose of the present study was to examine short-term and chronic effects of aerobic and resistance exercise on various sleep quality parameters, as well as sleep duration. Generally healthy, previously sedentary young (27±3 years) men completed a 16-week aerobic and 16-week resistance exercise program in random order separated by a minimum of 6 weeks with no formal exercise. Each exercise program consisted of three supervised exercise sessions per week. Quality and duration of sleep was determined with a multi-sensor device that was worn prior to, during week 1 and week 16 of each exercise program. A total of 8 participants provided valid data on time spent awake after sleep onset, sleep latency, total sleep time, sleep efficiency and time spent in bed for both exercise programs. During week 1, aerobic exercise was associated with a significant decline in sleep latency (-6.5±6.8 min) and time in bed (-39.2±42.2 min) while resistance exercise was associated with a decline in time spent awake after sleep onset (-21.6±16.7 min) and increased sleep efficiency (4.3±4.8 %). Effects were no longer significant after 16 weeks of exercise. These results indicate that aerobic and resistance exercise have beneficial effects on quality of sleep, particularly in the short-term, but the specific exercise-induced changes vary by exercise type.
Jun 2017 DOI 10.14302/issn.2576-9359.jot-17-1570
A. ForsbergCorresponding author
Institute of Health Sciences at Lund University, Sweden.
Chronic bodily pain after lung transplantation has received little attention. Therefore, the aim was to provide a multidimensional assessment of self-reported chronic pain 1-5 years after lung transplantation and its relationship with self-reported psychological general well-being (PGWB) and self-efficacy. This multicenter, cross-sectional study is a part of the Swedish national study: Self-management after thoracic transplantation (SMATT). In total, 117 lung transplant recipients, all white, due for their yearly follow-up at one (n=35), two (n=28), three (n=23), four (n=20) or five years (n=11) after transplantation were included. Of these, 113 reported their pain on the Pain-O-Meter (POM), which provides information about pain intensity, quality, location, and duration. In addition, they responded to the PGWB instrument and the Self-Efficacy instrument for managing chronic disease. The prevalence of pain was 51% after 1 year, 68 % after 2 years, 69.5 % after 3 years, 75 % after 4 years and 54.5 % after 5 years. Women experienced higher pain intensity and worse sensory and affective burden than men. Psychological general well-being was the main factor that contributed to the experience of pain. Better perceived psychological well-being lowered the odds for pain, while higher self-efficacy reduced the probability of experiencing pain. Many of the lung recipients lacked pain treatment and were uncertain about the reasons behind their pain. Chronic bodily pain is a common and serious symptom up to five years after lung transplantation. Female lung recipients experience more pain and pain related illness than men.
Apr 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1425
Damelan KombateCorresponding author
University of Lome (Togo)
Lemierre’s syndrome is rare jugular thrombosis associated with an oropharyngeal infection. The jugular thrombosis is from septic origin. This often happens in young males subjects. We described Lemierre’s syndrome in a 46 year-old man with a chronic ethmoidal sinusitis associated to the left jugular thrombosis extended to the transverse sinus with a partial recanalisation after three months of oral anticoagulant therapy.
Apr 2017 DOI 10.14302/issn.2474-3585.jpmc-17-1449
L. James WesleyCorresponding author
University of Memphis
Using proprietary data of patient records from four medical clinics in the Mississippi Delta, this research utilizes a natural experiment design to explore if the patient centered medical home (PCMH) has a positive effect on chronic disease maintenance for low SES, majority African-American patients in a rural and medically underserved region. The patients are divided into two cohorts, those attending PCMH clinics (level 2) and those attending non-PCMH clinics. Each cohort is comprised of similar demographic, socioeconomic, and health (large proportion of diabetics) characteristics. HbA1c scores of the cohorts are compared at two time periods, baseline and six-month follow-up. PCMH patients report more uncontrolled diabetes at baseline but the trend reverses at follow-up, providing evidence that the PCMH model of primary care produces positive health outcomes for patients with diabetes in the sample area.
Mar 2017
Vélez Ortiz DanielCorresponding author
School of Social Work, Michigan State University
The objective of this study was to examine differences between Latino and White older adults in attitudes toward suicide and physician-assisted suicide in chronic pain scenarios. We used a cross sectional study design at four outpatient care sites in San Antonio, Texas. The study sample included 204 subjects (106 Whites and 98 Latinos), 60 years of age and older, with Mini Mental State Examination scores of 24 or higher. No statistically significant between ethnic group differences in attitudes toward suicide or physician-assisted suicide in chronic pain scenarios were found. However, separate analyses by ethnic group showed that the factors associated with these attitudes differed between ethnic groups, with attitudes among Whites significantly and negatively associated with religiosity and those among Latinos significantly and positively associated with depression, while acculturation was significantly and negatively associated with attitudes toward physician-assisted suicide in chronic pain scenarios. This study’s findings suggest that depression and acculturation among Latino elders and religion among White elders are determinant factors of these attitudes in chronic pain, end-of-life scenarios. Further research is needed with more heterogeneous study samples, including Latino subgroups (e.g. Mexican Americans, Puerto Ricans, Cubans) and more diverse ethnic groups in terms of socioeconomic status and educational level characteristics.
Mar 2017 DOI 10.14302/issn.2476-1710.jdt-16-1262
Schoenfeld R.Corresponding author
Martin Luther University Halle-Wittenberg, Department of Psychology, Halle, Germany
Background. Emotional deterioration is frequently found in patients with chronic kidney disease, but some patients are affected by depressed mood without fulfilling the criteria of a depressive disorder. Those patients might rather suffer from an apathy symptom. Apathy as a symptom of a medical disease is accompanied by loss of motivation and interest, cognitive impairments, and emotional distress. Our study tested how groups of apathetic and depressed chronic kidney disease patients responded to a single haemodialysis session on measures of mood. Methods. 21 haemodialysis patients were assigned to subgroups (depressed, apathetic only, without depression and apathy) according to clinical relevant cut-offs. Sensitive questionnaires were administered to monitor mood state in general and mood changes before and after a single haemodialysis session in the chronic kidney disease patients. The results were compared to 20 age-matched healthy controls receiving no treatment. Results. Fortheen dialysis patients had eighter apathy or depressen and seven had neighter apathy nor depression. Mood state was seriously affected in all haemodialysis patients with depressed patients showing the largest effect compared to healthy controls. Patients with apathy and patients without apathy and depression were comparable in their mood state. We observed a positive mood change after the haemodialysis only in patients without apathy and depression. Their mood state improved significantly and reached nearly the level of healthy controls. Conclusions. The absence of a short-term mood change in apathetic dialysis patients makes them comparable to dialysis patients with depression. We argue that apathetic patients lack the probable mood brightening effect of the haemodialysis. The lack of emotional improvement by dialysis sessions could also lead to decreased adherence of the patients. Hence, apathy seems to be a serious symptom in chronic kidney disease that is worth to be considered at least in the diagnostic process. Accompanying psychotherapeutic care for these patients would be desirable
Dec 2016 DOI 10.14302/issn.2379-7835.ijn-16-1381
Kishan Gupta BalCorresponding author
Senior Professor, In-charge Medical ICU, Department. of Medicine, S.P.Medical College, Bikaner.
Introduction: Vitamin D deficiency has been reported highly prevalent in Chronic liver disease (CLD) and there is an emerging interest to explore the relationship of vitamin D deficiency and severity of various types of CLD. Aim: To evaluate vitamin D level in patients with various type of CLD and clinical significance of its deficiency. Materials and Methods: Serum vitamin D levels were measured by ELFA in 100 patients (91 male and 9 female) suffering from CLD. The degree of liver dysfunction was estimated by Child Pugh criteria and Model for End stage Liver Disease (MELD) score. Results: Prevalence of vitamin D deficiency and insufficiency were 43% and 42% respectively among CLD patients. Low levels of vitamin D were associated with leucopenia or leucocytosis indicating increased risk of infection. On Linear regression vitamin D level showed significant negative correlation with Child Pugh score (r = – 0.7382, p<0.0001) and MELD score (r = – 0.6673, p<0.0001). Our study shows low vitamin D level was associated with poor outcome (mean vitamin D level 10.38 ± 2.35 who died vs 23.14 ± 6.68 who survived and discharged). Conclusion: CLD is associated with a significantly low level of vitamin D which was independent to patient’s gender, BMI, residence and education level. The lower level of vitamin D is associated with severity of CLD, mortality and increased risk for infections. Awareness of serum vitamin D level in patients with CLD is important to improve outcome.
May 2016 DOI 10.14302/issn.2574-4488.jna-15-720
El Bardai GhitaCorresponding author
Nephrology department, Hassan II University Hospital, Fez, Morocco.
Introduction: Sonographic B-lines, also known as lung comets, have been shown to correlate with the presence of extravascular lung water. The aim of this study is to assess if chest ultrasound could detect lung water imbibition and its variations induced by dialysis, an experimental model of controlled rapid fluid loss. Methods: A cross-sectional study was conducted in a hemodialysis center in the city of Fez. Lung ultrasounds, impedance measurement, and ultrasound of the inferior vena cava were achieved 30-60 minutes before and after the hemodialysis session. Results: The values, measured by the different techniques used, decrease significantly after hemodialysis (p <0.001). The values studied before and after the hemodialysis, had shown a significant correlation between the results of the impedance measurement, lung ultrasound, and the maximum and minimum of the VCI index diameter and its collapsibility. The decrease in B-lines was correlated with weight decrease during dialysis (p0.005); none of the parameters concerning the IVC were correlated with fluid removal. Conclusion: ultrasound performed at the bedside is now emerging as a reliable, easy-to-apply, and safe method for measuring both lung water and intravascular overload and their decrease after dialysis even on asymptomatic patients. These observations strongly support the use of lung ultrasound in estimating volume overload and monitoring the response to therapy in hemodialysis patients.
Feb 2016 DOI 10.14302/issn.2572-5424.jgm-15-815
Abd Elhamid SamahCorresponding author
Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University*, Cairo, Egypt
Background: Polymorphonuclear leucocytes are the first line of defence against foreign invaders and constitute the major cell type involved in certain types of acute and chronic inflammatory diseases. Aim of the Work: The aim of the present study was to investigate the changes in expression of BCL-2 and BAK genes by real time PCR and to study whether they were involved in the accelerated neutrophil apoptosis which might be responsible for the recurrent bacterial infections seen in chronic renal disease and hemodialysis patients. Subjects and Methods: This study was conducted on sixty two subjects. Patients were selected from those admitted to Theodor Bilharz Research Institute (TBRI). Patients under study were classified into three groups; CKD patients (group I) kept on conservative treatment (22 cases), ESRD patients (group II) maintained on dialysis therapy, HD (20 cases). In addition, twenty healthy individuals served as a control group (group III) were involved. Results: There was significant increase in level of BAK gene in both patients' groups compared to control group with more increase in CKD group than ESRD group. Significant difference between the 3 groups was encountered with a higher expression level in CKD and ESRD groups than controls. There was decrease in level of BCL2 gene in both groups less than control group with more declines in ESRD group than CKD group. Conclusion: Bcl2 and Bak genes could have a role in survival and apoptosis of the studied groups and suggested their impact in controlling the inflammatory mechanisms and eventually their therapeutic potential.
Aug 2015 DOI 10.14302/issn.2372-6601.jhor-15-667
CL Jr CowanCorresponding author
Department of Ophthalmology, Washington, D.C. Veterans Administration Medical Center, Washington, D.C.
Trichomegaly is a known adverse effect with the epidermal growth factor receptor inhibitor (EGFRI) and prostaglandin analogue drug classes. We present a chronic Latanoprost user who developed symptomatic trichomegaly subsequent to initiating an EGFRI medication and believe this case offers evidence that the two classes of medications may cause a similar eyelash manifestation through different mechanisms.
