Contemporary Scientific Evidence Research Articles

Venesection (Fasd): Historical Insights and Modern Implications: A comprehensive review

Ilaj bit Tadbeer, a vital therapeutic approach in the Unani system of medicine, focuses on modifying six essential elements to restore health. This approach encompasses various regimenal therapies such as cupping (Hijāma), leeching (Ta'līq or irsal-e- 'Alaq), venesection (Fasd), massage (Dalk), irrigation (Natūl), emesis (Qay'), diuresis (Idrār-i-Bawl), diaphoresis (Tariq), concoction and purgation (Mundij and Mu'shil therapy), medicated steam (Bukhoor), cauterization (Kaiyy), and enema (Huqna). Fasd is a crucial regimen in Ilaj Bit Tadbeer, serving as a method to eliminate morbid material from the body to treat diseases or maintain good health. With a history of almost 3000 years, Fasd has been effectively utilized in treating various ailments across different eras. Although venesection, or Fasd, has a historical significance, its modern application has declined due to the lack of scientific validation. This review aims to explore the historical context, therapeutic applications, contraindications, and contemporary scientific evidence of Fasd, emphasizing its potential in modern medicine. Keywords: Ilaj bit Tadbeer, Unani medicine, Fasd, venesection, therapeutic applications, scientific evidence.

Impact of the Mediterranean Diet (Med-Diet) on Cancer and Cardiovascular Disease (CVD) Prevention and Management: A Narrative Review

Cancer and cardiovascular diseases (CVD) are the leading causes of mortality and morbidity worldwide. Dietary patterns play a crucial role in the prevention and management of these life-threatening diseases. Moreover, the Mediterranean diet (Med-Diet) is consistently associated with health benefits. Therefore, the current study attempted to synthesize the contemporary scientific evidence, outlining the impact of Med-Diet on CVD. The key components of this dietary pattern include a high intake of fruits, vegetables, whole grains, seafood, olive oil, and moderate consumption of poultry and dairy products which interact to provide protective effects against these diseases. The Med-Diet emphasizes the use of monounsaturated fats from olive oil and polyunsaturated fats from seafood, which significantly contribute to cardiovascular health. This diet is also rich in antioxidants and phytochemicals, offering potential protective qualities against cancer through combating inflammation and oxidative stress. High fiber content contributes to a healthy digestive system and potentially reduces the incidence of colorectal cancers. While, the Med-Diet alone cannot guarantee complete immunity against these diseases, it is an essential element of a holistic approach to disease prevention and management. Moreover, it also reinforces the importance of incorporating dietary patterns into public health strategies. To strengthen the evidence base, future research should focus on long-term randomized controlled trials in diverse populations.

Chemical Diversity and Medicinal Potential of Vitex negundo L.: From Traditional Knowledge to Modern Clinical Trials.

In recent times, there has been a resurgence of interest in V. negundo, with numerous ongoing clinical investigations exploring its therapeutic potential and the development of formulations derived from its bioactive constituents. Moreover, the market availability of homoeopathic medicines containing V. negundo highlights its enduring popularity. This review article provides a comprehensive analysis of V. negundo, encompassing its phytochemical composition, traditional uses, ethnomedicinal practices, and pharmacological properties. It explores the wealth of knowledge passed down through generations and the potential relevance of this traditional wisdom in modern healthcare. Additionally, the review presents findings from recent clinical trials, shedding light on the efficacy and safety of V. negundo-based formulations in various therapeutic contexts. Furthermore, the review delves into the emerging application of nanoparticles in V. negundo-based pharmaceutics, considering their potential to revolutionize drug delivery and formulation techniques. The incorporation of nanotechnology may enhance the bioavailability and targeted delivery of V. negundo's active compounds, further amplifying its medicinal potency. The amalgamation of traditional knowledge and contemporary scientific evidence underscores the relevance of V. negundo in the field of chemistry and biodiversity, paving the way for its continued exploration as a promising source of health-promoting compounds.

Patent landscape analysis-Contributing to the identification of technology trends and informing research and innovation funding policy.

