Allopathic Research Articles

How Does Lacking a Home Program Impact Otolaryngology Applicants?

To compare otolaryngology interview and match outcomes between applicants with and without home residency programs. Otolaryngology applicants from US allopathic medical schools during the 2019-2023 cycles who responded to the Texas Seeking Transparency in Application to Residency (STAR) survey were identified. Students were stratified based upon whether their medical school had an affiliated otolaryngology residency program. The primary outcomes were number of interviews and match rate. Wilcoxon-rank sum and χ2 testing was used to assess associations between home program status and interview and match outcomes. Of the 633 fourth-year medical students applying to otolaryngology during the 2019-2023 application cycles, 89 had no home program (NHP) and 544 had a home program (HP). Applicants with NHP completed significantly more away rotations than applicants with a HP (2.2 vs. 1.5; p < 0.01). There was no difference in mean number of applications submitted between applicants with NHP and applicants with a HP. However, applicants with a HP received a significantly greater number of interviews (14.7 vs. 11.8; p < 0.01), attended more interviews (12.4 vs. 11.3; p = 0.02), attended a lower percentage of their offered interviews (84.4% vs. 95.8%), and had a higher match rate (81.8% vs. 70.8%; p = 0.02) than applicants with NHP. Applicants with NHP interviewed at (1.9 vs. 1.3; p < 0.01) and matched at (33.7% vs. 23.9%; p = 0.048) significantly more away rotation institutions than applicants with a HP. Applicants with NHP received fewer interviews and had lower match rates. Away rotations may be especially important for applicants with NHP. NA Laryngoscope, 134:4494-4500, 2024.

A comparative study of hypolipidemic effect of atorvastatin and Coriandrum sativum in triton-induced hyperlipidemic albino rat model

Background: Hyperlipidemia is the main factor responsible for coronary artery disease. Atorvastatin commonly used, as a competitive inhibitor of HMG-Co-A reductase, is known to reduce LDL and triglyceride levels and increase HDL levels. Coriandrum sativum (Coriander) belongs to the Apiaceae family and has hypolipidemic, antidiabetic, and antioxidant properties. Triton WR1339 has been used by several studies to induce hypercholesterolemia in animals which acts on both the synthesis and excretory phase. This study aimed to compare the hypolipidemic effect of Coriandrum sativum and atorvastatin in triton-induced hyperlipidemic rats. Methods: Following approval from the Institutional Animal Ethics committee, 36 Wistar albino rats were divided into 6 groups of 6 animals each. Triton 200mg IP was administered to all the groups except Group 1 (control). Groups 3 and 4 received Coriander extract 300mg/kg and Atorvastatin 80mg/kg orally with Triton. Groups 5 and 6 received Coriander extract and Atorvastatin respectively 22 hours later. Lipid profile was estimated 24 hours before, 24 and 48 hours after administering Triton. Results: In the synthesis phase, there is a statistically significant increase in the lipid levels in Groups 2, 5, and 6 compared to Groups 3 and, 4 indicating hypolipidemic effects of both Coriander extract and Atorvastatin. In the excretory phase, all groups have shown a decrease in lipid levels but a decrease in total cholesterol level in Group 5 compared to Group 3 was significant. Conclusions: Atorvastatin and Coriander extract both affect the lipid levels in the synthesis and excretory phase. Even though coriander cannot replace atorvastatin in the management of hyperlipidemia, it can be used as an adjuvant to atorvastatin to reduce the cost effects and adverse reactions caused by allopathic medicines.