Feb 2015 DOI 10.14302/issn.2379-7835.ijn-14-461
Acosta-Navarro JulioCorresponding author
Heart Institute (InCor), University of São Paulo, Medical School, Brazil
Objective: To investigate the association of meat consumption with self-reported chronic diseases (heart disease, hypertension, diabetes (type I or type II) and dyslipidemia), according to demographic, social and anthropometric variables. Methods: This was a cross sectional study, conducted at the Heart Institute, University of São Paulo, with 549 adults (≥ 18 years) who answered a questionnaire to select people for The CARVOS Study (Carotid Atherosclerosis, Aortic Stiffness and Risk Factors in Vegetarians and Omnivorous Subjects). The variables analyzed were: age, gender, education level, meat consumption, self-reported coronary heart disease, hypertension, diabetes (type I or type II) and dyslipidemia, smoking and body mass index (BMI) (kg/m2). Study subjects were classified as omnivorous (OMN=consumption of meat or fish four or more times/week) (n=228, 41.5 %), semi-vegetarians (SV=consumption of meat or fish 1-3 times/week) (n=97, 17.7%) and vegetarians (VEG=no consumption of meat or fish) (n=224, 40.8%). The differences between mean values was calculated by T-ANOVA test. To test the association between the variables, chi-square test and multiple logistic regression were used (p<0.05; CI = 95%). Results: There was a greater prevalence of smokers among OM than SV and VEG respectively 56.5%, 14% and 29.4 %, p=0.009, and a higher prevalence of overweight (41.7%) in OMN in comparison with SV (29.2%) and VEG (29.0%), p=0.008. Being OM significantly increased the risk of referring hypertension, regardless of sex and age (OR 2.19; CI 95% 1.08-4.46), and was also associated with dyslipidemia, regardless of body mass index, smoking, sex and age (OR 1.78; CI 95% 1.03-3.08). Conclusion: Higher meat consumption was associated with a greater prevalence of risk factors for hypertension and dyslipidemiachronic diseases.
Feb 2014 DOI 10.14302/issn.2372-6601.jhor-13-346
E. Clapham ChloeCorresponding author
Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
Targeting cell metabolism is a therapeutic approach which has been used for the treatment of cancers with high levels of proliferation. Inhibition of metabolic processes in cancer cells has shown synergy with current therapeutic options to reduce refractory disease and relapse. In contrast, chronic lymphocytic leukaemia (CLL) is a disease where expansion of the malignant clone results from a combination of enhanced cell survival coupled with low level proliferation. The purpose of this article is to highlight how further research is needed to determine whether targeting cell metabolism may be a viable therapeutic strategy in this disease. We discuss how lymphocyte doubling time (LDT) remains a robust prognostic indicator used in the current clinical management of CLL, and how recognition of CLL as a proliferative disease has led to a greater understanding of the importance of energy-generating processes in its pathobiology. We summarize what is currently known about normal B cell metabolism and consider whether there is evidence of the Warburg effect in CLL cells. Finally, we speculate on how CLL cells may exploit protective mechanisms such as autophagy during times of metabolic stress and how they might influence or be influenced by metabolic characteristics of the microenvironment.
Mar 2013 DOI 10.14302/issn.2329-9487.jhc-12-edt1
Sharma SanjivCorresponding author
Sanjiv Sharma, MD, FACC, FSCAI
A concise review of chronic atrial fibrillation covers mechanisms, stroke risk, and rate versus rhythm control. It highlights anticoagulation strategies and shared decision‑making to individualize therapy.
Feb 2026
Xing HuiCorresponding author
Keratinocytes are pivotal in mediating cutaneous inflammation. Identifying anti-inflammatory factors within these cells holds promise for developing novel therapeutic strategies to manage skin inflammation. Transcription factor EB (TFEB) has recently emerged as a key regulator linking cellular energy metabolism to inflammatory processes, primarily through its influence on autophagy and NF-κB signaling. However, whether TFEB activation exerts anti-inflammatory effects in keratinocytes remains unclear. In vitro inflammation model was established in HaCat cells by incubation with proinflammatory mediators LPS and IL-1β. Cell viability and TFEB expression and phosphorylation were measured. The effect of TFEB activation by C1 and adenoviral TFEB overexpression on the expression of proinflammatory genes including COX-2, MCP-1 and IL-6 were detected. Also, IκBα protein level were determined. TFEB phosphorylation is increased while TFEB total protein expression is inhibited by treatment with LPS and IL-1β. Pharmacological activation of TFEB by compound C1 and TFEB overexpression suppressed the expression of COX-2, MCP-1 and TNF-α induced by LPS and IL-1β. TFEB overexpression increased basal IκBα expression and restored IκBα level under LPS treatment. TFEB knockdown reduced TFEB expression and lowered basal expression level of COX-2, MCP-1 and TNF-α. Our findings indicate that TFEB activation can mitigate inflammatory gene expression in keratinocytes triggered by LPS and IL-1β. This implicates TFEB as a significant novel modulator of cutaneous inflammation, highlighting its potential as a therapeutic target. Targeting TFEB could thus be a viable strategy for developing new treatments for chronic inflammatory skin conditions.
Feb 2026 DOI 10.14302/issn.2689-4602.jes-25-5926
Easttom ChuckCorresponding author
The impact of ionizing radiation on genetic change is well established, yet the extent to which naturally occurring radiation fields have influenced evolutionary trajectories remains incompletely understood. This study examined correlations between microbial evolution and the radiation and geochemical environments associated with natural fission reactors, with emphasis on the Oklo–Bangombé system in present-day Gabon, Africa. The current paper compares plausible doserate regimes adjacent to reactor zones with published observations of radiationinduced phenotypes, geneexpression changes, and repair strategies in model organisms and complex biotas. This study further considers indirect mechanisms (e.g., water radiolysis, redox restructuring, tracemetal mobilization) by which natural reactors could have modulated ecological selection pressures over long timescales. The synthesis supports the plausibility of three interacting pathways: (i) increased mutation supply under low, chronic dose rates; (ii) selection in oxidantrich, redoxstratified niches; and (iii) metabolic subsidies (e.g., H₂) from radiolysis that support chemotrophic guilds. Although temporal–spatial associations exist between reactor activity and biological innovations preserved in Paleoproterozoic strata of Gabon, current evidence remains correlational rather than demonstrably causal. The study further outlines testable predictions and experimental designs capable of discriminating among these mechanisms.
Jan 2026 DOI 10.14302/issn.2640-6403.jtrr-25-5922
Kalmeta MargaretCorresponding author
Diabetic foot and leg ulcers represent a significant global health burden and are frequently associated with peripheral neuropathy, vascular compromise, infection, and high rates of recurrence and amputation. Standard wound care often fails to achieve healing in chronic cases due to unaddressed underlying neuropathic and vascular pathology. This feasibility study evaluated the Hemastyl™ System in patients with long-standing diabetic foot and leg ulcers that had failed standard care and, in many cases, had been diagnosed for amputation. Two prospective feasibility cohorts comprising 39 chronic infected diabetic wounds were treated with the Hemastyl™ System. Outcomes included rapid microbe reduction, high wound closure rates, subjective improvement in neuropathy-related symptoms, and avoidance of amputation in all amputation-diagnosed cases. These findings suggest that targeting neuropathy, vasculature, and microbial burden concurrently may offer a promising approach for healing complex chronic wounds in high-risk populations.
Jan 2026 DOI 10.14302/issn.2474-7785.jarh-25-5940
Marks RayCorresponding author
Lower limb osteoarthritis, a widespread age related chronic condition is often accompanied by an increased tendency to fall and thereby various degrees of intrinsic and extrinsic injury. Falls, in turn may provoke the disease alone and in turn a high falls risk and cycle of recurrent falls and heightened disability. This report which updates what is known about falls in the context of disabling osteoarthritis argues for a possible future ecological orientation rather than a focal uni dimensional approach to addressing this costly health problem. It examines osteoarthritis falls risk factors, falls injury prevention attempts, and recommendations to advance research and practice using an ecological analytic approach in this regard. Using the PUBMED data base and others, lower limb osteoarthritis linkages and falls interaction studies were sought and examined. The data revealed osteoarthritis can lead to the chances of incurring one or more falls and further health and disability challenges, while falling can provoke the onset of osteoarthritis in its own right. Although many factors appear to be involved, these are rarely viewed through a broad multi dimensional ecological perspective, thus are confusing or overwhelming to apply to the active community dwelling elderly subject.
Dec 2025 DOI 10.14302/issn.2574-612X.ijpr-25-5849
Yılmaz GülsümCorresponding author
Bipolar disorder is a chronic condition marked by episodes of mania and depression, significant functional impairment, and challenges with treatment adherence. Current guidelines highlight the importance of both medication and psychosocial approaches in treatment. This review explores the primary psychosocial interventions for bipolar disorder. Psychoeducation helps recognize early symptoms, improves medication compliance, and prevents relapses. It is simple to implement and cost-effective. Family-Focused Therapy (FFT) enhances family communication, reduces emotional expression, and lowers the frequency of depressive episodes. Interpersonal and Social Rhythm Therapy (IPSRT) supports maintaining social stability by addressing disturbances in biological rhythms. Cognitive Behavioral Therapy (CBT) decreases depressive symptoms and boosts treatment adherence by restructuring automatic thoughts. Additionally, cognitive and functional rehabilitation programs improve attention, memory, and executive functioning. Peer support groups and digital e-health tools, though supportive, have limited evidence of effectiveness. In summary, multicomponent psychosocial interventions serve as a valuable addition to medication, helping to prevent relapses, improve functioning, and enhance quality of life in individuals with bipolar disorder.
Dec 2025 DOI 10.14302/issn.2329-9487.jhc-25-5778
S Kallistratos ManolisCorresponding author
Calcium channel blockers (CCBs) are widely used for the treatment of arterial hypertension, but they differ in terms of pharmacology, tolerability, and pleiotropic actions. Lercanidipine, a highly lipophilic third generation dihydropyridine, reduces blood pressure (BP) effectively as monotherapy and in combination without inferiority to other major antihypertensive classes. We systematically searched PubMed and the Cochrane Library (last update: September 1, 2025) and screened reference lists for additional studies. Evidence from dose finding trials, randomized controlled studies, large observational cohorts, and meta analyses shows clinically meaningful reductions in office, home, and ambulatory BP with lercanidipine, including in patients with diabetes, obesity, chronic kidney disease, or high cardiovascular (CV) risk. Fixed- dose combinations with renin angiotensin system blockers (e.g., enalapril) provide greater BP reductions than monotherapy and are associated with favorable neurometabolic profiles. Beyond BP control, lercanidipine improves central hemodynamics and arterial stiffness, favors endothelial biology, and contributes to left ventricular hypertrophy regression. Across comparative trials, lercanidipine is generally better tolerated than older dihydropyridines. Presents lower rates of vasodilatory adverse events, less sympathetic activation, while discontinuations due to adverse events are uncommon. Overall, lercanidipine particularly within single pill combinations offers effective, durable BP lowering across diverse patient profiles with a favorable safety and tolerability profile and pleiotropic benefits that extend beyond BP reduction. Figure 1. Graphical Abstract: Pleiotropic effects of Lercanidipine
Nov 2025 DOI 10.14302/issn.2379-7835.ijn-24-5360
Alam RashedCorresponding author
Background Malnutrition is a significant public health issue in Bangladesh, particularly impacting women and children. Rajshahi, marked by socio-economic disparities, offers a distinctive context to explore the nutritional status and health outcomes of these vulnerable groups. Objectives This study aims to assess the nutritional status of women and children in Rajshahi and investigate associated health outcomes. Additionally, it seeks to identify socio-economic and cultural factors that influence nutrition. Methods A mixed-methods approach was utilized, incorporating a cross-sectional survey of 460 households and in-depth interviews with mothers and caregivers. Anthropometric measurements were taken to evaluate the nutritional status of women and children, while dietary assessments measured nutrient intake and diversity. Logistic regression analysis was performed to determine the likelihood of malnutrition based on socio-economic characteristics, thereby identifying key risk factors. Results The findings indicate a troubling prevalence of malnutrition, with 36% of children under five classified as stunted and 25% as underweight. The analysis highlights critical factors contributing to chronic undernutrition, including maternal education, employment, and dietary diversity. Notably, mothers aged 27-37 exhibit a lower risk of undernutrition, and urban households with secure food access demonstrate better nutritional outcomes. Discussion Maternal education and employment were positively associated with better nutritional outcomes, as educated and employed mothers had higher chances of maintaining a normal BMI. Regular ANC visits (≥4 visits) were crucial for improved maternal nutrition. Household food security emerged as a significant determinant, with food-secure households showing better maternal nutritional status. Safe water access and adequate dietary diversity were also linked to improved maternal BMI. Additionally, factors such as child birth weight, exclusive breastfeeding, and childhood diarrhea significantly influenced maternal nutrition. Moreover, frequent antenatal care visits and a diverse diet are vital in mitigating undernutrition risks among children. Conclusion This study emphasizes the urgent need for targeted interventions to combat malnutrition in Rajshahi. Recommendations include implementing community-based nutrition education programs and improving access to healthcare services. By addressing the socio-economic and cultural determinants of nutrition, stakeholders can enhance health outcomes for women and children in the region, ultimately contributing to broader public health objectives in Bangladesh.