Patents and the systematic analysis thereof provide important decision information for a range of stakeholders pursuing diverse goals. However, in particular academia and small-scale private sector innovators underappreciate the value of patent information for identifying research gaps, ensuring originality of their work and, in turn, maximisation of limited (public) funds. By the same token, pertinent public sector organisations, such as regulators, require overviews of potentially upcoming technologies to adequately adapt regulatory protocols. The latter, in particular if contemporary scientific evidence is not sufficient, can require a substantial amount of time and lead to a delay in the marketing of important innovations. Patent landscape analysis (PLA) is a very useful method to create overviews of technology fields and thereby indicate if, inter alia, a specific line of scientific enquiry and its application have already been pursued or potential regulatory gaps will exist in the near- to mid-term future. The objective of this communication is to increase awareness of the utility of patent information and provide support in retrieval and analysis of pertinent information for those involved in biotech R&D. Based on Espacenet, a patent search engine, we provide basic guidance on search strategy development, piloting and execution, and data preparation and analysis. To highlight the value of PLA, we also summarise selected results of a PLA we performed recently for microbiome targeting interventions, also referred to as live biotherapeutic products.

Advocating for Coccidioidomycosis to Be a Reportable Disease Nationwide in the United States and Encouraging Disease Surveillance across North and South America.

Coccidioidomycosis (Valley fever) has been a known health threat in the United States (US) since the 1930s, though not all states are currently required to report disease cases. Texas, one of the non-reporting states, is an example of where both historical and contemporary scientific evidence define the region as endemic, but we don't know disease incidence in the state. Mandating coccidioidomycosis as a reportable disease across more US states would increase disease awareness, improve clinical outcomes, and help antifungal drug and vaccine development. It would also increase our understanding of where the disease is endemic and the relationships between environmental conditions and disease cases. This is true for other nations in North and South America that are also likely endemic for coccidioidomycosis, especially Mexico. This commentary advocates for US state and territory epidemiologists to define coccidioidomycosis as a reportable disease and encourages disease surveillance in other endemic regions across North and South America in order to protect human health and reduce disease burden.

Perception and knowledge of dementia prevention and its associated socio-demographic factors in China: A community-based cross-sectional study.

Although considerable progress has been made on the risk factors of dementia, less is known about the extent of the gaps between the general public's understanding of dementia prevention and contemporary scientific evidence. This study aimed to determine the beliefs and knowledge of dementia prevention among the Chinese general public and examine the socio-demographic factors of the belief and knowledge of dementia prevention. The study adopted a cross-sectional design. A total of 358 Chinese adults aged over 40 years were recruited from four healthcare centers. We designed questionnaires that include items on the belief of dementia prevention, risk factors for dementia, and health education needs regarding dementia prevention based on previous literature. Descriptive statistics and multivariate regression analyses were conducted. Only 32.4% of the respondents agreed that dementia is preventable. Less participants were able to correctly identify cardiovascular risk factors (i.e., obesity, diabetes, dyslipidemia, hypertension, unhealthy diet, smoking, and alcohol) as part of dementia risk factors. Younger age, higher education, and having contact with patients with dementia are associated with stronger belief that dementia is preventable. Older age, higher income, higher education, having memory complaint, and having contact with patients with dementia are associated with a better understanding of dementia risk factors. A total of 88.9% respondents thought that they are not well informed of dementia from public education, and most respondents (65%) prefer receiving dementia-related health advice from primary care providers. The present study reveals the great gaps between the Chinese general public's knowledge of dementia prevention and the latest research evidence. Public health educational programs for all age groups are encouraged to close this knowledge gap. More attention and resources should be paid to individuals with low income and low education level as they have limited access to dementia prevention information. Researchers should work in partnership with primary care providers to help translate evidence into community practice with a special focus on the link between cardiovascular risk factors and dementia.

Current perspectives and clinical practice of physiotherapists on assessment, rehabilitation, and return to sport criteria after anterior cruciate ligament injury and reconstruction. An online survey of 538 physiotherapists