In vitro Evaluation of Antidiabetic Properties of Probiotic Lactic Acid Bacteria Isolated from Herbal Extracts (Asava, Aristha, Sarko, Swarasa)

Probiotic bacteria have immense potential to be used as biotherapeutic agents. They are alternatives to many allopathic medicines, antibiotics that can be used for the treatment of diabetes without causing any side effects. Generally, Lactic acid bacteria have been isolated from human and animal origin to be used as therapeutic or nutraceutical agents. However, there is lack of information about the role of natural herbs associated LAB to be used as biotherapeutic agent for the treatment of diabetes. Diabetes is a common disease that affects globally to major population worldwide. The impact of this disease is greater however, complete cure of diabetes s is not available till date. Thus many reseraches is going on this direction to fi d the better cure in a natural way. In the present study isolation of Lactic acid bacteria was carried out from the herbal extracts like Asava, Aristha, Sarko and Swarsa. About 29 isolates were screened for probiotic potential. On confirmation, the isolates were subjected to evaluate for anti-diabetic properties. The results revealed that out of 29 isolates about 8 isolates were found to have antidiabetic properties. From the result, it can be said that, this opens new dimension in the field of medicines for the treatment of diabetes and related ailments with biotherapeutic agents.

Communication and empathy within the patient-physician relationship among patients with and without chronic pain.

Chronic pain may affect the relationship between patients and their treating physicians. This study was designed to compare four aspects of physician communication and physician empathy reported by patients with chronic pain and in chronic pain-free controls. A cross-sectional study was conducted within a national pain research registry from July 2020 through January 2024. Patients with chronic low back pain of greater than 3months duration were matched to chronic pain-free controls utilizing propensity scores derived froma logistic regression model based on 11 variables thatincluded sociodemographic characteristics, cigarette smoking status, history of comorbid medical conditions, and duration of the current patient-physician relationship. Patients reported on the primary outcomes of physician communication utilizing the Communication Behavior Questionnaire (CBQ) and physician empathy utilizing the Consultation and Relational Empathy (CARE) measure. Group means were compared for each aspect of physician communication (patient participation and patient orientation, effective and open communication, emotionally supportive communication, and communication about personal circumstances) and physician empathy, and Cohen's d statistic was utilized to assess the clinical relevance of between-group differences. Secondary exploratory analyses were also performed to compare patients treated by osteopathic physicians vs. allopathic physicians and to determine whether study group X physician type interaction effects were present. The 387 patients in each study group were matched within a caliper width of 0.001 on the propensity score. Overall, patients ranged from 21 to 79 years of age (mean, 50.7 years; standard deviation [SD], 15.1 years), and 617 (79.7 %) of them were female. Patients in the chronic pain group reported poorer scores for all aspects of physician communication and physician empathy than the chronic pain-free controls. All between-group differences were clinically relevant. There were no differences in physician communication or physician empathy according to physician type in the exploratory analyses, and study group X physician type interaction effects were not observed. In this cross-sectional study, patients with chronic pain reported having physicians with poorer communication and less empathy than chronic pain-free controls. Longitudinal research is needed to more clearly determine the temporal relationship between patients' chronic pain and physician communication and physician empathy during medical encounters.

Trade-off between herbal and allopathic treatments: An ethnopharmacological case study in Rema-kalenga wildlife sanctuary, Bangladesh

The Rema-Kalenga Wildlife Sanctuary (RKWS) is a protected forest in Bangladesh that houses a variety of rare flora and fauna and supports the sustenance of 13 ethnic communities. This forest's indigenous and other inhabitants traditionally have a strong cultural connection to the plants, particularly medicinal plants. Due to modern allopathic medicine's rapid growth and commercial tree species prioritization, many medicinal plants are now on the verge of endangerment. Under such circumstances, it is crucial to explore how the local community perceives the importance of herbal treatments in contrast to allopathy, the underlying reasons for their perceptions, and the specific ailments for which they use the plants. The main objectives are: 1) to evaluate the perceptions of the local community towards allopathy and herbal medicine using Nussbaum's central capabilities approach, 2) to identify medicinal plant diversity, therapeutic usages, and quantitative indices, 3) to determine the factors that influence the use of medicinal plants. Repeated interviews and field surveys were conducted at the RKWS, interviewing 145 people, including the indigenous community (72.42 %) and traditional healers (8.27 %) from the surrounding seven villages. The study identified 51 medicinal plant species belonging to 39 families for their potent medicinal properties in treating various ailments. The predominant parts of the plants used in the treatments were leaves and roots. The uses were classified into 12 categories according to Nussbaum's central capabilities. The findings identified Aloe vera, Phyllanthus emblica, and Azadirachta indica as highly culturally important species. In contrast, Terminalia arjuna, Swertia chirata, and Azadirachta indica were found to have the highest relative importance. The underlying determinants influencing the preferences of individual users towards herbal medicine were income from agroforestry, beliefs, knowledge, and ethnicity, as revealed by the analysis of the ordinal logit model. The respondents viewed their strong inclination toward herbal medicine with many positive attitudes. Herbal medicine users held a negative perception of allopathy except for affiliation and practical reasons being viewed as the positive outcomes. Conversely, allopathic medicine users expressed mixed perceptions towards the treatment, with both positive and negative aspects being identified. Promoting the sustainable use of medicinal plants and their conservation efforts is imperative for the benefit of present and future generations in this region.

