Common Ailments Research Articles

Unrivalled Insight into Possible Biopharmaceutical Application of Justicia vahlii Roth. (Acanthaceae): Chemodiversity, In Vitro Bioactivities, and Computational Analysis.

Justicia vahliiRoth. is an important wild medicinal food plant traditionally used for treating inflammation and various common ailments. This study investigated the chemical composition, antioxidant, enzyme inhibition and toxicity profiles of n-hexane (nHEJv) and chloroform (CEJv) extracts of J. vahlii. Moreover, the effect of the extracts was evaluated on CCl4 induced liver injury. The total phenolic and flavonoid contents were present in both extracts in significant amount. The UPLC-Q-TOF-MS and GC-MS profiling of CEJv tentatively identified several important phytocompounds. The CEJv extract was comparatively more active for antioxidant activity and α-amylase inhibition, whereas the nHEJv extract presented higher inhibition potential against urease, tyrosinase, and α-glucosidase enzymes. Similarly, the in-silicostudy of four major compounds, i. e., 1-acetoxypinoresinol, 3-hydroxysebacic acid, nortrachelogenin, and viscidulin-III have shown a good docking score against the clinically significant enzymes. The acute oral toxicity and brine shrimp lethality assaysrevealed the extracts as non-toxic. The CCl4 treated animals showed a geared depletion of various antioxidant enzymes which were significantly reversed with the treatment of the extracts. Overall, the study's findings revealed J. vahliiwith antioxidant mediated hepatoprotective and enzyme inhibition potential and warrant further research on isolation of the bioactive compounds.

A Mendelian Randomization Study of the Connection Between Exogenous Hormones and Perianal Abscess in Pediatric Patients.

Background: Recent years have witnessed the hypothesis that bioavailable testosterone (BT) might be closely related to the development of inflammatory diseases, especially anal abscess (AA), a common inflammatory ailment with unclear pathogenesis. Given that AA is more prevalent among males, this study investigates the causal relationship between BT and AA. Objective: To explore the causal link between BT and AA, a Mendelian randomization (MR) study was conducted using large-scale genomic data. Materials and Methods: Utilizing genomic data from the UK Biobank and IEU OpenGWAS databases, a two-sample MR analysis was executed. Twenty-six genetic variants strongly associated with BT were selected as instrumental variables (IVs) to assess their link with AA risk. Various MR methods were employed for consistency checks, including sensitivity analyses for heterogeneity and horizontal pleiotropy. Results: Using a combination of MR methods, we identified a significant causal relationship between BT and the risk of AA. Specifically, the MR analysis revealed that higher levels of BT were associated with an increased risk of AA. Sensitivity analyses, including heterogeneity tests and assessments for horizontal pleiotropy, confirmed the robustness of these findings. The IVs used in the analysis demonstrated a strong association with BT and showed no evidence of significant heterogeneity or horizontal pleiotropy, indicating the validity of the causal inference. Conclusion: This study, employing two-sample MR for the first time, confirms a causal relationship between BT levels and the risk of AA. These findings provide preliminary evidence of the causal relationship between BT and AA and may offer new insights into the pathophysiological mechanism of AA and future therapeutic strategies.

The most common neonatal presentations to the pediatric emergency department

Introduction The first 28 days of life are considered the neonatal period, when pediatric health is most vulnerable. While crises can undoubtedly arise during this time, many ED or urgent care visits could be avoided with sufficient preventive hospital care during the newborn period and suitable follow-up with a primary care physician. The use of emergency rooms for non-urgent care could be the cause of rising healthcare costs and ineffective resource use. Purpose This study aimed to determine the presenting features, management, and disposition of neonatal attendance in the emergency department. Methods This was a retrospective observational cross-sectional study of medical records identified via the emergency department of neonatal visits (≤28 days) to King Fahd Hospital of the University (KFHU), Khobar, Saudi Arabia, over 12 months (2021–2022). The Chi-square test was performed to compare various etiologies, with a 5% significance level. Results A total of 649 neonate visited pediatric emergency department with a mean age of 15.5 ± 7.4 days and almost equal distribution of the gender. The most common presentation was upper respiratory tract infection (URTI) (26.8%), followed by physiological jaundice (20.2%), and colic (14%). A total of 205 (31.6%) neonates who visited the ED showed significant laboratory findings. Seventy-nine patients (12.2%) presenting with PED were admitted to the hospital. Conclusion Healthcare systems must devise strategies to address the growing number of non-urgent visits to emergency departments in a more efficient manner, while simultaneously reallocating scarce resources to higher-acuity cases. This emphasizes the necessity of health personnel educating caregivers. It’s also critical that medical professionals understand the common ailments that affect newborns and are skilled at correctly identifying ailments that could indicate a serious pathology.