ObjectivesTo evaluate the perspectives and clinical practice of physiotherapists regarding rehabilitation after anterior cruciate ligament reconstruction (ACLR). DesignOnline survey. SettingSurvey platform. ParticipantsGreek physiotherapists. Outcome measuresThe survey consisted of 7 sections: participant demographics, importance of ACLR rehabilitation, clinical measurements, practice, criteria to progress rehabilitation, return to running and return to sport. ResultsSignificant variability in measures and criteria used for clinical decision-making were found including: limb symmetry in strength and function, knee range of motion and effusion, progression, and return to sport criteria. The majority of the practitioners (28.3%) extrapolate knee strength from hop capacity. Return to running ranged from 3 to 5 months post-operatively reflecting that this was tied to physical capacities, not time from surgery. 70.0% of the Greek physiotherapists would allow return to sport ≤9 months after ACLR. Agreement was found in using: physical measures, function, and dynamic stability in ACLR rehabilitation, but the mode and interpretation varied substantially. Less than 29.0% of the physiotherapists reported using patient-reported outcome measures in their decision-making. ConclusionCurrent ACLR rehabilitation practices in Greece are largely not aligned with the contemporary scientific evidence and guidelines.

Treatments of Eye Diseases in Malay Medical Manuscript Ramuan Obat EAP153/9/4

The Malay medical manuscript Ramuan Obat EAP153/9/4 is a Malay medical manuscript from Riau Archipelago in today’s Indonesia. It appears to focus on eye diseases and treatments. This study aims to evaluate if the traditional medicines and interventions in the manuscript can be supported scientifically. Critical transliteration and data extraction were performed by applying philological method in identifying and categorising the diseases and interventions. The materia medica was analysed by comparing scientific reports presented in PubMed and Google Scholar, and matching each ingredient to the intended purpose as indicated in the manuscript. The manuscript contains both physical and spiritual interventions amounting to 28 formulations for 7 different types of eye disease. Half of the materia medica and their use in Ramuan Obat EAP153/9/4 could be supported by contemporary scientific evidence. The lack of contemporary scientific evidence for other materia medica, on the other hand, could be attributed to the lack of scientific research on them rather and not necessarily a deficiency in effectiveness. More scientific studies would need to be carried out to validate the safety and efficacy of formulations contained in Malay medical manuscripts as the content could potentially lead to new drug discovery. Apart from scientific gains, the study could also contribute to the preservation of Malay medical culture and heritage.

Do We have the Evidence to Repurpose Levamisole for Treatment of COVID 19?

The human civilization is reeling under the COVID19 pandemic with no promising news of any effective treatment against the infection to date. A number of drugs have been repurposed without any remarkable efficacy. Amidst the crisis, utilising immunomodulators for boosting host immunity to mitigate disease severity and infectivity appears a viable option. In this article, we have explored the contemporary scientific evidence about levamisole for its potential use in COVID 19. Though the primary pharmacological use of the drug is as an anthelminthic, its immunostimulatory action has been shown to increase T-cell function, neutrophilic chemotaxis and immunoglobulin production both in vitro and in vivo. Clinically, the drug has been used with limited success in the treatment of herpes and HIV. The potential role of the drug in COVID 19 stems from the fact that the immunostimulant action can initiate a strong immune response and surmount the surreptitious virus, which evades host cell immunity. However, great caution has to be exercised in deciding the dosing schedule because the drug-disease interaction, especially the fatal hyperimmune response, is unknown and unpredictable. Being a widely available drug, enlisted in the WHO List of Essential Medicine, without any major safety issue, the drug is already in clinical trials carrying out worldwide. As the pandemic continues to ravage mankind with unabated intensity, any favourable outcome is eagerly awaited from the ongoing trials with levamisole and other drugs.

Experimental Evidence Supports New Perspectives in Homeopathy.

The contentious debate between homeopathy and orthodox medicine has been due to the fact that homeopathy is founded on a heuristic philosophy that is not justified by contemporary scientific evidence. In this context, however, two pillars of the method, that is, serial dilution and succussion, are poorly understood in orthodox pharmacology. The experimental data collected in the last 10 years, by means of electronic microscopy, electron diffraction and DNA arrays investigations, are consistent with the presence of nanoparticles (nanoassociates) in homeopathic medicines and seem to provide a coherent view of the essence of the homeopathy discipline, superseding all previous speculative interpretations. An acceptance of this new evidence is here suggested to remove, in principle, the barrier that separates the conventional and homeopathic therapeutic methods, and to offer new and important perspectives on future health care.

