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Jun 2026 DOI 10.14302/issn.2474-7785.jarh-26-6358
Hip fractures, which remain an immense public health concern, have been subject to study and prevention efforts for many decades, but with limited success in averting either incident, second or subsequent hip fractures, commonly attributed to a combination of age related proclivity to fall, low bone and muscle mass. This review examines second hip fracture incidence rates and determinants of this serious functionally debilitating injury as observed over time remains a current 2026 public health concern. It specifically explores if more preventive efforts are currently warranted in this regard, and in what respect, if indeed, more frail older adults are living longer, but may be in excessively poor health, fearful of moving or falling, malnourished, weak with poor balance, or depressed. Based on what is published, it is concluded 1) second hip fracture incidence rates remain considerable, especially among those who are frail with osteoporotic bone disease, poor vision, heart/or cognitive conditions, plus those with muscle deficits of the lower limb, live alone and have a falls history; 2) studies to identify possible mitigation approaches appear promising in this regard, along with more routine efforts to minimize falls risk and bone attrition.
Feb 2026 DOI 10.14302/issn.2576-6694.jbbs-26-5964
The combination of ultrasonography (US) and cone beam computed tomography (CBCT) has been proposed as a multimodal imaging strategy capable of uniting realtime softtissue assessment with highresolution threedimensional visualization of osseous structures. This study critically evaluated whether such integration provides measurable diagnostic or workflow advantages in mandibular imaging. Despite strong theoretical justification, the combined use of US and CBCT failed to demonstrate clinically meaningful improvements in diagnostic accuracy, confidence, or efficiency when compared with CBCT alone. Fundamental physical mismatches, hardware incompatibilities, geometric constraints, and operatordependent variability limited the anticipated synergistic benefits. These negative findings underscore the importance of reporting unsuccessful integration attempts to guide future research and prevent premature clinical adoption of technically incompatible imaging paradigms.
Nov 2025 DOI 10.14302/issn.2470-0436.jos-25-5503
Purpose Create a new diagnostic and therapeutic framework for patients with Exudative Age-Related Macular Degeneration (ARMD) and choroid imaging biomarkers of non-neovascular choroidal pathology who have persistent neovascular exudation during the course of monotherapeutic interventions. Methods Retrospective, longitudinal case series study of 25 eyes from 23 patients with the referral diagnoses of treatment resistant Exudative ARMD who had persistent neovascular exudation despite various monotherapies. Inclusion criteria required choroidal imaging biomarkers of non-neovascular pathology including a thickened subfoveal choroid (greater than 300 microns) and vessels (subjectively dilated choroidal vessels in Haller’s layer) on Optical Coherent Tomography (OCT), choroidal neovascularization on IVFA and OCT Angiography (OCTA), as well choroidal leakage noted on indocynanine green videoangiography (ICG). Treatment consisted of OCTA and ICG - Directed Photodynamic Therapy (PDT) Triple Therapy, hereafter described as Combination Therapy, to areas of choroidal hyperpermeability and choroidal neovascularization. Combination therapy consisted of an anti-Vascular Endothelial Growth Factor (VEGF) intravitreal injection on Day 0 followed by half-fluence PDT and 2 mg intravitreal triamcinolone acetonide on Day 3-14. Results All study patients had treatment resistant Exudative ARMD defined as persistent subretinal and/or intraretinal fluid during their course of monotherapeutic interventions. Complete resolution of all exudation occurred in 23 eyes (92.0%) at 8 weeks. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. The mean vision at baseline was 0.46 ± 0.42 LogMAR, best corrected visual acuity (BCVA). 8 weeks after treatment, the vision was 0.35 ± 0.38 LogMar, an improvement of over one line, and this was maintained at one year. The baseline central subfield thickness (CST) was 296.4 ± 136.1 microns and improved by 111.4 ± 105.4 microns at 8 weeks after treatment. Treatment duration was negatively associated with the Caucasian race. Conclusions Patients with subretinal and/or intraretinal fluid secondary to Exudative ARMD should have a complete baseline multimodality imaging study to confirm the presence of neovascularization and whether choroidal hyperpermeability coexists. This study shows that patients with Exudative ARMD and persistent neovascular exudation despite monotherapuetic interventions often have choroidal biomarkers of non-neovascular choroidal pathology and that ICG and OCTA-directed PDT Triple Therapy resulted in complete resolution of all exudation in 92.0% of patients at 8 weeks with a reduction in central subfield thickness (CST) of 111.4 microns. The vision improvement at 8 weeks was 0.11 ± 0.38 LogMar and was sustained over 1 year. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. Additionally, this study shows that the treatment that addresses both pathological processes is successful and should be considered as a primary protocol when the biomarkers are present at baseline or as a secondary protocol if indeed the neovascular leakage is persistent despite monotherapy. Summary Patients with an Exudative ARMD with persistent neovascular exudation despite anti-VEGF monotherapy and who have imaging biomarkers of non-neovascular choroidal pathology often have two pathophysiological processes: choroidal hyperpermeability and angiogenesis. A proposed framework provides the rationale for OCTA and ICG-directed PDT Triple Therapy which successfully resolves 92% of the leakage that was persistent after various monotherapeutics.
Jun 2024 DOI 10.14302/issn.2474-7785.jarh-24-5141
Efforts to mitigate or prevent painful disabling osteoarthritis have been pursued for more than a century with limited success. This current overview briefly summarizes how selected beliefs and behaviors, including coping and stress management approaches are potential mediators or moderators of osteoarthritis pain and its overall common adverse prognosis and outcome. Published data housed predominantly in PUBMED, PUBMED CENTRAL, SCIENCE DIRECT, and GOOGLE SCHOLAR sites and pertaining to selected aspects of the literature of current interest, cumulative results reported as of May 30, 2024, show a modest to strong rationale exists for considering the abovementioned factors in efforts to reduce pain and enable daily functions. Accordingly this line of research should be continued, and translated clinically without undue delay, especially in the face of increases in the aging population and osteoarthritis prevalence and undue suffering.
Feb 2024 DOI 10.14302/issn.2474-7785.jarh-24-4967
This editorial aims to propose and delineate that disciplined open-air exercise can slow down aging in humans. The aging process may be slowed down by outdoor physical training (e.g., mountaineering, climbing, running, swimming, walking, jogging) mainly because of fresh air inhalation and psychological calmness. However, for outdoor exercise to be a healthy asset, it should be performed in unpolluted and uncontaminated environments. Advanced public education policies must be developed to persuade people to maximize their outdoor physical activities. This is to ensure achieving peace and serenity for both body and psych. Integrated social activities may also be encouraged with open-air exercise. As such, stress in the third millennium can be pragmatically attenuated and managed. As a result of slower aging process, human life quality may improve worldwide.
Jan 2024 DOI 10.14302/issn.2692-5257.ijgp-23-4772
Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries. Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community. In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach. While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems. Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries. Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community. In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach. While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems.
Dec 2023 DOI 10.14302/issn.2474-7785.jarh-23-4794
This triangle of care is the result of an ethnographic research conducted with hard pandemic restrictions in Barcelona during 2020. Even if it is based in a bibliography on gender and migration, care and aging, the article is basically empirical. For the interpretation of the debates and discussion groups carried out, we identify here: the elderly person (as we have seen in the interviews in the previous article, Natalia-Ribas Mateos and Herrera 15,“The care debate during the first covid lockout in Barcelona); the caregivers - from family members to hired workers, especially immigrant women- and thirdly, as the third aspect of the triangle, and which remains in this article more blurred, from municipal and health public services. The pandemic highlights the existing systemic inequalities, particularly affecting the elderly, but also migrants and ethnic minorities, people who work in the care sector, and health personnel.
Dec 2022 DOI 10.14302/issn.2377-2549.jndc-22-4351
Molecular imaging is a new method in examining physiological studies in molecular dimensions. Among the various methods that have been introduced for this purpose, the magnetic resonance spectroscopy (MRS) method has made it possible to more accurately study the activities of the brain region as well as tumors in different parts of the body. MRS imaging is a type of non– invasive imaging technique that is used to study metabolic changes in the brain, stroke, seizure disorders, Alzheimer's disease, depression and also metabolic changes in other parts of the body such as muscles. In fact, since metabolic changes in the human body appear faster than anatomical and physiological changes, the use of this method can play an important role in the early detection and diagnosis of cancers, infections, metabolic changes and many other diseases. (Graphical Abstract) Graphical Abstract. CERN Large Hadron Collider (LHC) radiation source for magnetic resonance biospectroscopy in metabolic and molecular imaging and diagnosis of cancer.
Feb 2022
Using samples of small cell lung tumors, a research team led by biologist Dr. Raymond discovered two new ways to induce tumor cell death. By activating ferroptosis, one of two subtypes of tumor cells can be targeted: first, iron-dependent cell death due to oxidative stress, and second, oxidative stress. Therefore, cell death can also be induced in a different way. Both types of cell death must be caused by drugs at the same time to eliminate the majority of the tumor mass. It is currently in clinical trials for cancer treatment. Auranofin, which inhibits the production of protective antioxidants in cancer cells, has been used to treat rheumatoid arthritis for decades. Future clinical trials using this combination therapy will determine the extent to which this targeted treatment option improves the prognosis of small cell lung cancer patients. It is currently in clinical trials for cancer treatment. Lung cancer is the leading cause of cancer death in the United States. Despite evidence of molecular abnormalities in biological specimens, progress in this disease is hampered by the lack of diagnostic markers useful for clinical practice. The majority of patients with lung cancer are still diagnosed at an advanced stage, when prognosis is poor. This article reviews new strategies being studied for the early detection of lung cancer. These strategies involve new methods of imaging (including low-dose computed tomography CT scanning), DNA analysis, and proteomic-based techniques. These strategies have not only improved our understanding of lung cancer but show promise in offering better survival to patients with this deadly disease. Of paramount importance in the search for methods of early detection is the need for the identification of the ideal population to screen, a multidisciplinary approach, and validation of promising techniques.
Oct 2021 DOI 10.14302/issn.2474-7785.jarh-21-3979
Background Aging, a state often associated with poor emotional health status greatly impedes life quality and independence for many. Aim This mini review examines the potential of the concept of positive psychology as an active approach to fostering successful or more successful, rather than suboptimal aging. Methods and Procedures Articles that addressed the current topic of interest and were located in the PUBMED, Medline, Web of Science, PsycINFO and Google Scholar electronic data bases were carefully sought and analyzed and presented in narrative form. Results Various forms of positive psychology appear to provide a safe efficacious evidence based approach for purposes of ameliorating various degrees of anxiety and depression and for improving cognition, life quality, and health well-being in diverse subgroups of older adults Conclusion More research to examine who might benefit most from this highly promising form of intervention, and in what respect appears to have considerable merit in light of the growing populations of older adults and few intervention options to help them to age optimally and as successfully as possible.
Jul 2021 DOI 10.14302/issn.2474-7785.jarh-21-3850
The aim of the study was to evaluate the immunomodulatory activity of the Biofield Treated/Blessed proprietary test formulation consisting of essential ingredients viz. minerals (zinc, magnesium, iron, and copper) and vitamins (B6, B12, and D3) in male Sprague Dawley rats. Each ingredient of the test formulation was divided into two parts. One part was denoted as the control without any Biofield Energy Healing Treatment/Blessing, while the other part was defined as the Biofield Energy Treated/Blessed sample, which received the Biofield Energy Healing Treatment/Blessing by a renowned Biofield Energy Healer, Mr. Mahendra Kumar Trivedi remotely. Additionally, three group of animals were also received Biofield Energy Treatment per se (at day -15) under similar conditions. The parameters were assessed such as immune biomarkers (IgM, IgG, IgA, IgE, CD4+, CD8+, and CD28+), biochemistry and hematology and histopathology. The experimental results showed IgG level was significantly increased by 10.70% and 8.03% in the G6 (Biofield Energy Treatment per se at day -15) and G8 (Biofield Treatment per se to animals plus Biofield Treated test formulation from day -15) groups, respectively as compared with untreated test formulation (G4). Additionally, CD8+ count was significantly increased by 20.67% in the G8 group, while CD28+ count was significantly increased by 11.70%, 8.32%, and 9.82% in the G7 (Biofield Energy Treated test formulation at day -15), G8, and G9 (Biofield Treatment per se (day -15) to animals plus untreated test formulation) groups, respectively after Biofield Energy Treatment to the animals as compared with the untreated test formulation. In hematological analysis, platelet count was increased in the G5, G6, G7, G8, and G9 groups by 40.69%, 27.95%, 26.67%, 38.58%, and 28.28%, respectively compared with the disease control (G2) group. Biochemical parameters showed significant decrease in the level of creatinine by 32.14% in the G9 group as compared with the G2 group. Further, animal body weight, feed intake, relative organ weight, and histopathological findings of all the tested groups did not show any abnormal findings with respect to the safe and non-toxic treatment strategies. Overall, the experimental data concluded that the Biofield Energy Treated/Blessed test formulation showed considerable improved cellular and humoral immune response as compared with the untreated test formulation. Thus, the Trivedi Effect®-Biofield Energy Healing Treatment per se and the test formulation has the significant capacity for immunomodulatory effect, stress management and anti-aging by improving overall health.