SoundMind Trial: a study protocol for a randomised controlled trial for online acceptance and commitment therapy and sound therapy for tinnitus

IntroductionTinnitus is a common ailment that affects 10%–15% of adults worldwide. Comorbidities associated with tinnitus often include hearing loss, emotional distress and sleep disorders, with insomnia being a common issue...

Damage assessment of the CRTS III ballastless slab track in high temperature regions

Temperature-induced interfacial damage between the prefabricated slab and filling layers is a common ailment faced by slab-type ballastless tracks systems. In this study, the damage behaviour of the CRTS III ballastless track in high temperature regions is explored. To this end, a 3-dimensional finite element model of the CRTS III ballastless track is built in Abaqus, which takes into account the non-linear temperature distribution along the track depth, the non-linear cohesive relationship between the concrete to self-compacting concrete interface, and the constitutive stress-strain relation of concrete. Upon subjecting the model to various temperature and wheel loading conditions, the following main conclusions were drawn: (1) Upward warpage of the prefabricated slab undergoes an average percentage increase of 37.62 % with each 10 °C/m increase in temperature gradient, signalling a greater up-warping effect in higher temperature regions; (2) the stresses along the interface’s first and second shear directions have the greatest influence on damage initiation of the interface; (3) under the effect of equally increasing temperature gradient loads, interface nodes where damage initiation had taken place showed a steady increase with an average difference of 5.21 %; (4) applied wheel loads significantly increase the damage initiation area of the track, but the effect of varying concentrated forces typically experienced during the track’s service life does not affect the change in damage initiation area as severely.

Exploring aegle marmelos (bael fruit): understanding its health benefits and potential for therapy

The kidneys play a crucial role in maintaining the body's fluid balance through precise regulation of sodium, chloride, and water levels. They expel sodium and chloride, prompting water release and reducing fluid volume. Conversely, retaining these elements leads to water retention and increased fluid volume. This intricate mechanism ensures internal stability. Kidneys filter these substances into tubules, with most being reabsorbed into the blood and exiting as urine. Complex processes in various tubule segments complicate sodium and chloride reabsorption. Diuretics are valuable in treating edema, congestive heart failure, and hypertension. Bael (A. marmelos), a significant herb in Ayurveda, contains compounds like flavonoids and alkaloids. It's used for diarrhea, diabetes, inflammation, and hyperlipidemia. An alcoholic extract from the mature fruit of Aegle marmelos exhibits diuretic activity, potentially assisting with common kidney ailments. Bael's therapeutic potential arises from its diverse compounds and established use in traditional medicine.

The association between retinol binding protein 4 and peripheral neuropathy in type 2 diabetic patient

Background & Objective: The most common microvascular consequence of diabetes is peripheral neuropathy. A very common ailment that has a significant impact on a patient's quality of life is peripheral neuropathy (PN). The purpose of this study was to look into the possible link between retinol binding protein 4 (RBP4) and peripheral neuropathy in individuals with type 2 diabetes mellitus (T2D), as the relationship between RBP4 and PN is still unclear. Methodology: We enrolled 152 participants who were matched for age and sex in a case control study during August and December 2023. There were 50 healthy controls, 50 diabetic patients without PN, and 52 diabetic patients with PN. ELISA was used to measure serum RBP4. Results: Diabetic individuals with PN had significantly greater serum levels of RBP4 than diabetic patients without PN (P ˂ 0.001). Increased age (r = 0.262, P ˂ 0.01), DM duration (r = 0.565, P ˂ 0.01), and BMI (r = 0.183, P ˂ 0.05) were all substantially linked with RBP4 levels. RBP4 levels exhibited a negative correlation with high-density lipoproteins (HDL) and a positive correlation with total cholesterol, triglycerides, low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL). Conclusion: Elevated RBP4 level is strongly and independently linked with PN in type 2 diabetic patients, and may play an important role in PN progression. Abbreviations: DM - Diabetes mellitus; PN - peripheral neuropathy; PBP4 - retinol binding protein 4; T2D - type 2 diabetes mellitus Keywords: diabetes mellitus; peripheral neuropathy; retinol binding protein 4. Citation: Nafakhi IA, Abdalsada NH. The association between retinol binding protein 4 and peripheral neuropathy in type 2 diabetic patient. Anaesth. pain intensive care 2024;28(5):908−913; DOI: 10.35975/apic.v28i5.2563 Received: May 03, 2024; Reviewed: June 04, 2024; Accepted: August 23, 2024