Restorative Treatment in Patients with Amelogenesis Imperfecta: A Review

To summarize the contemporary scientific evidence available regarding restorative dental treatment in patients with Amelogenesis imperfecta (AI). An electronic literature search was conducted using the search term "Amelogenesis imperfecta" and the PubMed/MEDLINE database as well as Google Scholar. Prospective and retrospective clinical studies that investigated the outcome of direct and/or indirect dental restorative treatment in patients with AI, were published in English, and had an observation time of at least 1 year were included in this review. The articles identified were screened and analyzed by two reviewers according to inclusion and exclusion criteria in three review rounds. Six prospective or retrospective clinical studies analyzing longevity and complications associated with dental restorative treatment in patients with AI met the inclusion criteria. Extracted data suggest that in patients with AI, indirect restorations feature superior predictability and longevity than direct restorations. As endodontic complications were infrequently observed and periodontal parameters regularly improve with the insertion of indirect restorations, dental treatment in patients with AI should focus on indirect restorations as soon as possible. While adhesive bonding techniques to enamel surfaces in patients with AI feature merely limited predictability and longevity and as the available data is scarce, further laboratory and clinical studies should be performed to investigate the performance of minimally invasive indirect restorations bonded to enamel in patients with AI. Scientific evidence indicates that indirect restorations should be preferred over direct restorations in patients with AI.

Translating scientific evidence into global health policy: Making mental health count for individuals′ and populations′ health

Scientific evidence in all sciences, inclusive of the brain and neurosciences as well as in assessing health systems’ performance is rapidly evolving in the 21st century. This new evidence is augmenting the understanding of the brain and its functions, its transactions with the human genome, the microbiome,Β the social determinantsΒ of health, and the dominant global burden of diseases presented by non-communicable diseases, inclusive of mental disorders, and their comorbidities. Together they are stimulating new research and innovation in addressing the challenges of primary, secondary and tertiary prevention continuum as well as the current health systems’ fragmentation. The author presents contemporary scientific evidence, its impact on developing Total Health models of integrated health systems, and its translation into global health policy to benefit individuals’ and populations’ health.

Male circumcision to prevent syphilis in 1855 and HIV in 1986 is supported by the accumulated scientific evidence to 2015: Response to Darby

ABSTRACTAn article by Darby disparaging male circumcision (MC) for syphilis prevention in Victorian times (1837–1901) and voluntary medical MC programs for HIV prevention in recent times ignores contemporary scientific evidence. It is one-sided and cites outlier studies as well as claims by MC opponents that support the author's thesis, but ignores high quality randomised controlled trials and meta-analyses. While we agree with Darby that risky behaviours contribute to syphilis and HIV epidemics, there is now compelling evidence that MC helps reduce both syphilis and HIV infections. Although some motivations for MC in Victorian times were misguided, others, such as protection against syphilis, penile cancer, phimosis, balanitis and poor hygiene have stood the test of time. In the absence of a cure or effective prophylactic vaccine for HIV, MC should help lower heterosexually acquired HIV, especially when coupled with other interventions such as condoms and behaviour. This should save lives, as well as reducing costs and suffering. In contrast to Darby, our evaluation of the evidence leads us to conclude that MC would likely have helped reduce syphilis in Victorian times and, in the current era, will help lower both syphilis and HIV, so improving global public health.