Oct 2025 DOI 10.14302/issn.3070-3360.ijco-24-5294
Adhikari RameshwarCorresponding author
Ayurveda is a traditional and scholarly medical system practiced in South Asia since the Vedic period. It integrates science and philosophy to promote a healthy, happy and prosperous life. Ayurvedicbhasmas are classical formulations that contain non-toxic forms of metals and minerals, enriched with therapeutic metabolites. These bhasmas are produced through repeated trituration of metals and minerals with the extracts from potent Ayurvedic herbs, followed by intense heating at temperatures above 650 °C. The preparation process of bhasmas closely resemble top-down approach in nanoparticle synthesis, resulting in very fine calcined nano-powders. These powders are used effectively in Ayurvedic treatments for various ailments, particularly chronic diseases. Recent studies have highlighted that bhasmas possess antioxidant, anti-inflammatory, antibacterial, antiviral and antitumor properties and may serve as potential carriers for drug delivery. This paper aims to compare bhasma particles prepared by traditional and modern methods, explore the therapeutic benefits of different bhasmas, and investigate the nanomedicinal features of various Ayurvedicbhasmas.
Sep 2025 DOI 10.14302/issn.2768-0207.jbr-25-5706
Nakamura YusukeCorresponding author
Artificial Intelligence (AI) is emerging as a transformative force across many sectors, with healthcare representing both one of the most promising and most challenging areas of application. This review summarizes current and future applications of AI in healthcare, focusing on its potential to improve diagnosis, therapy, chronic disease management, and overall patient care, while also alleviating physicians’ workload. Recent literature demonstrates that AI systems can reduce diagnostic errors/delays by mitigating cognitive biases, support imaging and pathology through improved accuracy and speed, and prevent prescribing errors by integrating pharmacogenomic and clinical data into decision-support systems. In chronic disease management, AI-powered wearable devices enable continuous monitoring and early detection of conditions such as atrial fibrillation, thereby reducing the risk of stroke and long-term disability, particularly in elderly people. Therapeutic applications include AI-driven drug discovery, personalized oncology, and tailored medicine that integrates multi-omics and lifestyle data. Beyond direct medical intervention, AI contributes by automating routine tasks, optimizing workflows, and facilitating greater patient–clinician interaction. Despite these benefits, significant challenges remain, including issues of data quality, privacy, security, equity, and the need for transparency and trust in “black box” systems. Looking ahead, the integration of multimodal data, digital twins, and robotics is expected to advance more comprehensive, equitable, and human-centered care. We conclude that, when applied ethically and responsibly, AI should not replace clinicians but rather serve as a powerful partner that enhances medicine by restoring empathy and humanity.
Aug 2025 DOI 10.14302/issn.2379-8572.joa-25-5645
Beridze BerdiaCorresponding author
Purpose The objective of this prospective case-control study was to perform translation, cross-cultural adaptation, and validation of the sino-nasal outcome test 22 (SNOT-22) into the Georgian language. Methods The translation and validation of the SNOT -22 questionnaire was performed using the forward-backward translation technique. After proper translation, the translated questionnaire was completed by chronic rhinosinusitis (CRS) patients before and after functional endoscopic sinus surgery (FESS) and by healthy individuals as controls. Results SNOT22 was translated into the Georgian language; the pilot study involved 34 patients, the test–retest group consisted of 30 patients with CRS and the control group of 71 patients without CRS complaints; 34 patients were evaluated before surgery and 3 months after surgery. The results showed a good internal correlation with Cronbach’s alpha - 0.88 at the initial examination, and 0.93 at the retest examination; both values suggest good internal consistency within SNOT-22. Pearson’s correlation coefficient was 0.72 (p<0.001), revealing a good correlation between initial scores and retest scores. Our sample of healthy individuals had a median score of 10,11 points and the instrument was able to differentiate between the healthy and the patient group, demonstrating its validity (p<0.0001). Conclusions The Georgian version of the SNOT-22 questionnaire is a valid outcome measure for patients with CRS.
May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Al-saeed NawafCorresponding author
Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.
Feb 2025 DOI 10.14302/issn.2641-4538.jphi-25-5436
J Johnson RalphCorresponding author
High rates of workplace psychological stress and burnout have been chronic among Healthcare Practitioners. Research shows that Healthcare Practitioner psychological stress / burnout is related to poor quality of care and a high probability of making medical errors and mishaps resulting in harm to patients and even workers themselves. In response, relatively impactful programs have been developed to address Practitioner burnout. To derive a better understanding of the subject and inform best practices and policy regarding the problem and its fixes, this article reports findings from a novel study of a systematic (PRISMA-based) literature review of current (circa ~10 years <) literature reviews; or a distillation of reviews already at 100 proof then undergoing a further distillation into a review of 200 proof.* This study employed a grounded theoretic qualitative methodology to iteratively generate and enumerate descriptive themes from the study’s literature review articles. This article reports on what is currently known regarding the precipitants of Health Practitioner Burnout, Burnout itself, its relationship to Safety lapses and mishaps, and Programmatic Interventions (i.e., Fixes). The primary conclusion is that Health Practitioners are the foundation of healthcare organizations and key to quality care and management / leadership should be concerned for their wellbeing; and this article provides a general blueprint in terms of addressing burnout and safety. Study Limitations and Future research are also discussed.
Feb 2025 DOI 10.14302/issn.2641-4538.jphi-25-5420
Nagaraj NitashaCorresponding author
South Asian women in the United States face disproportionate health challenges, including higher rates of intimate partner violence as well as higher rates of Type 2 diabetes and gestational diabetes compared to other racial and ethnic groups. This cross-sectional study examines the association between intimate partner violence (psychological, physical, and sexual) and the diagnosis of gestational diabetes and type 2 diabetes. A web-based survey recruited 2,634 South Asian women in the U.S., collecting data on socio-demographics, intimate partner violence experiences, stress levels, and diabetes diagnosis. Logistic regression models adjusted for significant sociodemographic factors revealed that women with a history of intimate partner violence were 5.82 significantly more likely to report a type 2 diabetes diagnosis and 3.91 more likely to report a gestational diabetes diagnosis. Furthermore, stress as measured by the perceived stress scale, was also higher among women with intimate partner violence, potentially moderating the relationship between intimate partner violence and adverse health outcomes through cortisol dysregulation. Despite high levels of educational attainment and employment, the prevalence of intimate partner violence was alarmingly high (66.7%), highlighting its pervasive impact on socioeconomic strata. These findings underscore the urgent need for culturally tailored interventions addressing intimate partner violence and its health consequences within South Asian communities. Further research is warranted to elucidate causal pathways and inform integrated public health strategies to mitigate disparities in chronic disease and intimate partner violence-related health outcomes.
Jan 2025 DOI 10.14302/issn.2644-1101.jhp-24-5355
Abuelaish IzzeldinCorresponding author
This paper examines the concept of conflict- and war-related hatred as a multifaceted construct. Drawing upon various theoretical frameworks, we hypothesized that hatred in the context of conflict and war would encompass five distinct dimensions: Groupthink (Contagious Hatred), Destructiveness, Exposure, Chronicity, and Extreme-Severe Affect. To empirically validate this conceptual framework, we conducted a second-order factor analysis using data from 709 questionnaire responses collected from citizens in the Gaza Strip. The findings revealed that the optimal model comprises three primary constructs: Contagious Hatred, Chronicity, and Extreme- Severe Affect. Based on these results, we argue that collective existential threats in contexts of protracted conflict and war amplify groupthink, foster a sense of chronicity, and evoke intense negative affect. These findings underscore the complexity of hatred as a psychological and social phenomenon in conflict zones.
Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Kar SonaliCorresponding author
Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.
Dec 2024 DOI 10.14302/issn.2470-0436.jos-24-5322
Pestana Aguiar CatarinaCorresponding author
Studies show that individuals with limited health literacy skills experience worse health outcomes in a multitude of chronic diseases including glaucoma. These patients have poorer compliance, worse disease understanding and greater disease progression. The main purpose of our study was to evaluate the knowledge about glaucoma basic concepts in patients with this disease. A 24 question survey was given to patients followed by the glaucoma department, by phone or in person. Epidemiological data and personal therapeutic regimens were collected as well as data concerning the pathophysiology, treatment and prognosis of the disease. Survey responses were obtained from 79 patients with a mean age of 72 years old. Most of the patients had a low education level. The majority of patients could not enumerate glaucoma risk factors (74.5%), their glaucoma type (94.9%) or the best glaucoma definition (57%). However, they were able to relate the disease to a high IOP (75.9%) and the possibility of it leading to blindness (96.2%). We believe that patients, when observed in their glaucoma appointments, tend to retain information related to the prognosis and consequences of the disease and not focus on the understanding of its pathophysiology, causes and mechanisms, which may reflect their concern about their own future. However, this may lead to some misconceptions about the definition of glaucoma and specially about what can cause this disease. Some investment should be done to improve health literacy in the glaucoma population, with appropriate language and handed material.
Sep 2024 DOI 10.14302/issn.2474-7785.jarh-24-5212
R. von Schwarz ErnstCorresponding author
From an academic and clinical point of view, stem cell therapy represents one of the most promising advances in modern medicine, with the ability to partially induce the regeneration of acutely injured or chronically damaged tissues. Stem cell research provides new opportunities for the treatment of various conditions, among them diabetes mellitus, HIV, cardiovascular diseases, and neurodegenerative illnesses. Stem cell therapy is currently not FDA-approved in the US (except for certain blood cancers). While bioethics and religion have mostly discussed the source of cells, i.e., embryonic cells that require the destruction of embryos versus adult tissue for research purposes, we also discuss the controversies with regard to currently offered therapies, and marketing of unapproved procedures from a scientific, clinical, and religious viewpoint.
