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Mar 2026 DOI 10.14302/issn.2574-4518.jsdr-26-6010
Background/Aim Sleep disturbances are common and are associated with impaired daytime functioning, reduced quality of life, and increased health risks. Non-pharmacological neuromodulatory interventions have gained interest as alternatives to hypnotic medication. Pulsed electromagnetic field (PEMF) therapy has been proposed as a non-invasive approach to improve sleep quality and recovery, but evidence from large, well-controlled trials remains limited. The objective of this study was to evaluate the efficacy and safety of pulsed magnetic field therapy (PMT) on sleep quality, sleep-related symptoms, daytime functioning, and well-being in adults with heterogeneous sleep complaints. Materials and Methods In this remote, randomized, double-blind, placebo-controlled trial, 217 adults reporting non-restorative sleep, difficulties initiating sleep, or frequent nocturnal awakenings were assigned to active PMT using a PEMF device (Night Harmony Female/Male protocol) or a sham application for three weeks. Primary outcomes were changes in the Pittsburgh Sleep Quality Index (PSQI) global score and self-rated sleep satisfaction, restfulness, and sleep initiation difficulties. Secondary outcomes included sleep diary measures, daytime functioning, well-being (WHO-5), symptom burden (MYMOP), and daytime sleepiness (Epworth Sleepiness Scale). Analyses followed the intention-to-treat principle using ANCOVA with baseline values of the respective parameter as covariate. Results Both groups showed significant improvements over time in global sleep quality and most secondary outcomes (p < 0.001). Between-group differences in PSQI global score were not significant (p = 0.314). However, active PMT resulted in significantly greater improvements in subjective sleep satisfaction (p = 0.02) and restfulness (p = 0.02), particularly among participants with moderate to severe baseline sleep disturbances (p < 0.001 for both). Sleep continuity measures improved similarly in both groups. No serious adverse events were reported. Conclusions PMT produced modest but significant improvements in subjective restorative aspects of sleep beyond placebo effects and was well tolerated. Further studies using objective sleep measures and longer follow-up are warranted.
Dec 2025
Background Research and drug development industries have multiphase drug screening procedures, which can be debated. As a result, harmful products may still reach for public health service delivery due to vulnerabilities in the process. Main body A wide range of test compounds have delayed manifestation of undesired effect on the study subject, with the time to undesired effects after acute exposure being weeks and months. Acute toxicology in a preclinical trial also has limited clinical value as its lethal dose is the endpoint for a conclusion, and death sometimes occurs after a scheduled period of acute toxicology. Countless resources are wasted, and numerous new drugs are introduced into the pharmaceutical market with assumed safety analysis every year due to vulnerable multi-procedures in preclinical trials. The principal use of collected data from a preclinical trial is to support regulatory categorization and harmful labelling decisions. However, the data can also be used to derive safe use threshold levels, which may lead to the use of unsafe material. The criteria for classification and labelling also differ among countries, sometimes among authorities within the same country. The fundamental concept of toxicology states that ‘all chemical substances are potential poisons depending on the amount and duration of exposure. However, the toxic property of a test compound cannot be created or eliminated by simply the amount administered to study animals. Conclusion All xenobiotics are poisons at any amount with different severity that can be calculated using biological parameters.
Dec 2025 DOI 10.14302/issn.2329-9487.jhc-25-5778
Calcium channel blockers (CCBs) are widely used for the treatment of arterial hypertension, but they differ in terms of pharmacology, tolerability, and pleiotropic actions. Lercanidipine, a highly lipophilic third generation dihydropyridine, reduces blood pressure (BP) effectively as monotherapy and in combination without inferiority to other major antihypertensive classes. We systematically searched PubMed and the Cochrane Library (last update: September 1, 2025) and screened reference lists for additional studies. Evidence from dose finding trials, randomized controlled studies, large observational cohorts, and meta analyses shows clinically meaningful reductions in office, home, and ambulatory BP with lercanidipine, including in patients with diabetes, obesity, chronic kidney disease, or high cardiovascular (CV) risk. Fixed- dose combinations with renin angiotensin system blockers (e.g., enalapril) provide greater BP reductions than monotherapy and are associated with favorable neurometabolic profiles. Beyond BP control, lercanidipine improves central hemodynamics and arterial stiffness, favors endothelial biology, and contributes to left ventricular hypertrophy regression. Across comparative trials, lercanidipine is generally better tolerated than older dihydropyridines. Presents lower rates of vasodilatory adverse events, less sympathetic activation, while discontinuations due to adverse events are uncommon. Overall, lercanidipine particularly within single pill combinations offers effective, durable BP lowering across diverse patient profiles with a favorable safety and tolerability profile and pleiotropic benefits that extend beyond BP reduction. Figure 1. Graphical Abstract: Pleiotropic effects of Lercanidipine
Feb 2025 DOI 10.14302/issn.2641-4538.jphi-25-5436
High rates of workplace psychological stress and burnout have been chronic among Healthcare Practitioners. Research shows that Healthcare Practitioner psychological stress / burnout is related to poor quality of care and a high probability of making medical errors and mishaps resulting in harm to patients and even workers themselves. In response, relatively impactful programs have been developed to address Practitioner burnout. To derive a better understanding of the subject and inform best practices and policy regarding the problem and its fixes, this article reports findings from a novel study of a systematic (PRISMA-based) literature review of current (circa ~10 years <) literature reviews; or a distillation of reviews already at 100 proof then undergoing a further distillation into a review of 200 proof.* This study employed a grounded theoretic qualitative methodology to iteratively generate and enumerate descriptive themes from the study’s literature review articles. This article reports on what is currently known regarding the precipitants of Health Practitioner Burnout, Burnout itself, its relationship to Safety lapses and mishaps, and Programmatic Interventions (i.e., Fixes). The primary conclusion is that Health Practitioners are the foundation of healthcare organizations and key to quality care and management / leadership should be concerned for their wellbeing; and this article provides a general blueprint in terms of addressing burnout and safety. Study Limitations and Future research are also discussed.
Dec 2024 DOI 10.14302/issn.2835-2165.jfsh-24-5371
One of the primary goals and aims of studying chemistry in society is the promotion of the well-being of humanity and the sustainable utilization of the available resources. Chemistry has played a significant role in water treatment, food production, energy production, and medicine, among other critical areas of society. This study explored the utilization of liquid chromatography-mass spectrometry in the aspect of promoting food safety for human consumption. Various factors might affect the composition and storage of the food items in the society. Through the utilization of chemistry techniques such as (LC-MS), there can be Identification of the various aspects that require consideration in the Improvement of the different health and nutritional requirements that the food items are expected to have in society. As illustrated in this study, the analytical and technical aspects are highly influential in the determination of the proper measures for each component and the illustration of the various toxins that are likely to affect the overall food safety of the members of society in general.
Jun 2024 DOI 10.14302/issn.2379-7835.ijn-24-5117
In this study, the efficacy and safety of DKB-131 (extract of Siraitiagrosvenorii) in adults of both genders presenting mild symptoms of knee arthritis were evaluated in comparison to a placebo. This clinical trial was randomized, double-blind, multicenter, and lasted for 12 weeks. A total of 120 participants with Visual Analogue Scale (VAS) scores of 30 mm or higher in the knee area and Kellgren & Lawrence Grade I or II knee arthritis on X-ray were enrolled, with 60 subjects randomized to receive DKB-131 and 60 subjects receiving placebo. Following 12 weeks of consumption, the change in K-WOMAC total score assessed in the per protocol (PP) set revealed a reduction of 21.86±15.98 points in participants who received DKB-131 (p<0.0001), whereas those in the placebo group exhibited a reduction of 14.92±16.66 points (p<0.0001). This demonstrated a statistically significant difference between the test groups (p=0.0389). Additionally, significant differences were observed between the DKB-131 and placebo groups in the changes in K-WOMAC pain (p=0.0157) and physical function (p=0.0447). For the secondary efficacy endpoint, the change in Visual Analogue Scale (VAS) scores, analyzed in the PP set after 12 weeks of consumption, the test group showed a reduction of 17.82±13.80 mm (p<0.0001), while the control group exhibited a reduction of 11.81±13.99 mm (p<0.0001), indicating a statistically significant difference between the test groups (p=0.0359). Safety evaluations including hematological tests, biochemical tests, and urinalysis revealed no clinically significant differences between the consumption groups. Additionally, vital signs (pulse, blood pressure) and anthropometric measurements (body weight) did not exhibit clinically significant differences between the consumption groups, confirming the safety of DKB-131. We propose that the consumption of DKB-131 is safe for humans and may contribute to joint health. Trial registration (CRIS.NIH.go.Kr): KCT0008527
Mar 2023 DOI 10.14302/issn.2690-0904.ijoe-21-3884
Background and Purpose Public health problems are caused by the emergence of environmental pollution and infectious diseases, which have caused concern around the world. The public health threat affects the relationship between people. Population growth and associated pressures increase difficulties associated with effective means of maintaining public health. The diseases transmitted from human and livestock communication, water pollution, air pollution, and environmental pollutants urge us to find new solutions to address these problems. Understanding the environmental and environmental health is a prerequisite for protecting public health. In Iran, like other countries in the world, the issue of environmental protection and its compliance with the first program of economic, social and cultural development of the Islamic Republic has begun and expanded in the future. In this regard, new perspectives are being introduced that will bring about dramatic changes at various levels of planning, processes and specialized sectors such as civil, industrial and educational sectors. The training of engineers in this regard can play a very important role in refining the attitudes of young engineers and using these bases in their specialized activities. One of the important tasks of universities is to provide a suitable platform for such training. In this regard, it is essential that the major industrial universities of the country develop various programs in this field. Materials and Methods The present study is a review of the type of validity that is performed through search of authoritative scientific databases such as PubMed and Scopus, Google scholar, PubMed using the key words of building safety and health, HSE, and prevention methods are the latest information. Results Implementing the principles of HSE in various construction, industrial and other projects requires time, because any change that is considered in the system requires a change of attitude, which in turn requires time to adapt and adapt to the new conditions. The conditions for the projects in this research are their current conditions, and the next research, after a while, can determine the percentage of project progress in terms of HSE. Conclusion In order to comply with the principle of HSE cases, there is a need for training. These trainings should be executed at different levels and levels of contracting and monitoring so that the level of awareness of the risks involved in the development of civil operations between the personnel reaches a common frontier.
Mar 2023 DOI 10.14302/issn.2690-4837.ijip-22-4342
Introduction Vaccination against SARS CoV-2 started on March 2020 in Iran and people with multiple sclerosis (pwMS) have a priority to be vaccinated in line of other high-risk population. Up to now, BBIBP-CorV (Sinopharm) is the main vaccine which have been used in Iranian population, and in high risk population such as pwMS. Method In this survey, the safety and possible side effects of this vaccine after the first or/and second doses in 520 pwMS have been assessed from July to August 2021. MS Patients who have received one or two doses of Sinopharm vaccine were evaluated. Results Around 44% of pwMS who received Sinopharm reported few minor side effects, whereas its side effect have been reported in 60% of patients who received the second dose. All side effects have begun within the first 24 hours and subsided between 48-96 hours afterward. No serious side effects or mortality have been reported. There was no correlation between the side effects and age, the disability status, and the type of first or second line DMDs (disease modifying drugs). Only some side effects were significantly higher in the progressive form of the disease. Conclusion MS patients can receive Sinopharm vaccine safely and the minor side effects should not scare them.