IJU this issue

This issue covers a wide range of clinical topics of urology, and contains three Review Articles, one Perspectives in Urology, seven Original Articles, one Short Communication, one Case Report and one Letter to the Editor. There has been a long history of controversies, including some superstitions, surrounding circumcision. Most circumcisions have been carried out for religious reasons, and have also been used to decrease the likelihood of developing penile cancer, or contracting a urinary tract infection or a sexually transmitted infection. The Review Article by Hayashi et al. (Nagoya, Japan) focuses on a prophylactic basis of circumcision, helping us to learn the contemporary scientific evidence and real-world situation of this well-known issue. Another article by Shin et al. (Seoul, Korea) discusses one of the common pediatric diseases, nocturnal enuresis. Spina bifida occulta was detected in 26.9% of the children with nocturnal enuresis. The presence of spina bifida occulta significantly affects the response to treatment for nocturnal enuresis, thus it should not be overlooked. Renal cell carcinoma has been considered to be an immune-responsive cancer, and several immunotherapeutic modalities including interferon-α or high-dose interleukin-2 have been investigated. Recently, research regarding vaccination therapy has been of special interest for the treatment of renal cell carcinoma. The Review Article by Yoshimura et al. (Osaka, Japan) reviews the present status of clinical trials, and discusses current knowledge and future perspectives of vaccine therapy in the era of recently developed targeted therapy. Small cell carcinoma of the bladder (SCCB) is a relatively rare condition, and poorly differentiated tumors are associated with more aggressive behavior and a poorer outcome than bladder urothelial carcinoma. Because of this low incidence, a consensus on the optimal treatment strategy has not been reached. Meijer et al. (Utrecht, the Netherlands) investigated the role of the sequential combination of chemotherapy and radiotherapy in the treatment of localized stage SCCB. Using a relatively large study cohort, sequential chemoradiation for limited disease SCCB results in a reasonable outcome with a high bladder preservation rate. They also showed significantly better cancer-specific survival for complete responders to induction of systemic chemotherapy. Further data accumulation is required to establish an optimal bladder-sparing strategy for patients with locally advanced SCCB. There has been an increasing use of brachytherapy as a less invasive means to cure localized prostate cancer. Acute and late urinary toxicities are the main sequelae of the treatment. Araki et al. (Okayama, Japan) examined the predictive factors associated with Radiation Therapy Oncology Group urinary toxicity in prostate brachytherapy patients. They found that acute and late urinary toxicity after brachytherapy is strongly related to the baseline International Prostate Symptom Score and the percentage of the prostate gland that receives 100% of the prescribed dose (prostate V100). These findings help physicians, as well as patients, to make better decisions in the treatment of localized prostate cancer. From the standpoint of the natural history of male lower urinary tract symptoms, patients with moderate-to-severe voiding symptoms could be candidates for radical prostatectomy rather than brachytherapy. Although salvage radiotherapy is the only curative treatment for patients with prostate cancer showing biochemical recurrence after radical prostatectomy, it is hard to accurately know the pattern of recurrence; that is, local, distant or combined. Thus, the best candidates for salvage radiotherapy remain to be determined. Kinoshita et al. (Hirakata, Japan) evaluated the clinicopathological parameters that influence the outcome of salvage radiotherapy. They identified Gleason score of prostatectomy, prostate-specific antigen nadir after prostatectomy and positive surgical margin as independent predictors. The presence/absence of these risk factors might help to facilitate further stratification of salvage treatment. None declared.

Efficacy and Safety of Ethylene Oxide Sterilization of Allogeneic Bone for Human Transplantation: A Forty-year Experience

Context: Since the year 2000, allogeneic tissues utilized for operations in humans in the United States have commonly undergone terminal sterilization with gamma irradiation. Ethylene oxide sterilization of tissues processed for human implantation has been abandoned Objectives: (1) To record the long-term successful experience of a precursor transplantation laboratory in the provision of human bone and fascia sterilized with “cold cycle” ethylene oxide; (2) to report the successful experience of a single neurosurgeon operating in a community hospital using only this bone to fuse and stabilize the lumber spine without instrumentation; (3) to review historic and contemporary scientific evidence for the biologic and biomechanical effects of ethylene oxide gas and gamma irradiation exposure on tissues, along with their virucidal, fungicidal and bactericidal properties for surface and interstitial sterilization. Design: Records from the Western Transplantation Services (WTS) laboratory were scrutinized documenting the 18 years of its existence (1978-1996) as well as the voluminous, carefully preserved records of patient interactions, preoperative, operative, and postoperative records archived over three decades from 321 patients undergoing 339 operations by a single neurosurgeon utilizing 1,135 tricortical iliac crest wedges sterilized with ethylene oxide. Main Outcome Measures: Rates of infection and neoplasia in allograft recipients or in laboratory personnel from preparation and distribution of over 50,000 ethylene oxide sterilized allografts provided by a single processing laboratory; lumbar spine fusion rate and complications attributable to grafts among patients receiving these implants. Results: Over 50,000 allografts distributed from Western Tranplantation Services resulted in no reported infections or neoplasia in any recipient and no neoplasia among technicians processing four tissues with exposure to ethylene oxide. Fusion rate among patients undergoing uninstrumented posterior lumbar interbody fusion (PLIF) with tissues distributed by this laboratory was 96% with no reported infections and no allograft fractures. Complication rate of 4% related to the operation and not the performance of the allografts processed by the laboratory. Conclusions: Ethylene oxide sterilization of allogeneic tissues for human transplantation is a safe, efficacious method and merits reconsideration as a remarkably unique surface and interstitial tissue sterilant that is bactericidal, fungicidal and virucidal without compromise of biomechanical integrity of grafts at doses achieving these sterilizing effects.