Jul 2024 DOI 10.14302/issn.2641-4538.jphi-24-5017
V K SashindranCorresponding author
Background Frailty is an ageing-associated state linked to poor prognostic outcomes. Chronic inflammation due to HIV-infection, AIDS-related infections. and the adverse effects of antiretroviral therapy (ART) all contribute to frailty in people living with HIV/AIDS (PLHA). Frailty has been comprehensively studied in populations comprising predominantly of Caucasian PLHA. However, there remains a dearth of such data in Indian populations, especially in younger PLHA. Methodology This cross-sectional study aimed to estimate the prevalence of frailty in PLHA (18 - 50 years) who had been on ART for 24-60 months and identify markers linked to frailty. Frailty was assessed in 152 subjects using the Fried frailty-index. Parameters measured included the mid-upper arm and calf circumferences, pain-severity (using the Brief Pain Inventory), highly-sensitivity C-reactive protein, d-dimer, and interleukin-6. Results The prevalence of frailty and pre-frailty were 6.58% and 23.02%, respectively. Reduced grip strength and self-reported exhaustion were associated with frailty (15.79% and 13.16%, respectively). Low calf-circumference and mid-upper arm circumference were not significantly associated with frailty/pre-frailty. The prevalence of pain was 21.7% and both pain severity and pain interference were significantly associated with frailty/pre-frailty. CD-4 counts at the time of assessment showed an inverse association with frailty. Elevated C-reactive protein (CRP of 0.04 associated with 0.49 probability of frailty (95% CI 0.40 – 0.59), CRP of 0.12 associated with 0.63 probability of frailty (95% CI 0.47 – 0.76)). D-dimer levels were not significantly associated with frailty /pre-frailty. Conclusion In this first-of-its-kind study on frailty in young PLHA (mean age 37 years) from the Indian sub-continent, the prevalence of frailty and pre-frailty was 6.58% and 23.02%, respectively. Multivariate analysis showed a strong association of frailty with pain severity, CD4 count at time of assessment, hs-CRP levels and duration of ART.
Jul 2024 DOI 10.14302/issn.2575-1212.jvhc-24-5146
C SteffenCorresponding author
Dietary intake of inorganic phosphates is linked to various adverse health effects. Excessive intake of highly soluble inorganic phosphates, which are used as feed and food additives, have been found to impair parameters of kidney health. As chronic kidney disease represents one of the most frequently occurring terminal diseases especially in cats, extensive knowledge regarding the safety of these additives is important. Other minerals, such as calcium, can modulate their effects on the phosphate homeostasis and kidney health. Therefore, it is crucial to examine further factors, such as the dietary cation-anion balance (CAB), resulting from the concentrations of major minerals in a diet. In this study, eleven healthy cats were fed a control diet and two diets with added sodium monophosphate (NaH2PO4) with either a low (-10 mmol/kg dry matter) or high (+450 mmol/kg dry matter) CAB for 28 days each. The serum concentrations of phosphate and parameters of phosphate homeostasis were determined in the fasting and postprandial blood samples next to the apparent digestibility and retention of phosphate and calcium. The diet with positive CAB led to an increase of serum phosphate and the phosphatonin FGF23, apparently digested phosphate, and phosphate retention. This is further proof that source and amount of phosphates in a diet are not the only determinants of the extent of potential adverse health effects. Until the interactions between inorganic phosphates and other dietary compounds are fully understood, recommendations regarding the safe use of phosphate containing additives in pet food are precarious.
Jul 2024 DOI 10.14302/issn.2470-5020.jnrt-24-5148
Marcelli VincenzoCorresponding author
Magnesium is essential for the proper functioning of all human cells and is involved in the regulation of neurotransmitter function and neurological function. Acute and chronic hypomagnesemia cause severe neurological symptoms such as neuromuscular irritability, myoclonus, stridor, dysphagia, mainly postural tremor and movement disorders along with vertical downbeat nystagmus. Here we report a case of cerebellar downbeat nystagmus syndrome induced by acute hypomagnesemia (HICS) due to very frequent vomiting in a 75-year-old woman with benign paroxysmal positional vertigo (BPPV). The clinical condition improved with daily intravenous and then oral magnesium supplementation. To our knowledge, this is the first described case of HICS induced by acute hypomagnesemia due to vomiting triggered by a benign peripheral pathology such as BPPV which was then successfully treated once the central syndrome was resolved.
May 2024 DOI 10.14302/issn.2379-7835.ijn-24-5111
Isea RaúlCorresponding author
The purpose of this work is to emphasize the possible benefits of a microRNA-based diet in reducing the negative effects of a number of diseases, such as cancer, diabetes mellitus, obesity, hypertension, chronic respiratory conditions, and others.
Apr 2024 DOI 10.14302/issn.2690-4721.ijcm-24-5030
S. Gunn* JohnCorresponding author
Typhoid fever, caused by the human restricted pathogen Salmonella Typhi, remains a major global public health concern. Even after successful treatment, approximately 3-5% of patients with typhoid fail to clear the bacteria within one year and become chronic carriers. Most typhoid carriers have gallstones in their gallbladder, and biofilm formation on gallstones is highly correlated with chronic carriage. This study’s goal was to identify asymptomatic typhoid carriers in an endemic setting in Kenya, and to compare acute versus chronic isolates. A cohort of typhoid fever patients identified through blood and/or stool culture, and their household contacts, were followed up after treatment to detect longitudinal S. Typhi stool shedding. An abdominal ultrasound scan was used to identify individuals with gallstones. A total of 32 index patients and 32 household contacts were successfully followed-up. Gallstones were detected in 4 cases and 1 household contact. The duration of S. Typhi shedding was significantly longer in individuals with gallstones compared to those without, P<0.001. Eighty-three (83) S. Typhi strains were tested for susceptibility to commonly used antimicrobials and examined by in vitro biofilm formation assays. Out of 37 infected individuals, 32.4% had infections caused by multidrug resistant (MDR) S. Typhi strains and only 18.9% were infected by susceptible strains. Non-MDR strains formed significantly better biofilms in vitro than the MDR strains (P<0.001). This study provides data on S. Typhi chronic carriage that will influence public health approaches aimed at reducing typhoid transmission and the burden of infection.
Feb 2024 DOI 10.14302/issn.2693-1176.ijgh-23-4879
Lin Shih-PingCorresponding author
Background Cancer and diabetes are risk factors for COVID-19 mortality rates. Remdesivir, dexamethasone, and vaccines are used to improve clinical outcomes. We aimed to evaluate the factors associated with COVID-19 mortality rates. Methods This retrospective study enrolled moderate to critical COVID-19 patients. The index day was the day of the COVID-19 diagnosis. Patients were followed up until either death or discharge. A two-way analysis of variance examined the interaction between independent mortality risk factors. Results A total of 205 patients were analyzed, and the mortality rate was 29.5% (n=60/205). The cumulative survival rate was significantly lower in patients with a CCI score ≥ 6, cancer, and diabetes. In multivariate analysis, critical illness, cancer, diabetes, chronic liver disease, a CCI score ≥ 6, unvaccinated, and early use of remdesivir/dexamethasone were independent risk factors for mortality. The onset of remdesivir/dexamethasone ≥ 2 days and < 3 doses of vaccinations were higher mortality rate, with its impact being more significant amongst patients with cancer/diabetes, compared to those without cancer/diabetes (p for interaction = 0.046/0.049, 0.060/0.042, and 0.038/0.048 respectively). Conclusions COVID-19 vaccination ≥ 3 doses and early administration of remdesivir and dexamethasone can significantly reduce mortality rates, particularly in patients with cancer or diabetes.
Jan 2024 DOI 10.14302/issn.2642-9241.jrd-23-4809
Kadiatou SamakeCorresponding author
Introduction People living with HIV (PLHIV) are susceptible to developing non- communicable chronic respiratory diseases. Our objective was to study the spirometric profile of this population. Material and methods This was a descriptive and analytical cross-sectional retro-prospective study conducted from March 15 to June 15, 2022 and relating to the analysis of the medical files of asymptomatic and eligible for spirometry PLHIV, aged 18 years and above. They were received in the voluntary counselling and testing (VCT) centres of one of the two pulmonology departments in Abidjan. Results The study involved 54 subjects including 22 men (40.7%) and 32 women (59.3%) with an average age of 48.9 years. The majority of patients were non-smokers (81.4%) and the main history was pulmonary tuberculosis (35.2%). Only 29.6% had chronic respiratory symptoms and 42.6% had a normal BMI. The frequency of spirometric abnormalities was 57.4%. These spirometric abnormalities included 40.7% peripheral obstructive pattern; 9.3% restrictive pattern; 3.7% asthma and 3.7% COPD. A more than 10 years duration of HIV infection (p=0.001 OR= 0.2 (0.1 – 0.7)) and a duration of ART of at least 10 years (p=0.001 OR= 0, 2 (0.1 – 0.7)) were significantly associated with the existence of ventilatory abnormalities. Conclusion The high frequency of ventilatory anomalies in PLHIV independently of the existence of chronic respiratory signs leads us to propose spirometry in the follow-up assessment of PLHIV while paying particular attention to those on ARVs for more than 10 years.
Jan 2024 DOI 10.14302/issn.2474-7785.jarh-24-4890
Marks RayCorresponding author
Knee joint osteoarthritis, a chronic condition resulting in considerable disability, particularly in later life, not only impacts life quality significantly and severely, but is also strongly associated with the persistence of intractable pain, depression, helplessness, and a high falls injury risk. This narrative overview synthesizes the knowledge base regarding painful knee osteoarthritis and what is known about Tai Chi exercise participation in the context of reducing knee joint disability and its associated risk of one or more injurious falls, as well as pain and depression. To this end, all relevant articles published in the English language on the topic were sought. While most reports rely on Eastern observations, rather than Western medicine studies, collectively, these data reveal that Tai Chi practiced widely in Asia for many centuries may have an enormous positive impact on reducing distress and increasing function and autonomy among older adults living in the community and diagnosed as having knee osteoarthritis. They specifically suggest the increasing numbers of older adults diagnosed as having knee osteoarthritis can safely practice selected Tai Chi exercises with the expectation that consistent applications will enhance mobility, reduce pain and depression, plus instability and possible injurious falls, while reducing fatigue, even if surgery is forthcoming.
Sep 2023 DOI 10.14302/issn.2574-4496.jtc-23-4722
J. Conway PatrickCorresponding author
Background Patients with distant metastatic Medullary Thyroid Carcinoma (MTC) have an estimated 40% ten-year survival rate. Gain of function mutations in the REarranged during Transfection or RET gene in MTC can result in an aggressive phenotype resistant to traditional therapy. In this case report, we describe the treatment of an MTC patient with a unique RET kinase deletion mutation. Case presentation Since diagnosis, 21 years ago, this patient has had chronically elevated calcitonin levels (>40,000 pg/mL) that was unable to be controlled by conventual therapy and clinical trials. As result of uncontrolled MTC, metastatic disease was found in the spine, liver, and lungs. Circulating tumor DNA (ctDNA) analysis identified a RET 898-901Del mutation, reported as a variant of unknown significance. The treating physician identified that the deletion was in the activation loop of RET kinase and considered that the mutation was constitutively activating RET kinase. The patient was prescribed Pralsetinib, a small molecule inhibitor targeting the ATP binding site of RET. Pralsetinib treatment achieved a durable response and was able to significantly decrease serum calcitonin levels (<200 pg/mL) and tumor size. Conclusion This RET deletion mutation is a pathogenic mutation with comparable enzymatic activity to the more common RET M918T mutation. The case report highlights the versatility of structural biologic approaches to guide therapeutic decisions.