Piper attenuatum leaves extract reduced renal crystallization formation in urolithiasis might be due to probable interaction with uromodulin protein: An evidence based in vivo and in silico studies

Urolithiasis can cause excruciating pain and hardly managed by allopathic medicine without surgery. Recently, many of research on validation of traditional medicinal plants provided a hope for management of urolithiasis. In this context, we have found a gap between traditional claims and scientific validation on use of Piper attenuatum (P. attenuatum) towards mangement of renal caliculi. Therefore, present study was planned to determine anti-urolithiatic efficacy of ethanol extract of P. attenuatum (EEPA) leaves on ethylene glycol induced urolithiasis on male Wistar rats. Further, study pertaining to phytochemical analysis followed by molecular docking of selected bioactive phytochemicals of P. attenuatum against human uromodulin (a key potential biomarkers relevant for renal function and chronic kidney disease including urolithiasis) protein. As a result, EEPA (400 mg/kg/bw) was found to significantly improves various urinary (volume: 7.19 ± 0.11 ml/24 hr; calcium: 6.15 ± 0.51 mg/dl; phosphate: 7.83 ± 0.56 mg/dl and oxalate: 1.78 ± 0.03 mg/dl) and serum parameters (creatinine: 1.85 ± 0.04 mg/dl; uric acid: 1.65 ± 0.08 mg/dl and blood urea nitrogen or BUN: 32.20 ± 1.41 mg/dl), when compared with negative control group followed by reverse in changes as an evidence of histological studies. Additionally, molecular docking studies revealed higher binding affinity to some selected phytoconstituents against human uromodulin enzyme. It was further concluded that EEPA leaves exhibits significant antiurolithiatic activity due to presence of aristolactam A II, cepharadione A and B, piperolactam A, norcepharadione B and pipoxide chlorohydrin via strong binding efficiency with uromodulin protein.

Prescribing Pattern and Treatment Outcomes in Upper Respiratory Tract Infection: A Comparative Study of Allopathic and Unani Medicine

Background and objectiveUpper respiratory tract infections (URTIs) rank among the top three diagnoses in outpatient settings. URTIs patients currently have access to treatment choices encompassing traditional and allopathic medications. The study aimed to elucidate the prevailing treatment practices in Unani and allopathic systems for URTIs, while concurrently assessing their efficacy in alleviating its symptoms. Materials and methodsA cross-sectional study was conducted at NIUM Hospital and a primary health centre in Bengaluru between June to December 2022. 200 eligible patients (100 per facility) were selected through purposive sampling. Prescriptions were analysed using established WHO and customized Unani indicators. Treatment efficacy was assessed using the WURSS-21 and Jackson scales. Information from the patients was gathered through interviews after obtaining written informed consent. ResultsThe average number of drugs per prescription was 2.68 in allopathy and 3.87 in Unani medicine. Antihistamines and antibiotics were the most prescribed drugs in allopathy, with cetirizine and amoxicillin dominating the list. In Unani Medicine, Arq Ajeeb and Nuqoo-e-Nazla were commonly prescribed. Only 10.8% of prescribed drugs in allopathy were from WHO list of essential medicines. Statistically significant improvement (p<0.001) in URTIs symptoms was observed with both Unani and allopathic treatments. ConclusionThe findings indicates that average number of drugs per prescription in both facilities were above the recommendations. In allopathy, overprescribing of antibiotics and antihistamines, and deviation from EDL, was observed, while polypharmacy was noted in Unani prescriptions. Findings indicate that both Unani and allopathic treatments are effective in alleviating the URTIs symptoms, as reported by patients.