Jun 2021 DOI 10.14302/issn.2474-7785.jarh-21-3867
Background Aging is said to represent a declining state that is possibly especially compromised by sleep issues, and declining melatonin levels. Aim This review examined the idea that aging can be favorably influenced in numerous ways by the addition or maintenance of adequate melatonin levels. Specifically, the impact of melatonin on skeletal muscle was the key topic of interest. Method Reviewed were peer reviewed research and review articles specifically pertaining to healthy aging, melatonin, and muscle associated observations. Results Declining melatonin levels greatly impact multiple essential body systems and tissues. Supplements or interventions that heighten melatonin presence appear to have beneficial impacts on aging in general, and muscle function and structure, in particular. Conclusion The use of melatonin early on in the aging process is likely to produce more favorable long-term outcomes than not in cases of deficiency, and should be further investigated.
Apr 2021 DOI 10.14302/issn.2474-7785.jarh-21-3815
Background Aging, a commonly accepted time period of declining heath has been shown to vary in terms of its impact on function and independence. Aims This mini review examines the current impact of COVID-19 on the goal of ‘successful aging’, a conceptual model and outcome variable deemed desirable, but hard to attain. Methods Peer reviewed articles published between March 1 2020 and April 15 2021 focusing on ‘successful aging’ and COVID-19 secondary impacts, as located in the PUBMED data base were specifically sought. Results Despite a lack of consensus on the concept of ‘successful aging, and whether this can be achieved or not, ample evidence points to a severe secondary impact on efforts to age as successfully as possible by older adults, especially those isolated in the community as a result of lockdowns. Conclusion Pursuing more efforts to counter predictable harmful cognitive as well as physical impacts of lockdowns, resource and movement restrictions is urgently needed.
Mar 2021 DOI 10.14302/issn.2574-4372.jesr-20-3593
Background Women play an important role in the work setting. This leads them to put off their motherhood, sometimes preventing them from getting pregnant. Delaying pregnancy face women with low ovarian response, such as in Premature Ovarian Insufficiency (POI) or Ovarian Aging (OA). There is no current treatment, although there is evidence of improving ovarian function by inyecting mesenchymal stem cells (MSC). Materials and Methods Prospective, observational study of 17 women who attended Pronatal Clinic from 2019 to 2020. Each patient was registered in Assisted Reproductive Treatment (ART) and was enrolled in ovarian treatment with an autologous adipose tissue Mesenchymal Stem Cell (AD-MSCs) protocol. Three groups were assembled: 1) Control: AMH >1.2 ng/mL, without AD-MSCs, 2) POI/OA: female infertility due to POI/OA with AMH <1.2 ng/mL and 3) Amenorrhea: female infertility due to POI/OA with amenorrhea and AMH <1.2 ng/mL. Variables: Age, weight, height, serum AMH, endometrial thickness, follicular size and number on day 2 and 11 of the menstrual cycle, oocyte number, number of blastocysts and pregnancy rate. Results Between month 2 and 5, after AD-MSCs inyection, POI/OA group showed an increase in follicle number (2 to 9) and size (13.5 to 15.5 mm) on day 11 of the menstrual cycle, which resulted in a higher number of MII oocytes (2.6 to 4.2), and an increase in number of blastocysts (0 to 3) and endometrial thickness (8.6 to 9.4). Regarding the Amenorrhea group, a reboot in menstrual cycle was observed, although no further development of blastocyst was found. Conclusion The AD-MSCs inyection directly in the ovary allowed an increase in number of blastocysts and improved pregnancy rates in POI/OA patients.
Jan 2021 DOI 10.14302/issn.2766-8630.jrnm-20-3689
The goal of this review is to assess the importance of various imaging modalities which can be used in assessing the viability and integrity of the bone allograft. As it is widely in use in majority of major and minor reconstructive procedures.
Dec 2020 DOI 10.14302/issn.2641-5518.jcci-20-3636
Objective To highlight the value of 3D ultrasound and Doppler angiography imagingin the prenatal assessment of left fetal isomerism. Methods A retrospective offline analysis of volume datasets of 3 fetuses with left atrial isomerism by 3D ultrasound was conducted. Conclusion We believe that parasagittal view demonstrating the heart and the abdominal vessels is easy to obtain and interpret, offer a realistic anatomic image, needs no mental reconstruction of spatial relationships and is very beneficial mainly in detecting the situs. We propose to use 3D ultrasound systematically in suspected cases of atrial isomerism, and better understand and interpret fetal anatomy.
Sep 2020 DOI 10.14302/issn.2694-2283.jsem-20-3539
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.
Aug 2020 DOI 10.14302/issn.2324-7339.jcrhap-20-3003
Human immunodeficiency virus (HIV) is a retroviral disease in which the viruses copy their genetic material into the genetic material of the human beings. Infected cells remain infected for the whole of their life. First discovered in the year 1981, Human immunodeficiency virus infections is considered to be a pandemic by the World Health organization.
Aug 2020 DOI 10.14302/issn.2474-7785.jarh-20-3425
The study was aimed to investigate the potential benefits of the Consciousness Energy Healing Treatment (the Trivedi Effect®) per se and Biofield Energy Healing treated novel test formulation in male Sprague Dawley rats for their antiaging activity by monitoring aging biomarkers such as brain-derived neurotrophic factor (BDNF), silent information regulator-1 (SIRT-1), and klotho protein. The test formulation was distributed into two parts. First part did not provide any Biofield Energy Treatment was denoted as the untreated sample, however the second part was received Biofield Energy Healing Treatment by a renowned Biofield Energy Healer, Mr. Mahendra Kumar Trivedi and defined as the Biofield Energy Treated sample. In this experiment, nine groups (n=10) were assigned, in which four were preventive maintenance groups. Among them, three groups of animals were also received Biofield Energy Healing Treatment per se (at day -15). BDNF was significantly increased by 25.83%, 19.35%, and 14.67% in the Biofield Energy Treated test formulation (G5), Biofield Energy Treatment per se at day -15 (G6), and Biofield Energy Treatment per se to animals plus Biofield Treated test formulation from day -15 (G8), respectively as compared to the disease control (G2) group. Moreover, expression of SIRT-1 protein was increased by 14.63% in the G5 group than the untreated test formulation (G4) group. Additionally, SIRT-1 activity was increased by 39.7%, 32.5%, 15.9%, and 136% in the G6, Biofield Energy Treated test formulation at day -15 (G7), G8, and Biofield Treatment per se (day -15) to animals plus untreated test formulation (G9) groups, respectively than the G4 group, while it was increased by 57.3% in the G9 group as compared to the G2 group. Besides, Klotho protein in kidney homogenate was significantly increased by 16.67% in the G5 group as compared to the G2 group. Altogether, the results showed a significant improvement of longevity mediators and antiaging biomarkers in the preventive maintenance groups. Therefore, results envisaged the significant slowdown of aging-related disorders and other complications in the preventive Biofield Energy Treatment group per se and/or Biofield Energy Treated Test formulation groups (viz. G6, G7, G8, and G9) comparatively with the disease control group and could be utilized against various aging-related disorders like Alzheimer's disease, hypertension, osteoporosis, cataracts, type 2 diabetes, cancer, etc. along with it could be used to extend the life-span, stress and immune-related disorders.
Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3463
Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.
Apr 2020 DOI 10.14302/issn.2372-6601.jhor-20-3293
Objective Meningiomas are most common intracranial benign tumors comprising around one third of all intracranial neoplasms, and typically have benign and indolent nature with slow-growing behaviour. Benign meningiomas are slow growing tumors typically following an indolent disease course. Nevertheless, atypical or anaplastic meningiomas may follow a more aggressive disease course with invasion of critical structures and recurrences. In the current study, we evaluate the incorporation of magnetic resonance imaging (MRI) for radiosurgery treatment planning of atypical meningiomas. Materials and Methods Atypical meningioma radiosurgery target volume determination with and without incorporation of MRI has been evaluated. Ground truth target volume used as the reference has been outlined by the board-certified group of radiation oncologists after comprehensive assessment, thorough collaboration and consensus. Results Target volume definition by use of Computed Tomography (CT)-only imaging and by CT-MR fusion based imaging has been comparatively evaluated in this study for linear accelerator (LINAC)-based radiosurgical management of atypical meningioma. Ground truth target volume defined by the board-certified radiation oncologists after detailed evaluation, collaboration, colleague peer review and consensus has been found to be identical to target determination by use of CT-MR fusion based imaging. Conclusion Despite significant progress in neurosurgical techniques over the years, complete surgical resection may not be feasible in the presence of meningiomas located at eloquent brain areas in close association with important neurovascular structures. RT may have a role in multidisciplinary management of meningiomas. Incorporation of MRI into treatment planning for radiosurgery of atypical meningiomas may improve target definition despite the need for further supporting evidence.
Nov 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-3070
The telomeres existing at the end of the eukaryotic chromosome, play an important role in localization, pairing of homologous chromosomes during cell division and synapsis formation, while telomerase is involved in maintenance of the telomere length. The application of antiHIV-1 molecules particularly NRTIs have been shown to interfere with telomerase function thereby inducing aging processes. Since the application of these molecules has already indicated production of oxidative stress and toxicity in AIDS patients, their adverse impact on telomerase function may further worsen the situation. In addition, the negative influence of antiHIV-1 regimens on certain host factors involved in telomerase function may enhance aging. HAART changes the landscape of the disease by progressively decreasing the progression of HIV-1, but exerts prolonged adverse effects on the telomerase function. Though there is no exact information available on this issue, intensive efforts are needed to explore regulation of telomerase expression in HIV infected individuals and particularly those receiving antiretrovirals.
Sep 2019 DOI 10.14302/issn.2474-7785.jarh-19-2994
Telomerase and SIRT1 (member of the sirtuin protein family) along with the lifestyle and diet are the major determinants of aging and its associated diseases such as cancer and cardiovascular disorders. The study objective was to investigate the effect of Consciousness Energy Healing based novel test formulation in pre-adipocytes (3T3-L1) and human peripheral blood mononuclear cells (PBMCs) for anti-aging activity using SIRT1 and telomerase assay. The test formulation was divided into two parts. One portion was denoted as the untreated test item without any Biofield Energy Treatment, while the other portion was defined as the Biofield Energy Healing Treatment, which received the Biofield Energy Healing Treatment by a renowned Biofield Energy Healer, Mahendra Kumar Trivedi. The cell viability using MTT assay showed that the cell viability of 3T3-L1 and PBMCs cells was more than 70% indicating a safe and nontoxic profile. The experimental data in PBMCs cells showed that the Biofield Energy Treated Test formulation showed a significant improved telomerase activity by 39.25%, 20.86%, and 17.95% at concentrations 0.01, 5, and 100 µg/mL, respectively as compared with the untreated test formulation group. These results indicate that the Biofield Energy Healing Treatment would be the significant approach to prevent aging-related disorders such as decline cardiovascular diseases, osteoporosis, dementia, osteoarthritis, Alzheimer’s, hypertension, cancer, Parkinson's Disease, Chronic Obstructive Pulmonary Disease (COPD), Stress, Asthma, cataract, age-related macular degeneration (AMD), hearing loss and metabolic disorders.
Apr 2019 DOI 10.14302/issn.2998-4211.jalr-19-2658
Alzheimer’s Disease (AD) is one amongst the overwhelming types of dementia that distresses the brain nerve cells leading to a perpetual loss in memory and creating a lot of difficulties for the family members in caretaking. The prediction of the disease at an earlier stage is a common problem. The most prevalent imaging modalities used for diagnosing AD are Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT). They can provide valuable information regarding the changes in internal and external brain regions and activities for diagnosing AD. But the relevant studies made on retina reveals that in addition to brain changes there are some variations on the retina layers of the AD patients. Therefore, the retina can be used as a biomarker for diagnosing AD. There are different techniques available for an eye examination. Most noticeable of them are Fundus Imaging and Optical Coherence Tomography (OCT). In this paper, we have focused on OCT retinal images of AD patients for the early diagnosis of AD.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-18-2458
Introduction Cognitive and physical (especially aerobic) training have been reported to enhance cognition in the elderly. The goal of this study was to compare the effectiveness of two types of training, namely combined cognitive-and-physical training and cognitive training alone, for cognition and in particular for executive function and working memory. Material and Method Healthy older adults (aged 65–86 years) were included in cognitive-and-physical - CAP (n=16) - or cognitive - COG (n=16) - training groups or in a passive control group – CONT (n=16). The training took place in 60-minute sessions conducted twice a week for 8 weeks. Cognitive functions were assessed before and immediately after the interventions and at a 1-month follow-up. Results In the short-term, the CAP and COG groups showed a transfer on updating, unlike the CONT group. In the long-term, although the gains achieved by both CAP and COG persisted, the benefit observed in the COG group was greater than that in the CAP group. Conclusion Our data suggest that there may be a complementarity between cognitive and physical training effects at the level of short-term transfer, given that physical training was able to boost cognitive training. Moreover, regarding transfer, physical training may help improve performance on untrained tasks. However, as far as the long-term persistence of the benefits of training is concerned, the results tend to indicate the superiority of cognitive training.