Tremor revisited: Treatment of PD tremor

Parkinsonian tremor is among the most emblematic medical signs and is one of the cardinal manifestations of Parkinson's disease (PD). Its semiology has been extensively addressed by ancient and contemporary medical literature, but more attention has been dedicated to its medical treatment in the past than nowadays. Among the hundreds of studies performed to determine the value of medical and surgical approaches on motor and non motor signs of PD, only a minority specifically considered effect on tremor as an efficacy outcome. Current available guidelines for PD treatment include attempts to specifically address tremor treatment but stress the low level of evidences available. In these conditions, with its still poorly understood pathophysiological basis and variable clinical expression PD tremor treatment is a clinical challenge. Only surgery (lesion or high frequency stimulation) of discrete deep brain targets consistently provides symptomatic long lasting alleviation. Through revision of contemporary scientific evidence, the purpose of this paper is to offer a systematic pragmatic approach to symptomatic management of tremor as one of the distinctive signs of PD that may generate substantial disability.

Fluoride in the media: a review of newspaper articles from 1999 to 2009

The effects of fluoride are regularly discussed in newspapers. This paper reviews this coverage over a ten-year period and compares the content with contemporary scientific evidence. The reporting used in a sample of daily newspapers when the subject of fluoride and its effects were mentioned was analysed and factual statements within the articles were compared with contemporary scientific studies, to assess the accuracy of reporting. Practitioners may face questions from patients regarding the evidence base for the safety and efficacy of the use of fluoride in dentistry.

Psychiatric Fraud and Force: A Reply to Szasz

Thomas Szasz has made major contributions to many areas of psychiatric thought. He has correctly decried “diagnosis creep” in American psychiatry and emphasized the potential for political abuse of psychiatric labels. He has correctly asserted that only individuals with a true brain disease should qualify as having a “mental illness” but unfortunately ignores overwhelming evidence that schizophrenia has been proven to be a brain disease. His unchanging views on schizophrenia, despite contemporary scientific evidence, appear increasingly anachronistic and allow critics to dismiss his other contributions, many of which remain valuable.

Kanıta Dayalı Tıp ve Tıp Kütüphaneciliği

Binlerce yıllık tıp mesleği günümüzde hiç olmadığı kadar büyük bir değişimiçindedir. Paternalistik tıp geleneğinin terkedilmeye başlandığı, her gün yüzlerce bilimsel makalenin dergilerde yerini aldığı ve hastaların internet aracılığı ile bir kaç dakika içinde en son klinik araştırmalar hakkında bilgi sahibi olabildiği bir dünyada yaşamaktayız. Bu ortam bizi Kanıya Dayalı Tıptan, Kanıta Dayalı Tıbba (KDT) doğru zorunlu bir yönelişe itmektedir. Hastaların tanı ve tedavi süreçlerinde en güncel ve doğru bilimsel kanıtların ışığında hareket etmesi olarak kısaca özetlenebilen KDT pratiği, kütüphanecilik ve kütüphanecilerin vazgeçilmez bir biçimde içinde yer aldığı bir takım çalışmasıdır. Bu yazıda KDT incelenecek ve tıp kütüphaneciliği ile ilişkisi tartışılacaktır.

Antepartum fetal surveillance: Number 9, October 1999 ( replaces Technical Bulletin Number 188, January 1994) Clinical management guidelines for obstetrician—gynecologists

The goal of antepartum fetal surveillance is to prevent fetal death. Antepartum fetal surveillance techniques based on assessment of fetal heart rate patterns have been in clinical use for almost three decades. More recently, real-time ultrasonography and Doppler velocimetry have been used to evaluate fetal well-being. Antepartum fetal surveillance techniques are now routinely used to assess the risk of fetal death in pregnancies complicated by preexisting maternal conditions (eg, type 1 diabetes mellitus) as well as those in which complications have developed (eg, intrauterine growth restriction). This document will review the current indications for and techniques of antepartum fetal surveillance and outline management guidelines for antepartum fetal surveillance, consistent with the best contemporary scientific evidence.