The cost of virtual interviews; more than just the money

PurposeThe COVID-19 pandemic resulted in travel restrictions to limit virus transmission, altering the residency interview process across the country. While the transition to virtual interviews has the potential benefit of convenience and cost savings, concerns remain about the impact on applicants’ ability to distinguish programs. We sought to understand individual applicant motivations when presented with the opportunity to interview in-person or virtually and the associated costs.MethodsAn anonymous, voluntary, mixed-methods survey was distributed to all US allopathic medical school general surgery applicants who applied to our program in the 2023 cycle. The primary outcome was identifying factors that impacted the decision to interview either in-person or virtually. Secondary outcomes included costs associated with the entire interview process, including travel for away rotations, in-person interviews, and program second looks.Results155 (21.3%) applicants completed the survey. The average number of interviews completed was 14.2 ± 6.25. Females completed more interviews than males (14.9, 12.6, p = 0.047). Respondents accepted a mean of 89% of virtual interviews offered. 73% of applicants selected to complete at least one interview in-person. Top reasons for electing in-person interviews were to gain a stronger impression of the program (64%), make a greater impression of the program (50%), and strength of interest in the program (64%). Top factors for choosing virtual interviews were decreased costs (64%), less travel time (53%), and the ability to complete more interviews (53%). 58% of applicants planned to visit at least one program in-person post-interview. The mean total cost of interviews was $122 for virtual and $358 for in-person. Travel for a “second look” visit cost $279. 53% of respondents completed an away rotation, spending an average of $1688 per away rotation.ConclusionWhen presented with the option, applicants chose to interview in-person because of a mutual feeling of portraying and receiving a stronger impression. Candidates chose virtual due to cost reduction and the ability to complete more interviews. The financial savings of virtual interviews should be examined in the context of increased applications, increased interviews, post-interview travel or "second look" experiences, and costs associated with away rotations. Future work is needed to elucidate the role of in-person contact or away rotations on the likelihood of an applicant to interview and match in a largely virtual interview era.

Herbal Healer: A Comprehensive Review of the Overall Plant Profile and Medicinal Properties of Glycyrrhiza glabra

This review highlights the significance of licorice (Glycyrrhiza glabra) as a traditional medicinal plant with diverse therapeutic benefits. In India, where traditional remedies are widely preferred over allopathic medicines, thanks to its natural nature and fewer side effects, licorice has a notable position. Being one of the four "Medhya Rasayana" in Ayurveda, G. glabra has been used for memory enhancement, cognition, and nerve function improvements for over 4,000 years. Liquorice cultivation is widespread in several countries, and its chemical constituents include flavonoids, glycosides, triterpenoid aglycone, glycyrrhizin, and Glabridin. The plant has demonstrated multiple pharmacological activities such as, anti-inflammatory, antioxidant, memory enhancement, antistress, hepatoprotective, immunomodulation, antihyperglycemic, and anticancer effects. moreover, licorice shows antimicrobial, antinociceptive, dermatological, and neuroprotective properties. These diverse therapeutic effects have led to its potential use in various health-related concerns. To completely comprehend its modes of action, additional research is needed, define optimal dosages, and ensure long-term safety and efficacy. In conclusion, licorice stands as a significant herbal medicine with a rich history of use and remarkable potential for enhancing human health. Its multiple biological activities make it a valuable candidate for complementary and alternative medicine. Standardization of licorice extracts and rigorous quality control are essential for consistent therapeutic applications. As scientific research expands, licorice-based products are anticipated to play an increasingly vital role in holistic healthcare.

Association of Gender and Personal Choices with Salaries of New Emergency Medicine Graduates.