Feb 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3727
Background and Purpose Providing health care is the basic right of people(1). Diagnostic radiology is one of the main procedures in health care services and proper benefiting from this technology is brought only under well planning and management(1). Supervision of the available condition and its comparison with the recommended standards is a key role in assessing assurance from the benefit of these instruments (2). Data show that more than 80% of patients referring to these hospitals need radiology image (3).Improper service causes repetition of radiography and even wrong diagnosis, as a results threatening health of the patients (3) lack of protective barrier leads to the exposure of the staff to X-ray which is obviously carcinogen us (4). It happens that the instruments are not working properly, like of symmetry in X-ray field, defects in collimators, lack of adjusting ray field and X-ray, low quality or defective developing machine, lack of proper protective barrier, using low quality film and drugs, lack of protective barrier for children, all of which cause severe hazards for the patients and staff (4). Materials and Methods The crucial aim of medical services is to provide the public with their needs which are very important. The sensitivity of such services is to such an extent that in case of lack of care, the hazards are too high. In evaluation of health services, the first thing is to evaluate the device used. Methods, efficiency, profits and their combination for prevention and eradication of diseases are also important. Therefore to gain this goal, it is necessary the obtain results comparable with recommended standards. The purpose of this study was to access the conditions of radiology units at Mazandaran University hospitals and compare them with the standards of ICRU NCRP and ICRP. Radiology unit is the most expensive section of any hospital for its instruments, manpower and space provided. In a study conducted in 51centers on radiology staff, radiography room and protective barrier, ray leakage, the outcome were 89%, 82%, 77% and 37% respectively. It was found that the condition of these centers regarding the protective barriers is very unsuitable due to unawareness of the leakage (5, 6).Considering the mentioned necessities, in this study, the condition of radiography centers affiliated to the Mazandaran University of Medical Sciences was studied for the type and the rate of problem, in order to provide a proper solving method. Results Data were collected through, observation, interviewing and filling questionnaire. Results show that, the situations of the radiology units are for from international standard, to such an extent that it is matched clout 50%. Conclusion The results showed that, none of the dark rooms are standard, and do not have proper alarm signal. In 63% of these units there no tiling system about staff protection from radiation. Defects in radiography room, protective barrier and lack looking rays were 60%, 51% and 47% respectively. Referring to the obtained data, periodic supervision, and obeying of the standards are necessary.
May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3368
General practitioners are the first contact between the person, the family and the community with the health system. The philosopher and epistemologist K. Popper (1902-1994) recommended the need to register errors, in order to know them, catalog them and therefore prevent them. J.Reason in 1963 introduced the systemic approach to the study of errors with the theory of latent errors. The knowledge of the causal factors, or which in any case contribute, of possible errors, as well as of the latent gaps in the system, is a fundamental prerequisite for the construction of paths aimed at improving the quality of assistance, structures and organizational aspects.
Dec 2018 DOI 10.14302/issn.2379-7835.ijn-18-2491
Objective: To evaluate the efficacy and safety of a novel tomato-based food supplement on the lower urinary tract symptoms (LUTS) of patients with benign prostatic hyperplasia (BPH). Methods: Twenty patients with BPH were enrolled in this observational study. They were assigned to consume daily a sachet of Lycoprozen® (5 grams) dissolved in water for two months. Results: All patients successfully completed the Lycoprozen scheduled regimen and the IPSS (International Prostatic Symptom Score) questionnaire before and after treatment. No side effects due to treatment were noticed. In this preliminary study, we have found that Lycoprozen® significantly reduced the LUTS severity (paired t-test, two-tailed p value < 0.0001). The IPSS mean values before and after the treatment were 16.95+6.0 SD (range 31-6) and 12.2+4.9 SD (range 20-2), respectively. Conclusions: Based on these data, Lycoprozen® may represent a suitable alternative option for the treatment of symptomatic BPH patients which worth of further testing in a phase 2 prospective randomized double blind placebo controlled study. The treatment was without side effects and acceptance among patients was high.
Nov 2018 DOI 10.14302/issn.2642-3146.jec-18-2416
Wind turbines are often perceived as benign. This can be attributed to the population majority dwelling in urban locations distant from most wind turbines. Society may understate the risk to individuals living near turbines due to an overstatement of the perceived benefits of turbines, and an understatement of the risk of injury from falling turbine parts, or shed ice. Flaws in risk calculation may be attributed to a less than fully developed safety culture. Indications of this are the lack of a comprehensive industry failure database, and safety limits enabling the industry growth, but not protective of the public. A comprehensive study of wind turbine failures and risks in the Canadian province of Ontario gives data to enable validation of existing failure models. Failure probabilities are calculated, to show risk on personal property, or in public spaces. Repeated failures, and inadequate safety separation show public safety is not currently assured. A method of calculating setbacks from wind turbines to mitigate public risk is shown. Wind turbines with inadequate setbacks can adversely impact public health both directly from physical risk and indirectly by irritation from loss of safe use of property. Physical public safety setbacks are separate from larger setbacks required to prevent irritation from noise and other stressors, particularly when applied to areas of learning, rest and recuperation. The insights provided by this paper can assist the industry to enhance its image and improve its operation, as well as helping regulators set safety guidelines assuring protection of the public.
Aug 2018 DOI 10.14302/issn.2379-7835.ijn-18-2262
Objective: To analyse safety, tolerability, efficacy and logistic issues related to administration of 3 types of therapeutic feeds to children with severe acute malnutrition (SAM) from tribal district of Nandurbar, Maharashtra. Design: A three arm open label, block randomized trial using 3 therapeutic feeds i.e. commercially available ready to use therapeutic feed (C-RUTF), locally prepared ready to use therapeutic feed ( L-RUTF) & amylase rich food(ARF) was given to 1092 tribal children of SAM in Nandurbar District, Maharashtra, India during 2014-2015. Setting: Tribal district of Nandurbar, Maharashtra. Participants: 1092 children of SAM, 766 on C-RUTF, 184 on L-RUTF & 143 on ARF followed on treatment for 8 weeks. Outcomes: The recovery rates in the three groups, any untoward effects during treatment and logistic aspects of procurement, delivery, storage & administration of therapeutic feeds. Results: Total number of children with SAM were 1092. Gr 1 – Out of 765 children of SAM, 404 (52.8%) recovered on C-RUTF. Gr 2 – 80 (43.5%) recovered out of 184 on L-RUTF. Gr 3 – 64 (44.8%) recovered on ARF at the end of 8 weeks of treatment, the difference being statistically significant between C-RUTF & others. Out of 38 children on C-RUTF, it was observed that 1 had diarrhoea, 1 had vomiting, 1 had fever, 4 children reported more activity in terms of playfulness, more speaking & smiling. 31 children had nothing specific to report. Out of 34 children on L-RUTF, 6 children reported diarrhoea, 1 had vomiting & 4 children reported fever. 3 children reported more activity. 23 children had nothing specific to report. Out of 19 children on ARF, 1 had diarrhoea, 1 had vomiting, 1 had fever, 3 reported more activity. 13 had nothing specific to report. Untoward effects were noted in 3 out of 38 (7.89%) in C-RUTF group, 11 out of 34 (32.35%) in L-RUTF group and 3 out of 19 (15.7%) in ARF group. Conclusion: C-RUTF was found to be more efficacious, with least untoward effects, easy to administer and was more palatable when compared to L-RUTF & ARF.
Mar 2018 DOI 10.14302/issn.2690-0904.ijoe-18-2009
This perspective connects green economy transitions with occupational health and safety. It outlines potential hazards, workforce training needs, and prevention policies to ensure safe, sustainable jobs.
Dec 2017
This paper aims to examine the challenges and implications of the Village and Commune Safety Policy (VCSP) on harm-reduction programs and describe lessons learned from a harm-reduction program within the context of the VCSP in Cambodia. Data were collected from a monitoring and evaluation database and reports of a drop-in center that provides a wide range of harm-reduction services. In addition, qualitative data were collected through key informant interviews and focus group discussions with 38 participants including people who use drugs (PWUD) and people who inject drugs (PWID). Desk reviews and consultative meetings with key stakeholders were also conducted. In total, 496 PWUD were registered into the program between 2010 and 2012, of which 22.4% were PWID, and 15.0% were women. The mean age of participants was 26 years old. HIV prevalence among PWUD was 1.0% compared to 16.2% among PWID. Remarkable achievements were observed such as high uptake of services by PWUD and PWID with active referrals to methadone maintenance treatment (MMT) and voluntary HIV confidential counseling and testing (VCCT). However, distribution of clean needles and syringes in communities was limited. Also, the newly initiated needle and syringe program (NSP) based in pharmacies failed to reach PWUD and PWID. Appropriate coordination and collaboration with law enforcement and authorities were observed given the complexity of the VCSP. However, the implementation of the VCSP poses challenges including NSP and accessibility to harm reduction services. For future successes of harm-reduction programs, it is important to maintain close coordination and collaboration between program implementers and local authorities with mutual understanding and flexibility.
Jul 2017 DOI 10.14302/issn.2574-4372.jesr-17-1705
Drug-induced cardiotoxicity is one of the predominant reasons for drug attrition and withdrawals. This is of critical concern when potentially cardiotoxic drugs are administered to individuals with inherited arrhythmogenic cardiac diseases or with metabolic diseases such as obesity and diabetes, which are key risk factors for cardiovascular diseases. Pathophysiological alteration prevalent under such conditions can alter or exacerbate cardiotoxic responses. The growing incidence of obesity, diabetes and metabolic syndrome subject a significant percentage of the population to drug treatments, thereby augmenting their risk for drug-induced cardiovascular toxicity. Hence, screening for drug-induced cardiotoxicity early in the preclinical stages of drug development, by using appropriate human disease models, can be effective in ensuring safety in clinical trials and preventing late stage and post-marketing drug withdrawals owing to cardiotoxicity. The advent of human pluripotent stem cells (hPSC) and induced pluripotent stem cell (iPSC)-derived cardiomyocytes are revolutionizing safety/toxicity screening in human cells by providing relevant human-specific, renewable model systems to explore human drug toxicity. The ability to generate patient-specific iPSCs that can model cardiac diseases, now offers a valuable option that can further improve drug safety assessments and enable a more accurate prediction of toxicity that occurs in the representative population that are prescribed the drugs. Use of appropriate disease models will not only provide cost savings by decreasing potential drug attrition and withdrawals, seen with many drugs, but will also be a promising option to advance precision medicine
Aug 2016 DOI 10.14302/issn.2574-4496.jtc-16-1129
Objective: Radiation exposure to the general public and patients undergoing diagnostic or therapeutic procedures is of great concern, especially to the medical community. Revision of Nuclear Regulatory Commission rules several years ago yield new recommendations for the administration of therapeutic doses of 131-Iodine that included the release criteria. The guidelines for ambulatory treatment included patient education and radiation safety measures to minimize exposure and contamination. Our goal in this study was to evaluate patient compliance with the radiation safety instruction protocols given to them before the therapeutic dose and monitor radiation levels in different house areas at different times after an ablation therapy of 3700MBq or more. Method: Patients with well differentiated thyroid cancer being evaluated for ablation therapy with 131-Iodine were invited to participate. A thorough set of instructions on radiation protection were given verbally and in writing. Patient house was assessed with a Geiger Muller detector at 24 and 72 hours or above to obtain direct radiation levels in several areas. Patient radiation levels were also monitored. Results: A total of 12 patients have been included, 11 females and 1 male, median age was 53 years. Tumor histology was 10 papillary, 2 papillary-follicular variant and 1 follicular carcinoma; 92% of the cases were T1, N0, M0. Home location was urban in 77% and rural in 33% of the patients; 67% of the patients had an educational level between 9-12 grade. Radioiodine doses range from 3441-5994MBq. None of the patients had a relatives or companion in the house. Mean patient exposure 24 hours after the dose at 1 meter was 12mrem/hr, 0.120mSv/h; this represented a retained dose of 2181MBq (59mCi). Only one patient (T1, Nx, M1) had an exposure rate at 1 meter of 100mrem/hr (1mSv/hr) at 24 hours. At 72 hours the exposure changed to 4mrem/hr, 0.040mSv/hr, retained dose of 725.2MBq (19.6mCi). Higher exposure rates in the house were at 24 hours in the bed and pillows (7mrem/hr), kitchen trash (13mrem/hr) and bathroom sink (8mrem/hr). The exposure rates at the toilet and shower were similar (3-4mrem/hr). There was a significant decreased in the exposure rate at 72 hours in all house areas. Patients with the higher exposure rates were those with metastatic disease, and small living facilities. Patients living in rural or urban location had no difference in the exposure rate. The educational levels were not related either to the exposure rate. Conclusion: Patient compliance with radiation protection instructions and Nuclear Regulatory Commission release criteria was good. Radiation exposure levels in the house areas are safe. Special instructions must be design to minimize contamination in the bathroom and kitchen Caution is recommended in the release of patients with extensive metastatic disease and doses of 5920MBq or more.