Sep 2018 DOI 10.14302/issn.2641-5526.jmid-18-2328
Background: Monitoring ultrasonic probe quality remains an important problem which impacts diagnostic accuracy. Here we present a quantitative method to assess probe quality primarily based on measuring probe maximum contrast (dB) and dynamic range. Method: Contrast relevant parameters of 26 transducer models manufactured by five manufacturers were measured with a novel Random Void Phantom (RVP) approach. 3D-data were acquired and analysed to determine image quality. Results: Acoustic contrast values ranging from 15dB to 36dB were observed. Conclusion: By examining artefact producing side lobes, the novel RVP approach presented here permits a quantitative assessment of ultrasound probe quality.
Aug 2018 DOI 10.14302/issn.2641-4538.jphi-18-2190
Optical imaging method provides safe and encouraging tool in many medical applications. In this editorial, principle operation, instrumentation, medical applications and advantages of diffuse optical imaging technique are presented and discussed.
May 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2059
Extant epidemiological and social diagnosis information shows an alarming upsurge in the prevalence of overweight and obesity over the last decade in developing countries including Ghana. Despite literature on the dangers and associated risk factors of these two health related constructs is well-written and documented, there seems to be a distinct knowledge gap on cultural influences that may trigger the onset of overweight and obesity, and related comorbidities. This review paper provides a general overview on overweight and obesity, and presents a supportive evidence of their rising prevalence as well as associated overall implications on public health in Ghana. Additionally, the paper explores how indigenous cultural perceptions, beliefs and norms impact on dietary and physical activity behaviours of the people. Based on available evidence, the complementary role of behaviour modification towards the management of overweight and obesity is suggested. The PEN-3 model as an appropriate cultural framework is proposed for future empirical investigations. This would afford programme planners to assess how to design culturally underpinned appropriate intervention programmes that would positively influence long term behavioural practices of the local people.
Feb 2018 DOI 10.14302/issn.2639-1716.jn-18-1965
Lipomatous tumors are among the most common primary musculoskeletal neoplasms affecting both pediatric and adult patient populations. Patient age, tumor location, and imaging features all contribute to the differential diagnosis of musculoskeletal tumors. Tumors identified outside of common patient demographics or in unusual locations may lead to preoperative misdiagnosis. We present an uncommon adipocytic tumor occurring at an uncommon age which was proven at surgery to represent a preoperatively unexpected diagnosis. A 13 year old male presented with a fatty anterior proximal thigh mass; age and magnetic resonance findings suggested lipoblastoma. However, following complete surgical resection, histopathology confirmed hibernoma, a benign lipomatous tumor characterized by the presence of white and multivacuolated brown fat cells, the vast majority of which occur in adult patients.
Aug 2017 DOI 10.14302/issn.2379-8572.joa-17-1672
Accurate diagnosis of tumor thrombus and distinguishing benign thrombus from tumor thrombus avoid unnecessary anticoagulant treatment of oncological patients and it is important for patient management. In this case report, the role of FDG PET/CT in the presentation of a suspicious tumor thrombus in the left brachiocephalic vein of a patient with known laryngeal carcinoma and leiomyosarcoma diagnosis is presented.
Jul 2017 DOI 10.14302/issn.2577-2279.ijha-17-1587
This review explores crosstalk between Ca2+ and cAMP signaling and its therapeutic implications for neurodegeneration and aging. It summarizes candidate interventions and translational challenges.
Mar 2017 DOI 10.14302/issn.2572-5424.jgm-16-1352
In this investigation, Rifabutin dithiocarbamate (RFND) was labeled with Technetium-99m (99mTc) using tricarbonyl technique. The labeled RFND was further characterized in terms of radiochemical purity, stability in saline & serum, in vitro bacterial binding, biodistribution in animal model rats and for scintigraphic accuracy in animal model rabbit. Finally different radiobiological characteristics of the 99mTc(CO)3-RFND was compared with the recently reported 99mTc-RFN. It was observed that the dithiocarbamate form of RFN showed better radiochemical purity, stability in saline, bacterial binding, biodistribution and targeted imaging than the recently reported 99mTc-RFN. These better radiobiological parameters posed 99mTc(CO)3-RFND as a more reliable agent for tuberculosis imaging.
Aug 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1167
Context: The present study was undertaken to do a comparative evaluation of the role of Cone Beam Computed Tomography (CBCT) imaging and Orthopantomography (OPG) for pre-operative implant planning in combination with sinus grafting procedures in order to assess sinus anatomy and morphology and the existing bone height in three dimensions. Aims: To assess sinus anatomy and morphology and the existing bone height in three dimensions. Materials and Methods: Pre-operative assessment of maxillary sinuses for implant planning using CBCT imaging was performed on 20 sinuses (17 patients). These patients were subjected to orthopantomographs and CBCT imaging both pre-operatively and post-operatively. CBCT imaging helped to decide the type of sinus augmentation procedure best suited for the patients as per the individual needs and depending on the residual alveolar bone height, timing of implant placement, sinus morphology, anticipation of complication and comparative analysis between pre-and post-procedural gain in vertical alveolar bone height and increase in bone density. Statistical Analysis: The results were tabulated and statistically analyzed using Paired and Unpaired t-tests. Results: In the majority of cases, there was a concordance between the treatment type based on pre-operative and post-operative CBCT scans. The assessment of sinus morphology revealed a significantly higher detection rate of abberations in the form of sinus mucosal hypertrophy and septae on CBCT which were imperceptible on routine radiographs. The most appealing result was that vertical alveolar bone height could be measured precisely and there was a significant increase in surgical confidence and a significantly better prediction of complications when using CBCT imaging. Conclusions: A pre-operative planning based on CBCT imaging seems to improve sinus diagnostics and helps to execute a better treatment plan. Also, it is a good tool for the comparison of vertical alveolar bone height pre-and post-operatively following sinus augmentation procedures using various graft materials.
Feb 2016 DOI 10.14302/issn.2379-8572.joa-15-906
Objective: We compared preoperative data of physical examination, CT and diffusion MRI findings of temporal bone with our intraoperative observations. We investigated the diagnostic efficiency of single-shot spin echo echoplanar diffusion MRI (SS SE EPI) on primary cholesteatoma. Methods: 33 patients with chronic otitis media who had been admitted to Otolaryngology Department of Haydarpasa Numune Training and Research Hospital between June 2010 and September 2011 were involved in this study. All patients did undergo otoscopic and audiometric examination. After imaging of temporal bone by CT and diffusion MRI, patients were operated and intraoperative observations were recorded. Patients with intraoperatively approved cholesteatoma were defined as group 1 and those without cholesteatoma were defined as group 2. Perioperative and preoperative findings of physical examination, CT and MRI of all patients were compared one by one. Results: Positive physical examination findings have been superior to MRI and CT, having a sensitivity of 96%, specifity of 87.5%, positive predictive value of 96% and negative predictive value of 87.5%. In terms of effectiveness of MRI in diagnosing intraoperative cholesteatoma, we had a sensitivity of 80%, specifity of 50%, positive predictive value of 83.3% and negative predictive value of 44.4%. These values are also lower than previously reported results. Conclusion: When we had preoperative suspection of cholesteatoma on physical examination and diffusion MRI, in addition with bone tissue erosion on CT, we found that physical examination is superior to MRI and CT in terms of capability of diagnosing the disease.
Oct 2015 DOI 10.14302/issn.2470-0436.jos-14-571
Purpose: To describe a new functional magnetic resonance imaging (fMRI) method for measuring the influence of regular astigmatism, both against-the-rule (ATR) and with-the-rule (WTR), on the human visual cortex. Setting: Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan. Design: Experimental study. Methods: Images were acquired in two healthy volunteers using a 1.5 T scanner equipped for echo planar imaging. Horizontal and vertical sine wave grating flickering at a frequency of 8 Hz were simultaneously presented during the 20-second stimulation period. During the control period , subjects fixated on a control target. Stimulations were performed under three different conditions that included with hard contact lenses that were equal to emmetropia without astigmatism (condition 1); with hard contact lenses and cylindrical glasses of +6.00D at 0°, imitating WTR (condition 2); and with hard contact lenses and cylindrical glasses of +6. 00 D at 90°, imitating ATR (condition 3). Raw data were processed using in-house software with the significance of activation determined by Statistical Parametric Mapping (SPM 99). Results: Although higher activation was found in the primary visual cortex for condition 1 versus conditions 2 and 3, activation in the dorsal pathway was higher in conditions 2 and 3 compared to condition 1. Dorsal pathway activation was also higher in condition 3 versus condition 2. Conclusions: Study findings showed the potential influence of ATR and WTR on the human visual cortex , with fMRI able to detect the influence of regular astigmatism on the visual cortex. Our current results suggest that fMRI may be useful in exploring the influence of astigmatism on vision.
Jan 2015 DOI 10.14302/issn.2379-7835.ijn-14-606
Telomeres are strings of DNA that are not themselves genes but that extend every chromosome beyond its last gene. Terminal telomeres are sacrificed during every mitotic event in human cells (“telomere attrition”), preserving the functional genome despite the “end replication problem.” However, the “telomeric theory of biological aging” suggests that when an individual cell has reproduced itself a sufficient number of times (the “Hayflick limit”), some the its telomeres have become critically shortened (“telomeric crisis”) and cannot completely “cap off” a chromosome, and any further attempts to replicate such a chromosome would produce damaged DNA and a dysfunctional cell (“cellular aging”). As cells enter telomeric crisis, they usually initiate intracellular signaling cascades that arrest DNA replication and mitotic activity, converting biologically active cells into inactive cells (“cellular senescence”). The progressive accumulation of senescent cells impairs the healthy functioning of tissues and produces “biological aging.” Oxidative stress damages telomeres and accelerates telomere attrition and biological aging. Premature biological aging is associated with degenerative diseases and diminished quality of life. Reducing the level of systemic oxidative stress can ease the oxidative drive toward cellular senescence and premature biological aging. Increased intakes of antioxidant-rich foods and specific antioxidant nutrients (such as fruits and vegetables, α -lipoic acid, astaxanthin, eicosapentaenoic acid, docosahexaenoic acid, trans-resveratrol, N-acetylcysteine, methylsulfonylmethane, lutein, vitamin C, vitamin D, vitamin E, and γ-tocotrienol) may decrease cellular and systemic oxidative stress and decelerate biological aging.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-191
Objective: This cross-sectional study examined cognitive subtypes and influential factors in HIV-positive (HIV+) adults. Method: Two-step cluster analysis was conducted on a neurocognitive test battery in a sample (N = 78) of adults and older adults with HIV (Mage = 46.1). Next, cognitive, functional, and mental and physical health differences were compared between the HIV+ clusters and an HIV- reference group (N = 84; Mage = 47.9). Results: A two-cluster solution emerged, with a lower performing cluster exhibiting poorer performance across all domains except psychomotor speed, and a “normal” cluster displaying similar performance as the HIV- group. The most influential factors to classification in the lower performing cluster were older age and presence of stroke and hypertension. There were trends for longer duration of HIV-infection, higher unemployment rates, and greater prevalence of Hepatitis C co-infection in the lower performing cluster. Conclusions: These findings suggest that there are not unique cognitive subtypes in HIV, but rather a subset of individuals who exhibit globally normal performance and those with below average performance. Older age and the related cardiovascular comorbidities of both aging and HIV medications may be key influential factors to variability in neurocognitive functioning in this population and thus should be considered in future studies. Implications for research and practice are provided.
Feb 2014 DOI 10.14302/issn.2374-9431.jbd-13-312
Objective: This study assessed the baseline knowledge, perceptions, attitudes and behaviors of prediabetes patients in order to tailor a new technology-enhanced primary care-based lifestyle modification intervention. Methods: Patients with a diagnosis of prediabetes were enrolled in a randomized, controlled pilot study, Avoiding Diabetes Thru Action Plan Targeting (ADAPT), a technology-based intervention to promote action plan discussions around patient-selected behavior change goals. Results: A total of 54 adults (82% female) were enrolled in the pilot study. Most (89%) had comorbid conditions and mean BMI was 36. Participants exhibited significant levels of diabetes risk knowledge and diabetes risk perception, as well as high levels of willingness to make changes to decrease diabetes risk. Number of daily steps was inversely correlated with perceived physical activity (r=-0.35082, p<0.001). Poorer scores on diet quality were inversely correlated with BMI. Conclusion: Participants in this sample demonstrated requisite levels of knowledge, self-efficacy, motivation and risk perception for effective behavior change. These data suggest that primary care-based prediabetes interventions can move beyond educational goals and focus on enhancing patients’ ability to select, plan and enact action plans.