The medical literature has demonstrated disparities and variability in physician salaries and, specifically, emergency physician (EP) salaries. We sought to investigate individual physician characteristics, including sex and educational background, together with individual preferences of graduating EPs, and their association with the salary of their first job. The American College of Emergency Physicians and the George Washington University Mullan Institute surveyed 2019 graduating EPs. The survey included respondents' demographic and educational background, post-training job characteristics and location, hospital characteristics, importance of different personal priorities, and starting salaries. We performed a multivariable regression analysis to determine how salaries were associated with job types and individuals' characteristics. We sent surveys to 2,192 graduating residents in 2019. Of these, 487 (22.2%) responded, and 270 (55.4%) accepted first-time clinical jobs and included salary data (12.3% of all surveys sent). Male sex, osteopathic training, and full-time work were significantly associated with higher salary. Men and women prioritized different factors in their job search. Women were more likely to consider such factors as parental leave policy, proximity to family, desired practice setting, type of hospital, and desired location as important. Salary/compensation was considered very important by 51.8% of men and 29.6% of women. Men's median salary was $30,000 more than women's (p = 0.01, 95% CI +$6,929 -+$53,071), a significant pay differential. Salaries of graduating emergency medicine residents are associated with the resident's sex and degree type: doctor of osteopathic medicine or doctor of allopathic medicine. Multiple factors may contribute to men having higher salaries than women, and some of this difference reflects different priorities in their job search. Women were more likely to consider job conditions and setting to be more important, while men considered salary and compensation more important.

Imbalanced specialty representation of USMLE and NBME test writers

PurposeThe United States Medical Licensing Examination (USMLE) is an examination series required for allopathic physician licensure in the United States (US). USMLE content is created and maintained by the National Board of Medical Examinations (NBME). The specialty composition of the USMLE and NBME taskforce members involved in the creation of examination content is currently unknown.MethodsUsing the 2021 USMLE and 2021 NBME Committees and Task Forces documents, we determined each member’s board-certified primary specialty and involvement in test material development committees who we dubbed “test writers”. Total active physicians by primary specialty were recorded from the 2020 Physician Specialty Data Report published by the Association of American Medical Colleges (AAMC). Descriptive statistics and chi-square analysis were used to analyze the cohorts.ResultsThe USMLE and NBME test writer primary specialty composition was found to be significantly different compared to the US active physician population (USMLE χ2[32] = 172, p < .001 and NBME χ2[32] = 200, p < .001). Only nineteen specialties were represented within USMLE test writers, with three specialties being proportionally represented. Two specialties were represented within NBME test writers. Obstetrics and Gynecology physicians were proportionally represented in USMLE but not within NBME test writers. Internal Medicine (IM) accounts for the largest percentage of all USMLE test writers (60/197, 30%) with an excess representation of 31 individuals.ConclusionsThere is an imbalance in the specialty representation of USMLE and NBME test writers compared to the US active physician population. These findings may have implications for the unbiased and accurate portrayal of topics in such national examinations; thus, future investigation is warranted.

Phyto-cytogenotoxic potential assessment of two medicinal plants: Davilla nitida (Vahl) Kubitzki and Davilla elliptica (A. St.-Hill) (Dilleniaceae)

ABSTRACT Humans have been using plants in the treatment of various diseases for millennia. Currently, even with allopathic medicines available, numerous populations globally still use plants for therapeutic purposes. Although plants constitute a safer alternative compared to synthetic agents, it is well established that medicinal plants might also exert adverse effects. Thus, the present investigation aimed to assess the phytotoxic, cytotoxic, and genotoxic potential of two plants from the Brazilian Cerrado used in popular medicine, Davilla nitida (Vahl) Kubitzki, and Davilla elliptica (A. St.-Hil.). To this end, germination, growth, and cell cycle analyses were conducted using the plant model Lactuca sativa. Seeds and roots were treated with 0.0625 to 1 g/L for 48 hr under controlled conditions. The germination test demonstrated significant phytotoxic effects for both species at the highest concentrations tested, while none of the extracts produced significant effects in the lettuce growth test. In the microscopic analyses, the aneugenic and cytotoxic action of D. elliptica was evident. In the case of D. nitida greater clastogenic action and induction of micronuclei, (MN) were noted suggesting that the damage initiated by exposure to these extracts was not repaired or led to apoptosis. These findings indicated that the observed plant damage was transmitted to the next generation of cells by way of MN. These differences in the action of the two species may not be attributed to qualitative variations in the composition of the extracts as both are similar, but to quantitative differences associated with synergistic and antagonistic interactions between the compounds present in these extracts.