Performance of health and wellness centre in providing primary care services in Chhattisgarh, India

IntroductionPrimary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India’s Chhattisgarh state.MethodsWe conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care.ResultsOn an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population’s health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure.ConclusionHWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population’s acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India.

Enhancing Preoperative Diagnosis of Subscapular Muscle Injuries with Shoulder MRI-based Multimodal Radiomics

PurposeRotator cuff injury is a common ailment in the musculoskeletal system, with the subscapularis muscle being the largest and most robust muscle of the rotator cuff. The occurrence of subscapularis muscle tears is more frequent than previously reported. The main objective of this research is to harness the power of artificial intelligence to enhance the precision in diagnosing subscapularis muscle injuries via magnetic resonance imaging of the shoulder joint, prior to surgical intervention. This study seeks to integrate advanced artificial intelligence algorithms to analyze magnetic resonance imaging data, aiming to provide more accurate preoperative assessments, which can potentially lead to better surgical outcomes and patient care and promote technological progress in the field of medical imaging analysis. MethodThis is a multicenter study that involves 324 patients from a major medical center serving as both the training and testing groups, with an additional 60 patients from two other medical centers comprising the verifying group. The imaging protocol for all these subjects included a series of shoulder magnetic resonance imaging scans: T1-weighted coronal sequences, T2-weighted coronal, axial, and sagittal images. These comprehensive imaging modalities were utilized to thoroughly examine the shoulder joint's anatomical details and to detect any signs of subscapularis muscle damage. To enhance the diagnostic accuracy before surgical procedures, radiomic analysis was employed. This technique involves the extraction of a multitude of quantitative features from the magnetic resonance imaging, which can provide a more nuanced and data-driven approach to identifying subscapularis muscle injuries. The integration of radiomics in this study aims to offer a more precise preoperative assessment, potentially leading to improved surgical planning and patient outcomes. ResultIn the course of this study, a comprehensive extraction of 1197 radiomic features was performed for each imaging modality of every patient. The coronal T1-weighted modality, when assessed within the internal verifying cohort, delivered a diagnostic accuracy of 0.766, coupled with an AUC of 0.803. In the case of the T2-weighted modality, the coronal planes exhibited a diagnostic accuracy of 0.781 and an AUC of 0.844. The axial T2-weighted images recorded an accuracy of 0.719 and an AUC of 0.761, while the sagittal T2-weighted images scored an accuracy of 0.766 and an AUC of 0.821. The amalgamation of these imaging techniques through a multimodal strategy markedly enhanced the accuracy to 0.828, with an AUC of 0.916 for the internal verifying group. The diagnostic performance of the coronal T1-weighted modality in the external verifying cohort yielded an accuracy of 0.833, with an area under the curve (AUC) of 0.819. For the T2-weighted modality, the coronal imaging demonstrated an accuracy of 0.767 and an AUC of 0.794. The axial T2-weighted images had an accuracy of 0.783 and an AUC of 0.797, while the sagittal T2-weighted images achieved an accuracy of 0.833 and an AUC of 0.800. When combining the modalities, the multimodal approach significantly improved the accuracy to 0.867, with an AUC of 0.803 in the external verifying group, indicating a robust diagnostic capability. ConclusionOur study demonstrates that the application of multimodal radiomic techniques to shoulder magnetic resonance imaging significantly enhances the precision of preoperative diagnosis for subscapularis muscle injuries. This approach leverages the comprehensive data provided by various magnetic resonance imaging modalities to offer a more detailed and accurate assessment, which is crucial for surgical planning and patient care.