Nov 2013 DOI 10.14302/issn.2329-9487.jhc-13-272
Background: Conventional transthoracic echocardiography (TTE) and tissue Doppler imaging (TDI) are usually unable to reveal very early subtle abnormalities in left ventricular (LV) systolic function caused by hypertension, prior to manifestation of hypertrophy (LVH). This study was undertaken to assess whether speckle tracking echocardiography (STE) provides more insight into early hypertension induced LV systolic dysfunction, with the purpose of identifying patients at higher risk for heart failure (HF). Methods: Fifty patients (54.16 ± 8.4 years) and 50 controls (52.17 ± 8.6 years) were enrolled. According to the presence or absence of LVH, patients were classified as LVH(+) and LVH(–), respectively. Global longitudinal function was calculated by TDI, global strains (longitudinal (LS), radial (RS), and circumferential (CS)) were assessed by STE. Results: Conventional TTE showed a normal systolic function in all patients. TDI was able to detect a systolic dysfunction only in the LVH(+) group (P < 0.001) whereas STE revealed an impairment of systolic LS and CS in all patients, including those without hypertrophy (P =<0.0001). Furthermore, in the LVH(+) group, STE showed increased RS . Conclusion: In hypertensive patients, STE provides more detailed information than conventional echocardiography and TDI, since it reveals a systolic dysfunction before hypertrophy occurs (Stage A of ACC/AHA classification of HF) and identifies some early LV mechanic changes that might improve the clinical management of these patients
Jun 2026 DOI 10.14302/issn.2574-4496.jtc-26-6304
Objective To evaluate the treatment outcomes of patients with Differentiated thyroid cancer (DTC) who underwent total thyroidectomy followed by RAI therapy at the Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) in Oman. Methods This is a retrospective observational clinical study conducted at SQCCCRC. The study included all patients diagnosed with DTC who were admitted to SQCCCRC between June 2021 and November 2023. A total of 255 patients were identified and met the inclusion criteria for this study. Results The mean age at diagnosis was 39.9 ± 12.4 years (range: 14–79), with 78% of patients being female. The mean BMI was 30.3 ± 6.4 kg/m², with nearly half of the cohort (48.2%) classified as obese (BMI ≥ 30). Most patients had papillary thyroid carcinoma (92.9%), while follicular and Hürthle cell carcinoma accounted for 5.9% and 0.8% of cases, respectively. Based on the American Joint Committee on Cancer (AJCC) staging, 86.3% of the patients were classified as stage I and 3.9% as stage II. Six patients (2.4%) had stage IVB disease. According to American Thyroid Association (ATA) risk stratification the majority were low-risk. Patient age was strongly associated with disease stage. The distribution of metastatic cases varied by region, with the highest proportion observed in Dhofar. Most patients (87.1%) received a single dose of radioactive iodine (RAI), with a median cumulative dose of 3.7 mCi). At six months post-treatment, 70.2% of patients had a TG level < 0.2 ng/mL. Conclusion The outcome of therapy in majority of our patients is favorable with 72% having excellent biochemical response at last follow up. None of the patients with distant metastasis achieved excellent response and a high proportion of them came from the Dhofar governorate, a targeted intervention would be of benefit. Low risk patients require special attention and may need radioactive iodine during follow up, unlike other regions and hence warrant very close follow up and further review to establish the best practice guidelines in our region.
Feb 2026
Objective The landscape of non-small cell lung cancer (NSCLC) has changed due to liberalized utilization of computed tomography, developments in immunotherapy and targeted treatments, and guidelines encouraging sublobar resections. We analyzed the implications of these advances for surgical procedures over a 16-year period. Methods The National Cancer Database was used to identify NSCLC incident cases from 2004 to 2020. Histology, stage, grade, and treatment were analyzed using descriptive statistics and logistic regression. Results 2,028,553NSCLC patients were identified. Each year was associated with an increase in Stage I for NSCLC (OR1.05, 95%CI 1.05-1.05) and histological subtypes (adenocarcinoma: OR1.03, 95%CI 1.03-1.04; squamous: OR1.02, 95%CI 1.02-1.02; neuroendocrine: OR1.11, 95%CI 1.11-1.12), with no change in adenosquamous histology. A similar increase was observed for well- or moderately-differentiated histology (OR1.04, 95%CI 1.04-1.04). The proportion of patients receiving chemotherapy decreased (OR0.98, 95%CI 0.98-0.98), while more patients were treated with immunotherapy or targeted therapy, including an increase of 14% using immunotherapy or targeted therapy as first-line treatment. There was a decrease in the likelihood of receiving pneumonectomy (OR 0.91, 95%CI 0.91-0.91). Despite guidelines advocating sublobar resections, these procedures only increased by 1.1% per year. Conclusions Over the 16-year study period, there was a significant trend towards diagnosis of Stage I NSCLC. The most pronounced change in treatment patterns has been more patients receiving immunotherapy and less chemotherapy. Despite a promising decrease in pneumonectomies, the frequency of sublobar resections remains stagnant, indicating limited uptage in current practice.
Jan 2026
There is no shortage of terms that are used to describe and articulate the strategies, practices, and underpinnings associated with the work engaged in by behavior analysis. Two terms that a clinic-focused behavior analyst may hear often are maladaptive behavior and problem behavior. These terms are not only common within our everyday practice, but they are also peppered throughout behavioral literature. Despite their permanency in the behavior analyst's repertoire, their meanings remain inconsistent, interchangeable, and conceptually unclear. For over a century, this lack of precision has gone unchecked, despite extensive research on undesirable or clinically significant behaviors. This article offers individuals a recount of the history, definitional limitations, and functional implications of these terms. From the perspective of early psychological scholarship and contemporary behavior-analytic sources, I argue that the field of Applied Behavior Analysis (ABA) will benefit from distinguishing maladaptive behavior as the presence of behavior that adversely affects the individual, while problem behavior should refer to the absence or inhibition of adaptive responses in relation to others' social behaviors. Furthermore, I propose that both terms be used to describe the effects on the person engaging in the behavior, instead of others around the individual, as a method of improving directionality and functional clarity. As a field focused on verbal behavior, becoming more conceptually precise with our own verbal behavior will lead to a more coherent basis for interpreting and treating behaviors that interfere with individuals' adaptation and well-being.
Dec 2025 DOI 10.14302/issn.2324-7339.jcrhap-25-5715
Recruitment for research studies focused on communicable diseases such as HIV (Human Immunodeficiency Virus) has historically been challenging, particularly among populations who have been underrepresented in media messaging, yet maintain a significant vulnerability to new HIV cases, like Black women. This study examines the recruitment strategies utilized in Aim 2 of pilot study at the University of Texas Health Science Center (UTHealth) in Houston, Texas that was funded by the Ujima Mentoring Program to develop, implement, and evaluate a video log (vlog)-based intervention. The overarching goal of the pilot study was to promote the uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women in Harris County, Texas. Aim 2 involved the creation of a culturally relevant vlog for use in Aim 3, which sought to educate and motivate participants to consider PrEP as an HIV prevention strategy. With the growing role of digital platforms in public health outreach, social media was employed alongside traditional recruitment methods such as flyers and word-of-mouth referrals. Despite an expanded online reach, engagement remained low, and participation rates did not increase proportionally to the number of individuals who viewed recruitment materials. The reluctance to participate was largely attributed to stigma surrounding HIV and concerns about being publicly associated with an HIV prevention study based on participants feedback to the research team. Even the availability of research incentives to encourage participation did not significantly improve recruitment accrual goals, particularly among healthcare providers who experienced limitations with eligibility due to institutional policies. This study underscores the need to better understand the social and cultural barriers that prevent Black women and healthcare providers from engaging in HIV prevention research. While digital recruitment strategies can enhance visibility to a larger audience, they must be supported with trust-building efforts, community partnerships, and culturally competent messaging to encourage meaningful participation. These findings point to the critical need for multi-faceted recruitment strategies that go beyond social media campaigns and actively build trust within communities, ensuring that HIV prevention research and interventions are both accessible and culturally resonant.
Dec 2025 DOI 10.14302/issn.2381-862X.jwrh-25-5447
Objective This study aimed to explore the respondents’ reproductive health profiles, examining the physiological and psychosocial perimenopausal symptoms affecting productivity, and identifying occupational needs. It also determined the relationship between menopausal symptoms and the productivity and occupational needs of peri-menopausal women. Methodology A descriptive cross-sectional design was used, surveying 50 women over 40 years old with a validated four-point Likert scale instrument. The instrument undergone content validation, reliability test, and ethical approval. Survey was administered personally and online using purposive sampling. Statistical treatments included weighted mean, F-test, T-test, Pearson r correlation, and ranking. Key results The majority of participants had their first menstruation between 11 to 15 years old and experienced regular menstrual cycles. Most had one child, with an equal number of cesarean and normal deliveries, and reported no pregnancy complications. The study found that participants seldom experienced physiological and psychosocial menopausal symptoms. They agreed on the occupational needs during the perimenopausal period. It was found that physiological symptoms were influenced by factors such as early menarche, cesarean delivery, and pregnancy complications. Additionally, psychosocial symptoms varied based on menstrual status, the number of children, and pregnancy complications, with those experiencing earlier menstruation or complications reporting more intense symptoms. The study revealed a significant relationship between both physiological and psychosocial perimenopausal symptoms, which negatively impacted productivity and increased occupational needs. Women with higher menopausal symptoms expressed a greater need for workplace policies that support perimenopausal women, highlighting the need for tailored workplace interventions for this demographic. Future Direction The study recommends including pap smears and mammograms in annual exams for peri-menopausal women, offering awareness seminars on managing perimenopausal symptoms to reduce workplace disruptions, and suggests future research exploring additional variables affecting perimenopausal women’s health and productivity
Dec 2025 DOI 10.14302/issn.2574-4496.jtc-25-5497
Our study gathered information on the diagnosis, treatment, and long-term outcome in adult and pediatric Hispanic patients with Well Differentiated Thyroid Cancer. Methods We performed a retrospective review of the clinical and imaging nuclear medicine records of cases of WDTC evaluated and treated in the Nuclear Medicine CLINICc. Evaluation included the clinical PROFILE, histology, radioiodine (RAI) therapies and treatment response, long-term outcome and survival. The data was ASSESED using the 2015 ATA Risk level guidelines and recommendations. Results Three hundred eleven cases were reviewed, 81% females, 19% males, median age of 41 years. Eleven percent (34 patients) of the patients were in the pediatric group and 49% were between 16-45 years. The tumor histology was 60.5% Papillary, 28.2% Papillary-Follicular variant and 11.3% Follicular type. All patients had a total thyroidectomy. A total of 287 (92%) of the patients were treated with RAI. The median RAI dose was 128 mCi. Patients in the low risk group received a dose range of 25-105 mCi, 73 cases in the intermediate RISK group received 106-160mCi and 104 cases in the high-risk group received doses greater than 160 mCi. The overall median cumulative dose was 151 mCi (55-926 mCi). Annual follow up was done in all cases , WITH A median follow-up OF 5-10 years. Residual functioning tissue in the neck was found in 52% of the cases by US and/or RAI imaging. of those, 43% belonged to the low risk group, while 57% were in the intermediate and high-risk groupS. The mean treatment dose received by those with persistent functional thyroid tissue in the neck was 157 mCi. Recurrent disease was found in 15% of the patients, 85% of them belonged to the intermediate and high-risk GROUPS. Forty-seven percent of the patients with recurrent disease had residual disease. Conclusion We believe ablative and/or adjuvant RAI treatment early in the disease is important to decrease residual thyroid tissue and/or residual disease, and to improve disease-free survival. We recommend total thyroid surgery in all tumors above 1 cm, post-operative evaluation with RAI Whole Body (with 123-I or 131-I), planar and SPECT/CT imaging and RAI ablation to remnant tissue. Follow-up post treatment evaluation is also recommended.
Dec 2025
The journey from personalized medicine to customized nutrition represents a significant paradigm shift in healthcare, emphasizing the holistic method for a person's or girl's well-being. in this transition, the know how of the unique genetic makeup , metabolic profile, and way of lifestyles elements of everybody will become paramount. customized medicinal drug has long centered on tailoring scientific remedies to the genetic and physiological traits of sufferers, optimizing efficacy, and minimizing detrimental effects. Now, custom-designed nutrients increase this idea further, recognizing that weight reduction plays an essential function in health and disease prevention. Key to this evolution is the mixing of advanced technology together with genomics, metabolomics, and microbiomics, allowing the suitable identification of dietary styles and nutritional requirements tailored to a person's particular desires. This summary explores the trajectory of this adventure, highlighting the pivotal characteristic of interdisciplinary collaboration among healthcare professionals, nutritionists, and researchers. With the useful resource of leveraging slicing facet generation and records-pushed strategies, personalized vitamins keep the promise of revolutionizing knowledge we method nutritional interventions, moving some distance from generalized guidelines towards targeted strategies tailored to all people's precise organic make up and way of life. expertise, traumatic conditions which include accessibility to this technology, ethical issues, and the desire for sturdy, proof-primarily based practices remain. In conclusion, the shift from customized treatments to personalized nutrient expertise is a transformative generation in healthcare, empowering people to take proactive management of their health through tailor made nutrition interventions. This summary underscores the importance of endured studies and collaboration in figuring out the entire functionality of personalized vitamins in selling health and well-being.