Sep 2023 DOI 10.14302/issn.2576-9383.jhhr-23-4713
Bhoite RachanaCorresponding author
A global increase in incidence of chronic liver disease (CLD) indicated the necessity of dietary and lifestyle modification. Low glycemic index (GI) diet was reported to have a significant role in controlling diabetes caused by liver dysfunction. The International Standards Organisation (ISO) has standardized the determination of GI of a food in healthy individuals. This study aimed to estimate GI value of a high protein, energy dense liver nutritional supplement. This cross-over randomized controlled study randomly allotted 15 participants to consume either reference food 27.5 gm glucose (glucose monohydrate) or 77 gm nutritional supplement (equivalent to 25 gm of available carbohydrates); switching to another arm was done after 3 days wash-out period. After overnight fast, blood samples were collected at 15, 30, 45 and 60 minutes post-consumption of s upplement or reference food. The GI was calculated from the incremental area under the blood glucose response elicited by the nutritional supplement as a percentage of the response after consumption of 27.5 gm of glucose (glucose monohydrate) by the same participant using a standard formula. Mean GI of the nutritional supplementwas estimated as 11.4 ± 2.4.With the consumption of this nutritional supplement, the blood glucose levels were reduced at all postprandial time points, compared to the reference food. The liver nutritional supplement tested has a low GI, and comparatively slower and more sustained blood glucose response. Therefore, it can be used in patients with CLD to prevent CLD-associated metabolic complications and improve health outcomes and quality of life.
Sep 2023
Stenberg DanielCorresponding author
Groove pancreatitis (GP) is a rare type of segmental chronic pancreatitis that affects the anatomical area between the pancreatic head, the duodenum, and the common bile duct, referred to as the groove area. Most patients with groove pancreatitis are males aged 40–50 years with a history of alcohol abuse. The prevalence of this condition was not determined due to rarity of cases.The clinical symptoms commonly reported were weight loss, upper abdominal pain, postprandial vomiting, and nausea due to duodenal stenosis. It is considered difficult clinically and radiographically to distinguish this form of chronic pancreatitis from other differential diagnoses of inflammatory conditions or malignancies affecting the pancreas or adjacent structures to that groove area. We report a challenging case of GP in an asymptomatic female patient during routine gastric ulcer screening. Our objective is to draw attention to this rare and atypical type of chronic pancreatitis and the importance for early detection on screening EGDs prior to its symptomatic sequelae and complications.
Sep 2023 DOI 10.14302/issn.2381-862x.jwrh-23-4601
Ali Jemal SamrawitCorresponding author
Background The novel coronavirus COVID-19 has created massive challenges to public health worldwide. Pregnant women are an immune-depressed status which makes pregnant women generally more vulnerable to COVID-19 infection and severe illness. The present preventive measure practices have gaps. Therefore, the current study aimed to present accurate and latest information regarding preventive measures for COVID-19 infection among pregnant women. Methods and materials Institution-based cross-sectional study design was conducted on 422 pregnant women in public hospitals in Addis Ababa using a pretested structured questionnaire. Face-to-face interview on pretested and structured questions was conducted to collect the data between January 12 and February 15, 2022. The collected data were entered into Epi data version 4.4.2.2 and exported to SPSS window version 25 for analysis. Descriptive statics and multivariable logistic regression were analyzed. Odds ratio with a 95% confidence interval and p-value ≤ 0.05 were declared statistical significance independent variables. Result A total of 418 pregnant women participated, and the response rate was 99.05%. About 417 (99.8%) pregnant women reported never hearing about COVID-19. Of those who heard about COVID-19, only 49% and 54.3% had good knowledge and had good practice towards COVID-19 infection respectively. Age (26-30yrs (AOR=0.46, 95%CI: 0.014,0.12), no education (AOR=0.23, 95%CI: 0.099-0.52), Primary school (AOR=0.199, 95%CI: 0.104-0.4) and Secondary school (AOR=0.282, 95%CI: 0.14-0.55), divorced (AOR=0.15, 95%CI: 0.065-0.34) and widowed (AOR=0.16, 95%CI: 0.024-1.03)) were factors that associated with knowledge towards COVID-19 infection. Age (30-35yrs (AOR=0.334, 95%: 0.115-0.97) and >36yrs (AOR=0.28, 95%CI: 0.11-0.69)), no education (AOR=0.06, 95%CI: 0.019-0.18), being a civil servant (AOR= 0.28, 95%CI: 0.122-0.66), divorced (AOR=0.042, 95%CI: 0.01-0.18), having >4 family size (AOR=0.334, 95%CI: 0.169-0.66), no previous complication of pregnancy outcomes (AOR=0.019, 95%CI: 0.01-0.061), chronic health problem (AOR=14.66, 95%CI: 0.457-39.4) and two ANC visit (AOR=5.704, 95%CI: 2.41-13.5) were factors that associated with the practice towards COVID-19. Conclusion In this study area, only half of pregnant women had good knowledge and good practice about covid-19 infection prevention measures.
Jul 2023 DOI 10.14302/issn.2574-450X.jom-23-4654
Hodges StephanieCorresponding author
Background Nearly 40% of the adult population in the United States are considered obese by current standards, which equates to approximately 93 million people. Obesity is a chronic disease that is linked to more than 40 other diseases, including hypertension, heart disease, stroke, diabetes, and at least 13 distinct types of cancers. The direct and indirect costs of obesity have been estimated at up to $210 billion annually. Local Problem In Cumberland County, North Carolina, 34% of the adult population was considered obese. The aim of this quality improvement study was to increase effective care (screening, patient engagement, and referral to treatment) in adult patients with a BMI greater than 30 kg/m2 to 75% within 90 days. Methods A rapid cycle plan-do-study-act framework was used to evaluate four focus areas concurrently over 8 weeks with a small test of change completed in each 2-week cycle. Interventions An expanded screening with a checklist, shared decision-making tools (SDMTs), and a referral to treatment checklist were implemented. Activities from the team engagement plan were initiated. Results The effective care of patients increased by 42 percentage points while engaging both the patients and the staff. Conclusions Utilizing standardized communication, SDMTs, checklists, and management plans improved effective care while motivating and enabling patients to take control of their care and make sustainable lifestyle changes that enhance overall health.
Apr 2023 DOI 10.14302/issn.2576-9383.jhhr-22-4259
Bekele DamtewCorresponding author
Asthma is a chronic disease of airways; that is widely characterized by an increased responsiveness to a large variety of stimuli, airway inflammation and obstruction. It is the most common respiratory disorder disease in developed and developing countries. The study was aimed to assess the factors that contribute for the cause of asthma disease in Ambo town and cross-sectional survey was conducted to gather information from March to April 2022. 30 respondents were selected using purposive sampling technique for interview and data collections. According to the study the more affected age group were 22-32(53%) and the major risk factor for the disease was air pollution (53%). The pollution is due to domestic wastes that are discharged to the environment. Therefore, the government and extension health workers should aware the community about the risk factors of asthma and proper waste disposal mechanisms.
Mar 2023
Md. Shafat KarimCorresponding author
Moyamoya disease is a very rare chronic circulatory occlusive disorder of the blood vessels of the brain, in which patients complain of headache, seizure, weakness, and sometimes paralysis. A 5 years old female child with a complaint of headache and seizure was admitted elsewhere and during the treatment, she was diagnosed with Moyamoya disease. Further, she went to AIIMS Patna, where the neurosurgeon advised Digital Subtraction Angiography (DSA) and after the final diagnosis, they suggest the surgical intervention of the brain. During the search for an alternative treatment, they consulted my center for Unani treatment. We advised a semiliquid Unani polyherbal formulation containing Gule Banafsha (Viola odorata), Ustukhuddoos(Lavandula stoechas), and Nilofer (Nymphaea alba Linn) for three months. After the completion of the treatment schedule, she went for DSA again in Patna AIIMS and they find that there is no sign of occlusion in the blood vessels of the brain. The patient has no complaints and the report also showed that she gets improved.
Dec 2022 DOI 10.14302/issn.2576-9383.jhhr-22-4397
J Johnson RalphCorresponding author
Research PA-C/Research Coordinator, University of Texas MD Anderson Cancer Center
Despite vast improvements in chemo-therapeutic interventions extensively extending the life span of patients with chronic and terminal diseases, there also is the unhappy extension of side- effects and adverse events. Thus, Health-Related Quality of Life (HR-QoL) becomes equally as important as length of life. Accurately, reliably, validly, and representatively measuring the on-going pulse beat of HR-QoL means ensuring optimal responses and response rates, which in turn means fostering and maximizing Survey Participants’ continued rapport, enlistment, engagement, and participation regarding HR-QoL research survey studies. This is generally true regarding all human subjects’ research. HR-QoL survey work at a nationally renowned Cancer Center recently identified an example of Potlatch or gift-giving (i.e., gifting), and its surrounding nuances, that were calculated and appear to evoke enhanced reciprocal engagement in a HR-QoL survey. This work involves continuous, iterative marketing study. The intent of this field note is to describe the methodological phenomenon that may have epistemological and theoretical relevance for ubiquitously advancing the interest of health survey research. Specifically, the contention will be that considered, and tactically deployed Potlatch can serve as a mechanism for facilitating and enhancing health survey research as well as enhancing stronger social engagement in research and treatment for patients undergoing medical care for long-term, chronic illness. First, it can rejuvenate and refocus Survey Participants’ involvement. Second, it can serve as an entrée and springboard to further forge a social connection in the interest of research. Lessons Learned and implications are reported.
Nov 2022 DOI 10.14302/issn.2690-4721.ijcm-22-4341
Gwladys Gangoue LéaCorresponding author
Laboratoire de Biologie Cellulaire et Moléculaire (BCM), Faculté des Sciences et Techniques, Université Marien NGOUABI, BP 69 Brazzaville, Congo
Bacteria of the genus Staphylococcus are pathogenic Gram-positive bacteria responsible for various infections, including skin suppuration, which can be severe or chronic. The objective of this study was to confirm Staphylococci strain’s identification isolated by bacteriological methods from biological products of CHU-B patients, by molecular methods based on the analysis of the gene coding for 16S rRNA. In total, 30 strains of Staphylococci were isolated including 8 (26.66%) community strains, 22 (73.33%) hospital strains. The products of the amplification of gene fragments encoding 16S rRNA from 10 strains of Staphylococci including 6 strains of Staphylococcus aureus (S. aureus) and 4 Coagulase Negative Staphylococci (CNS) were sequenced. The sequences obtained were subjected to bioinformatics analysis to confirm the results of conventional bacteriological methods. Six (6) S. aureus strains, 2 Staphylococcus haemolyticus strains, 1 uncultured bacterium clone nbw618g09c1, and one Staphylococcus sp. have been identified. These results made it possible to confirm the effectiveness of the molecular method and to show the limits of traditional bacteriological methods in the complete identification of bacteria.
Aug 2022 DOI 10.14302/issn.2474-7785.jarh-22-4271
Marks RayCorresponding author
Department of Health and Behavior Studies, Columbia University, Teachers College New York, USA.
Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.
Jun 2022 DOI 10.14302/issn.2641-5518.jcci-22-4171
Dosoky Elayouty HamdyCorresponding author
Prof. of CT Surgery at Suez Canal University and Abo-Khalifa Emergency Hospitals; Ismailia; Egypt
Purpose Is it safe to excise only the external portion of the pacemaker wires? This presentation aims to find out the proper way to manage pacing wires postoperatively. Methods We report 5-cases of sub-xiphoid abscesses and sinuses after valve surgery. Each case presented with a recurrent abscess that opens and drains its contents through a sinus around the lower-most portion of the xiphoid process. The duration between open heart surgery and evolution of these abscesses varied between 18 and 60 months. Valve surgeries were mitral and/or aortic valve replacement. Surgeons usually insert pacemaker wires to control any persistent post-operative arrhythmias that can affect hemodynamic circulation. On the day of discharge, some surgeons (not in our center) usually excise the pacemaker wires. Results The remaining intra-thoracic portions underwent some degree of corrosion that caused a state of chronic inflammation, sinus track formation and abscess evolution. This indicated radiological examination and surgical exploration to extract these foreign bodies. These 5 cases were diagnosed and operated upon between 15th January 2022 and 1st March2022, all at Abo-Khalifa Emergency Hospital-Ismailia, Egypt. Conclusions This confirms the significance of total withdrawal of the external pacemaker wires. Surgeons should not apply tight sutures at the site of insertion of the wires.