Postoperative Complications After Gynecological Surgry in Al Kut City

Introduction: Post-operative problems are common. How the complications develop depends on the kind of operation, the preoperative treatment, and the patient's pre-existing comorbid condition. Problems following surgery can be divide into two categories: general and procedure-specific, as well as having emerged promptly, early, or late. Objectives: To determine the postoperative complications type after gynecological surgery in AL-Kut city. Methodology: A cross-sectional study had carried out in AL-Kut City, at the AL-Zahraa Teching Hospital and AL-Kut Hospital for Gynecology and Pediatrics. The seven-month data collection period started on October 16, 2023, and ended on May 16, 2024. Results: 400 female participants, ranging in age from 13 to 72, were be studied. The age distribution of the patients was 31.5 ±10, with the age group 24-34 accounting for the largest percentage of patients (41%) and the age group over 45 accounting for the lowest percentage (7.8%). In terms of marital status, the largest proportion of women (96.2%) were married, while the lowest (1.3%) were widowed. 51.2% of patients lived in urban areas, compared to 48.8% in rural ones. Patients with two to three children had the highest number of parities (34.8%), whereas 18% of patients did not have any parties. 31.8% of patients had an abortion, whereas 68.3% did not. Of which 44.3% had considered as normal BMI, 34.5% of people are overweight, 12% belong to the obese I, 4.3% to the obese II, and 4.5% are morbidly obese. Based on the patients' past medical history, hypertension was the most common ailment detected, accounting for 30.3% of cases (chronic HTN 13%, gestational HTN 17.3%), while diabetes patients made up 9.5% (chronic D.M. 6.5%, gestational D.M. 3%). Classification of Complications: 90.3% of complications occurred within 48 hours, whereas 51.3% developed intraoperative complications. Finally, 50.2% of patients experienced a late problem 48 hours later. Conclusion: The study discovered a link between complications after gynecologic surgery and pre-operative blood transfusion and hospital stay. Hemorrhage, anesthesia difficulties, and cardiac arrhythmia were significant, were the most common late complications among the patients. On the other hand, late complications had linked to surgical duration, number of parities, and age.

Chloroplast mini-barcodes combined with high resolution melting analysis to identify herbal medicine Difengpi (Illicium difengpi)

Difengpi, derived from the air-dried stem bark of Illicium difengpi and enlisted in the Chinese Pharmacopoeia for its therapeutic effect against common ailments, confronts challenges due to dwindling wild resources and intentional substitution with potentially harmful botanical relatives. The imperative need to authenticate this herbal remedy has led to the development of robust methods. Here, we integrated chloroplast mini-barcoding and high resolution melting (HRM) analysis to distinguish Difengpi from the reported adulterants. We assembled the complete chloroplast (cp) genomes of I. difengpi and substituted close relatives I. jiadifengpi and I. majus, and conducted an in-depth comparative analysis to screen divergent regions for exploiting as DNA mini-barcodes. Despite the conservativeness characterizing the whole cp genomes among these Illicium species, we identified some highly variable regions with promising potential as molecular markers for species identification. Subsequently, we designed DNA mini-barcodes and subjected them to HRM analysis to assess their efficacy in species discrimination. Melting profiles unveiled that mini-barcodes designed from four divergence regions trnL–trnF, trnF–ndhJ, ycf1–ndhF and rpl32–trnL exhibited substantial discriminatory power, distinctly differentiated I. difengpi from I. jiadifengpi, I. majus and I. verum. We tested ten commercially available Difengpi products from online stores and local traditional markets using these four mini-barcodes. All ten samples clustered closely with the reference I. difengpi with genotype confidence higher than 93 %, indicating the presence of the claimed species in these samples, sans any reported toxic adulterants. Consequently, we simulated Difengpi mimic samples utilizing I. jiadifengpi, I. majus and I. verum and subjected them to evaluate the practicability of these mini-barcodes. The outcomes confirmed the precision of the four mini-barcodes in accurately discerning the mimic samples. In conclusion, integrating taxon-specific DNA mini-barcodes with HRM analysis is an efficient strategy for the authentication of species identity within commercial herbal products.