Oct 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5626
Background Masculinity remains a dominant phenomenon in the social construction and performance of male roles in society, influencing economic participation, access to essential services, and decision-making at household levels. Research focusing on women's empowerment has been extensively done, with little focus on how masculine support from men impacts the well- being of married women. This study examined how married women perceive male support in the context of economic, emotional, and physical support in Luwero district, Uganda. Methods This was an exploratory qualitative study conducted among married women aged 18 to 49 years. Key informant interviews were conducted with community women aged 30 to 40 years, and village health teams aged 30 to 40 years. The study participants were purposively selected based on the inclusion criteria of the study. Data were analysed using content analysis and the findings were presented using themes/sub-themes along with participant quotes. Results We interviewed married women aged 18 to 49 years old, with the majority falling in the age category of 30 to 39 years (59.1%) and were married for over 6 to 9 years (45.5%). Concerning the key informants, 2 VHTs were aged between 30 to 39 years (66.7%), and the women leaders were aged between 30 to 40 years (60%). About male support among women, nine subthemes emerged, including low engagement in family affairs, lack of financial support and cultural traditions, women’s insecurity, emotional neglect, women as providers of emotional support, lack of emotional responsiveness, emotional support driven by institutional policy, shared domestic responsibilities, and lack of physical presence during sickness. Generally, male support towards women was found to be lacking. Conclusion Male support among married women remains insufficient, contributing to emotional strain and unequally distributed responsibilities. Strengthening community awareness and engaging men through tailored programs can foster a more supportive domestic environment.
Sep 2025 DOI 10.14302/issn.2768-0207.jbr-25-5706
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.
Sep 2025 DOI 10.14302/issn.2643-2811.jmbr-25-5688
Obesity is associated with functional limitations in muscle performance. The true effect of obesity on skeletal muscle mass, including any interactions with aging effects, remains to be elucidated. The present study investigated the impact of obesity on the stimulation of muscle growth, based on a new model of body composition. A dataset of 44 men and 64 women was analysed. Body weight (Wt), body height (Ht), hand circumference (HdC) and waist circumference (WC) were measured. Processed by the Dahlmann-Body-Analysis (DBA) system, a new model of body composition, the increase of skeletal muscle mass (ΔSMM) compared to the individual reference weight was calculated. Muscle mass data derived by the DBA model are compared with DXA-derived predictive equations of studies representing different countries and ethnicities estimating the appendicular skeletal muscle mass. Means of these groups are tested by ANOVA. Age ranged from 18 to 72 years. All subjects had a BMI ≥ 29.7 (kg/m²). The mean values of ΔSMM as an estimate of muscle mass gain calculated by the DBA-system were 11.8 ±3.6 kg for men and 8.9 ±2.6 kg for women, respectively, demonstrating a linear, significantly rising relationship with BMI (ß > 0, p<0.001). The study population did not show a decrease in muscle mass with age in either men or women up to an age of 65 years. The results suggest that the present model has satisfactory prediction qualities to detect an increase in skeletal muscle mass associated with a growing burden of body fat.
Aug 2025 DOI 10.14302/issn.3066-8042.jac-25-5652
Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.
Jun 2025 DOI 10.14302/issn.2474-7785.jarh-25-5598
Osteoarthritis, the most prevalent joint disease and one affecting many aging adults is strongly associated with various degrees of disability and high health costs. Commonly deemed largely incurable and progressive, it appears muscle fat deposition and its encroachment on muscle tissue may account for multiple adverse health outcomes, especially the osteoarthritic disease process. This mini review examines whether contemporary evidence supports a role for efforts towards preventing excess fat infiltration into vulnerable muscles as one means of reducing osteoarthritic pain and disability. To this end, research on this theme and reported as of June 2025 on this issue was sought. We found that with few exceptions and regardless of joint examined a role for muscle mass infiltration in osteoarthritis disability appears of high clinical significance.
May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
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.
Dec 2024 DOI 10.14302/issn.2474-9273.jbtm-24-5317
Adolescence in Cameroon, as in many parts of sub-Saharan Africa, is often marked by early childbearing. Studies have shown a national prevalence of adolescent deliveries to be around 14.2% - 14.4%, a higher rate than the average for sub-Saharan Africa This presents a unique challenge for young mothers, who must navigate the complex process of identity reorganization while still navigating their own adolescence with its multiple changes. This article explores the experiences of primiparous (first-time) Cameroonian adolescents as they transition from daughters to mothers. The objective of this article is to understand how identity reorganization takes place among primiparous Cameroonian adolescents who pass without transition from the status of daughter to the status of mother. Drawing on qualitative data from semi-structured interviews, with seven participants chosen on the basis of selection criteria, the article examines the psychological, social, and cultural factors that shape this identity shift. An interview guide with three main themes made it possible to collect verbatim comments from the participants. The thematic analysis highlights the challenges faced by these young mothers, such as navigating social stigma, managing emotional upheaval, and balancing motherhood with their own developmental needs. The findings of this study highlight the complex and multifaceted nature of identity reorganization among primiparous Cameroonian adolescents. The social stigma associated with early childbearing, coupled with the emotional and practical demands of motherhood, can pose significant challenges to these young women. However, a study on a larger sample could reveal the resilience and resourcefulness of some adolescents, who find support within their communities and employ various coping mechanisms to navigate this transition. Finally, the article discusses the implications of these findings for adolescent maternal health interventions and social policy in Cameroon.
Oct 2024 DOI 10.14302/issn.2691-5014.jphn-24-5310
Cystic neck masses are uncommon in children, and a minority of them are soft. Internal jugular vein phlebectasia (IJVP) is a rare cause of soft neck cysts. It presents usually as a unilateral soft neck mass of changing size. In most cases it is unilateral, right sided and predominantly in males. Imaging study modalities are diagnostic and helpful for observation and follow up. In the vast majority of cases, it decreases in size with time requiring only conservative treatment. However, surgery might be necessary in large or complicated phlebectasia. IJVP is underdiagnosed or misdiagnosed especially in pediatrics, with few cases documented in medical literature. To improve awareness of presentation and management-plan of this rare case, the authors present an extremely rare case of huge left internal jugular phlebectasia in a 14 year-old boy worsened and complicated over years of wait and see approach that needed surgical treatment.
Sep 2024 DOI 10.14302/issn.2577-137X.ji-24-5207
COVID-19 vaccine hesitancy has emerged as a major challenge to global efforts to control the pandemic, particularly in Nigeria, where hesitancy to other effective vaccines such as polio and measles has been widely reported. Several individual, societal, and structural factors contribute to this behaviour and prevent the effectiveness of COVID-19 prevention efforts. Objectives This study sought to identify the predictors of COVID-19 vaccine hesitancy in the seven states of North-Central, Nigeria. Methods A population-based cross-sectional online survey was conducted among residents using a semi-structured questionnaire adapted from the WHO SAGE vaccine hesitancy scale and distributed via social media networks over 8-weeks. Results A total of 1,429 responses met the inclusion criteria and were analysed. Among the respondents, 60.7% were males, 47.5% were between the ages of 26 and 45, and 80.1% had postsecondary education. A total of 421 respondents (29.5%) were hesitant and unwilling to receive the vaccine. The reasons for hesitancy were concerns about side effects (37.1%), doubt about the existence of COVID-19 (11.0%), and the perception of time required to receive the vaccine (9.6%). Post-secondary education (AOR: 0.49, 0.36-0.66) and people of the Islamic faith (AOR: 0.68, 0.52-0.90) were found to be associated with lower levels of hesitancy. Conclusion The study found that vaccine hesitancy is a complex problem that is linked with multiple social determinants of health as lower educational attainment, lower income and Christian faith were found to be predictors of vaccine hesitancy. Confidence, Complacency and Convenience factors were expressed by respondents as concerns about side effects, doubt about the existence of COVID-19 and time required to receive the vaccines were the most prominent reasons for unwillingness to receive the vaccine. In order to protect the public health of communities, targeted interventions are required to increase vaccine acceptance by cultivating trust in vaccines, disseminating accurate information, and engaging with community stakeholders including religious groups.
Sep 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5215
Background The understanding of older persons with non-communicable diseases (NCDs) regarding health well-being is paramount and can translate to increased self-efficiency, independence, and enhanced well-being. However, little is known about older persons' understanding of the concept of health-related quality of life (HRQoL) in Uganda. The study explored perceptions and unveiled understanding of older persons with NCDs on HRQoL in central Uganda. Methods This exploratory qualitative study design involved 23 participants recruited from selected Primary healthcare facilities in Central Uganda. Thematic analysis using an inductive approach generated themes that informed the study's qualitative findings. Results The study highlighted the physical domain as a key component of HRQoL, encompassing holistic well-being, lifestyle modification, and financial stability. To promote well-being and support a healthy aging journey, it is essential to adopt a person-centered approach that aligns with the perceptions of older adults on HRQoL.
Aug 2024 DOI 10.14302/issn.2470-0436.jos-24-5162
Introduction Cystoid macular edema (CME) is a sight-threatening condition caused by fluid accumulation in the macula due to blood-retinal barrier disruption. Various factors, including drug reactions, can lead to retinal fluid leakage. Leflunomide, a disease-modifying anti-rheumatic drug, marked significant progress in managing rheumatoid arthritis. Although effective, Leflunomide has rarely been linked to CME. This report presents a unique case of Leflunomide-induced CME, adding to the limited literature on this subject. Methods We report the case of a 75-year-old female with rheumatoid arthritis treated with Leflunomide, presenting with bilateral CME and reduced visual acuity (VA). Comprehensive ophthalmic evaluations, including VA tests, fundus examination, and optical coherence tomography, were conducted. Results The patient presented with CME and decreased VA in both eyes for several months. She had undergone cataract surgery 20 years prior and was using topical nepafenac, dorzolamide, and dexamethasone. Initial VA was OD 20/50 and OS 20/40. VA improved with treatment, but CME recurred upon discontinuation. The patient had been on Leflunomide for one year. After consulting with the Rheumatology department and considering a previous case of bilateral Leflunomide-induced CME, the drug was discontinued. CME resolved without recurrence or the need for topical treatment. At her final visit, VA was OU 20/25. Conclusion This case highlights Leflunomide as a potential, though rare, cause of CME. It emphasizes considering systemic medications in CME diagnosis. Timely discontinuation of Leflunomide may resolve CME and prevent further visual impairment. Further studies are needed to understand this rare side effect comprehensively.
Jul 2024
Vitamin D deficiency is known to affect bone healing 1. In this case report, the potential link between vitamin D, calcium, and phosphorus deficiency and periapical lesions is explored, offering fresh insights into the complex relationship between systemic health and dental pathology. This pathology is caused by a mutation in the PHEX gene on chromosome X, which encodes a protein necessary for vitamin D synthesis and phosphate reabsorption, which are essential for the mineralization of bone and teeth 23. A 25-year-old man with rickets and vitamin D deficiency presented to our clinic with recurrent abscesses in multiple teeth. Radiographic imaging revealed periapical lesions on multiple teeth with advanced endo-perio lesions on teeth 26 and 16, and a negative cold test on all his teeth. Despite successful endodontic treatment, the patient’s compromised metabolic healing raised concerns about the prognosis. This case report highlights the intricate interplay between vitamin and mineral deficiencies and dental health, emphasizing the need for cautious management and long-term follow-up.
Jun 2024 DOI 10.14302/issn.2998-4785.ijne-24-5128
A brief case communication discusses a rare breast carcinoma subtype, summarizing pathology features, imaging, and considerations for surgical and adjuvant management.
Apr 2024 DOI 10.14302/issn.2692-5257.ijgp-24-5041
Introduction Globally, 36.7 million individuals live with HIV/AIDS, with 2.5 million new cases annually. Youth (14-25 years) account for 45% of these new infections. Those aged 15-24 years are less likely to be aware of their HIV status and engage in HIV care compared to older adults. This study explores the use of HIV self-testing to improve access to HIV care among Kenyatta University undergraduates. Objective To identify barriers and facilitators to HIV self-testing in this group. Methodology Employing multistage cluster sampling, 398 students were surveyed using a self-administered questionnaire. Results Of the participants (median age 21 years, 1:1.03 male-to-female ratio), 91.7% understood HIV's seriousness, with sexual intercourse as the primary transmission mode. Self-testing usage was 28.8%. Key barriers included fear of partner reaction, stigma, and lack of confidence. Significant facilitators were being female, knowledgeable about HIV, and sexually active. Conclusion Only 24% had prior HIV testing experience. The study highlights the importance of addressing fears and misconceptions while leveraging knowledge and sexual activity awareness to promote HIV self-testing.
Apr 2024 DOI 10.14302/issn.2998-4211.jalr-24-4926
This article has been retracted on 20 March 2025. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2998-4211.jalr-25-5855) The research is focused on neuroinflammation a normal physiological process which is known to be associated with neurodegenerative diseases could be the potential targeted therapy via the microglia cells, it starts with defining Alzheimer’s; a neurodegenerative disease which causes deposition of Aβ (amyloid beta) protein in the cerebral cortex as well as NFT (neurofibrillary tangles) in the hippocampus and basal ganglia. The paper then describes process of neuroinflammation, microglia’s role, apolipoprotein E4 gene in relation to Alzheimer’s, which leads to different stem cell research and how pruning microglia as well as targeting microglia receptors in the brain is being used in current research trials, we included multiple meta-analysis showing microglia receptors being targeted currently by emerging drugs like propofol, antibodies CSF1R inhibitor etc, which are currently under trial phase, the research ends with concluding potential diagnostic markers like sirt1 considered to be an anti-aging protein which can be used as therapeutic interventions and Lps effect on Sirt 1. A Microglia initiated target therapy in Neuroinflammation for Alzheimer’s Patients.