May 2026 DOI 10.14302/issn.2641-4538.jphi-26-6161
Objectives Motor fluctuations and non-motor disorders not manageable by first-line treatments in advanced Parkinson's disease require continuous dopaminergic stimulation strategies such as subcutaneous infusions of apomorphine (APO) or foslevodopa/foscarbidopa (FLD/FCD). A Budget Impact Analysis (BIA) was performed to estimate the cost difference between both treatments assuming equivalent clinical efficacy and safety. Material and methods The efficacy results of pivotal clinical trials at 12 and 52 weeks of treatment and the safety profile of APO vs FLD/FCD were compared, based on latest scientific publications and other available clinical data. A comparative BIA was performed, based on estimated annual drug treatment costs at Spanish published prices. Results The efficacy of APO (16 h/day) and FLD/FCD (24 h/day) in reduction of OFF hours (2.47 vs 2.75, 12 weeks; 3.66 vs 3.50, 52 weeks; respectively) and increase of ON hours without disabling dyskinesias (2.77 vs 2.72, 12 weeks; 3.31 vs 3.80, 52 weeks; respectively) could be considered clinically equivalent, as well as their safety profiles. However, a significant discrepancy is observed in the costs of the aforementioned alternatives. Considering published prices and the average dose reported in the literature, in Spain the annual cost of APO would be €13,980 compared to €55,198 for FLD/FCD. Consequently, the financial resources required for the treatment of FLD/FCD would enable the treatment of approximately three to four patients with APO. The BIA indicated the potential for annual savings in more than €2,500 million, considering a total target population of over 60,000 patients per year. Finally, an univariant sensitivity analysis was performed, considering a scenario in which the hospital acquisition cost of FLD/FCD decreased between 20%-30% (€44,159- €38,638/year). In this scenario, the total annual savings range between €1,875-€1,532 million per year. Conclusions Overall APO is more efficient than FLD/FCD, as it provides similar clinical efficacy at a lower treatment cost. The selection of an appropriate treatment option is to be determined by clinical criteria and patient characteristics, but cost evaluation should be considered to select the most cost-effective therapeutic option.
Feb 2026 DOI 10.14302/issn.2641-5518.jcci-26-5982
Introduction A retained surgical towel in the abdomen is a serious postoperative complication and the most avoidable. Known as “gossypiboma”, it may migrate into adjoining cavities like the stomach, small bowel, colon, vagina, urinary bladder, pericardium, and urethra. Case Report A 32-year-old male presented with complaints of abdominal pain, 4 months after a laparotomy for complicated appendicitis. Initial history and presentation gave an impression of a lower urinary tract obstruction. However, symptoms progressed with signs of bowel obstruction and investigations pointed to a possible retained foreign body. This was confirmed on laparotomy with indications of a transmural migration during the period of evaluation. The report discusses the pathophysiology and manifestations of a migratory surgical gossypiboma. Conclusions A rare case of gossypiboma displaying transmural migration is reported. This showed an initially peritoneally placed sponge that migrated into the intestinal lumen with the sudden presentation of obstructive symptoms. Routine practice of the World Health Organization Surgical Safety Checklist can significantly prevent these incidents.
Dec 2025 DOI 10.14302/issn.2688-5328.ijp-25-5402
Background Prescribing appropriate analgesics with optimal dosages based on patients' pain severity is challenging, especially when multiple painkillers are involved. Tracking and analyzing the effectiveness of analgesics and their dosages over time is crucial for pain management. Existing systems lack the ability to integrate analgesic equivalent doses with temporal trends in pain scores, hindering effective decision-making. Methods We developed a Clinical Support System that calculates the daily oral morphine equivalent dose and analyzes trends in consumed equivalent doses of analgesics. The system provides a graphical user interface that displays medication prescriptions, actual medication usage, and pain scores. It offers features such as correlating analgesic drug usage with pain intensity, trend analysis of analgesic drug usage and pain intensity, and identification of effective oral morphine equivalent doses. Results The system overcomes previous barriers in drug analysis by providing real-time calculation of oral morphine equivalents and trend analysis of pain duration. It assists physicians in prescribing appropriate and safe medication dosages, enhancing medication safety for patients. Conclusions Our clinical support system offers a comprehensive solution for analyzing trends in consumed equivalent doses of analgesics. It integrates medication prescriptions, actual usage, and pain scores, providing decision-making support for pain management.
Nov 2025 DOI 10.14302/issn.2694-2283.jsem-25-5730
Objective The goal of this systematic review is to identify common themes amongst acute spinal cord injuries (SCI) in equestrian athletes. Design A systematic review was performed using PubMed, CINAHL Plus with Full Text (EBSCO), Cochrane Library, and Scopus with pre-determined MESH terms. The initial search returned 354 studies. Following PRISMA guidelines, 13 articles were included. Exclusion criteria included injuries to the horse only, non-English language, cauda equina, and case reports. Data extraction was completed, and common findings were evaluated narratively due to heterogeneity of data. Results Seven manuscripts listed specific horse-related activities that caused SCI, with fall from horse as the highest percentage of injury. Nine articles identified the injury region, with large variations and no clear dominant area of injury. Five articles identified the length of hospital stay with ranges from 1 to 82 days. Four articles looked at the association of professional vs non-professional riders. Only two articles evaluated helmet use at time of injury, with one article showing 81% of those with SCI used helmets, and the other showing only 35.6% utilized this safety measure. Conclusion SCI in equestrian athletes can have a wide presentation, with large variation on location of injury, length of stay, and other factors. However, non-professional riders are at greater risk of SCI and individuals are more likely to sustain injury from a fall from a horse rather than a kick or another modality of injury. Future study can elicit presenting symptoms, types of surgical intervention used, and long-term outcomes and recovery.
Aug 2025 DOI 10.14302/issn.3070-1937.ijbt-25-5540
The rising need for structured and efficient blood transfusion services in low-resource settings has driven the adoption of collaborative blood transfusion management systems (CBTMS). This study explores the functionality and impact of the Cornerstone University Blood Management System version 1.0 (CUBMS vs 1.0) in Cameroon. This study was an exploratory research design which used a system interface analysis, comparative case reviews from four countries, and literature synthesis, to reveal that CUBMS improves accessibility, data management, inventory control, emergency responsiveness, and community engagement. Despite infrastructural challenges in rural regions, the system can enhance efficiency, transparency, and safety in blood services. The success of CBTMS in Cameroon is linked to digital infrastructure, training, and culturally relevant community engagement. The Ministry of Public Health of Cameroon should prioritize the nationwide implementation of CBTMS, ensuring consistency in digital health tools.
Aug 2025 DOI 10.14302/issn.3070-1937.ijbt-25-5408
Background and Objectives Platelets are small, anucleate blood cells produced in the bone marrow, primarily involved in blood coagulation. Platelet concentrate is a vital blood product with extensive applications. However, its short lifespan and limited donor availability pose global challenges. This study aimed to follow the trend of platelets 5 during days of storage. Material and Methods We studied on 40 platelet bags and analyzed glucose levels, lactate dehydrogenase (LDH), bacterial culture, and apoptosis using flow cytometry with Annexin V-PI over three consecutive days (first, third, and fifth) post-blood collection. Data were analyzed using SPSS. Results No significant correlations were found between age, blood group, or gender and the variables studied. No bacterial growth was detected. Glucose levels decreased significantly from day 1 (382 mg/dl) to day 5 (298 mg/dl). The average platelet apoptosis increased significantly from 3.65% on day 1 to 9.06% on day 5. Significant correlations were observed between glucose levels and apoptosis on days 3 (p<0.05) and 5 (p<0.01). No correlation found between LDH and apoptosis or necrosis, although a significant relationship between necrosis and apoptosis was noted on day 5 (p=0.003). Conclusion These findings suggest that while demographic factors do not influence the studied variables, the significant decrease in glucose levels correlates with increased platelet apoptosis over time, highlighting potential metabolic interactions that warrant further investigation. Highlights 1. The study revealed subtle variations in metabolic markers related to donor demographics, particularly gender and age. Understanding these differences can inform targeted donor selection strategies to optimize platelet quality. 2. A significant negative correlation was found between glucose levels and apoptosis rates, indicating that as glucose decreases, platelet viability declines. This relationship highlights the need for careful monitoring of glucose levels during storage to maintain platelet function. 3. Fluctuations in lactate dehydrogenase (LDH) levels were correlated with increasing rates of apoptosis, suggesting that LDH could serve as a valuable biomarker for assessing platelet quality throughout the storage period. This finding could lead to improved storage protocols and enhanced transfusion safety.
Jul 2025 DOI 10.14302/issn.2577-137X.ji-25-5581
Coronavirus Disease 2019 (COVID-19) placed significant pressure on global health systems, necessitating rapid and widespread immunization, especially among healthcare workers (HCWs). Despite being prioritized in immunization programs, variations in vaccine uptake among HCWs have been reported across different settings. This study aimed to investigate the predictors of COVID-19 vaccine uptake among HCWs in Kiambu County, Kenya. An analytical cross-sectional study design was employed, involving 112 HCWs sampled using stratified random sampling from Level 2 to Level 5 healthcare facilities. Data were collected through a pre-tested and validated 18-item questionnaire and analyzed using SPSS version 29.0. Statistical methods included descriptive analysis, chi-square tests, logistic regression, and ANOVA. The overall COVID-19 vaccine uptake was 88.9%. Significant predictors of uptake included age (p = 0.048), cadre (p = 0.015), and facility level (p = 0.031). Knowledge of COVID-19 vaccines emerged as the strongest predictor, with HCWs demonstrating good-to-excellent knowledge being 14.97 times more likely to be vaccinated (p < 0.001). Confidence in vaccine safety and effectiveness was also significantly associated with uptake (p < 0.001). Uptake was highest in Level 5 hospitals and lowest in dispensaries. The study reveals high vaccine uptake among HCWs in Kiambu County, but disparities persist due to individual and systemic factors. Strengthening vaccine education, institutional support, and deploying mobile vaccine education units in lower-level facilities could help close these gaps, offering practical strategies for improving HCW vaccine coverage in Kenya and other low- and middle-income countries.
Jul 2024 DOI 10.14302/issn.2575-1212.jvhc-24-5146
Dietary intake of inorganic phosphates is linked to various adverse health effects. Excessive intake of highly soluble inorganic phosphates, which are used as feed and food additives, have been found to impair parameters of kidney health. As chronic kidney disease represents one of the most frequently occurring terminal diseases especially in cats, extensive knowledge regarding the safety of these additives is important. Other minerals, such as calcium, can modulate their effects on the phosphate homeostasis and kidney health. Therefore, it is crucial to examine further factors, such as the dietary cation-anion balance (CAB), resulting from the concentrations of major minerals in a diet. In this study, eleven healthy cats were fed a control diet and two diets with added sodium monophosphate (NaH2PO4) with either a low (-10 mmol/kg dry matter) or high (+450 mmol/kg dry matter) CAB for 28 days each. The serum concentrations of phosphate and parameters of phosphate homeostasis were determined in the fasting and postprandial blood samples next to the apparent digestibility and retention of phosphate and calcium. The diet with positive CAB led to an increase of serum phosphate and the phosphatonin FGF23, apparently digested phosphate, and phosphate retention. This is further proof that source and amount of phosphates in a diet are not the only determinants of the extent of potential adverse health effects. Until the interactions between inorganic phosphates and other dietary compounds are fully understood, recommendations regarding the safe use of phosphate containing additives in pet food are precarious.
Jan 2024 DOI 10.14302/issn.2641-5526.jmid-24-4893
This evidence-based brief commentary discusses the potential of EPIC ® medicalrecords software to help or hinder in advancing High Reliability in healthcare—namely, the intent to attain repeatable, increasingly high levels of quality and safety over time. Four of EPIC’s key aspects relevant to High Reliability are examined: Standardized (High Quality) Information / Data Collection, Technological Somnambulism, Enhanced Patient Safety, and Reminders / “Hardstops.” A conclusion is drawn that EPIC, if used correctly, has vast potential to advance High Reliability high-quality and safety, specifically in medical treatment and regarding healthcare organization practice in general. However, it has hidden costs that are more than money; if unfettered, those costs can hinder its usefulness and even render it counterproductive. EPIC only works well in terms of Maximum High Reliability in healthcare as long as users and leaders remain mindful, prudent, and balanced in its use.
May 2023 DOI 10.14302/issn.2642-9241.jrd-23-4566
Safe and effective antitussive therapy remains a significant area of unmet need for cough management. Antitussive drugs are commonly used cough suppressants and include centrally acting (opioids and non-opioids) cough suppressants and peripherally acting antitussives. Authors searched PubMed, Google Scholar and additional studies from reference lists via cross-referencing to identify studies assessing levodropropizine for the treatment of cough. Of the 748 studies identified, 13 were included. Recent clinical evidence, guideline recommendations and findings from this review suggest that levodropropizine is a peripheral antitussive which reduces cough intensity, frequency, and nocturnal awakenings in children and adults and provides better efficacy outcomes with a more favourable risk/benefit ratio compared to centrally acting antitussive agents which pose greater safety concerns and present an unacceptable risk–benefit profile. This review is aimed at Indian primary care physicians for making effective cough management decisions where the clinical evidence needs to be translated to clinical practice. Key Messages The usage of currently available centrally acting antitussive agent is greatly limited by their central depressing action and frequent side effect. The findings of this review indicate that levodropropizine is an effective antitussive agent and well tolerated in the management of cough in patients of all ages.