Indigenous Knowledge and Herbal Medicine: Exploring the Ethnobotany of the Karo Tiganderket Tribe in Indonesia

This ethnobotanical study investigates the traditional use of medicinal plants in Tiganderket Village, Karo Regency, Indonesia, to document local plants' diversity, uses, and preparation methods for medicinal purposes. Utilizing a quantitative descriptive approach, data were gathered from 30 informants, including traditional healers and residents. The study identified 92 plant species from 44 families, with the Zingiberaceae family being the most dominant. Frequently used plants, such as Piper betle (belo) and Zingiber officinale (ginger), were primarily employed to treat common ailments like fever, boils, and joint pain. Boiling (74%) was the most common method of plant preparation, and leaves (50%) were the most frequently used plant parts. The Relative Frequency of Citation (RFC) revealed Acorus calamus and Curcuma longa as the most cited species. At the same time, 40 of 66 recorded diseases showed high Informant Consensus Factor (ICF) values, reflecting shared knowledge of plant use. This study highlights the rich preservation of traditional medicinal plant knowledge in Tiganderket Village, which continues to play a crucial role in local healthcare practices.

Young Doctors Program-Colorado: An Elective Elementary School Program to Improve Health Literacy, Utilization of the Healthcare System, and Osteopathic Awareness

AbstractThe Young Doctors Program (YDP) is a “mini medical school” series for fifth-grade elementary children. The YDP was designed and led by medical students in the Academic Medicine and Leadership Track at the Rocky Vista University College of Osteopathic Medicine in Colorado. The curriculum of the program was designed around the State of Colorado Learning Standards with the purpose of educating students about emergencies and common ailments in five body systems (cardiovascular, respiratory, gastrointestinal, musculoskeletal, and renal) while also providing exposure to healthcare as a profession. YDP provides children with insights into the healthcare system, an introduction to osteopathic medicine, and it enhances community outreach. This article provides a framework for the semester-long YDP curriculum as well as our final event which synthesizes learned information using standardized patients. We describe successes including community outreach and healthcare exposure in the elementary school, and challenges initiating connections with local schools and funding. Future goals include expanding outreach to other fifth-grade schools as well as growth to different age levels. Authors plan to pursue IRB approval for research to examine the benefits and efficacy of the YDP.

Perceptions of Practice Towards Management of Common Ailments In Indonesian Community Pharmacies: A Cross-Sectional Study

Managing common ailments is a growing service in developing countries. Community pharmacists and pharmacy technicians managing common ailments are essential for improving treatment outcomes. While common ailment services have been successfully implemented in developed countries, Indonesia needs more documentation of these practices. This study aimed to document the scopes of community pharmacists and pharmacy technicians in managing common ailments, their practices, and the perceived experience in providing these services. These cross-sectional surveys were conducted from May to June 2023 in separate pharmacists’ and pharmacy technicians’ seminars in Surakarta, Indonesia. Binary logistic regression compared the pharmacists' and pharmacy technicians' perceptions of managing ailments. A total of 180 pharmacists and 140 pharmacy technicians participated. Among 13 common ailments listed in the survey, acute pain (P<0.001) was an ailment that was perceived as limited to a pharmacist's scope. Ailments such as dandruff, constipation and mild headache were perceived to be within the scope of a pharmacy technician (P<0.001). Given the differing approaches by pharmacists and pharmacy technicians, there is a need to ensure that each professional practices within their area of scope.

Ab Initio Molecular Dynamics Simulations of Phosphocholine Interactions with a Calcium Oxalate Dihydrate (110) Surface.

We use ab initio modeling (CASTEP) to help elucidate the crystallization phenomena and chemistry behind kidney stone composition and formation. To explore the stone formation process, we have constructed a surface model of calcium oxalate dihydrate-the mineral most commonly found in patients with hypercalciuria and modeled stone growth, by simulating further calcium oxalate adsorption onto the surface (-7.446 eV, -0.065 eV/atom). Furthermore, urine analysis of kidney stone patients has previously revealed that their urine contains higher concentrations of phospholipids compared to healthy individuals. Therefore, to investigate the interactions between urinary macromolecules and the growing crystal surfaces at an atomic level, we have performed ab initio molecular dynamics simulations of phosphocholine adsorption on calcium oxalate surfaces. We have shown that the phosphocholine headgroups become entrapped within the growing crystal and the lowest energy structures (-18.008 eV, -0.0396 eV/atom) are those where the calcium oxalate dihydrate surfaces have become disrupted, with reorganization of their crystallographic structure. Urinary calculi (kidney stones) are a common ailment affecting around 10% of the world's population and resulting in nearly 90,000 finished consultant episodes (FCE) each year in the United Kingdom [Hospital Episode Statistics, Admitted Patient Care-England, 2011-12 NHS Digital, 2021-2022. https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/hospital-episode-statistics-admitted-patient-care-england-2011-12].