Mar 2024 DOI 10.14302/issn.2694-1201.jsn-22-4184
Sarcoidosis is granulomatous autoinflammatory autoimmune remitting relapsing disease affecting every organ in the body, it is the most difficult disease to diagnose in the absence of serum or imaging biomarker. Differential diagnosis is broad which included inflammatory, infective, neurodegenerative and neoplastic, histological biopsy is the only confirmative marker, and even histological confirmation is not robust as infection, malignancy and some drugs can induce granuloma, the most common organs affected are lung, lymph nodes, skin, eyes, liver, and less commonly pituitary gland, bones, brain, peripheral nerves, and heart, causing bilateral hilar lymphadenopathy, granulomatous lymphadenitis.
Mar 2024 DOI 10.14302/issn.2642-3146.jec-24-4935
Promoting responsible energy usage in student hostels and residential buildings plays a crucial role in ensuring sustainable development. By implementing cost-efficient strategies for managing and conserving energy, both students and homeowners can not only reap economic and social benefits but also mitigate the adverse environmental effects associated with energy consumption. Unfortunately, student hostels and residential buildings in developing countries like Ghana are falling behind in the adoption of energy efficiency and management practices, thereby missing out on valuable implementation opportunities. This study investigates the potential for energy efficiency and conservation measures in student hostels, specifically the GETFUND hostel of the University of Energy and Natural Resources in Ghana. The hostel's monthly energy consumption is approximately 64,929.458kWh, which translates to $5,667.20. The objectives of the study include analysing the current electricity consumption pattern, identifying energy misuse, and recommending measures to save energy, as well as calculating the financial benefits of implementing energy management practices. The methodology employed is an energy audit approach. The results of this study can contribute to overall energy conservation efforts in Ghana and may be applied to other university residence halls in sub-Saharan African countries with similar climatic and energy-use characteristics. In a broader sense, the primary objective of this study is to enhance the energy efficiency of the GETFUND hostel and minimize energy wastage, resulting in substantial financial savings.
Mar 2024 DOI 10.14302/issn.2372-6601.jhor-24-4962
While highly curable in developed countries, Hodgkin's lymphoma (HL), remains a significant challenge for resource-limited ones. This study aimed to describe the profile of HL in Togo. This was a retrospective, descriptive study conducted at the Clinical Hematology Department of the Campus University Hospital Center in Lomé, Togo. It focused on patient records diagnosed with HL between January 1, 2006, and December 31, 2022. Various variables such as age, gender, histological type of HL, Ann Arbor stage, prognostic classification, therapeutic protocol used, and patient outcomes were examined. The annual incidence of HL was 1.5 with a mean age of 38.7 years (range 12-63). Lymph node enlargement was the primary clinical sign (100%). Histologically, classical HL was found in 21 patients (87.5%). Staging was conducted for 16 (66.7%) patients, among whom 11 (66.7%) were at an advanced stage, and 6 (37.5%) had an unfavorable prognosis. The ABVD protocol was used in 13 patients (54.2%), receiving between 1 and 6 cycles. One patient achieved complete remission (4.1%), three deceased (12.5%), and 17 (71%) were lost to follow-up. Hodgkin's lymphoma prognosis remains unfavorable with low remission rates in Togo. Improving the technical facilities will ensure better management of this lymphoma.
Jan 2024 DOI 10.14302/issn.2574-4496.jtc-23-4835
The prevalence of thyroid cancer is rapidly increasing worldwide, majorly due to overdiagnosis and overtreatment methods of differentiated thyroid cancer. The emergent and potent preclinical models, high-throughput molecular techniques, and genetic expression microarrays have delivered deeper insights into understanding the molecular features in oncogenesis. Thus, molecular markers have become a promising tool in managing thyroid cancer for differentiating benign and malignant tumors, prognosis, recurrence, and determination of novel therapeutic targets. In differentiated thyroid cancer, molecular markers are majorly utilized for guiding the development of indeterminate thyroid nodules on fine needle aspiration (FNA) histologies. Dissimilar to this, in advanced thyroid cancer, molecular markers permit targeted treatment of a modified signaling cascade. Determining causal mutation of targeted kinase receptors in advanced thyroid cancer can depict a promising treatment strategy with mutation-targeted tyrosine kinase inhibitors to reduce progression and eradicate mutation effects when conventional methods fail to manage. This review will focus on the molecular landscape and discuss the impact of molecular markers on the prognosis, treatment, and surveillance of differentiated and anaplastic thyroid cancer.
Sep 2023 DOI 10.14302/issn.3070-2232.jf-23-4696
Small island states, such as Malta face numerous, unique challenges in relation to agricultural sustainability, with solutions amenable to larger states being unfit given the particular characteristics of the island. These include the poor soil conditions, the limited water resources, the aging farmer population, farming being mainly part-time, and most farmers having no formal training. Currently farmers practice intensive agriculture to achieve higher crop productivity at lower production costs by relying heavily on agri-chemicals and over-extracting groundwater. This destroys the Maltese natural environment and urges for the development and implementation of sustainable agriculture practices, whereby traditional farming is supplemented with sustainable alternatives such that local agriculture remains productive in the long-term while safeguarding the local environment. Here we outline some of the critical issues that urgently need to be addressed and potential ways forward in relation to soil, water and biodiversity, implementing permaculture principles in small-scale, practical actions in order to improve the sustainability of local agricultural through a combination of scientific evidence, agricultural technology and traditional practices.
Aug 2023 DOI 10.14302/issn.2474-7785.jarh-23-4730
Background Osteoarthritis and depression are both key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. When combined what are the implications? Aim This mini review examines 2023 data pertaining to osteoarthritis and depression and older adults and a possible theoretical framework of stress that may direct our approaches in the future. Methods and Procedures Articles published between January 1 and August 15 2023 that addressed the current topic of interest and that were extracted from PUBMED, PubMed Central, Science Direct, and Google Scholar were carefully read and their key points arepresented in narrative form. Results As in the past, very few tangible theory-based prospective analyses that employ valid measures of depression and examine any association of any form of osteoarthritis longitudinally and in a consistent manner prevail. Several reports use the same or similar large cohort to draw upon, and find various degrees of clinical implications, but this may not embrace the need for more inclusivity, sampling strategies, control and diversity issues, as well as embracing the role of cognitions positive and negative. Conclusion Without efforts to develop sound research designs of diverse and carefully differentiated osteoarthritis substantive samples it is impossible to delineate the origin or implications of the osteoarthritis-depression linkage reported currently or arrive at a deep understanding of its relevance, to life quality and public health costs. What is needed to protect against or minimize either or both these clinically related disabling correlates in the aged population warrants timely study.
Aug 2023 DOI 10.14302/issn.2688-5328.ijp-23-4624
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.
Aug 2023 DOI 10.14302/issn.2639-3166.jar-23-4662
Environmental pollution until this moment still become crucial environmental problem. Environmental pollution can occur anywhere, one of them is in agriculture sectoral. Environmental pollution in the agriculture area caused by usage of chemical pesticide for managing agriculture. Using chemical pesticide can leave residue that raises pollution. Bioremediation become one of the solutions for the problem. Besides it is environmental friendly, bioremediation is also easy to apply and cheap. This study aim to examine the potency of Bacillus altitudinis , Bacillus subtilis, Pseudomonas b68, and Pseudomonas b70 as biological agent for bioremediation of pesticide residues in soil Biological agent was incubated in liquid medium polluted pesticide type fungicide for 15 days on some variation concentration pesticides (100, 200, 300) mg/L. Concentration of pesticides and values Optical density (OD) is measured every 3 days with spectrophotometer UV -Vis on long 280 nm and 578 nm waves. The Results showed that the bioagents lower pesticides concentration. and can growing under polluted pesticides conditions The effectiveness and decline in pesticide residue by Bacillus altitudinis ranged from 49.91-59.33%; Bacillus subtilis (50.06-60.51%); Pseudomonas b68 (81.32-86.13 %); Pseudomonas b70 (50.02- 62.1 %). The bioagents produced decreases in the concentration of pesticides, increase in OD value, and decrease in pH indicate. The results affirmed that Bacillus altitudinis, Bacillus subtilis, Pseudomonas b68, and Pseudomonas b70 are effective as bioagents in the remediation pesticides polluted soils
Jul 2023 DOI 10.14302/issn.2574-450X.jom-23-4654
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.
Jul 2023 DOI 10.14302/issn.2639-3166.jar-23-4606
St. Augustinegrass (Stenotaphrum secundatum (Walt.) Kuntze) generally has poor cold tolerance yet good to excellent shade tolerance. As mostly hot summers follow cold winters in USDA Hardiness Zone 7, severely damaging tall fescue (Lolium arundinaceum (Schreb.) Darbysh.) and centipedegrass (Eremochloa ophiuroides (Munro) Hack.), a St. Augustinegrass cultivar cold tolerant enough to be grown for shady lawns would greatly benefit home owners, recreational sites, and sod growers in the “transition zone.” Eight St. Augustinegrass samples were selected, including industry standards ‘Raleigh’ and ‘Palmetto’, plus ‘Palisades’ zoysiagrass (Zoysia japonica Steud.) for further testing from an established germplasm collection of material collected from lawns grown in USDA Hardiness Zone 7. Overall, based on 8-week greenhouse studies, the experimental lines had similar shade tolerance compared to commercial standards ‘Raleigh’ ‘Palmetto’ and ‘Palisades’ zoysiagrass. Field studies may be warranted to validate greenhouse studies to help further evaluate shade tolerance of experimental and commercial lines. Information generated supports the use of certain St. Augustinegrass selection in a wider environmental conditions such as reduced light environments (RLE).
Jun 2023
The increasing demand for environmentally-friendly materials has led to a surge in research on the production of biodegradable polymers. In this study, we investigate the synthesis of a biodegradable polymer by graft copolymerization of gum Arabic (GA) and polyethylene glycol (PEG). GA, a natural polysaccharide and PEG, a synthetic water-soluble polymer, were used as the backbone and graft monomer, respectively. The graft copolymerization was carried out using benzoyl peroxide as an initiator and performed under nitrogen atmosphere. The resulting polymer was characterized by Fourier transform infrared (FTIR) spectroscopy, Xray diffraction (XRD), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM). The FTIR spectra confirmed the formation of the graft copolymer, and TGA analysis showed that the copolymer had higher thermal stability than GA. The DTA thermograms indicated two thermal events. The evaporation of water and organic polyethylene glycol components was measured, and the first mass loss was due to the loss of adsorbed and structural water in the gum Arabic, which occurred between 31.87 and 180°C, while the second, corresponding to the pyrolysis of polyethylene glycol functional groups and polysaccharide decomposition, resulted in a 70% mass loss. SEM morphological analysis of gum Arabic showed aggregates of high irregularity in particle shape. The cracks and holes obtained in the Gum Arabic micrograph disappeared from the new gum Arabic-graft-polyethylene glycol, leaving a smooth surface with scattered particles in the image, which was due to the grafting copolymer. From the XRD patterns, the percentages of the amorphous and crystalline phases were determined. The results show that gum Arabic has a 78% degree of crystallinity, whereas gum Arabic-graft-polyethylene glycol has the lowest value of 51%. Biodegradation activity was observed using the fungus Aspergillus flavus on different days on gum Arabic-g-polyethylene glycol. The results clearly showed inhibition zones with a change in the state of the copolymer from solid to liquid from days 8 to 14. These results indicate that the GA-PEG copolymer has potential as a biodegradable material for use in various applications, such as packaging, agriculture, and medical industries.
Jun 2023 DOI 10.14302/issn.2641-4538.jphi-23-4443
A case commentary discusses a skeletal chondroblastoma with atypical features. It highlights imaging, pathology, and management considerations.
Apr 2023 DOI 10.14302/issn.2641-5518.jcci-23-4554
This report details sequential rare complications arising from a vascular stent infection. Clinical course, microbiology, and imaging are outlined, with emphasis on early recognition and multidisciplinary management. Lessons for device surveillance and antimicrobial stewardship are highlighted.
Mar 2023 DOI 10.14302/issn.2470-0436.jos-21-4021
A case of lacrimal gland adenoid cystic carcinoma in a 36‑year‑old male is presented. The report reviews imaging, histopathology, perineural invasion risk, and multimodal management including surgery and radiotherapy.
Feb 2023 DOI 10.14302/issn.2641-5526.jmid-23-4450
Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.
Dec 2022 DOI 10.14302/issn.2574-4526.jddd-22-4151
Steroid cell tumors of the ovary are particularly rare, secreting sex hormones, characterized by steroid cell proliferation and represent only 0.1% of all ovarian tumors. They are classified into three subtypes according to their cell of origin: stromal luteoma, Leydig cell tumors and a third subtype of unknown lineage corresponds to a not specified steroid cell tumor (SCT-NOS). This third subtype accounts for 60% of steroid cell tumors. The clinical manifestations of SCT-NOS can take many forms, including pain, abdominal distension, but perhaps the most visible presentations are those related to hormonal activity and virilization of the tumor. We present a rare case of a 48-year-old woman with vaginal bleeding and a history of trunk obesity, hirsutism for 2 years and hypothyroidism with hormone replacement therapy. Clinical examination revealed a characteristic of obesity, virilization. Serum testosterone was 3.62 µg / L and CA-125 was 40.67. Magnetic resonance imaging identified a left ovarian solid mass and histopathology confirmed a steroid cell tumor not specific. The patient underwent exploratory laparotomy and left salpingoophorectomy. Macroscopically, the mass is well circumscribed, solid, homogeneous and yellowish. Microscopically, the tumor is mainly composed of eosinophilic or vacuolar granular cytoplasm. Immunohistochemistry showed that the tumor cells were strongly positive for inhibin. The postoperative period was uneventful. Through this rare observation, we will discuss the aspects that characterize this type of tumor and present some guidelines to be used in the differential diagnosis, as well as the difficulties encountered in the clinical, radiological and therapeutic fields.