Apr 2022 DOI 10.14302/issn.2372-6601.jhor-22-4133
Qing XinCorresponding author
Department of Pathology, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502, USA.
Background Monoclonal gammopathy of undetermined significance (MGUS) and chronic myeloid leukemia (CML) are diseases of different lineages. The diagnosis of both MGUS and CML in the same patient is a rare occurrence and has not been reported in much literature. Case Presentation We describe a 56-year-old man with a history of rheumatoid arthritis incidentally found to have an increase in IgA paraprotein. With less than 10% monoclonal plasma cells on the bone marrow biopsy and absence of hypercalcemia, renal failure, anemia and bone lesions, MGUS was diagnosed. The conventional cytogenetics at the time showed the presence of the Philadelphia chromosome in 30% of metaphases. However, there was no morphologic evidence of CML in the peripheral blood or bone marrow. Patient received no treatment and lost follow-up until 3 years later when a routine CBC showed leukocytosis and thrombocytosis. CML, chronic phase was diagnosed following a bone marrow aspiration and biopsy with Philadelphia chromosome observed in 100% of metaphases. Patient was treated with imatinib and later switched to dasatinib and complete molecular remission was continued to be achieved. Discussion and Conclusion Here we report a case of pre-leukemic CML as an incidental finding during the diagnosis of MGUS. The possible underlying mechanisms of the association are discussed although the exact cause of the coexistence is unclear.
Mar 2022 DOI 10.14302/issn.2641-5518.jcci-22-4096
Iñaki L. Garcia JulianCorresponding author
Gastroenterology Fellow, De La Salle University Medical Center
Introduction Benign duodenocolic fistula (DCF), also known as a non-malignant fistula between the duodenum and colon, with or without cecum-involvement, is an unusual complication of different gastrointestinal (GI) diseases 12. Case This is a case of a 28-year-old Filipino female who presented with periumbilical pain for five months, with associated anorexia, fever, and weight loss. Biopsy showed chronic granulomatous inflammation with caseation necrosis and Langhan’s type giant cells consistent with tuberculous etiology (Figure 6 and Figure 7). Category I Anti-TB treatment for six months was started and the service planned to repeat both colonoscopy and CT-scan after the initial round of anti-TB treatment. Conclusion Benign duodenocolic fistula in the form of extrapulmonary TB is a rare GI finding that is triggered by inflammatory processes. Proper management in this case was to treat the underlying TB infection which is endemic in the Philippines.
Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4117
Wu JianqingCorresponding author
Healthier World (Independent researcher for cause), P. O. Box 689, Beltsville, MD 20704. USA
Several mRNA vaccines are used on the population in the U.S. I started predicting the dangers of mRNA vaccines before March 2021 and update my findings periodically. My prior model study enabled me to identify many flaws in clinical trials, side-effect evaluation methods and mechanism studies, and I also considered consistent failure in predicting drug side effects in the past and systematic failure of FDA in keeping out dangerous drugs from market. I found that the risks of vaccination cannot be determined by experiments alone and must be determined by using a combination of methods. By studying mRNA expression dynamics and kinetics, I predict that vaccination with mRNA vaccines may increase cancer risks, multiple organ failure risks, earlier death risks, genome alteration speeds by one or more mechanisms, alter the normal selection process for viral evolution resulting in more virulent viruses, and aggravate chronic diseases or cause healed diseases to relapse. Two root problems are practical inability to control expression sites and severe adverse reactions from repeated vaccination. Based on mRNA bio-distribution, the mRNA mainly strikes the liver and other vital organs, and poses grave dangers to persons whose vascular functional reserves are relatively small, or whose vascular systems are temporarily burdened by other causes such as viral infections or life activities. If an mRNA vaccine is administered on a pregnant woman by second or booster shots, spike protein synthesis in fetus brain disrupts the highly regulated protein synthesis processes, resulting in potential brain damages. In less than a year, most of my early predicted damages are being materialized or are on the track to hit the population. In this update, I present a benefits-and-risks map to show how the number of deaths caused by mRNA vaccines is grossly underestimated and why claimed benefits like 95% effectiveness rate and 90% death rate reduction are meaningless and misleading.
Dec 2021 DOI 10.14302/issn.2692-1537.ijcv-21-4025
M. Quirit AllenCorresponding author
MD.
Introduction The COVID-19 pandemic continues to affect a large swath of the global population. The Philippine records four hundred seventy-four thousand sixty-four (474, 064) confirmed COVID 19 cases since December 31 2020. The COVID 19 pandemic recently highlighted the role of systemic hyperferritenemia as a major cause of death. In this study, we were able to correlate the serum ferritin level and predict 30 day in hospital mortality in COVID 19 pneumonia. Objective The aim of the study is to investigate the correlation between serum ferritin level and disease mortality in COVID19 pneumonia with subset analysis on demographics and co-morbidities of patients with COVID 19 pneumonia. Methodology We reviewed the records of all laboratory confirmed COVID 19 patients from World Citi Medical Center from April 2020 up to April 2021.A statistically significant sample size of seventy nine (79) admitted patients were used in this study. A serum ferritin level was assayed using electrochemilumenescence immunoassay with a Roche COBAS analyzer. Results Result showed that high ferritin level is associated with in hospital mortality. With ferritin level of 1437.07ng/ml, poor clinical outcome and in hospital mortality was considered. We also observed that demographics and co morbidities of patients in this study were significant to predict in hospital mortality. Further sub-analysis of co morbidities such as Hypertensive cardiovascular disease, Type 2 Diabetes Mellitus, Chronic kidney disease, Liver disease, Chronic obstructive pulmonary disease and Cerebrovascular disease showed poor outcome which were directly related to ferritin levels with p value of <0.0001. Conclusion This study has demonstrated that elevated ferritin levels were shown to correlate with 30 day in hospital mortality as well as medical comorbidities such as Hypertensive Cardiovascular disease, Type 2 Diabetes Mellitus, and chronic kidney disease have shown significant evidence for in hospital mortality.
Nov 2021 DOI 10.14302/issn.2471-2140.jaa-21-3996
Singh SushilaCorresponding author
Department of Chemistry, CCS Haryana Agricultural University, Hisar, Haryana, India.
Plants are an important source of medicines since ancient times. The traditional system medicine’s use a variety of native plants to diagnose, prevent, and eliminate acute and chronic diseases.Asparagus racemosus(Willd.), also have been widely used for medicinal purpose and its extensively distributed in the tropics and subtropics of India, commonly known as Satawar, belongs to the family Asparagus. The purpose of this was to identify the phytochemicals and to assess the antioxidant potential in aqueous extracts prepared at different pH levels of Satawar tubers. The maximum amount of phenolics and flavonoids content was present at pH 9 i.e.18.88mg GAE/g and 2.83mg CE/g. The total antioxidant capacity was highest at pH 2 (15.96mg AAE/g) and IC50 values of DPPH free radical scavenging activity was the lowest at pH 7, 2582.85µg/mL. According to the whole study, this plant is a very good source of phytochemicals and acts as a powerful antioxidant.
Oct 2021 DOI 10.14302/issn.2641-7669.ject-21-3970
Dias Toledo Arruda-Neto JoaoCorresponding author
Linear Accelerator Laboratory, Physics Institute, University of Sao Paulo, São Paulo-SP, Brazil
Microcystins (MCs) are toxins profusely synthesized by cyanobacteria, causing livestock poisonings and endangering human health. We design and execute an experiment to investigate the attenuation (degradation) of microcystins by exposing them to gamma radiation and electron beams at doses of 0 (control), 3, 5, 10 and 15 kGy. The experimental conditions simulate microcystin contamination of aquatic environments; we thus consider (1) microcystins inside whole cells and extracellular dissolved in water, simulated by non-sonicated and sonicated cells, respectively, and (2) two acute microcystin concentrations within water. Toxicity tests of Microcystis aeruginosa detected immobilization (i.e., paralysis) of Ceriodaphniasilvestrii exposed to aqueous crude extracts of irradiated and non-irradiated M. aeruginosa (NPLJ-4 strain) at concentrations of 45 and 90 mg.L-1 (mg dry weight of freeze-dried material), and the results were analyzed using the Trimmed Spearman-Karber statistical program to obtain 48-h EC50, the average effective concentration causing immobility in 50% of organisms after 48 hours. We conclude that electron beams are effective physical agents for toxin attenuation (degradation) and reach 100% effectiveness at 5 kGy and above; their efficiency is two orders of magnitude greater than that of gamma radiation. This new body of information contributes to (1) remediating environmental water sources; (2) designing water/wastewater treatment facilities; (3) combatting chronic microcystin environmental contamination; and (4) inspiring further studies to promote the use of biomonitors (e.g., Cladocerans) to detect and evaluate microalgae contamination.
Oct 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3966
Polyana Rocha Mendes MicheleCorresponding author
Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
The impact of the environment on the development of non-communicable chronic diseases has gained prominence in recent years. In this context, a new chemical exposure assessment strategy is needed that is capable of revealing multiple exposures, as well as reflecting the cumulative interaction between such environmental contaminants in the biological system. From this perspective, metabolomics emerges as a promising tool in this field of knowledge, since it is able to identify changes in metabolism and/or gene expression resulting from exposure to environmental factors. The aim of this study was to describe important concepts, as well as the steps that permeate the metabolomics analysis, and also to present some relevant works with the application of metabolomics in the assessment of chemical exposure. A literature review showed a significant increase in the use of metabolomics in environmental toxicology in recent years. This increase is mainly due to advances in analytical techniques and the improvement of data processing tools. However, this field of investigation remains little explored, especially with regard to the study of toxicity associated with chronic exposure to low levels of chemical agents. Thus, it is urgent that omic biomarkers can be used as a tool for decision-making, especially with a view to protecting, diagnosing and recovering human health.
Sep 2021 DOI 10.14302/issn.2693-1176.ijgh-21-3838
Kofi Gokah TheophilusCorresponding author
Cardiff University School of Social Science.
COVID-19 also known as Corona Virus is a new strain of Chronic Obstructive Pulmonary disease. While its virology is yet to be properly understood, its impact by way of human deaths is well registered. Stigma of infected persons is least mentioned as a ‘sub-strain’ that can push people into social isolation and exclusion (like in the book of Leviticus 13) leading to COVID-19 Related Depression (C-19RD). Using inter-disciplinary approach, this paper seeks to understand how this can happen in a COVID-stricken world.
Aug 2021 DOI 10.14302/issn.2578-2371.jslr-21-3912
Erkabu SamsonCorresponding author
Department of internal medicine, Ras Desta Damtew Memorial Hospital, Addis Ababa –Ethiopia
Background Liver disease has caused significant morbidity and mortality worldwide. Its epidemiologic and clinical pattern, however, is not well characterized in sub-Saharan countries. Objective This study aimed to describe demographic, clinical characteristics, and patterns of liver disease in a community hospital in Addis Ababa, Ethiopia. Method A retrospective hospital-based study was conducted on patients with liver disease admitted at Ras Desta Damtew memorial hospital, in Addis Ababa-Ethiopia, from February 2015 to April 2020. Result Of the total 212 patients majority, 78.8% were male, 49.1% of patients were in the age range of 31-50 with a median age of 42. The most common initial clinical presentation was ascites (87.7 %), and more than half of patients (56.6%) had a history of alcohol misuse documented on their medical charts. Chronic liver disease (cirrhosis) was found in 177 (83.5%), and Hepatocellular Cancer accounted for 7.5% of the patients. Alcohol misuse caused 45% of chronic Liver Disease, followed by Hepatitis B virus infection. Conclusion Chronic liver disease is the most common form of liver disease, and the most affected were middle-aged men. The common cause of chronic liver disease was alcohol followed by hepatitis B virus infection.