Apr 2023 DOI 10.14302/issn.2644-1101.jhp-23-4473
An opinion essay examines hospital immunity doctrines and alleged sham peer review, outlining legal context, patient‑safety implications, and avenues for due process.
Feb 2023 DOI 10.14302/issn.2643-2811.jmbr-22-4302
The Gas Turbine operation was investigated with a view to evolving a system designed to provide a realistic imitation of the controls and operation of a Gas Turbine, used for training purposes. Operator Training Simulator has been widely adopted by many industries being a computer simulation which attempts to model a real-life plant so that it can be studied. A well trained and skilled operator is key in increasing power plant safety and productivity. Therefore, enabling quality training for operators is becoming more important as they need to handle increased load of information and duties whereas the lack of training is a major reason for inadequate performance. By changing variables in the simulator, predictions are made about the behaviour of the engine. It is a tool to virtually investigate the behaviour of the system while in operation. This work becomes indispensable because it is prohibitively expensive or simply too dangerous to allow trainees use the real equipment in a power plant. The Gas Turbine operation’s simulator is born from Object Oriented Programming, employing key programming languages. The simulator design focused on specific tasks in the operation of the Gas Turbine which include; startup, synchronization and monitoring of vital parameters like vibration, temperature, pressure, and angle of the Inlet Guide Vane. The statuses of various valves, pumps and motors as well as the Performance of actuators and the response of concatenated components are also being tracked. The simulator was found to effectively mimic a real plant life. With this simulator, trainee operators in Gas Turbine can spend time learning valuable lessons in a "safe" virtual environment yet living a lifelike experience. This will go a long way in minimizing operators’ error in GT power plants, thereby curtailing power outages and conserving power plant components.
Nov 2022 DOI 10.14302/issn.2641-4538.jphi-22-4335
It is estimated that over 47 million people use tobacco products, mostly in the form of combustible (smokable) tobacco cigarettes. Thirteen to 50% of smokers also use electronic cigarettes (also known as e-cigarettes or vaping). Use of tobacco is the primary preventable cause of death and risk factor for lung, head, neck, and oropharyngeal cancer. Electronic cigarettes are a $10 billion dollar industry and has the potential to surpass the tobacco cigarette market. E-cigarette use is a public health concern because of the health issues of vaping and the limited amount of scientific research to support the safety of e-cigarette use. The authors of this paper want to create awareness that use of e-cigarettes is not a safer alternative to smoking tobacco cigarettes as e-cigarettes contain known carcinogens that may lead to development of oropharyngeal cancer.
Sep 2022 DOI 10.14302/issn.2641-4538.jphi-22-4238
The safety of cyclooxygenase (COX)-2 inhibitors has been tested in patients who had cross-reactive hypersensitivity reactions (HSRs) to nonsteroidal anti-inflammatory drugs (NSAIDs). However, these studies have been mainly done before the current classification of NSAID hypersensitivity and cross-reaction between COX-2 inhibitors has been rarely reported.We aimed to assess tolerability of COX-2 inhibitors and to evaluate the cross-reactivity between them in cross-reactive phenotype of NSAID hypersensitivity. The diagnosis was based on clinical features, reliable history of HSRs to at least two chemically different NSAIDs, and/or positive provocation tests with implicated NSAIDs in 151 patients. Single-blind, oral challenges with 1/4 and 3/4 divided doses of placebo, nimesulide, meloxicam, and celecoxib, as COX-2 inhibitors, were performed. The most common cross-reactive phenotype was NSAID-induced urticaria/angioedema (56.3%). Positive reactions to meloxicam, nimesulide, and celecoxib challenges were observed in 23/140 (16.4%), 7/33 (21.2%), and none of six patients, respectively. Overall, 24 patients were tested with two, one was tested with three COX-2 inhibitors. Six (31.6%) of 19 patients with meloxicam intolerance reacted to nimesulide provocation. Nimesulide, meloxicam, and celecoxib appeared safe alternatives in cross-reactive phenotypes of NSAID hypersensitivity. Although celecoxib has the most favorable tolerability, cross-reactivity among COX-2 inhibitors seems to be possible.
Jun 2022 DOI 10.14302/issn.2328-0182.japst-22-4193
The strategy for safe drug discovery and development has limited clinical success as compared to wasted time and resources annually. This is due to the fact that the results of multiphase preclinical trials are less likely to make an accurate early prediction on the safety of test compounds to progress into the clinic as a valuable therapeutic agent. A lot of time and resources has been wasted in the multistage processes of drug discovery and development that does not work at the end of the procedure every year. During pre-marketing stage, for instance, the number of unsuccessful clinical trials are greater than the successful one because of safety issues. A toxicity study at different stages of preclinical and clinical trials is a routine procedure to investigate the undesirable side effects of test compounds being manifested on the natural processes of living things. It deals with the effect and mechanism of toxicity of test compounds that triggers different biological responses on different organ systems. The biological responses that would be manifested as a result of interaction between the receptors and active molecules of a test compound could be desirable pharmacological effect or undesirable side effect or both responses are manifested simultaneously depending on the selectivity or specificity of the molecule of a test compound for its receptor subtype which makes safe drug discovery and development very challenging. The response efficiency of the body (the net outcome of the body’s biological reaction against the side effect) would determine the potency of a test compound to manifest undesirable pharmacologic effect. In other words, the amount of a drug required to cause a biological harm or injury depends on the magnitude of the body’s biological reaction in which the immune response plays a great pharmacological role by neutralizing and harmonizing xenobiotics with the biological molecules. The dose of a test compound at 100 mg/kg body weight, for instance, could be lethal to some of the study animals while it is still non-lethal to some other study animals depending on the response efficiency of the body. The immune system is well connected to each and every biological systems of the body which allows it to detect undesirable side effects being manifested through immunoglobulins signalling and activation mechanisms. This complex communication network helps to localize the diverse side effects of a test compound being manifested on different organ systems into the immune system which makes a toxicity study relatively simple to monitor. The cellular immune system becomes active following the molecule-receptor interaction and start producing antibodies which is also known as immunoglobulins to protect bodily harm and destruction. Under normal biological circumstances, the amount of immunoglobulins produced by the cellular immune system following exposure to a test compound is proportional to the number of harmful molecules interacted with its receptor subtype. Thus, with the reference to the changes in the immune response against the administered dose, it would be able to deal with the diverse undesirable side effects of a test compound being manifested on treated study animals using computational systemic biology.
Mar 2022 DOI 10.14302/issn.2638-4469.japb-22-4102
The safety of plant-derived bioactive compounds has become a global concern. The present study investigated the dose response of total saponins isolated from the stem bark of Dialiumguineense. Adultmale Wistar rats (n = 15) weighing 170 – 190 g (mean weight = 180 ± 10 g) were randomly assigned to three groups (5 rats per group). The rats received varied doses of total saponins isolated from the stem bark of the medicinal plant (50 - 150 mg/kg body weight, bwt) orally for a period of 9 days. The concentration of fasting blood glucose (FBG) was used as the therapeutic index.The results of the analysis revealed that total saponins isolated from the stem bark of D. guineense significantly reduced the Fasting Blood Glucose (FBG) levels of normal Wistar rats (p < 0.05). The graded and quantal dose-response curves showed that150 mg/kg bwt was effective in reducing the blood glucose of rats (produced the best hypoglycemic effect). The study concluded that total saponins isolated from the stem bark of D. guineense possesses hypoglycemic effect at a relatively good dose.
Feb 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4078
Background The COVID-19 pandemic has had significant impact on healthcare worldwide. Surgeons are at increased occupational risk of contracting COVID-19. The impact of the disease on surgical practice will continue to evolve. We assessed the impact of the disease on surgical practice and training in Nigeria. Method Survey questionnaire was designed, transcribed to Google form and electronically circulated online to surgeons practicing in Nigeria. Surgeons from various subspecialties from the six regions in Nigeria were included. Survey questions pertaining to pre-COVID-19 era surgical practices, impact on current practice and changes occurring in health facilities during this COVID-19 pandemic. Responses were collated and analyzed statistically. Results One hundred and nine (109) surgeons completed the survey, of which 2.8% were women. Majority (68.8%) of the respondents are in the consultant cadre, majority (86.2%) are working in public hospital, 88.1% running their SOPD, 81.7% have isolation wards in their centers, 66.1% have dedicated team for COVID-19 management. Only 48.6% of the frontline health workers have access to personal protective equipment (PPE), and 33.9% had formal training on the use of PPE. Only 11.0% were satisfied with level of preparation of the management. Elective cases were done only in 45% of respondents. 103(94.4 %) confirmed that the numbers of elective cases are less than pre Covid-19 period. Emergency cases were carried out by 93.6% of respondents. Only 1.8% of respondents carried out screening tests for their patients before embarking on emergency surgery. Conclusion COVID-19 has led to reduction in surgical outpatients, significant reduction in elective surgeries in Nigeria. Adequate PPE needs to be provided, there should be guidelines for safety for future. There should be adequate preparation should there be any pandemic in the near future.
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.
Oct 2021 DOI 10.14302/issn.2324-7339.jcrhap-21-3961
Coronavirus disease (COVID-19) outbreak has severely affected the whole world. It has overshadowed all the developmental activities across different countries. The COVID-19 pandemic has negatively affected global economy and has threatened health security of people worldwide. This pandemic have affected environment dynamically. Decrease in economic activities, travelling, transport and traffic restrictions all over the world have led to decreased emissions of greenhouse gases and drop in air and water pollution observed universally. Also more than 40 % of downfall is observed in NO2 concentration in Asia and Europe as compared to 2019. Reduced pollution had a good effect on freshwater aquatic life. The reduction in worldwide aircraft flight directly impact on forecast and decreases 65% of weather prediction. Snow fall was observed even in a summer in India. This pandemic has had a long-term impact, affecting all aspects of human life and halting all developmental processes. Combating the COVID-19 pandemic is currently at the top of the global agenda. Quarantine measures opted for safety of the public have positively affected the environment. Although it has downturned the economic growth drastically, it has also contributed in lowering the pollution. If there is a silver lining to this horrible situation, it may be that it has given us a whiff of the air we will breathe in a low-carbon future.
Aug 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3919
Personal Protective Equipment (PPE) is mandatory for everybody in a threatening state, they are meant to provide safety and prevent injuries especially in hazardous issues. Facial guards are mostly used for providing eyes and face from splash-kind of hazards. During the COVID-19 pandemic, their use also was recommended to longer the use of masks or respirators, due to their shortage and the excessive demand of their reuse. This review gathered the information on eye and face protectors from various manufacturer, international and local guidelines; also authors’ experiment during the COVID-19 pandemic in Iran.
Aug 2021 DOI 10.14302/issn.2379-8572.joa-21-3913
This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.
Jun 2021 DOI 10.14302/issn.2474-3585.jpmc-21-3851
Background The rapid and ongoing spread of antimicrobial-resistant organisms threatens the ability to successfully prevent, control, or treat a growing number of infectious diseases in developed and developing countries. This study was designed to convey more insight on the profile of antimicrobial resistance and the capacity of laboratories conducting antimicrobial susceptibility testing in Cameroon. Methods A multicentre cross-sectional study was conducted from October 2019 to March 2020 in the Deido Health District. Laboratories that carry out culture and sensitivity testing within the Deido Health District were identified and assessed to determine their capacity as well as the quality of results from microbiological investigations. Information on antimicrobial susceptibility of various isolates was collected using tablet phones in which the study questionnaires had been incorporated. Results Gaps identified in antimicrobial susceptibility testing that cut across laboratories included; insufficient standard operating procedures, inadequate records on personnel training and competency assessment, lack of safety equipment such as biosafety cabinet, stock out and non-participation in external quality assurance program. The turnaround time for antimicrobial susceptibility testing ranged from 3 – 7 days. Out of the 1797 samples cultured, 437(24.3%) had at least one isolate. A total of 15 different isolates were identified with Candida albicans being the most frequent 178 (40.7%), followed by Escherichia coli 80(18.3%). Among the 15 classes of antimicrobial drugs used in this study, the overall resistance of the isolates showed that five classes had class median resistance above 40% (Cephalosporins, Penicillins, Beta-lactam, Macrolides, and Polyenes). Conclusion This study has shown the need to develop a coordinated national approach to fight antimicrobial resistance. Scaling-up of antimicrobial susceptibility testing will, therefore, require strengthening the microbiology units of laboratory systems as well as ensuring the use of laboratory data for decision making.