Dec 2022 DOI 10.14302/issn.2641-5518.jcci-22-4374
Intrathoracic foreign bodies secondary to penetrating wounds are rare in children. We report the observation of a 10-year-old patient who presented an intrapulmonary metallic foreign body following a playful accident. Its migratory aspect, highlighted by imaging, required urgent extraction which was performed by thoracotomy, with good clinical outcome. The interest of the question lies in the circumstances of the incident, the type of foreign body and the terrain.
Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4115
Background Cameroon is battling against the novel coronavirus (COVID-19) pandemic. Although several control measures have been implemented, the epidemic continues to progress. This paper analyses the evolution of the pandemic in Cameroon and attempts to provide insight on the evolution of COVID-19 within the country’s population. Methods A susceptible-infected-recovered-dead (SIRD)-like model coupled with a discrete time-dependent Markov chain was applied to predict COVID-19 distribution and assess the risk of death. Two main assumptions were examined in a 10-state and 3-state Markov chain: i) a recovered person can get infected again; ii) the person will remain recovered. The COVID-19 data collected in Cameroon during the period of March 6 to July 30, 2020 were used in the analysis. Results COVID-19 epidemic showed several peaks. The reproductive number was 3.08 between May 18 and May 31; 2.75 between June 1 and June 25, and 2.84 between June 16 and June 24. The number of infected individuals ranged from 17632 to 26424 (June 1 to June 15), and 28100 to 36628 (June 16 to June 24). The month of January 2021 was estimated as the last epidemic peak. Under the assumption that a recovered person will get infected again with probability 0.15, 50000 iterations of the Markov chain (10 and 3- state) demonstrated that the death state was the most probable state. The estimated lethality rate was 0.44, 95%CI=0.10%-0.79%. Mean lethality rate assuming ii) was 0.10. Computation of transition probabilities from reported data revealed a significant increase in the number of active cases throughout July and August, 2020, with a mean lethality rate of 3% by September 2020. Conclusion Multiple approaches to data analysis is a fundamental step for managing and controlling COVID-19 in Cameroon. The rate of transmission of COVID-19 is growing fast because of insufficient implementation of public health measures. While the epidemic is spreading, assessment of major factors that contribute to COVID-19-associated mortality may provide the country’s public health system with strategies to reduce the burden of the disease. The model outputs present the threatening nature of the disease and its consequences. Considering the model outputs and taking concrete actions may enhance the implementation of current public health intervention strategies in Cameroon. Strict application of preventive measures, such as wearing masks and social distancing, could be reinforced before and after the opening of learning institutions (schools and universities) in the 2020/2021 calendar year and next.
Mar 2022 DOI 10.14302/issn.2644-1101.jhp-22-4129
This essay discusses the practical aspects of mediation and arbitration. The article outlines effective steps to implement win-win, win-lose, lose-win, and lose-lose negotiation strategies. It is posited that with a win-win strategy, the job of a mediator or arbitrator is to find a win-win scenario that is acceptable to both sides. The role of a mediator or arbitrator when the parties are engaging in win-lose, lose-win, and lose-lose strategies is different in that at least one of the parties is not seeking a win for all sides. In particular, when the parties are not involved in a win-win, and court is an option, the parties need to gain as much information about the opposing party as possible to use it to their advantage in court. This is unfortunate but, at times, a necessary result of not participating in a win-win outcome.
Feb 2022 DOI 10.14302/issn.2470-5020.jnrt-22-4092
Acute disseminated encephalomyelitis (ADEM) is a monophasic, multifocal, demyelinating, autoimmune disease that affects the central nervous system (CNS). It usually occurs after a systemic infection, usually viral, including certain coronavirus infections. A 27-year-old girl presented with complaints of left interscapular pain, paresthesias and weakness in the ipsilateral upper limb. These symptoms followed paresthesias on the fingertips of her right hand the day before her admission. she was treated two weeks earlier for pneumonia with COVID-19. Her clinical pattern resulted in a moderate weakness of the left limbs associated with tactil and algic hypoesthesia in the lower left limb ascending until the C4 level in the left side. Magnetic resonance imaging (MRI) of the brain and spinal cord showed diffuse spontaneous hypersignals on fluid-attenuated inversion recovery (FLAIR) images at the cerebral level and on T2-weighted images at the spinal level. These imaging lesions coupled with the medical history of a recent COVID-19 infection led to the diagnosis of acute disseminated encephalomyelitis (ADEM) post covid-19. The clinical condition improved rapidly with intravenous (IV) corticosteroid therapy and IV immunoglobulin combined with physiotherapy. ADEM is a demyelinating autoimmune disease which is increasingly reported during this current corona virus pandemic.
Feb 2022 DOI 10.14302/issn.2692-1537.ijcv-21-4053
Drug industry, controlling medical publishers and large media promote flawed medicine for their revenues by systematically laundering medical knowledge in decades. They maintain and promote flawed research models and suppress disruptive discoveries, thereby precluding reform of medicine. In this study, I will deeply explore how the wrong life model, population-based research model, misused clinical trials, flawed statistical models, the symptom based research methods, binary disease classification, failure to address the massive vital organ capacities, failure to correct biases caused by expected delay in realizing side effects, and failure to address the interference effects of non-controllable factors affect the conclusions of “effectiveness and safety” for mRNA vaccines. I will directly analyze three studies that have been relied upon by FDA in approving mNRA use authorizations: one BNT162b2 effectiveness study published in NEJM, one booster shot study published in NEJM and a Seven Integrated Health Care Organizations study published by CDC. I will expose fatal flaws in the frequency risk concept, effectiveness rate, and hazard reduction ratios, and show why 3% death rate, 95% effectiveness rate and 90% mortality reduction are all meaningless and misleading, and should never have been used as treatment guidance. I will also examine common biases that can be easily practiced by sponsors’ researchers to alter conclusions in favor of approval. By relying on laundered medical “knowledge”, FDA has consistently failed to predict latent drug side effects for any drugs and vaccines in its history. FDA approved disastrous DES in 1941, Swine Flu vaccine in 1976, and mRNA vaccines in 2020. The vaccines are used to deliver short-term benefits on a small percent of persons at the costs of damaging health, causing deaths that could be avoided, and shortening lifespans for all people in the population. I thus urge FDA to reevaluate all mRNA vaccines and revoke their use authorizations.
Dec 2021 DOI 10.14302/issn.2577-2279.ijha-21-4012
Knowledge of accurate surface anatomy is essential for safe clinical practice. Different views and opinions for clinically important surface markings exist between clinicians. Pericardiocentesis is performed as an emergency procedure in conditions aggravating cardiac tamponade. The approach of pericardiocentesis should be held by the hands of an experienced operator because of the surrounding relations. Nowadays, the introduction of imaging-guided procedures, especially echo-guided procedures, has significantly improved the safety and feasibility of pericardiocentesis and has provided the possibility of choosing the best anatomical approach among the apical, subcostal and parasternal approaches. This case report also emphasizes the importance of instillation of agitated saline as a supplementary technique while performing echo-guided pericardiocentesis in order to reduce the likelihood of cardiac chamber perforations.
Dec 2021 DOI 10.14302/issn.2474-7785.jarh-21-4041
Background Many older adults are vulnerable to becoming frail. They are also often at risk for falling and serious injuries and poor health outcomes. Aim This exploratory review examines the correlates of frailty, and fear of falling and their association insofar as older adults wellbeing may be jeopardized. Methods and Procedures Articles extracted from major electronic data bases that addressed the current topic of interest were used. Key findings regarding the syndromes of frailty and fear of falling were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to exhibit frailty or become frail as they age. Many too are at risk for falls and fear of future falls, regardless of frailty status. A persistent fear of falls may however, heighten frailty risk or manifestations if not duly addressed in a timely manner. Conclusion Prompt comprehensive assessment of at risk older adults, as well as the frail and pre frail older adult, plus those who have fallen may avert serious injury and long term disability plus excess frailty and its deleterious impacts this syndrome has on aging older adults as well as societies.
Nov 2021 DOI 10.14302/issn.2470-0436.jos-21-4003
This is a case of a pediatric patient who presented with a sudden onset of right abducens nerve palsy with contralateral hemiplegia with no facial paralysis. With the constellation of symptoms aided by the presence of enhancing pontine mass on magnetic resonance imaging, the presence of diffuse intrinsic pontine glioma (DIPG) was presumed to have caused the findings consistent with the common type of Raymond syndrome.
Oct 2021 DOI 10.14302/issn.2470-0436.jos-21-3978
Objective To present a case of Bilateral Internuclear Ophthalmoplegia in a 75yo patient Case Description A 75 year old, Filipino, male, known hypertensive for 10 years, but not compliant to medications, presented with a sudden onset binocular horizontal, diplopia and bilateral exotropia associated with dizziness. No other symptoms like slurring of speech, body weakness, numbness were noted. Primary gaze exotropia, abduction nystagmus, gaze evoked vertical nystagmus were also noted. Imaging was done which revealed hypodense focus in the subcortical region of the right centrum semiovale extending to the right corona radiata, with unremarkable orbits, midbrain and pons findings. WEBINO was still considered even without the presence of a pontine lesion in the imaging. The patient was advised patching and was asked to follow up after a month.
Sep 2021 DOI 10.14302/issn.2639-3166.jar-21-3955
In the cultivation of vines the risk of hail appears to be increasing with the ongoing climate change. The use of protective plastic nets is spreading, but there is little knowledge on the additional processing costs and on the phenological and qualitative consequences, moreover, as depending on different colors of the nets. Thus, a randomized trial was carried out in Nebbiolo, a wine of great aging, testing three plastic anti-hail nets colored in green, gray and black. Results showed that 24% more-time was necessary for the canopy management practices under the nets. The black nets advanced the ripening process, with a berry weight decrease of about 13%. A significant decrease in the seed number per berry was observed under the black nets (-45%), while a rise (+102%) was observed under the green and gray nets with a parallel increase in the pH of the juice (+13%) and in malic acid (+28%) under the green nets. The berry skin did not show any significant differences in polyphenol and anthocyanin profiles, while the plants that matured in the upper part of the vineyard showed higher level in the berry skin extractable flavan-reactive to vanillin, and total polyphenol. On the other hand, in the seeds grown under green nets an increase in the extractable polyphenol compounds was observed, sign of a delay in seed ripening, with a higher tannin polymerization ratio, preserving the malic acid, and decreasing the acidity of the berry. In conclusion, the use of colored green may be a useful tool against excessive microclimatic warming and / or irradiation. The field internal variability affects much more the ripening dynamics than the nets used. A second aim was to develop a smart NIR SCiOTM model for polyphenols and the results were in line with the favorable expectations, providing R2 predictions of about 0.74 from the skin and 0.81 from the seeds.
Aug 2021 DOI 10.14302/issn.2474-7785.jarh-21-3935
Background Anxiety and depression are key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. Aim This mini review examines the potential of low level laser treatments or photobiomodulation therapy for ameliorating severe anxiety and depression in older adults. Methods and Procedures Articles that adressed the current topic of interest extracted from PUBMED and Google Scholar were carefully and presented in narrative form. Results Photobiomodulation therapy appears to be a safe efficacious modality for ameliorating various degrees of anxiety and depression and for improving cognition, and is supported by several well established mechanisms of action at the molecular, cellular, and tissue levels. Conclusion More research to examine who might benefit most from this form of therapy, and in what respect in this area of growing global concern and few intervention options is strongly warranted.
Aug 2021 DOI 10.14302/issn.2689-5773.jcdp-21-3890
Splenic hydatid cyst is very rare, caused by the parasite echinococcus granulosus. Humans are considered an accidental intermediate host in the development of the parasite cycle. It poses a diagnostic dilemma with other cystic masses despite improved medical imaging techniques often requiring exploratory surgeries for fear of missing out on a malignant tumor. Total or partial splenectomy remains the treatment of first choice and the most effective. We report a case of solitary splenic hydatid cyst and discuss the different differential diagnoses and therapeutic modalities.