Sex diversity in spine surgery fellowship training: analysis of recent trends and program characteristics associated with increased diversity

BACKGROUND CONTEXTSex diversity in the spine surgery workforce remains limited. Accelerated efforts to recruit more female trainees into spine surgery fellowship training may help promote diversity and inclusion in the emerging spine surgery workforce. PURPOSEThis study assessed the representation of female trainees in spine surgery fellowship training and program factors associated with greater sex diversity among fellows. Study Design/SettingThis was a cross-sectional analysis of spine surgery fellows in the United States during the 2016–2017 to 2022–2023 academic years. PATIENT SAMPLEN/A. OUTCOME MEASURESRepresentation (%) and participation-to-prevalence ratios (PPRs) defined as the participation of female trainees in spine surgery fellowship training divided by the prevalence of female trainees in previous training cohorts. PPR values <0.8 indicated underrepresentation. METHODSSex diversity was assessed among spine surgery faculty, spine surgery fellows, orthopaedic surgery residents, neurosurgery residents, and allopathic medical students. Fellowship program characteristics associated with increased sex diversity were calculated with chi square tests. RESULTSThere were 693 spine surgery fellows and 41 were female (5.9%). Sex diversity in spine surgery fellowship training decreased over the study period (6.4% vs. 4.1%, p=.025). Female trainee representation in spine surgery fellowship training was less than that in orthopaedic surgery residency (14.2%, PPR=0.42), neurosurgery residency (17.1%, PPR=0.35), and allopathic medical school (47.6%, PPR=0.12) training (p<.001). There were 508 faculty at 78 spine surgery fellowships and 25 were female (4.9%). There were 3 female fellowship program directors (3.8%). Fellowship program characteristics associated with increased sex diversity included the presence of female faculty (p=.020). Additional program characteristics including geographic region, accreditation status, number of faculty and fellows were not associated with sex diversity (p>.05). CONCLUSIONSFemale representation in spine surgery fellowship training decreased over the study period and remains underrepresented relative to earlier stages of medical and surgical training. There was a positive association between female faculty and increased sex diversity among fellows. Greater efforts are needed to create training environments that promote diversity, equity, and inclusion in spine surgery fellowship training.

Implementing the Debriefing Assessment for Simulation in Healthcare (DASH) Tool for Training Medical Faculty.

Introduction Despite simulation being widely recognized as an essential component of medical education, there remains a dearth of literature on its implementation and effectiveness in pre-clerkship medical education. In order to effectively encompass healthcare simulations within medical instruction, it is imperative to first address the often neglected gap in faculty development and training. With this in mind, we aim to present our experience in implementing the Debriefing Assessment for Simulation in Healthcare (DASH) tool in training faculty at Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA. Methods Twenty participating faculty practiced instructing a simulation session and completed the DASH tool. Quantitative and qualitative approaches were used to report the findings. Results The Survey Rater and Student DASH version results were analyzed using the Mann-Whitney U test to see if there was a difference between the two groups for each question. Conclusions All faculty participating in healthcare simulations should be trained in order to deliver a structured debriefing experience. In healthcare medical simulation, the identification of faculty training is imperative to address many of the challenges of healthcare today, including patient safety issues and limitations of medical training in hospital settings. Implications The study aims to serve as a template that researchers can use in identifying potential faculty training development, as the benefits of having faculty trained in simulation methodology are successful in higher educational settings. Further studies in simulation-based education faculty training are recommended.