A Comprehensive Review on Nephrolithiasis: Etiology Recent Advances and Clinical Trials

Abstract: Kidney stone disease, or nephrolithiasis, is a common condition with high morbidity that affects people all over the world. It is important to comprehend the etiology and contemporary developments in its management to enhance patient results. In this study, we describe a thorough analysis of nephrolithiasis, with particular attention to its etiology, current developments in treatment modalities, and ongoing clinical studies by utilizing electronic databases. A thorough search of the literature was carried out to find pertinent papers published through 2024 and the genesis of nephrolithiasis, new treatment developments, and ongoing clinical trials. The review clarifies the complex interplay between dietary variables, metabolic disorders, and genetic susceptibility that leads to nephrolithiasis. The most recent developments in treatment modalities, such as minimally invasive operations and medication therapies, are examined. Furthermore, ongoing clinical trials examining new treatments and preventative measures are emphasized. A multidisciplinary approach is necessary for the optimal care of nephrolithiasis because it is a complex condition influenced by a variety of factors. While ongoing clinical trials hold promise for additional innovation in nephrolithiasis therapy and prevention, recent therapeutic developments offer promising pathways for enhanced patient care. Addressing the difficulties brought on by this common ailment requires cooperation and ongoing study.

The burden of acute eye conditions on different healthcare providers in Wales: a retrospective population-based study

Objective & ApproachDemand for urgent eyecare exponentially outstrips public healthcare capacity in the United Kingdom. Such eye conditions, and related vision impairment, affect the lives of people everywhere. We aimed to quantify the burden of urgent eyecare on primary- and community-care providers in a national population using data produced by General Practitioner, Accident and Emergency, pharmacy and optometry services. A secondary aim was to characterise some drivers of this burden. We analysed data from the Secure Anonymised Information Linkage Databank (linked), Eye Health Examination Wales Service (unlinked) and Common Ailments Scheme (unlinked) during 2017-2018 to quantify burden. We applied generalised linear modelling and logistic regression to understand drivers. ResultsOf 365,044 episodes of care during the study, GPs and A&E managed 46.2% (168,877) and 1.4% (5,122) respectively while optometrists and pharmacists managed 51.8% (116,868) and 0.6% (2,635). Older females and infants of both sexes were more likely to use GP prescribing services, while adolescent and middle-aged males were more likely to visit A&E. GP prescribing burden was driven partially by economic deprivation, access to local services, and overall community health. Season, day of the week, and time of day were predictors of burden for GP and A&E services. Conclusion & ImplicationsAcute eyecare continues to place considerable burden on primary care services in Wales, particularly in urban areas with greater deprivation. This is likely to increase with an ageing population. With ongoing pathway development to better utilise community care, there may be scope to change this trajectory.

Prevalence and Socio-demographic Variations in Traditional Medicine Use: A Study from East Nile Locality, Sudan

Traditional medicine (TM) remains a cornerstone of healthcare in Sudan, across urban and rural settings. We explored TM use and its association with socio-demographic characteristics (age, sex, education, economic status, and residence) in East Nile locality (ShargAlneil), Khartoum State. A survey encompassing 609 households (44.7% rural, 55.3% urban) revealed a high prevalence of TM use: over 80% reported using at least one form. Notably, significant socio-demographic variations emerged. Individuals with higher education leaned towards herbalists (p<0.05), while those with lower education favored religious healers (p<0.05). Similarly, older adults preferred religious healers (p<0.05), while males tended to choose herbalists (p<0.05). The most common ailments preferred to be treated by TM practitioners were spiritual and psychological issues, bone injuries, stomachaches, and headaches. Conversely, conditions like malaria, diabetes, hypertension, and heart disease were primarily preferred to be managed by modern medicine. This study highlights the widespread use of TM across diverse demographics, with preferences for specific types of practitioners. It also underscores a selective trust in modern medicine for certain diseases. Integrating socio-demographic and cultural perspectives into healthcare delivery can enhance understanding of community needs and guide the development of appropriate interventions. Further research is warranted to delve deeper into the reasons behind these variations in treatment preferences.