May 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3783
Background Klippel-Feil Syndrome (KFS) is described as the clinical triad of short neck, low posterior hairline, and limitation of neck mobility. Objective Topresent our clinical experience with KFS patients who also had adjacent segment disease (ASD) and to propose a novel classification system for these patients. Methods This retrospective study was performed in the neurosurgery department of our tertiary care center. Data were gathered using the medical records of 22 KFS patients (10 males, 12 females) with ASD. Diagnosis was confirmed with imaging modalities including X-ray, computerized tomography, and magnetic resonance imaging. Clinical and radiological findings as well as therapeutic outcomes were noted. Results The average age of our series was 56.09 (range: 41 to 67) years. The operative technique was selected as for our novel “Yilmaz-Yucesoy Classification System”. Accordingly, one patient (4.54 %) received non-surgical treatment (Yilmaz-Yucesoy Grade 1), six cases (27.27 %) underwent anterior cervical arthroplasty, seven patients (31.81 %) underwent anterior cervical discectomy or corpectomy and fusion with cervical cage and plate (Yilmaz-Yucesoy Grade 3). Eight patients (36.36 %) with cervical spinal instability had anterior cervical discectomy or corpectomy and fusion with cervical cage and plate (Yilmaz-Yucesoy Grade 4). No mortality or remarkable complications were detected. Conclusion Appropriate and timely recognition and classification of patients with KFS and ASD based on our newly proposed “Yilmaz-Yucesoy Classification System” yielded promising treatment outcomes. However, further prospective, randomized, controlled trials are warranted on larger series to validate our preliminary results.
May 2021 DOI 10.14302/issn.2689-5773.jcdp-21-3799
Preface Frequently, benign bone tumours are an incidental discovery wherein clinical symptoms are contingent to tumour location and magnitude and manifest as localized pain, swelling, skeletal deformities or pathologic fracture. Radiographic imaging is a cogent methodology of discerning the neoplasms.
Apr 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3804
An algorithm to determine the possible mutations that can occur in the S protein responsible of the Covid-19 in humans is designed. To do that, nine tridimensional sequences available in the Protein Data Bank similar to the initial strain sequenced in Wuhan (December 2019) are identified. The conditions driving this potential mutation are: (1) an accumulated number of mutations greater than (or equal to) 5 in each position; (2), a cumulative value of the different variations of Gibbs free energy less than -2.0 Kcal/mol; and (3), a squared fluctuation greater than 1.6 Å obtained according to calculations for normal mode analysis based on anisotropic network models (ANM) after averaging the first 20 vibration modes. The result is that 491 positions can mutate, while 424 positions did not provide any mutation. Finally, the results reveal that there are mutations that cannot be predicted, so more studies are needed to determine why they are present in the human population.
Apr 2021 DOI 10.14302/issn.2470-0436.jos-21-3710
Introduction Large impaled object in the orbital region causes severe visual impact and requires specialized care within the shortest time possible. Objectives In this case report, we discussed the approach and management of a patient that presented with a penetrating orbitocranial injury, from management at the emergency unit, diagnostic imaging, referral to other subspecialty, surgical and medical intervention, and post-operative care. Discussion A 36-year old male had an impaled toilet brush on the supero-nasal aspect of the right orbit, with visual acuity of 6/60 and lacerated upper eyelid. The globe had minimal movement on all gazes, but pupil was reactive to light with no afferent defect. On plain cranial and orbital CT-scan, the foreign body entered the anterior and medial aspects of the right orbit penetrating the right superior orbital wall, right medial lamina papyracea, and the lateral and inferior border of the right frontal sinus with its distal tip at the intracranial region at the right frontal lobe compressing the medial rectus along its tract. Two hours after injury, patient underwent wound exploration, removal of foreign body, repair of eyelid laceration, right craniotomy, frontal contussectomy, duraplasty, and JP-drain insertion under general anesthesia. Intraoperatively, there was note of transected canaliculus and avulsed conjunctiva. The medial rectus was intact and attached. The frontal lobe was contused with embedded fragments of right posterior orbital bone with 3cm opening on the dura. Post-operatively, Fluconazole was added to the medications after culture results of the toilet brush tip tested positive for fungal elements. Patient was discharged after 21 days with visual acuity of 6/6 on both eyes and improved ocular movement. Conclusion These types of injury warrants thorough and systematic history taking and physical examination, acquiring pertinent imaging modalities to better visualize the extent of injury, and execute surgical and medical intervention that is multidisciplinary.
Mar 2021 DOI 10.14302/issn.2329-9487.jhc-21-3742
Cardiovascular disease is actually a major cause of mortality, illness and hospitalization worldwide. Several risk factors have been identified that are strongly associated with the development of cardiovascular disease. Public prevention strategies have relied predominately on managing environmental factors that contribute to cardiovascular disease, such as obesity, smoking and lack of exercise. The understanding of the role of genetics in cardiovascular disease development has become much more important to link genetics with the onset of disease and response to therapy. This seeks to examine how genes can predispose individuals to cardiovascular disease and how this knowledge might be applied to more comprehensive preventive strategies in the future. In addition, the review explores possibilities for genetics in cardiovascular disease treatment, particularly through the use of identified driver genes and gene therapy. To fully understand the biological implications of these associations, there is a need to relate them to the exquisite, multilayered regulation of protein expression and regulatory elements, mutation, microRNAs and epigenetics. Understanding how the information contained in the DNA relates to the operation of these regulatory layers will allow us not only to better predict the development of cardiovascular disease but also to develop more effective therapies.
Mar 2021 DOI 10.14302/issn.2329-9487.jhc-21-3754
Themain left coronary artery and its branches have wide variability in its morphology regarding caliber, as seen through angiographic imaging. This study aims to determine the diameters of the left coronary artery and its branches among the Sudanese population & to correlate these diameters and the personal and health data. Angiography of 441 patients of both sexes was used in this study. Personal and health information was obtained from the records. We found that the left coronary artery's diameter was between 2.90- 4.90mm, with an average of 3.96mm. The diameter of the left circumflex artery in the range between 1.70- 4.70mm, with an average of 2.73mm, and that of the anterior descending artery in the range between 1.20- 4.70mm, with an average of 2.78mm. We correlated the diameters of the three arteries and the variables of age, gender, BMI, coronary artery disease, smoking habits, and hypertension. Wefound many correlations to be significant. We concluded that the diameters of the left coronary artery and its branches are affected by age, gender, BMI, coronary artery disease, smoking habits, and hypertension.
Mar 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3736
In the catering industrytobacco smoke was the primary source of fine and ultrafine particles, which are well known for their health-damaging effects. As shown in studies, attempts to reduce passive smoking in the catering industry of Vienna, like separated smoking rooms, failed to reduce fine and ultrafine particle concentrations effectively. On November 1st 2019, an enlarged non-smoker’s protection law was introduced, including a total smoking-ban in the catering industry. 40 hospitality venues with areas for smokers and non-smokers before the ban had been selected as typical Viennese cafes, pubs, bars and discotheques to be sampled unannounced. Concentrations of fine particle mass (PM10, PM2.5, PM1) and ultrafine particle number (PNC) and lung deposited surface area (LDSA) could be measured before and after the introduction of the smoking-ban in 39 venues at nearly identical locations and under comparable circumstances. Results showed a statistically significant decline in both fine and ultrafine particle concentrations in the former smoking areas for all parameters as well as in the former non-smoking areas for PM2.5, PM1 and LDSA. After the ban concentrations in former smoking areas and non-smoking areas showed no significant differences any more. From these results the smoking-ban successfully removed particles from breathing air of guests and staff, however, some outliers in the study after the ban point to the necessity of repeated controls in Vienna. Also, outside Vienna the compliance with the law should be controlled in the Austrian hospitality industry.
Feb 2021 DOI 10.14302/issn.2474-7785.jarh-21-3752
Background Falls injuries continue to contribute to numerous premature deaths as well as high disability levels, and excess morbidity rates among older adults, worldwide. But can vitamin D account for excess falls injuries among older adults? This review specifically focuses on what is known about vitamin D in the context of postural stability or balance control, both fairly consistent independent predictors of falls among older adults. Methods and Procedures Drawn largely from a review of current relevant English language peer reviewed research publications published over the last 10 years detailing the relationship between vitamin D levels and balance control among the elderly, as this relates to falls injuries, evidence for any emerging consensus on this controversial topic was sought. Used to conduct the search were various key word combinations including: falls injuries and older adults, vitamin D or vitamin D deficiency and balance or postural control. The database used predominantly to provide input into this largely descriptive assessment and narrative overview was PUBMED. Results The prevailing data show falls injuries currently constitute a widespread costly major impediment to successful aging and longevity for many older adults, despite numerous efforts to prevent this disabling set of events over the past two to three decades. However, no consistent association appears to exist between the variables of vitamin D, falls, and balance attributes in the older population-despite years of research, regardless of study approach, and a strong rationale for hypothesizing a clinically meaningful relationahip. Conclusion It is not possible to arrive at any universal recommendation concerning the value of vitamin D supplementation as regards its possible influence on balance capacity among older adults in the realm of falls prevention efforts, as has been frequently proposed. However, until more definitive research is conducted, there still appears sufficient justification for considering the screening of vulnerable aging adults for serum vitamin D levels, along with balance impairments, and intervening as required in the case of deficits in either or both of these possible falls determinants.
Feb 2021
Introduction Risk reduction intervention is meant to provide enhanced and desirable interventions for HIV prevention among adolescents especially the in-school. Adolescents have been identified as the most vulnerable groups that can easily acquire human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). Therefore, adolescents are the appropriate target for HIV prevention efforts. Most interventions for adolescents focus on providing AIDS-related education with the assumption that improving knowledge would enable adolescents to protect themselves from sexually transmitted infections. Numerous studies have shown that using class-room education alone is insufficient in reducing adolescents’ risky sexual behaviours. Therefore, this study used role-plays and peer facilitation for the study. Materials and Method The study used role-play and peer facilitation for the intervention strategy. The theme of the role-play was ‘My Future is My Choice’ (MFMC) intervention which was aimed to reduce HIV risk behaviours among sexually inexperienced adolescents. The role-play was carried out by 4 peer leaders who were trained in the theoretical framework of role-plays and peer facilitation by a consultant. With mastery and experience they carried out the role play in a regular classroom section for over 3 class periods, co-facilitated with the assistance of a volunteer teacher. A unique feature of this intervention was the dual focus on strategies that influenced both individual risk factors (i.e., attitudes, behavioural skills) and social environments (e.g., peer resources). A school was chosen by simple random sampling for the intervention. In the school chosen, a total sample of 65 students in senior secondary classes 2&3 ( SS2&3) were included in the study. These were the students considered to be sexually active who can respond to the questions in the questionnaire. Self-administered pre-and post-questionnaire were completed by the students. The results were analysed using frequency tables, descriptive and inferential statistics. Results The students studied were between the ages of 13-18 years. There was evidence that the role play ‘My Future is My Choice’ (MFMC) intervention created positive effects on reduction of HIV risk behaviours among the sexually inexperienced participants aged 13–18. Perceptions on methods of preventing risk reduction behaviours were also positively impacted by the intervention as 12(18.5%) and 34(52.3 %) of the respondents realized after post- intervention that having sex with someone outside marriage and being transfused with infected blood respectively Will constitute risk to HIV infection. Conclusion The role play which used the theme ‘My Future is My Choice’ (MFMC) intervention provided safer choices for reducing one or more measures of sexual risk behaviours among the sexual inexperienced respondents. It created the opportunity for the students to recognize that engaging in unprotected sex constitutes high risk for HIV, other sexually transmitted infections and pregnancy.
Feb 2021 DOI 10.14302/issn.2328-0182.japst-21-3700
Objectives The present study addresses evaluation of acacia-guar gum combination as an enteric former for tablet coating aiming to add knowledge on how develop the ability of enteric forming ability of acacia-guar combination. Methods Five formulations of enteric coating solution incorporating guar gum as delayed release polymers along with film coating material acacia gum followed by CMC and glycerin as plasticizer and coloring agents were prepared to coat placebo tablet cores. Different enteric coating formulations organized in different acacia : guar gum ratios as 1:1, 1:2, 1:3, 1:4 and 1:6 were sprayed on placebo tablets surface resulted different delayed coated tablets (F1,F2,F3,F4 &F5) respectively. General appearance and physical parameters were evaluated of each. Enteric coated tablets that revealed promising properties were subjected to accelerated stability study for 3 months to explore the influences of physical aging on tablet coat properties. Results Physical parameters of enteric coated tablets post coating within the range of pharmacopeia specification. The disintegration test was carried out in pH 1.2 and pH 6.8 at 37ºC. F1, F2 and F3 enteric tablets disintegrated immediately with no acid resistance compared F4 and F5 enteric tablets showed good acid resistance coat with smooth tablet surfaces and no coat defects. F5 formula contain acacia: guar gum as 1:6 ratio showed delayed release for 30min in pH 1.2 and 15min in phosphate buffer. The study statistically analyzed and concluded that, an efficient and stable acacia-guar enteric coat is achievable with no effect on tablets physical parameters. Guar gum at 60% as a delayed tablet coating material capable of protecting the tablets core from being released in acidic media and be release in the alkaline buffer as well as stable coat under accelerated storage for three months.
Feb 2021 DOI 10.14302/issn.2641-4538.jphi-21-3725
This brief report article is a retrospective, descriptive, first-person account of following-up on a difficult-to-find client of an HIV/AIDS community-based pre-post intervention and disease prevention Research and Demonstration project in Houston, TX. Through the story about the personal journey of searching for the client, the author experiences an epiphany, especially in light of current events. Specifically, as opposed to social distancing and disconnection, public health disease prevention probably would be better served through leveraging the powerful and positive natural human features of social connectivity and closeness.