A Disease is a Condition in which the Potency of Chromosomes and Organs Decreases and the Potency of Pathological Formations Increases. Treatment-Normalization of the Potency of Chromosomes, Organs and no Testing of Pathological Formations

A disease is a condition in which the potency of chromosomes and organs decreases and the potency of pathological formations increases. Restoring the potency of chromosomes, organs and stopping testing of pathological formations is evidence of the recovery of the organ. In allopathic medicine, the concept of potency of an organ or organism is absent - it is available in homeopathic medicine. The article provides a method for changing potency in homeopathic medicine, presents materials on changing the potency of chromosomes, organs and stopping testing of pathological formations, which is evidence of the recovery of the body. The author of the article clearly understands that restoration of only the potency of organs does not always lead to recovery - there are other mechanisms that are part of recovery. However, restoring the potency of the organ is an extremely important part of recovery, which has not previously received any attention in allopathic medicine.

A GUDA AGNIKARMA FOR THE MANAGEMENT OF MANYASTAMBHAA WITH SPECIAL REFERENCE TO CERVICAL SPONDYLOSIS: A CASE STUDY

Background: Manyastambhaa, akin to cervical spondylosis in modern medicine, is prevalent due to lifestyle factors such as poor posture and stress. It is characterized by stiffness and neck pain, and it significantly negatively influences quality of life, especially in the elderly. The slight relief that conventional treatments provide often leads to the investigating of alternative therapies. Methodology: The 67-year-old male patient in this case study has persistent neck discomfort, stiffness, and sensory abnormalities that are not improving with allopathic medicine. The patient received a parasurgical Ayurvedic treatment called Guda Agnikarma therapy. Over ten days, sessions were held on alternate days. The Visual Analog Scale (VAS) and range-of-motion assessments were among the subjective and objective methods used to evaluate pain, stiffness, and discomfort. Observation: After the treatment, there was a noticeable improvement. There was a significant reduction in stiffness and a noticeable discomfort alleviation from severe to none. Flexion, extension, lateral flexion and rotation substantially improved range of motion. Conclusions: Guda Agnikarma showed promise in reducing cervical spondylosis symptoms by acting as an analgesic, reducing inflammation, and relaxing muscles. The method is suitable for outpatient settings, minimally invasive, and reasonably priced. These results point to Guda Agnikarma as a potential treatment for Manyastambhaa, indicating that more research is necessary to confirm its effectiveness and incorporate it into general therapeutic practice.

The Healing Heuristic of the Medicine Buddha in Bhutan

This paper examines the role of the Medicine Buddha in the healthcare system in Bhutan, a bipartite system where allopathic and Bhutanese Traditional Medicine co-exist. Discussion is informed by a wider study that explored the use of mindfulness practices by nurses across both sectors. An emergent theme from this narrative inquiry is that health practitioners across the sectors spoke of the importance of the Medicine Buddha in their professional practice. To better understand this centrality, we provide a historical overview of the long-standing presence of the Medicine Buddha in Bhutanese society and the materiality and spirituality of Medicine Buddha practice, and review how this healing aspect of Awakened Mind (Buddha) is integrated into nurse training. We then explore how this unique holistic education is integrated into the lives and practices of nurses and their workplaces. While recognizing that empirical proofs remain elusive, this paper is also informed by our own reflective practice and individual experience with the Medicine Buddha in affirming a healing heuristic in our own lived experiences. To wit, we can see value in the pivotal role of Medicine Buddha in the Bhutanese health system, and, more broadly, the health of Bhutanese society.

Exploration of Potential Anti-inflammatory cum Anti-Rheumatoid-arthritis Phyto-molecule through Integrated Green Approach: Network Pharmacology, Molecular Docking, Molecular dynamics, In-vitro and Ex-vivo study.