Aug 2021 DOI 10.14302/issn.2379-8572.joa-21-3913
Mohamed Bofares KhaledCorresponding author
Professor of otorhinolaryngology Omar Almoukhtar University, Elbyda, Libya
This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.
Feb 2021 DOI 10.14302/issn.2377-2549.jndc-21-3722
Jana SnehasisCorresponding author
Trivedi Science Research Laboratory Pvt. Ltd., Thane (W), Maharashtra, India.
Iron sulphate is used in the treatment of iron deficiency anaemia and other chronic disorders such as heart and kidney diseases. This study has the objective to analyze the impact of The Trivedi Effect®-Energy of Consciousness Healing Treatment on the physicochemical, spectroscopic and thermal properties of iron sulphate using various analytical techniques. In this, the test compound, i.e., iron sulphate was divided into two parts; one as control (without Biofield Energy Treatment), and the other as Biofield Energy Treated, which received the Biofield Energy Treatment remotely by the renowned Healer, Mr. Mahendra Kumar Trivedi. The PXRD analysis of the Biofield Energy Treated sample showed significant alterations in the range of -39.49 to 301.40% in the relative intensities, and from -15.40 to 33.36% in the crystallite sizes, compared with the control sample. The average crystallite size of the treated sample was also increased by 4.98% as compared to the control sample. The particle sizes in the treated sample at d10, d50, d90 and D(4,3) values were significantly increased by 67.12%, 47.72%, 33.18% and 42.01%, respectively; whereas, the specific surface area was significantly reduced by 38.39%, compared with the control sample. The TGA thermograms showed three steps of thermal degradation in which, the weight loss of Biofield Energy Treated sample in the first and second step was reduced by 5.82% and 16.09%, respectively, while, it was increased by 6.78% in the third step, compared to the control sample. The total weight loss in the treated sample was also reduced by 2.76%, along with slight alteration in the maximum thermal decomposition temperature, compared with the control sample. The DSC analysis showed the decrease in the melting temperatures of the 1st, 2nd and 4th peaks by 8.24%, 19.29%, and 0.61%, respectively, while 4.57% increase in the 3rd peak of the treated sample, compared with the control sample. The latent heat of fusion (ΔH) corresponding to the 1st, 2nd, 3rd and 4th peaks of the treated sample also showed alterations by -92.29, -86.29, 60.92, and 6.37%, respectively, compared with the control sample. The Trivedi Effect®-Consciousness Energy Healing Treatment might produce a novel polymorphic form of iron sulphate having increased crystallite and particle size along with enhanced thermal stability. It may help in improving the quality, safety and stability during the process of handling, storage, and shipment of the iron sulphate with better therapeutic response against iron deficiency anaemia.
Jan 2021
Vladimir Leonidovich MartynovCorresponding author
Doctor of Medical Sciences, Associate Professor, National Research Nizhny Novgorod State University named after N.I. Lobachevsky (UNN), Russia
The presence of numerous complaints of a gastroenterocolitic nature in patients with proven NBZ and CNDP and a sharp regression of these complaints after surgical correction of NBZ and CNDP allows us to conclude that the causes of these pathological manifestations are the failure of the Bauhinia valve and chronic violation of the duodenal patency, and the most adequate surgical aid for elimination of clinical manifestations of reflux disease is bauginoplasty with simultaneous duodenojejunostomy.
Jan 2021
Vladimir Leonidovich MartynovCorresponding author
Doctor of Medical Sciences, Associate Professor, National Research Nizhny Novgorod State University named after N.I. Lobachevsky (UNN), Russia
Annotation On the basis of 40 years of work on the treatment of 415 patients with gastroenterocolitis clinic, the author revealed the presence of refluxes due to anatomical defects of the Bauhinia valve (its failure) and the duodenum (chronic duodenal obstruction) at all levels of the gastrointestinal tract. After surgical correction of these anatomical breakdowns, the author states a significant improvement in all indicators of the state of both the digestive system and some extraintestinal manifestations, possibly the onset of precancer. The results obtained allowed the author to conclude that there are no "functional" disorders, this is only the level of our knowledge. Operations have been developed to correct the failure of the Bauhinia flap, intraoperative prevention of refluxes, and indications for methods of correcting chronic disorders of duodenal patency.
Jan 2021 DOI 10.14302/issn.2474-7785.jarh-21-3702
Marks RayCorresponding author
Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY 10027, USA.
Background Older adults with hip joint osteoarthritis, a major cause of chronic progressively disabling highly painful functional experiences, may require a surgical joint replacement procedure known as total joint arthroplasty surgery. Objective This review aimed to address the question of whether there an association between hip joint arthroplasty infection rates and prevailing pre or preoperative vitamin D levels that warrants consideration in efforts to prevent or minimize infection related hip arthroplasty complications among older adults particularly during the current ongoing COVID-19 pandemic. Methods PUBMED, SCOPUS, and WEB OF SCIENCE articles related to the topic and published between January 2016-2021 were searched, examined, and summarized. Results Older adults with hip joint osteoarthritis and low vitamin D serum levels who undergo total hip joint arthroplasty surgery may be at higher risk for post-operative infections than those with adequate vitamin D serum levels. Conclusion More research to verify whether efforts to screen for, and maximize vitamin D levels, before and after surgery, as indicated, may be helpful in the context of minimizing total hip joint arthroplasty surgery infection susceptibility and severity among older vitamin D deficient severely disabled hip osteoarthritis cases.
Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3682
Marks RayCorresponding author
Department of Health and Behavior Studies, Teachers College, Columbia University, NY 10027, United States
Background to the Issue Many older adults, including those already suffering from chronically painful disabling osteoarthritis of one or more joints remain more susceptible than healthy age and gender matched adults to the COVID-19 corona virus. Aims This report sought to examine what has been published in 2020 on this health condition from the perspective of the variable of widely imposed social isolation strategies designed to mitigate the spread of this highly infectious disease, and to especially keep older community dwelling adults ‘safe’ from infection. Methods Reviewed were all articles published in 2020 in PUBMED from January 1-December 24, 2020 on osteoarthritis and COVID-19 isolation impacts, plus relevant past osteoarthritis and isolation literature among older adults. The focus was on ascertaining how social isolation and distancing strategies might impact current community-dwelling adults diagnosed with osteoarthritis and whether more should be done specifically to mitigate any potentially preventable ‘socially’ induced negative health impact among this group, in spite of the laudable goals of this public health strategy. Results Older adults with osteoarthritis living in the community who are asked to self-isolate, may incur more osteoarthritis pain and disability than would otherwise be encountered if actions taken to counter this possibility are not forthcoming. Advocated over and above basic care approaches are several psychosocial strategies including the role of mobilizing various forms of social support. Conclusion Data indicate a need for concerted thoughtful and immediate attention to offset isolation, fear, and anxiety and depression effects as part of a carefully devised integrated plan of management to reduce excess osteoarthritis disability, as well as excess COVID-19 risk among otherwise free living older adults already compromised by osteoarthritis.
Dec 2020 DOI 10.14302/issn.2577-2279.ijha-20-3634
Oloruntoba Adekeye AdeshinaCorresponding author
Department of Anatomy, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
The hippocampus is involved in learning and memory processes, an integral component of cognitive function. The aim of this study is to assess the efficacy of quercetin on manganese-induced neurotoxicity in the hippocampus of the adult mice. In this study, 40 adult mice of average weight of 18 –29g were randomly distributed into five groups of eight each. The brain was harvested and the region of the hippocampus was grossed for histological and immunohistochemical analysis. The results revealed a significant increased level of oxidative stress markers of manganese treated mice when compared with the normal control and quercetin treated animals (p<0.05). Immunohistochemical analysis also showed a decrease expression of Tumour necrosis factor alpha (TNFα) with quercetin treated animals when compared with manganese treated animals indicating its neuroprotective function. In addition, quercetin treated animals all had an improved working spatial memory in Y-maze test. The histological results also revealed a degeneration of pyramidal cells with a characteristic pyknotic activities at the granular layer of the hippocampus leading to neuronal integrity damage following chronic exposure to manganese but normal architectural design was however maintained with quercetin. Conclusively, exposure to manganese in excess may have adverse effect on extensive neuronal degeneration that could affect the learning, memory and possibly spatial navigation ability of miceand quercetin attenuates this induced neurotoxicity via inhibition of oxidative stress and reduction of TNF expression.
Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3662
Marks RayCorresponding author
Department of Health and Behavior Studies, Teachers College, Columbia University, NY 10027, United States
Background Most current Corona virus or COVID-19 pandemic deaths have been found to occur among populations older than 65 years of age, who often suffer from the presence of an array of chronic diseases that may be related to a co-occurring vitamin D deficiency. Another factor affecting older adults’ immune response mechanisms is air quality. In turn, air quality can impact the absorption of vitamin D from sunlight sources, a factor which could explain why older people, who are often vitamin D deficient, may be more likely than younger adults or healthy adults to be at risk for COVID-19 and poor outcomes. Aim This work was designed to examine the recent literature on COVID-19, vitamin D and air pollution and what it might imply for public health workers, policy makers, and others. Methods Available data accessed largely from the PUBMED data base for the year 2020 using the key words COVID-19, air pollution, and vitamin D deficiency were sought and selected items were carefully examined and documented in narrative and tabular formats. Results Many publications on COVID-19 prevail, but far fewer focus specifically on vitamin D deficiency and its possible role in explaining COVID-19 global health risk among older adults. A similar, albeit small number of publications, discuss the global pandemics of air pollution and its possible COVID-19 association, as well as its impact on vitamin D production. However, while most related articles support a possible independent as well as a dual role for both factors in COVID-19 the realm of this highly infectious widespread disease, very few actual studies have been conducted to date on any of these topical issues Conclusion More research to examine if vitamin D-based nutrients or supplements may provide some degree of community wide protection against COVID-19 in the older vitamin D populations, especially among those living in highly polluted areas may prove highly valuable. Controlling air pollution emissions globally and locally may also prove to be a highly impactful public health approach to reducing overall COVID-19 risk, and extent, and warrants study.
Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3650
Marks RayCorresponding author
Department of Health and Behavior Studies, Teachers College, Columbia University, NY 10027, United States
Background The coronavirus Covid-19 strain that emerged in December 2019, continues to produce a widespread and seemingly intractable negative impact on health and longevity in all parts of the world, especially, among older adults, and those with chronic health conditions. Aim The first aim of this review article was to examine, summarize, synthesize, and report on the research base concerning the possible use of vitamin-D supplementation for reducing both Covid-19 risk and severity, especially among older adults at high risk for Covid-19 infections. A second was to provide directives for researchers or professionals who work or are likely to work in this realm in the future. Methods All English language relevant publications detailing the possible efficacy of vitamin D as an intervention strategy for minimizing Covid-19 infection risk published in 2020 were systematically sought. Key words used were: Vitamin D, Covid-19, and Coronavirus. Databases used were PubMed, Scopus, and Web of Science. All relevant articles were carefully examined and those meeting the review criteria were carefully read, and described in narrative form. Results Collectively, these data reveal vitamin D is a powerful steroid like compound that is required by the body to help many life affirming physiological functions, including immune processes, but its deficiency may seriously impact the health status and well being of the older adult and others. Since vitamin D is not manufactured by the body directly, ensuring those who are deficient in vitamin D may prove a helpful overall preventive measure as well as a helpful treatment measure among older adults at high risk for severe Covid-19 disease outcomes. Conclusions Older individuals with chronic health conditions, as well as healthy older adults at risk for vitamin D deficiency are likely to benefit physically as well as mentally, from efforts to foster adequate vitamin D levels. Geriatric clinicians can expect this form of intervention to reduce infection severity in the presence of Covid-19 infection, regardless of health status, and subject to careful study, researchers can make a highly notable impact in this regard.