May 2021 DOI 10.14302/issn.2328-0182.japst-21-3586
We evaluate a case report of Yasmin induced pulmonary embolism in order to provide reference for safety use of oral contraceptives.
Feb 2021 DOI 10.14302/issn.2641-5526.jmid-21-3739
Background As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices. Smart-Agility definition-ally ensures success due to its inherent ability to rapidly detect and react appropriately to varied and evolving unclear, complex, and seemingly tumultuous situations and produce high-quality, low-cost goods and services with high customer satisfaction. Thus, there is a vital need for Smart-Agile healthcare IT systems for collection, analyses, and reporting of substantial quantities of healthcare data to inform patient treatment and organizational decisions. EPIC® and its meaningful-use components appear increasingly popular, capturing a majority portion of the healthcare Electronic Healthcare Records (EHR) IT market (>~30%).Yet, there are few, if any, studies reporting on EPIC in terms of Smart-Agility. Aim The intent of this article is to report a systematic review of scientific literature regarding EPIC’s healthcare IT systems meaningful-use features cross-compared with Smart-Agility aspects to produce a positive vs. negative report card—and whether its features are critical vs. non-critical in terms of Smart-Agility. Method Findings reported herein derive from a grounded, iterative review of open-source, peer-reviewed scientific literature following PRISMA. Findings Report card results were mixed. EPIC clearly succeeds and excels (better than average) on Smart-Agile healthcare IT system core aspects that are the most central, critical and valuable in terms of informing healthcare organizations’ decisions and their patients’ care (6 out of 7; B+, -A), specifically: Standardized Data Collection / Connectivity, Real-Time Data Warehousing/Outcome Measures, Enhanced Patient Safety, Patient Tracking and Follow-up (Continuity of Care), Patient Involvement, and Potential Use in Medical Education. The only critical core criterion it failed on was End-User Satisfaction, and some of that appears to dissipate with new users’ software familiarity. Conclusion EPIC provides a solid and relatively inexpensive foundation with great potential for enabling Smart Agility in healthcare organizations with its high-quality collection and management of vast amounts of inter-connected raw data, auto-analysis, and fast report generation. But it does so with hidden costs and inefficiencies. Avenues of further inquiry are suggested.
Feb 2021 DOI 10.14302/issn.2328-0182.japst-21-3715
Zinc is an essential trace mineral that plays an important role in the human body as a regulator for different enzymatic systems. It is used in various supplements in the form of zinc chloride to meet the daily requirements. This study was designed with the aim to investigate the impact of The Trivedi Effect®- Energy of Consciousness Healing Treatment on the various physical, thermal, and spectral properties of zinc chloride. The study involves dividing the zinc chloride sample in two parts, followed by keeping the first part untreated and named it the control sample. Besides, The Trivedi Effect®- Biofield Energy Healing Treatment was provided to the other part remotely by the renowned Biofield Energy Healer, Mr. Mahendra Kumar Trivedi and the sample was termed as Biofield Energy Treated sample. Later on, both the samples were analyzed using PXRD, PSA, DSC, UV-Vis, and FT-IR analytical techniques. The PXRD analysis revealed the significant changes in the crystallite sizes (from -66.68% to 25.02%) and the relative peak intensities (from -81.35% to 141.22%) along with 26.46% decrease in the average crystallite size of the Biofield Energy Treated sample, compared with the control sample. Additionally, the treated sample showed reduction in the particle sizes d10, d50, d90, and D(4,3) values by 92.18%, 23.24%, 14.48%, and 29.31%, respectively as compared to the control sample. However, the surface area of the treated sample was observed to be significantly increased by 224.57%, compared to the control sample. The DSC analysis revealed slight increase in the melting and decomposition temperature of the Biofield Energy Treated sample by 0.84% and 3.62%, respectively; along with the significant increase in the latent heat of melting and decomposition by 24.85% and 123.23%, respectively, compared to the control sample. It showed that the thermal stability of the treated sample was significantly increased. However, the UV-Vis and FT-IR studies revealed that the structural properties of the control and treated samples were remained same. The overall study represents that The Trivedi Effect®- Energy of Consciousness Healing Treatment may be used to generate a polymorphic form of zinc chloride, which might possess enhanced solubility, dissolution and bioavailability profile along with improved thermal stability, compared to the control sample. Such properties of the treated zinc chloride may ensure its efficacy, stability and safety during the process of shipment, handling, and storage; thus, The Trivedi Effect®-Energy of Consciousness Healing Treated zinc chloride would be useful for designing the better formulation with enhanced bioavailability, stability and efficacy profile.
Feb 2021 DOI 10.14302/issn.2377-2549.jndc-21-3722
Iron sulphate is used in the treatment of iron deficiency anaemia and other chronic disorders such as heart and kidney diseases. This study has the objective to analyze the impact of The Trivedi Effect®-Energy of Consciousness Healing Treatment on the physicochemical, spectroscopic and thermal properties of iron sulphate using various analytical techniques. In this, the test compound, i.e., iron sulphate was divided into two parts; one as control (without Biofield Energy Treatment), and the other as Biofield Energy Treated, which received the Biofield Energy Treatment remotely by the renowned Healer, Mr. Mahendra Kumar Trivedi. The PXRD analysis of the Biofield Energy Treated sample showed significant alterations in the range of -39.49 to 301.40% in the relative intensities, and from -15.40 to 33.36% in the crystallite sizes, compared with the control sample. The average crystallite size of the treated sample was also increased by 4.98% as compared to the control sample. The particle sizes in the treated sample at d10, d50, d90 and D(4,3) values were significantly increased by 67.12%, 47.72%, 33.18% and 42.01%, respectively; whereas, the specific surface area was significantly reduced by 38.39%, compared with the control sample. The TGA thermograms showed three steps of thermal degradation in which, the weight loss of Biofield Energy Treated sample in the first and second step was reduced by 5.82% and 16.09%, respectively, while, it was increased by 6.78% in the third step, compared to the control sample. The total weight loss in the treated sample was also reduced by 2.76%, along with slight alteration in the maximum thermal decomposition temperature, compared with the control sample. The DSC analysis showed the decrease in the melting temperatures of the 1st, 2nd and 4th peaks by 8.24%, 19.29%, and 0.61%, respectively, while 4.57% increase in the 3rd peak of the treated sample, compared with the control sample. The latent heat of fusion (ΔH) corresponding to the 1st, 2nd, 3rd and 4th peaks of the treated sample also showed alterations by -92.29, -86.29, 60.92, and 6.37%, respectively, compared with the control sample. The Trivedi Effect®-Consciousness Energy Healing Treatment might produce a novel polymorphic form of iron sulphate having increased crystallite and particle size along with enhanced thermal stability. It may help in improving the quality, safety and stability during the process of handling, storage, and shipment of the iron sulphate with better therapeutic response against iron deficiency anaemia.
Jan 2021 DOI 10.14302/issn.2470-5020.jnrt-21-3699
A feasibility study explores neuroimaging approaches to identify brain regions engaged during extreme breath‑hold diving. Methods, safety considerations, and preliminary activation patterns are summarized to motivate further controlled studies.
Dec 2020 DOI 10.14302/issn.2835-513X.ijl-20-3247
Hypercholesterolemia plays an important role in atherosclerosis and cardiovascular diseases (CVD) that represent one of the greatest worldwide medical problems nowadays. Recently, an increased attention/ interest for natural antioxidant/ hypercholesterolemia as WG/WGO is increasing. Wheat germ/ Wheat germ oil (WG/WGO) is an excellent source of essential and polyunsaturated fatty acids and vitamin E. It is one of the richest natural sources of tocopherol. This work aims to evaluate the effect of administration of wheat germ (WG) /wheat germ oil (WGO) for 6 weeks on serum lipid profile, lipid peroxidation (liver malondialdehyde) in hypercholesterolemic rats. One hundred and twenty maleSprague Dawelyrats weighing 180-192 gm were used in this study. They were randomly distributed into six groups (20 rats/ group) as follow: g1: normal control, G2: hypercholesterolemic rats; G3: Normal rats treated with WG; G4: hypercholesterolemic rats treated with WG; G5: Normal rats treated with WGO; G6: hypercholesterolemic rats treated with WGO for 6 weeks. Also WG was analysed for its nutritive value, while WGO was analysed for fatty acid profile, and studied for its physico-chemical properties. The results showed significant elevation of liver malondialdehyde (MDA) and serum lipid profile in untreated rats fed on hypercholesterolemic diet. Hypercholesterolemic rats treated with WG/WGO showed an improvement in the biochemical assay of their lipid profile compared with untreated hypercholesterolemic rats. WG/WGO may be able to protect against atherosclerosis and CVD. The administration of WG /WGO to diets of rats caused a marked reduction in TC, LDL-C, VLDL-C, TG and MDA. This improvement effect may be mediated via enhancement of the antioxidant defence system and other factors. However, further clinical studies on human beings are required to assess the efficacy and safety of the WG/WGO.
Dec 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3652
Background The use of hydroxychloroquine in coronavirus disease (COVID-19) pandemic raised significant concerns as regards safety and efficacy in hospitalized patients. The objective was to examine the effect of hydroxychloroquine on clinical improvement and mortality among hospitalized patients with COVID-19. Methods A prospective cohort study was conducted at four general hospitals in the Western region, Saudi Arabia. Patients who had absolute or relative contraindication for using hydroxychloroquine were excluded. Patients concomitantly receiving other medications including azithromycin, antivirals, and supportive treatment were not excluded. Results A total 267 patients were included in the current analysis; 185 (69.3%) on hydroxychloroquine and 82 (30.7%) on non-hydroxychloroquine treatments. The average age was 46.0±13.3 years and 78.3% of the patients were males. Approximately 95.9% of the patients were symptomatic with mild (50.6%), moderate (32.6%), severe (8.2%), or ARDS symptoms (4.5%). Compared with no hydroxychloroquine, those on hydroxychloroquine had significantly longer length of stay (11.5±7.1 versus 7.8±4.3 days, p<0.001), more ICU admission (22.7% versus 9.8%, p=0.012), and more intubation (12.4% versus 3.7%, p=0.026). Improvement of symptoms (84.3% versus 81.7%, p=0.595) and hospitalization death (7.0% versus 1.2%, p=0.071) were not significantly different between groups. With exception of length of stay, the association of hydroxychloroquine with the above negative outcomes disappeared after adjustment for several factors including disease severity and concomitant use of azithromycin. Conclusions Hydroxychloroquine is not associated with better improvement of symptoms compared with other treatments. Moreover, it is associated with longer length of stay but not mortality or ICU admission in adjusted analysis.
Sep 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3545
Public health professionals working in rural communities are aware of the health disparities which result from lack of physicians, limited services, and income during the pandemic. Also they are aware that some populations are more vulnerable than others. People in the rural areas are experiencing problems on their physical, social and economic life styles because the pandemic is exacerbating some inequities. Individuals especially women and children in the rural areas are facing barriers in accessing health care services due to lack of resources and availability of health care providers in the communities. With COVID-19, women are less likely to seek services, including sexual and reproductive health services. Such services may be postponed to limit exposure to COVID-19 infection. This is particularly disturbing because in addition to the women maintaining their own health, they are also responsible for taking care of the mental, emotional and physical health needs of their families as well as all domestic responsibilities. As such, women in rural settings face special challenges as a result of these significant roles they play. Therefore, the impacts of COVID-19 are exacerbated on women by virtue of their sex and the roles they play in the family. This is a qualitative study that reviewed the reports of the 36 health care professionals under the aegis of members of COVID-19 committee working in partnership with state government to control, prevent and cushion the effects of COVID-19 in the society. This study is therefore, a summary of the observations of the COVID-19 committee members made up of 10(27.8%) females and 26(72.2%) males. The study focused on exploring how individual lifestyles in the rural areas have been affected in the face of COVID- 19 pandemic by identifying the vulnerabilities in social, political and economic systems which can amplify the impacts of the pandemic. Findings showed that preventive measures like lockdown and social distancing rules, wearing of face mask, hand washing with soap, and environmental cleanliness were not observed. The study noted that health seeking behaviours, sexual and marital life including income, education, employment and social interactions were all negatively affected. Most hospitals were battered and health care professionals boycotted the hospitals for fear of being infected. It was found that lack of health workers in the hospitals caused a good number of individuals to engage in self-medications. Also most pregnant women delivered their babies at home and few with traditional birth attendants. Some of the women who had deliveries at home experienced complications during and after delivery. Unfortunately, the report showed that governments’ financial supports to these women and their family members were insignificant as the government was more concerned with mitigating the spread of COVID-19 than assisting women to have safe deliveries. Therefore, the vulnerable groups especially women, children, and the elderly who experienced threats to their safety and wellbeing as a result of the services that were disrupted during the pandemic, should be assisted so as not to lose their lives to preventable diseases.
Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3488
Esophagectony remains a high-risk surgical procedure. Esophageal cancer is often associated with a weight loss. The best nutritional condition is crucial for successful oesophageal surgery. The increased septic complications and costs have limited the wide use of total parenteral nutrition. Currently, enteral nutrition is the preferred nutrition method following esophagectomy. However; jejunostomy-tube was associated with rare major complications that may lead to discontinuing nutrition. Choosing an enteral feeding route after esophagectomy depends greatly on the surgeon preference. The safety and benefits of early oral feeding on outcomes after major gastrointestinal surgery have been well documented. However, the surgical community is still reticent about initiating early oral feeding after esophageal surgery. Despite the limited number of published reports, comparative trials have clearly shown the feasibility, safety with no increase in morbidity rate.In this brief review, we tried to discuss the different routes of nutritional support after oesophagectomy with providing the current insights on early oral feeding.
Jul 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3459
As there is no specific treatment yet, the fight against the COVID-19 pandemic is being carried out with great difficulty today. The use of immune plasma is seen as a promising option since there is expectation that it will reduce mortality, as in influenza pandemics experienced in 1918 and 2009. However, the safety and effectiveness of this treatment option against SARS-CoV-2 viruses are not known for certain. In addition, the optimal obtaining methods and protection time of neutralizing antibodies to be used to provide passive immunization are not fully known. Therefore, it would be very useful to investigate the most effective neutralizing antibody collection methods without disrupting the overall structure and effectiveness of the antibodies subject to the use of the convalescent immune plasma. For this purpose, we found it appropriate to prepare a broad review on the structure and properties of antibodies, as well as the principles and storage conditions of antibodies to be used in passive immunization.
May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3335
The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.
May 2020 DOI 10.14302/issn.2692-5915.jafs-20-3351
Fire is an uncontrolled combustion that causes material damage and endangers human lives. Combustion is a chemical process that causes the oxidation of the fuel constituents of a some kind fuel. It is a process between fuel and oxidants in which heat is generated due to changes in chemical constituents. By releasing heat, it may occur light in the form of annealing or flame. There are accidental and arson fires. This work is dedicated to all firefighters in the world who very often find themselves in situations where they save the lives of others while neglecting their own safety. Firefighters are the heroes of modern times.
Apr 2020 DOI 10.14302/issn.2691-8862.jvat-20-3314
This article reviews toxicology practice challenges during COVID‑19, including laboratory safety, chemical exposures, therapeutics, and public health messaging. It identifies research needs and operational adaptations to support preparedness for future events.
Jan 2020 DOI 10.14302/issn.2641-4538.jphi-20-3163
The author reviews rabbinic decisions about smoking from a historical perspective along with the positions of the medical community. The author then brings the current, though limited, rabbinic considerations about vaping given the current state of science, as well as possible discussions for the future, as more becomes known about the safety and health risks associated with vaping.
Jan 2020 DOI 10.14302/issn.2641-4538.jphi-19-3132
Reaching efficient, safe and painless medical diagnosis procedure is a very valued goal for many research areas. Despite the great advantages of using optical imaging techniques in medical diagnosis including high safety and relative simplicity, it still suffers from relatively low resolution and penetration depth in the multiple scattering mediums such as biological tissues. Therefore, researchers began to devise ways to reduce the scattering properties of the tissue, hence increasing the imaging contrast. Optical clearing concept is introduced to do this job. This technique can reduce tissues scattering properties by using high refractive index chemicals, thus making the tissue transparent by equalizing the refractive index through that medium. In this paper, theory and techniques of optical clearing method are illustrated utilizing its benefits for deep imaging of different body tissues and organs.
Dec 2019 DOI 10.14302/issn.2641-5518.jcci-19-3133
To demonstrate that percutaneous coronary intervention (PCI) may in some cases be a safe option for patients with a high-risk surgical category, we report a complex clinical case of revascularization of multivessel coronary artery disease including left main coronary artery (LMCA) quadrifurcation. Methods For safety reasons, PCI was done in 2 separate sessions (staged PCI). Stenting of the LMCA quadrifurcation was performed using different stenting techniques in combination: modified balloon mini crush stenting technique was used - for LMCA and intermediate artery (IMA) stenting; modified balloon crush stenting technique was used for LMCA, circumflex artery (CX) and first obtuse marginal branch (OM1) stenting; provisional stenting technique was used for CX stenting, followed by sequential kissing balloon post-dilatation technique between LMCA and every branch; proximal optimization technique (POT) was performed in the LMCA. Left anterior descending artery (LAD), intermediate artery, circumflex artery, first obtuse marginal branch, left main coronary artery and its quadrifurcation were stented with 5 drug-eluting stents (DES) (Resolute Integrity, Medtronic); right coronary artery (RCA) was stented with 3 bare-metal stents (BMS) (Rebel, Boston Scientific). Results The interventions ended without complications, the ejection fraction increased from 35% to 48%, congestive heart failure functional class decreased to class I. Subsequent coronary angiography, eight months after the last PCI, revealed patent stents with mild, nonsignificant restenosis. More than three years after the intervention, the patient has no complaints (according to MACE). Conclusions It should be considered that in case of the selection of suitable patients and the use of the appropriate revascularization technique, LMCA quadrifurcation lesion can be successfully treated with PCI.
Mar 2019 DOI 10.14302/issn.2576-2818.jfb-19-2637
This preliminary study explores misoprostol as a preventive strategy for ovarian hyperstimulation syndrome. It outlines rationale, dosing considerations, and early safety signals, and calls for controlled trials to establish efficacy and risk–benefit.
Mar 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2633
Motorcycles have been increasing used widely in various urban, suburban and villages in Cameroon with an increased in accidents resulting to injuries among the population. Head and limbs injuries are responsible for most of the cases encountered from related crashes. A prospective study on head and limbs injuries resulting from motorcycle crash were assessed among the different cases brought to the casualty and emergency department of the Kumba district hospital. Most of the injured cases were of motorcycle and other vehicle collisions 203 (47.65) and the least among motorcycle lone crash 51 (11.97). Motorcycle to motorcycle collisions accounted for 107 (25.12 %) of the cases. 65 (15.26%) were motorcycle with pedestrians related collision. Stepping up and facilitating the regulations on licenses and the use of personal protective equipment for riders, improvement of roads infrastructures with pedestrian path, expanding health facilities and equipment, and human resources for health as well as empowering the population on road safety measures will be very important for RTAs control measures of the nation.
Feb 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2618
Objective Testing a new drug, treatment, and medical device clinically is critically important before prescribing it to patient. Not determining the drug’s safety and efficacy through clinical trials might impose life threatening outcomes on its consumers. The research paper describes the critical factors associated for testing any new drugs clinically, as limited research is performed in this field of public health. Study Design A qualitative systematic literature review was performed by mining relevant original peer reviewed research papers as well as some online resources like MedlinePlus due to limited availability of studies on such critical topic. Methods The databases used were Web of Sciences core collection, PubMed, Google scholar. The keywords used to search research papers were “clinical trials”, “testing new drugs”, “history of testing drugs”, “evidence-based medicine”. Conclusion Drugs which are prescribed to critical target population like pregnant women and children should be more often clinically tested if possible as majority of them are available in the market without Food and Drug Administration (FDA) approval. The abusive potential of any new drug could end up taking lives of innocent individuals. More evidence-based medicine can help translate research results on a heterogeneous population efficiently.
Dec 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2333
Introduction: The introduction of preexposure prophylaxis (PrEP) against incident HIV infection has changed the epidemiology of disease as continuous treatment with tenofovir and emtricitabine among high risk groups can reduce the relative risk for incident HIV infection by over 90%.However,despite the approved use of TDF+FTC, as a fixed dose combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg, for oral PrEP since 2012 , it does not appear to have become widely accepted and in use among healthcare workers especially those in low income countries. Researches are therefore needed to consider the awareness and practice of health workers towards the availability of PrEP services in this part of the world. Healthcare workers are expected to be promoters of the use of PrEP services. Method: A cross sectional questionnaire-based study conducted in southern Nigerian over a 6 months period. Data were collected from 250 healthcare workers using interviewer-administered questionnaires. The data analysis was done using statistical package for the social sciences (SPSS) for windows version 20.0 software (SPSS Inc; Chicago, IL, USA). Frequency counts were generated for all variables and statistical test of significance was performed with chi-square test. Significance was fixed at P < 0.05 and highly significance if P < 0.01. Results: A high proportion of the respondents(>60%) were highly educated healthcare workers(majorly Nurses and medical doctors) and about half (55%) having at least 10yrs working experience in the health sector with most especially on the HIV program(>90%), majority (94%) of the health workers were aware about ARV pre-exposure prophylaxis but very few ( 6% )could give the standard definition for PrEP as the use of ARV drugs by HIV negative persons to prevent the acquisition of HIV.Most(67%) of them gave wrong definition for PrEP and worse still about one fifth (20%) had no idea what PrEP was all about. Most (70%) could not correctly identify all the ARV drugs in a standard PrEP regimen while about 35% had no idea at all of the approved ARVs used for PrEP. Though PrEP services was not available at any of the facilities where the respondents were working ,the approved drugs(TDF+FTC) for PrEP were available at about 40% of the health facilities(public and private) and 15% community pharmacies in the vicinity of the respondents . Only 60% of the respondents were willing to access PrEP service for themselves if indicated while 35% would not use such services even if it is indicated for reasons which include concern about adverse effects and safety.Awareness of PrEP was significantly associated with the ability of the healthcare workers to identify the correct ARV regimen, ARV dosages and also correct indication for PrEP. Awareness was also associated with the knowledge of the correct proven efficacy for PrEP(>95%) and high likelihood of seeing a patient placed on PrEP and willingness to use PrEP based on personal indication Conclusion: The level of awareness of PrEP among healthcare workers was very high at about 90% yet many(60%) could not give correct standard definitions of PrEP, PrEP ARV regimen, dosages and level of efficacy of PrEP. Also none of the respondent had PrEP services available either at their center or any known referral centers. This is unacceptable in a country with second highest HIV burden in the world and has adopted PrEP in her national HIV guideline with ongoing PrEP demonstration studies. The few healthcare workers who were able to mentioned this information were more likely to have seen a patient placed on PrEP and were more willing to use PrEP based on personal indication. Recommendations: There is need to deepen the and knowledge of PrEP among healthcare workers especially those in poor resource settings by engaging them through update courses outreach, educational resources, campaigns/seminars and workshops and various job aids. All healthcare service providers should be very comfortable to carry out HIV risk assessment of their clients and provide PrEP to those indicated directly or indirectly through referral
Oct 2018 DOI 10.14302/issn.2638-4469.japb-18-2423
This review surveys medicinal plants and their traditional uses, summarizing common indications and bioactive constituents. It contrasts perceived safety with evidence on efficacy and potential toxicity or interactions. The authors highlight the need for standardized preparations and controlled studies to translate ethnobotanical knowledge into safe, effective therapies.