Rheumatoid arthritis (RA) and associated inflammatory complications are the most prevalent illnesses and can turn into fatal conditions if left untreated. Allopathic medicine is not satisfactory for curing RA. Scientific literature reports reveal that several phyto-compounds viz. flavonoids, saponins, and terpenoids, can heal joints and organs from auto-inflammatory rheumatoid arthritis and pain. Gene ontology, gene network analysis, molecular clustering, and literature review were used to optimise RA-specific highly expressed genes. In-silico molecular docking was performed to short-out potential phytomolecules (Neohesperidin dihydrochalcone (NHDC)) from 1000 datasets-library against RA and validate using MD simulation running at 100 ns. In-vitro anti-inflammatory assays of NHDC inhibited egg-albumin denaturation, IC50 of 47.739 ± 0.51 µg/ml. The ex-vivo MTT assay with NHDC rendered 67.209% inhibition at 100 µM against fd-FLS-cells. NHDC downregulated pro-inflammatory cytokine IL-17A production by 61.11% and 50% at 300 and 200 μM, respectively. Thus, this Studies recommend that NHDC may be highlighted as a novel multi-target PADI4 and JAK3 inhibitor with better efficacy and minimal toxicity in RA warranted to In-Vivo and clinical investigation. The current findings have uncovered remarkable genes and signalling pathways linked to RA, which could enhance our existing comprehension of the molecular mechanisms that drive its development and progression.

How Internal Medicine Clerkship Directors Are Using Entrustable Professional Activities: A National Survey Study.

In the present assessment environment in undergraduate medical education at U.S. medical schools, the prevalence and implementation of Entrustable Professional Activities (EPAs) in internal medicine (IM) clerkships are not well understood. To describe the prevalence and approach to EPA use in U.S. IM clerkships. Cross-sectional, nationally representative survey of core IM clerkship directors. One-hundred forty IM clerkship directors at Liaison Committee on Medical Education-accredited U.S./U.S. territory-based allopathic medical schools with membership in the Clerkship Directors in Internal Medicine (CDIM) as of December 2022. Use of EPAs in IM core clerkships, including use for grading, types of EPAs, use of supportive measures for assessment, and current validity frameworks. The survey response was 80% (112/140); two additional respondents completed the section on EPA use (n = 114). Approximately half of respondents (47%) reported their IM clerkship used EPAs. Among schools accredited after 1977, a higher percentage was associated with having incorporated EPAs (p = 0.03). The Association of American Medical Colleges Core EPAs for Entering Residency (CEPAER) was the most common framework used by Clerkship Directors (CDs) for developing EPAs (55%). Most CDs (56%) used EPAs for both formative and summative assessments, and approximately half of CDs (48%) used EPAs for a portion of the final grade determination. CDs who used EPAs were no more likely to report efforts to ensure the validity of assessment, the use of faculty development, or that written assessments were a valid measure of students' performance compared to those who did not use EPAs. Although EPAs have experienced substantial uptake in the IM clerkship and contribute to formative and summative assessment of learners, their use does not appear to be associated with enhanced efforts to obtain validity information.

Integrative therapeutics for ocular surface disorders.

Integrative medicine techniques are increasingly accepted into the treatment paradigm for many chronic disorders including eye disease. Over 71% of patients, including 67% of those with eye disorders, use some form of Integrative therapy. Physicians should be well versed in evidence-based therapies to know how to refer patients for the best complimentary care. We highlight the most effective integrative therapeutics from different complementary treatment paradigms to offer a framework for approaching therapy in patients with ocular surface disorders (OSDs). Lifestyle and behavioral modifications help a proportion of people with OSDs like dry eye disease and allergic conjunctivitis, which are interrelated disorders. Nutrition and supplementation can also play a role in addressing underlying inflammation and improving OSD symptoms. Acupuncture and traditional herbal medicine may also benefit some patients. New technologies offer innovative treatment pathways in the treatment of OSD but require referral to Ocular Surface Treatment Centers. Integrative treatment approach for OSD incorporates allopathic medicine, traditional remedies and lifestyle behavioral interventions, Ayurveda and herbal medicine, Nutritional Supplements, Homeopathy, Acupuncture and Chinese Medicine. New cutting-edge technologies offer breakthroughs in difficult to treat ocular surface cases. Collaboration between allergy or otolaryngology offices, complementary practitioners, as well as optometrists and ophthalmologists in Ocular Surface Treatment Centers can offer patients new avenues of treatment.