Ethnopharmacological survey of the therapeutic use of camel urine in the Guelmim-Oued Noun and Laayoune-Sakia El Hamra regions of Morocco

The therapeutic use of camel urine (CU) has shown an increasing trend in recent decades for treating diverse ailments and infections. An ethnopharmacological survey was conducted to collect and document the ethnomedicinal knowledge of local people in the Saharan region of Morocco, including the Laayoune Sakia El Hamra and Guelmim Oued Noun regions, regarding the traditional use of CU for treatment. Semi-structured interviews with 384 traditional practitioners, camel herders, and rural and urban dwellers were conducted from December 2022 to June 2023. The collected data covered diseases treated, CU quality attributes, modes of preparation, dosage, administration, treatment duration, and mild side effects. Quantitative data analysis was performed through the relative frequency of citations, informant consensus factor, informant agreement ratio, cultural importance index, and fidelity level. The results showed that CU was collected from virgin female camels (46.7 %) and pregnant camels (51.6 %) at different age stages (39.7 %) in both wet and dry seasons (57.5 %). For the treatment of the most common ailments (cancer, liver diseases, gastric ulcers, diabetes, and tuberculosis), accounting for 69 %, the recommended regimen involved orally consuming one teacup (69 %) of fresh urine (70.6 %) on an empty stomach (91.1 %) once a day (87.1 %) four days a week (56 %). In the case of integumentary system problems, applying one (13.2 %) to three teaspoons (17.8 %) topically (10.3 %) was also effective. Secondary effects occurred in 48 cases (13.8 %), including diarrhea (13 cases), nausea (11 cases), headache (7 cases), constipation (7 cases), and dry mouth (8 cases). The duration of these effects ranged from 2 to 3 h. The present survey indicates that CU is still used in traditional medicine by local inhabitants of the southern regions of Morocco to cure various human illnesses. The outlined findings strongly suggest the usefulness of CU as a valuable source of bioactive molecules for pharmaceutical, dermo-cosmeceutical applications, and developing innovative food supplements that promote significant job creation and entrepreneurial prospects.

Association of varicose veins with incidence risk of atrial fibrillation: a population-based cohort study.

Varicose veins (VV) were once considered benign and common ailments; however, recent research suggests a potential link between VV and cardiovascular diseases or mortality. VV share common risk factors and pathophysiology with cardiovascular disease, potentially influencing the vascular system. Therefore, the authors aimed to investigate the association between VV and the incidence risk of atrial fibrillation (AF) using a population-based cohort. Our retrospective cohort study included 2680971 individuals who underwent examination through the Korean National Health Screening Service from 2010 to 2011. VV was defined by two or more claims with the International Classification of Diseases 10th Revision diagnostic codes: I83.0, I83.1, I83.2 (VV of lower extremities with ulcer or inflammation, severe VV), and I83.9 (asymptomatic VV of lower extremities, mild VV). The 1:3 propensity score matching (PSM) was used to assess the risk of newly developed AF, identified via insurance claims coded as I48. The mean age of all participants was 48.5±14.2 years, with 51.4% being male. Among the population, 24557 (0.91%) had VV, including 3684 (0.14%) of severe VV and 20873 (0.77%) of mild VV. During a median follow-up of 10.06 years, 24557 (0.92%) cases of AF occurred. Participants with VV exhibited an increased incidence risk of AF compared to those without it before (HR: 1.13, 95% CI: 1.06-1.21, P <0.001) and after PSM (HR: 1.17, 95% CI: 1.08-1.27, P <0.001). This positive association was consistently observed in severe VV both before (HR: 1.19, 95% CI [1.09-1.28], P =0.002) and after PSM (HR: 1.20, 95% CI [1.10-1.30], P =0.003) and mild VV also before (HR: 1.10, 95% CI [1.04-1.16], P =0.003) and after PSM (HR: 1.13, 95% CI [1.03-1.-20], P <0.001). These findings suggest that VV may be associated with an increased risk of AF. Hence, the presence of VV should be considered as an association factor for AF occurrence.