Oct 2018 DOI 10.14302/issn.2328-0182.japst-18-2341
The present investigation was carried out to evaluate the safety of a stem bark aqueous extract of Harunganamadagascariensis Lam. (Hypericaceae) by determining its potential toxicity after acute and subacute administration in rodents. Acute toxicity tests were carried out in mice and the behavior, death and median lethal dose (LD50) were estimated. Subacute toxicity (28 days) studies were conducted in rats with oral daily doses of 200, 400 and 600 mg/kg. Parameters observed at the end of the subacute tests included changes in body and vital organ weights, mortality, hematological, biochemical, hepatic and kidney effects. Harunganamadagascariensisextract did not produce any visible toxicity or mortality with oral doses up to 2000 mg/kg within 14 days of single treatment, leading to the conclusion that the LD50 is greater than 2000 mg/kg. In the subacute toxicity tests, neither mortality nor visible signs of lethality was seen in rats. No significant change in the weight of the kidney, liver, heart, lungs spleen, pancreas and testicles was observed. Alanine transaminase (ALT) increased significantly in males at 400 and 600 mg/kg, whereas Aspartate transaminase (AST) decreased at 600 mg/kg in female rats. HDL Cholesterol was reduced at 600 mg/kg in female rats. There was a significant increase in urea concentration in female rats at 400 mg/kg. A significant decrease, both in platelet volume distribution (PVD) at 400 mg/kg in male rats and in red cell volume distribution (RDW) at 200 mg/kg were recorded in female rats respectively, but with no changes in other hematologic parameters. Histological study shows normal structure of liver, kidneys and heart of control and treated rats. Results indicate that oral doses of aqueous stem bark of Harunganamadagascariensis are relatively safe in rats; however, assessment of hepatobiliary function should be done during chronic use in humans.
Sep 2018 DOI 10.14302/issn.2689-2855.jan-18-2342
This study was devoted to the learning of the use of nanotechnology to correct the functional activity of red blood cells (RBCs) at the storage stages at a positive temperature. It was established that saline NaCl, which had previously been processed by magnetite nanoparticles (ICNB) had a marked membrane-stabilizing effect, inhibits hemolysis and increasing the sedimentation stability of preserved RBCs. The complex analysis of the obtained data allowed to determine the primary mechanisms effect of the saline NaCl, which had previously been processed by ICNB on the preserved RBCs. The proposed method of additive modernization of preserved RBCs was adapted to the production process. The optimization results were obtained in creating a simple and practical method of additive modernization of preservation solutions that does not violate the compliance requirements, improves the quality, efficiency and safety transfusion of RBCs.
Aug 2018 DOI 10.14302/issn.2379-7835.ijn-18-2212
Fish meat is a common and broadly used food due to its high nutritional values yet the bones and flavour of fresh fish can be unpleasant. The unpleasant fishy flavour makes it difficult to handle and process. The fishy flavour is as a result of microbial presence and growth. Studies associated with microbial contaminations have concentrated more on the carcass. Such contaminations which affect the microbiological status of processed products can emanate from spices and other non-meat ingredients, environment, equipment and handlers. The successful application of processing/preservation technology results in the conservation of desirable qualities in stabilized and varietal fish products. This study sought to use fish in the manufacture of frankfurter-type sausages, which could have improved preservation characteristics without any adverse effects on sensory properties. The nutritional composition and microbiological safety of fresh fish and sausages were determined using the methods described by AOAC and ICMSF respectively. The study showed that, catfish sausages were higher in protein (15.69 %) and were lower in fat (10.66%) compared to the other sausages. Total Viable Counts (TVC) were within the accepted limits (106 and 107cfu/g) for fish and pork respectively. E. coli was not detected in any of the treatments during frozen storage for 6 weeks. It was concluded that catfish frankfurter has high nutritive value because it contained less fat but with higher crude protein. Like pork frankfurters, both catfish and mackerel sausages could be stored for six weeks without any negative effects on microbial quality.
May 2018 DOI 10.14302/issn.2473-1005.jdoi-18-2076
This review examines the adjunctive use of ozone therapy for periodontal disease. It summarizes proposed antimicrobial and host‑modulating effects, delivery methods, and safety considerations, and calls for standardized trials to define clinical benefit.
Mar 2018 DOI 10.14302/issn.2574-4518.jsdr-17-1785
Sleep is vital for the maintenance of physical health and mental wellbeing. Sleep also plays a cardinal role in the process of healing. It is estimated that 50 to 70 million Americans suffer chronically from sleep disturbances and insufficiency, which not only hinders daily functioning but also adversely affects health, quality of life and longevity.1 Deficient sleep is associated with an increased risk of developing chronic diseases such as hypertension, diabetes, obesity, heart disease, stroke, depression, frequent mental distress, as well as increased mortality, and reduced quality of life and productivity.1,2Aging, medical conditions, pain, and mental illness further aggravate sleep disturbances such as insomnia, sleep fragmentation and daytime sleepiness.3, 4, 5, 6, 7, 8 The a common treatment for sleep disturbances and insomnia is pharmacological therapy. Benzodiazepines may have negative long-term side effects including residual daytime sedation and tolerance development. Withdrawal difficulties may increase dependency. In the older patient there are safety issues related to daytime sedation including increase risk of falls. With the importance of sleep in hospital recovery and the side effects of sleep medication becoming more widely recognized, there has been an impetus to s use nonpharmacological alternatives , such as music.. This pilot study builds on the potential impact of music’s effectivity by introducing music therapy as a safe, cost effective and culturally sensitive intervention.
Mar 2018
The crusade against cancer has a new army: immunotherapy. The rational design is very simple, but brilliant at the same time. Extract the patients T-cells, reprogram them in vitro for the expression of highly specific receptors against cancer, perfuse them back to the patient. As a result, T-cells are now instructed to selectively kill circulating tumor cells, while avoiding potential side effects. This ‘Fairy Tale’ however does not lack of drawbacks and limitations. First, malignant progression can be accompanied by profound immune suppression, which counteracts the immune system-mediated tumor elimination. Second, the immune cells modification does not match high standards in terms of safety for humans. Here, nanotech can fill these gaps, and help immunotherapy to be safer and more effective.
Mar 2018 DOI 10.14302/issn.2642-9241.jrd-18-1958
Background Bronchoscopic lung volume reduction (BLVR) has been applied in COPD patients with heterogeneous emphysema. In this first clinical trial in Vietnam, we evaluated the safety and initial results of BLVR by one-way valve in COPD patients with severe emphysema. Methods We performed a prospective, nonrandomized, single center longitudinal study in 30 stable COPD patients with heterogeneous severe emphysema on CT-scanner, the average age of 65.17 years old, FEV1≤35 %pred., TLC ≥ 100 %pred., RV ≥ 150 %pred. and 6MWT < 450 meters. The Zephyr one-way bronchial valves (PulmonX, Redwood City, CA, USA) with the size of 5.5 mm and 4mm were placed in lobar or segmental bronchi via flexible bronchoscopy. 28 patients were placed only one valve, 1 patient with two and 1 patient with three valves. 23 valves with the size 5.5 mm diameters and 10 valves with the size 4.0mm used. All patients received optimal medical treatment at the time of procedure and during the study period. Outcomes will be assessed at 3 months after treatment include the changes of clinic, and lung function, the occurrence of complications. Results After 3 months, mean CAT scores decreased significantly compared with before procedure (17.73 ± 3.53 vs 20.10 ± 3.58) (p<0.05), with the median change of 2.73 points and the improvement more than 2 points in 76.67% of patients. 6 MWT increased at 3 months with mean 32.13 meters, 93.33% of the patients increased 6MWT, 46.67% of the patients increased 6MWT more than 26 meters. MRC decreased with the median change of 0.5 score. VC decreased by a mean 0.2 (L) (0.42 - 0.02), FEV1 increased by a mean 0.05 (L) (0.04 - 0.05) but not statistically significant (p>0.05); FVC increased by a mean 0.14 (L) (0.01 - 0.28), RV decreased by a mean 0.62 (L) (1.05 - 0.2), TLC decreased by a mean 0.52 (L) (0.77- 2.4) with statistically significant (P<0.05). The early complications were 13.33%, the later complications were 23.34% of the patients. Conclusions The unilateral bronchoscopic lung volume reduction with one-way valve (mainly one valve) in treatment of heterogeneous severe emphysema in stable COPD patients in Viet Nam have shown that this procedure is safe with encouraging initial results.
Feb 2018
An inaugural editorial presents the journal's scope spanning chemotherapy research and clinical practice. It invites translational work linking mechanisms, regimens, and real‑world outcomes with an emphasis on safety and effectiveness.
Nov 2017 DOI 10.14302/issn.2471-2175.jdrt-17-1760
Metastatic melanoma is a very deadly type of skin cancer with poor prognosis and low 5-year survival rates. Until recently, patients with metastatic melanoma had very few treatment options, which only included dacarbazine and aldesleukin. In 2011, the first checkpoint blocker, ipilimumab was approved for the treatment of unresectable metastatic melanoma but its success was eclipsed by low response rates and high incidence of adverse events. Later in 2014, anti-PD-1 antibodies, nivolumab and pembrolizumab were approved for the treatment of metastatic melanoma. With comparatively high response rates and manageable safety profile, PD-1 blockers were remarkably successful in the treatment of melanoma and also other cancer subtypes such as non-small cell lung cancer and metastatic urothelial carcinoma. This article highlights the success of anti-PD-1 antibodies, discusses the mechanism of PD-1:PD-L1/2 pathway, responses of melanoma patients to PD-1 blockers and the research on improving response rates to PD-1 blockers.
Nov 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1768
Antifungal antagonism of different fourteen plant essential oils was examined as natural agents against economic and hygienic effective three yeasts; the preservative efficacy of most potent anti-yeast essential oil in food sanitary was also tested. Study involved oils antifungal bioactivity screening against Saccharomycescerevisiae, Candida albicans,and Candida utilis. Study also included selection and invitro extraction of most bioactive oil, and evaluation of its antifungal minimal inhibitory concentrations (MICs). Control ofjuice spoilage by Saccharomycescerevisiae under the effect of in vitro oil extract different concentrations was also screened. Among the tested essential oils, apricot seed oil was the most bioactive anti-yeast agent. Two MIC values of apricot oil invitro extract, 12.5μgml-1 and 25μgml-1 were recorded. In juice samples, oil extract bioactivity increased gradually up to concentration 100μgml-1.Highest oil preservative ability was observed at oil concentration of and above 125μgml-1. Higher oil concentrations needed for juice preservation were found more than in vitro assay to give the same effect. Applying of apricot oil and some other plant essential oils could be used as an environmental safety mode in osmophilic food preservation and in Candidate diseases biocontrol.
Aug 2017 DOI 10.14302/issn.2379-7835.ijn-17-1710
Background: High number of patients suffering from autism spectrum disorders utilize dietary intervention methods, especially gluten-free/casein-free diet. In contrast with its’ extensive usage no sufficient and consistent data exist to support its’ efficiency and safety. Objective: The main aim of this systematic review is to provide a general look to the efficiency and safety of gluten-free/casein-free diet treatment for autism spectrum disorders. Method: Studies used in this systematic review are gathered from 3 online databases (PubMed, Embase and the Cochrane Library). Inclusion criteria are established for study selection. Articles published in a peer-reviewed article between 1990 and 2016 in English about our topic of interest and conducted with patients under the age of eighteen (18) are selected and further analyzed (“Level of Evidence” and “Grade of Recommendation” criteria are utilized). Results: Even though some studies with high values of “Level of Evidence” claim that gluten-free/casein-free diet is beneficial for patients suffering from autism spectrum disorders, studies with lower risk of bias demonstrate otherwise. Since studies such as case reports and cohort studies may contain bias associated with small sample size, absence of clear assessment methods, lack of randomization and short treatment period we suggest that there is no sufficient data to support gluten-free/casein-free diet treatment. Conclusion: Due to controversial outcomes from studies that have different “Level of Evidence” we speculate that efficiency of gluten-free/casein-free diet might be related to individual genetic differences. Therefore, studies conducted with large study groups could not provide statistically significant data to support this treatment option. Further studies should be conducted, especially in the field of genetics, in order to test our hypothesis.
Jul 2017 DOI 10.14302/issn.3070-5835.jcpn-17-1562
Second-generation antipsychotics have relatively recently become available in long-acting intramuscular formulations (LAIs) and have been receiving a substantial amount of pharmaceutical industry promotion on the grounds that they improve treatment adherence in patients with psychotic illness. LAIs do have some drawbacks, however, which is the topic area covered by this review. A Global Scholar search of the nursing and medical literature reveals several factors that can negatively impinge on the clinical efficacy of LAIs: 1. The extent of training of injection personnel 2. The quality of surveillance of patient symptoms and side effects 3. The skilled use of the full range of injection techniques 4. The extent of drug accumulation over time 5. The potential loss of drug dose flexibility 6. The impact of exercise and temperature on drug distribution 7. The burden of the medication routine and the social burdens of LAIs 8. The safety of LAIs during pregnancy 9. The perceived coerciveness of LAIs 10. Issues of overdose and polypharmacy 11. Issues of cost 12. The important issue of responsibility for self-management of illness. Although the evidence is clinical and anecdotal, LAIs appear to work well for many patients, but their drawbacks are not negligible. Clinicians need to weigh individual risks and benefits when making treatment decisions.