Nov 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3501
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background A well-functioning drug supply management is the corner stone for any meaningful health service. However, Pharmaceutical supply systems in many developing countries have severe problems, including inefficient selection, procurement and use of drugs. The magnitude and extent of the problem is huge and chronic in the Ethiopian health care system for a long time. Objective To evaluate auditable pharmaceutical transaction service process in Seka primary hospital, Jimma zone south west Ethiopia. Evaluation Methodology Case study design involving both quantitative and qualitative methods was conducted in Seka primary hospital. The focus of this evaluation was on the process of Auditable pharmaceutical transaction service. The evaluation was focused on process part of the program with dimensions; availability, compliance and client satisfaction in the dimension of accommodation. Resource inventory, document review; key informant interviews and observations were conducted. Client satisfaction was assessed through exit interview; with sample size of 326. The qualitative data was analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 23 software. Results In Seka primary hospital, percentage availability of the 32 selected Key medicinewas 10.7(82.0%) and there were no expired drugs found on their shelves. The availability of 17 of the required 20(85%) professionals was adequate according the Auditable pharmaceutical transaction service. The average lead time was found to be less than five days. The average counselling and dispensing time were 5:43 minutes and 1:17 minutes, respectively. The average number of drugs per prescription was 2.0. The 1154(97.9%) of drugs prescribed by generic name and 1175(99.7%) of prescribed drugs on Essential Drug List indicates prescribers ‘adherence to facility specific List. Conclusion This evaluation revealed that (based on the pre-set judgment criteria) the achievement of the Auditable pharmaceutical transaction service in Seka primary Hospital was GOOD 82.6 % (achieved 355.2 of 430 weight given), i.e. even though it is Good achievement ,there are areas that needs improvement. Areas for improvement identified were: Pre- and in-service training for all health workers involved in store room and dispensary to improve on the medium counselling time, poor record keeping and the extremely poor labelingof drugs which this all improve the overall client satisfaction.
Sep 2020 DOI 10.14302/issn.2328-0182.japst-20-3526
Bekele AnbessaCorresponding author
Pharmacy School, Health Institute, Jimma University, Ethiopia
Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.
Sep 2020 DOI 10.14302/issn.2694-2283.jsem-20-3539
Tibebu AwokeCorresponding author
Lecturer, Department of Sport Science Debre Markos University, Debre Markos, Ethiopia
The following document provides important information that everybody know about physical exercise as a means of managing COVID-19. It addresses the health benefits of physical exercise on our body’s immune system, and stress reduction. Already today in the entire world, coronavirus is now the leading causes of morbidity and mortality. It kills thousands of peoples per day worldwide and continues its impact on the governments and the society. Nowadays it is the greatest public health problem in most countries in the world. Since its identification on Jan, 7 by the chines scientists named the pathogen as a novel coronavirus. In the current situation COVID-19 is rapidly spreading worldwide and the number of cases and deaths are rising up speedily. The spread of the virus is a headache to the government in general and the society in particular. The nature of the virus disallowed contacting with one another, working together, meeting, and other activities the majority of government and private business organizations are enforced to discontinue their work. The growing burden of the virus would place millions of jobs at risk an additional 8.8 million people in working poverty around the world. The danger of the disease and loss of employment leads the majority at stress. A chronically stressed person impairs the organism’s ability to mount a strong immune response with a resultant increase in morbidity and mortality.
Jul 2020 DOI 10.14302/issn.2377-2549.jndc-20-3413
M.A. Shihata AhmedCorresponding author
Forensic Medicine Authority, Chemical Lab, Egypt
Two analgesic were determined opium (morphine) and tramadol and comparison between two methods of extractions from biological samples. Opium and its derivatives and tramadol are the most commonly used medications for treatment of acute and chronic pain. opium was used as a sedative and hypnotic, but it was determined to be addictive and tramadol prescribed narcotic analgesic; main metabolite of opium is morphine and tramadol overdose was reported old male 40 years. Morphine and tramadol isolated by two methods of extraction, Stas Otto and ammonium sulfate extraction from liver tissues and comparison between efficiency of the two methods. Liver extractions have morphine and tramadol was quantified by GC-MS. Morphine was determined in liver concentration 176 u/g in Stas Otto. Liver concentration of morphine 267 u/g in ammonium sulfate extraction. Tramadol was determined in liver concentration 26.18 u/g in Stas Otto. Liver concentration of tramadol 22.41 u/g in ammonium sulfate extraction.
Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3448
Dani CarolineCorresponding author
Laboratório de Bioquímica, Centro Universitário Metodista – IPA, Porto Alegre/ RS, Brazil.
The aim of this study was to determine the influence of chronic supplementation with grape juice (400ml), in modulating the anthropometric and biochemical parameters. Thirty-nine seniors participated and were evaluated at baseline after 30 days. The chronic consumption of grape juice reduced weight, BMI and waist circumference. Indeed, the consumption modulated biochemical parameters, decreased the total cholesterol levels, Low-density lipoprotein (LDL) cholesterol, Urea and GGT. In addition, the intake of juice improved the performance in the TUG test, and caused more stability in the elderly. The levels of protein oxidation declined and the antioxidant potential significantly increased as well as SOD and the ratio SOD / CAT. In contrast, levels reduced sulfhydryl groups to consumption. In nuclear changes there are a decrease in the frequency of MN and picnosis. In conclusion, grape juice could be an excellent option to improve quality of life in elderly.
Jun 2020 DOI 10.14302/issn.2688-5328.ijp-20-3386
Pruneti CarloCorresponding author
Dept. of Medicine and Surgery, Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., University of Parma, Italy.
How to define pain? One of the most accredited definition is certainly “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage" (IASP (International Association for the Study of Pain - 1986) and World Health Organization (WHO) 1. However, what are the essential components of pain experience? Certainly many factors are involved such as, among others: Perceptual ability / suitability / subjective threshold; The "subjective" experience; Multidimensionality; Occasionally or chronicity. All these components have to be taken into consideration in the treatment of these disorders which, very often, require a multidisciplinary approach. From a clinical psychological point of view, much can also be offered at a diagnostic level, from the reception to listening to the patient's suffering, to the evaluation with standardized tests and psychophysiological analysis procedures in order to arrive at an effective personalization of treatments
May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3335
Luis Turabian JoseCorresponding author
Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain
The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.
May 2020 DOI 10.14302/issn.2642-3146.jec-20-3359
K.G. Palmer WilliamCorresponding author
Independent Researcher, TRI-LEA-EM, 76 Sideroad 33-34, RR 5, Paisley, ON N0G 2N0, Canada.
For 5 years, since the start-up of an array of 140 wind turbines, residents have filed complaints with the Ontario Ministry of the Environment (the regulator), and K2 Wind (the operator). Residents complained that the turbines produce a tonal sound, and that the irritation this produced impacted their sleep, their health, and the enjoyment of their property. To confirm tonality from the wind turbines, this research examined over 200 data examples from two families. These families collected data by two independent methods, a continuously recording system, and by making selected audio recordings. The recorded data was correlated with the wind turbine operational performance, and local weather conditions. The correlated data was analyzed for tonality using international standard evaluation methods. The analysis confirmed over 84% correlation between complaints of irritating conditions, and tonality from 5 dB to over 20 dB. Finally, the results showed that the assumption of the regulator to only require assessment of compliance when the resident was downwind of the nearest wind turbine was incorrect. Most complaints arose from other wind directions. Neither was the regulator’s assumption correct that curtailing the wind turbine operation to continue operating at only partially reduced outputs would give remediation. The research concludes that tonality arises consistent with the wind turbine operation, identifying a critical need to revise the practices to prevent chronic irritation. In the original issuance of this paper, the author inadvertently erred by stating that there was a difference between the method for assessing wind turbine tonality of an expert group panel and the method now prescribed by regulations. That statement was incorrect, and the author apologizes for the error and for any confusion it may have caused. The error, miscalculations resulting from the error, where necessary conclusions drawn from erroneous calculations are corrected.
May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3355
Kader Mohiuddin AbdulCorresponding author
Secretary and Treasurer, Dr. M. Nasirullah Memorial Trust, Tejgaon, Dhaka 1215, Bangladesh
Telemedicine and telehealth technologies are especially effective during epidemic outbreaks, when health authorities recommend implementing social distance systems. Currently, coronavirus COVID-19 has affected 210 countries around the world, killed more than 200,000 and infected more than 3 million, according to worldometer, April 26, 2020. Home-care is especially important in these situations because hospitals are not seemingly safe during pandemic outbreaks. Also, the chance to get out of the home during the lockdown period is limited. Telephone-based measures improve efficiency by linking appropriate information and feedback. It can also help provide education at distance on various health issues and topics. In addition to increasing access to healthcare, telemedicine is a fruitful and proactive way to provide a variety of benefits to patients seeking healthcare; diagnose and monitor critical and chronic health conditions; improve healthcare quality and reduce costs. The article reveals scope of pharmacy professionals in telemedicine sector during epidemic outbreaks.
Apr 2020 DOI 10.14302/issn.2832-4048.jsm-20-3211
Papaconstantinou JohnCorresponding author
The Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston Texas 77555-0643
Aging mammalian skeletal muscle satellite cells (MuSCs) undergo a decline of stem cell/progenitor cell proliferative and regenerative capacity, and the development of a physiological milieu characteristic of a state of chronic sterile inflammation. p38αMAPK and ERK1/2 are two major signaling pathways that regulate the age-associated decline of MuSC proliferative capacity. In this review we propose the following mechanism that links the p38αMAPK pathway to the decline of self-renewal and regenerative capacity of aged MuSCs: a) the HS-FGF-2-FGFR1-p38αMAPK-Axis, a tightly linked homeostatic signaling complex, is in synchrony with the autoinhibition of FGFR1; b) autoinhibition contributes to the Axis’ regulation of the homeostasis of P-p38αMAPK activity in juvenile MuSC; c) this combination of protein-protein interactions is characteristic of a juvenile cytoplasmic milieu of beneficial P-p38αMAPK activity and d) includes Sprouty1 inhibition that supports the stimulation of FGF-2 --> miR-29a; e) the miR29a dismantles the basement membrane in preparation for the initiation of replication; f) an age-associated impaired, dysregulated, over-sulfated heparan sulfate ligand (HS)-FGF-2 fails to activate FGFR1 in aged MuSCs; g) this uncouples its regulation of p38αMAPK and ERK1/2 pathways and results in desensitization of FGFR1; h) desensitization of FGFR1 and Sprouty1 interaction in aged MuSC uncouples their regulation of P-p38αMAPK in the aged MuSCs; i) this enables a state of chronic sterile inflammation to promote and sustain an increased level of P-p38αMAPK activity; and, j) the increased activity of P-p38αMAPK in aged MuSC stimulates the production of cell cycle inhibitors, miR-1 and miR-133, thereby attenuating the expression of the cell cycle regulators, SP1 and cyclin D1, resulting in a G1/S arrest; j) the increased level of p38αMAPK activity promotes the apoptosis of the aged activated MuSCs. This mechanism involves the synergistic interactions of HS-FGF2-FGFR-1, Sprouty (spry1), miR-1, miR-133 and miR-29a that unify the extracellular niche and intracellular milieu for the juvenile vs age-associated regulation of proliferative capacity of the MuSC. Our hypothesis unifies these interactions with the role of the extracellular niche and intracellular milieu in the stimulation of juvenile proliferation vs age-associated decline of skeletal muscle satellite cell self-renewal and regenerative proliferation. Word Count = 344