Jun 2017 DOI 10.14302/issn.2377-2549.jndc-17-1439
The effectiveness of atorvastatin calcium in lowering cholesterol is dose-related. It is available in 10, 20, 40, and 80 mg film coated tablets. In order to ensure quality, safety and efficacy of tablets in formulations, the objective of this presented work was to develop a new high performance liquid chromatographic-UV method for quantitation of active atorvastatin calcium in pharmaceutical formulations. The method was based on reversed-phase high performance liquid chromatographic-UV separation of atorvastatin at detection wavelength of 246 nm using Acclaim 120 C18 reversed phase LC column (5 mm, 250×4.6 mm) with mobile phase of acetonitrile-dichloromethane-acetic acid (68.6: 30.6: 0.8 v/v/v) at a flow rate of 1.0 mL min-1 at 25°C. Different variables affecting chromatographic separation were carefully studied and optimized. The study results provided chromatogram of atorvastatin with retention time of 2.68 min. The calibration curve was linear over the concentration range of 15-300 mg mL-1. No interference was observed from common pharmaceutical excipients present in dosage forms. The proposed method was successfully applied to the determination of atorvastatin calcium in pharmaceutical formulations and proved to be significantly not different with reference method. The proposed can be used as an alternate method for routine quality control analysis of active atorvastatin in research, hospitals and pharmaceutical laboratories.
Apr 2017 DOI 10.14302/issn.2474-3585.jpmc-16-1213
As people age, environments supporting changing needs can potentially impact their quality of life. The purpose of this exploratory study was to develop and assess the validity of a checklist instrument used to evaluate senior-supportive environmental risk factors within assisted living facilities (ALFs). Aging often leads to a decrease in the ability of a person to interpret sensory cues within his or her environment. This checklist instrument examined the relationship between sensory cue frequency and the influence on fall incidence within ALFs to maximize safety and quality of life. Observers visited 140 ALFs, utilizing the checklist instrument to document the presence or non-presence of 110 sensory cues. Contrary to the original hypothesis, a positive correlation was found between sensory cues and reported falls in each space. As the number of cues increased, the number of falls also increased. Additionally, the frequency of sensory cues within each room increased as facility size increased. Lastly, data revealed that more sensory cues were present in ALFs designed or renovated by design professionals. Although the results were contrary to expectations, the checklist instrument demonstrated face and predictive validity as a future research tool.
Dec 2016 DOI 10.14302/issn.2329-9487.jhc-16-1244
Objective: The prospective intervention study was conducted to investigate the effects of kale powder (Kale juice mixed with water or milk) consumption on metabolic syndrome in subjects with potential metabolic syndrome. Method: In Arita-cho, 149 male and female subjects with potential metabolic syndrome were instructed to consume kale powder for 8 weeks, and its effects on blood pressure, HbA1c, BMI, abdominal circumference, and blood triglycerides, LDL-C, HDL-C, and fasting blood sugar levels were assessed. Additionally, the safety of kale powder was examined. Results: After the 8-week long intake of kale powder, a significant decrease was observed in laboratory and home test-based blood pressure, abdominal circumference, and levels of LDL-C, HDL-C, and fasting blood sugar. Additionally, a hypotensive effect was observed on conducting stratified analysis, in which patients with blood pressure-related diseases were excluded. Furthermore, no safety concerns were identified regarding kale powder. Conclusion: Kale powder had a beneficial effect to maintain optimal blood pressure, blood sugar, and abdominal circumference in subjects with potential metabolic syndrome. Additionally, a hypotensive effect was observed within the normal range in subjects without blood pressure-related diseases.
Nov 2016
This practical overview lists prerequisites for emergent laparoscopic colorectal cancer surgery, including team readiness, equipment, and perioperative protocols to optimize patient safety.
Jun 2016 DOI 10.14302/issn.2381-862X.jwrh-15-820
Although structured taught aquatic baby programmes (STABPs) are one of the earliest forms of physical activity, the possible impacts of structured taught aquatic baby programmes are unknown. This study aims to understand the perceived impact that attending STABPs has on parents/carers, their baby/child and their family. An online survey was completed by 2854 parents/carers. It was advertised via numerous online advertisements. Of the respondents, 89% had attended STABPs. ‘Attendees’ were significantly older and were less likely to live in a more deprived area compared to ‘non-attendees’. STABPs are perceived to be beneficial in terms of water safety, confidence, benefits to parent-child relationships and interaction with other children but cost affects attendance. The evidence-base regarding the benefits of STABPs should be established to further understand their impact on parents/carers and babies. Further research should focus on understanding barriers to attendance and ways to facilitate attendance. The need to understand the ‘key ingredients’ of structured taught aquatic baby programmes was highlighted.
Mar 2016 DOI 10.14302/issn.2997-2108.jcc-15-856
This paper explores the potential of Gene‑Eden‑VIR as an adjunctive approach for cervical cancer prevention or management. The discussion reviews proposed antiviral and immunomodulatory mechanisms, existing evidence, and safety considerations. The authors call for controlled trials to clarify efficacy and appropriate clinical use.
Feb 2016 DOI 10.14302/issn.2328-0182.japst-15-855
An investigation into the proximate, mineral and antinutitional constitutents of natural cocoa powder (NCP), natural cocoa liquor (NCL) and alkalized cocoa powder (ACP) was carried out. Other parameters investigated were: energy values as contributed to the total metabolisable energy by protein, fat and carbohydrate and the energy percentages; calculated mineral quality parameters; mineral bioavailability as predicted by Ca: Phy, Phy:Zn and CaPhy/Zn molar ratios of the different cocoa products and mineral safety index (MSI) of some of the minerals of the samples. The data generated were subjected to statistical evaluation of chi-square (χ2). The three samples, NCP, NCL and ACP had proximate levels (g/100g) as: total ash, 3.73-10.8; moisture, 2.16-9.04; protein, 10.9-24.3; fat, 4.93-56.0; fibre, 1.03-17.3; carbohydrate, 20.5-48.9 and fatty acid, 3.95-44.8. For total energy contribution, results varied from, 1169-2656 kJ/100 g. In the minerals, the followings were higlhly concentrated: Na, K, Ca, Mg, Zn, Fe and P but low or not detected in Cu, Co and Mn. Virtually all the mineral quality parameters were poor as seen in these ratios: K/Na, Na/K, Ca/P and K/(Ca + Mg). The molar ratios of the samples were good enough to predict the bioavailability of the minerals. The mineral safety index (MSI) values showed that no mineral reached the toxic level in any of the samples. In the antinutritional constituents, ACP was highest in phytin phosphorus (Pp), phytin and Pp % of P; NCL was highest in oxalate and total phosphorus (P); tannin was highest in NCP. χ2 was significant in all proximate values (except ash, moisture and organic matter); all energy contributions, significant only in Mn (among the minerals); non was significant in the mineral quality parameters; only Ca: Phy was significant in the mineral molar ratios; no value was significant in the MSI and phytin was the only parameter significant among the antinutritional constituents.
May 2015 DOI 10.14302/issn.2379-7835.ijn-14-584
During the past three decades the prevalence of childhood obesity has steadily increased in the United States. Causes of childhood obesity are complex and include numerous individual and environmental factors. The purpose of this study was to determine parent perceptions on the social-ecological barriers (community, school, and family) to physical activity and healthy eating, perceived specific to their children. Self-reported data gathered from a 50-item questionnaire and six focus groups were conducted with parents (n=43) enrolled in the Women, Infants, and Children (WIC) Program. Participants (16 to 67 years old) were predominately female (88.4%), Hispanic (67%), low income, and living in or near Lompoc in Santa Barbara County, CA. The social-ecological model (family, school, and community) was utilized to create focus group questions and provide recommendations as part of the Lompoc Community Health Improvement Project (2006-to-the-present). Popular community barriers for physical activity were: disconnected sidewalks, lack of safe bike routes to school, lack of recreational programming at an affordable cost, and language barriers (lack of marketing physical activity programs in Spanish). Two safety barriers involved parks; fear of injury (dilapidated equipment) and fear of gangs (violence). Common school barriers were: teachers do not lead-by-example, lack of healthy food in school cafeteria, and insufficient time for children to purchase food and eat. Family barriers included: grandparents sabotaging healthy eating environments (e.g., spoiling children), insufficient nutrition knowledge (both children and parents), and economics (not being able to afford healthy food and a recreation/gym membership).
May 2015 DOI 10.14302/issn.2379-7835.ijn-14-588
Plant foods are staples of many cultures in the world. Conversely, the appearance of vegetarianism in Western countries is a relatively recent phenomenon, showing an upward trend: people following vegetarian diets (both lacto-ovo-vegetarian-LOV and vegan-VEG), account today for about 10% of the Western population. According to the principle of non-discrimination, the most recent national dietary guidelines for the general population (DGLs) of some Western countries have adapted their contents to comprise vegetarian eating patterns. Moreover, since 1997, specific vegetarian food guidelines (VFGs) were developed. The aim of this review was to summarize and compare the information and recommendations of the food-based dietary guidelines (FBDGs) contained in the DGLs usable by vegetarians, and in the main VFGs; to extract a list of basic criteria for the planning of a well-balanced vegetarian diet, and to identify the most valid FBDG for vegetarians. An Internet search was conducted in the English language, in order to identify national DGLs applicable to vegetarian dietary patterns, and international VFGs. Four Western DGLs and six VFGs were selected. Compared to the majority of DGLs, VFGs are not an "adaptation" of omnivorous (OMN) eating patterns to vegetarian ones, but rather devoted guides: they include only foods consumed by vegetarians, and take into account their specific nutritional needs. VFGs offer qualified advice to meet the most updated standards of adequacy and safety of the diet: the varied consumption of all plant foods, mainly unprocessed; the respect of individual’s calorie requirements; the optional addition of small amounts of foods of animal origin (dairy/eggs); the attention towards some potentially critical nutrients. According to this criteria, the VFG for North American Vegetarians can represent the most accurate and practical model: not only is it consistent with research on the adequacy of vegetarian diets, but it is applicable both to LOV and VEG eating patterns and to all lifecycle stages beyond 4 years of age.
May 2015 DOI 10.14302/issn.2644-0105.jbfb-14-547
Background: Scientific research is constantly expanding our knowledge of nutritional needs in pregnancy and lactation. In June 2014 the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) issued draft-revised advice encouraging pregnant women, those who might become pregnant, breastfeeding mothers and young children to eat more fish, a total of least 8 ounces per week and to eat a variety of fish lower in mercury in particular anchovies, butterfish, catfish, clam, haddock (Atlantic), herring, mullet, oyster, perch (ocean), sardine, shad, trout (freshwater). However, the presence of radionuclides released from the damaged Fukushima Daiichi nuclear power plant in Pacific biota has aroused worldwide attention and concern. Objective and Methods: Evaluating all the scientific literature available after the Fukushima nuclear disaster, the aim of this review is to demonstrate the safety of seafood products and the use of omega-3 supplements potentially derived from contaminated radioactive fish. Results and Conclusions: There are no reasons to fear the amount of radiation in Japanese fish. The dose received from seafood consumption can be estimated to result in two additional fatal cancer cases per 10,000,000 similarly exposed people. The safest way to get omega-3 fatty acids during pregnancy is by taking a high-quality fish oil supplement, approved by a governing body that provides proof of quality such as the Council for Responsible Nutrition, the European Pharmocopeia Standard or the Norwegian Medicinal Standard and by the Food and Drug Administration or the Environmental Protection Agency 12. Pregnant and breastfeeding women do not need to cut fish out of their diet completely, and it may be safely eaten up to three times per week safely 3.
Jan 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-edt.1.3
This hypothesis‑driven review considers phytochemicals with putative anti‑HIV activity. It summarizes proposed mechanisms, in vitro evidence, and formulation issues, and calls for standardized assays and clinical trials to determine real‑world efficacy and safety.
Dec 2012 DOI 10.14302/issn.2324-7339.jcrhap-12-edt.1.1
This editorial discusses combination strategies that concurrently target viral replication and host factors in HIV therapy. It surveys candidate mechanisms, potential benefits, and safety considerations, advocating rigorous trials to balance efficacy with tolerability in diverse patient populations.