Healthcare Research Research Articles

Tinnitus in Children.

This perspective reviews the current state of the art and literature on tinnitus in children, prevalence and risk factors, clinical management, and future priorities for healthcare provision and research. Most research in the field to date appears to be prevalence studies, which have reached dramatically different estimates; this reflects the lack of a standard language when asking about the presence of tinnitus, or how bothersome, distressing, or negatively impacting it is for the child. Estimates are also likely affected by a lack of awareness of tinnitus amongst children and parents. Children are less likely to spontaneously report tinnitus than adults, and parents are often unaware their child could even develop tinnitus, considering it a disease of older age for example. It is critical that children are asked and learn about tinnitus. In hearing clinics, clinicians should routinely ask about all children about tinnitus and offer tinnitus care and settings that are child- and family-friendly. As well as asking directly, clinicians should be alert to soft signs of tinnitus such as unexplained listening, speech perception, concentration difficulties, worry or anxiety, or difficulties completing hearing tests or using hearing aids. The recently developed impact of Tinnitus in Children Questionnaire (iTICQ) can then be used to assess problems that are most commonly core to children's experience of tinnitus. Clinical guidelines for tinnitus in children are few but provide recommendations for additional paediatric questionnaires and alternative assessments and for a range of treatment options. Of note, however, is the lack of clinical trials and, therefore, evidence of the effectiveness of any treatment for tinnitus in children. Significant and concerted work is therefore needed to raise awareness of tinnitus in children, understand the scale of clinical need, and standardise and evaluate clinical management options.

Association between non-alcoholic fatty liver disease and risk of sarcopenia: a systematic review and meta-analysis

ObjectivesTo determine the association of non-alcoholic fatty liver disease (NAFLD) with the incidence of sarcopenia.DesignSystematic review and meta-analysis of observational clinical studies.Setting and participantsAdults with NAFLD.MethodsDatabases such as PubMed, Embase,...

Towards sharing tools and artefacts for reusable simulations in healthcare

ABSTRACT Discrete-event simulation (DES) is a widely used computational method in health services and health economic studies. Despite increasing recognition of the advantages of open, reusable DES models for both healthcare practitioners and simulation researchers, in practice very few authors share their model code alongside a published paper. In the context of Free and Open Source Software (FOSS), this paper presents a pilot framework called STARS: Sharing Tools and Artefacts for Reusable Simulations to begin to address the challenges and leverage the opportunities of sharing DES models in healthcare. STARS aligns with existing guidelines and documentation, including reproducibility initiatives, and enables computer models to be shared with users of differing technical abilities. We demonstrate the feasibility and applicability of STARS with three applied DES examples using Python. Our framework supports the development of open, reusable DES models which can enable partner healthcare organisations to preview, validate, and use models. Academic research teams can benefit from knowledge exchange, enhanced recognition and scrutiny of their work, and long-term archiving of models.

Managing gastrointestinal challenges: Diarrhea in sickle cell anemia.

Sickle cell anemia (SCA), a hereditary hemoglobinopathy, is characterized by the presence of abnormal hemoglobin and has long been associated with a wide range of complications. While much attention has been given to the condition hematological aspects, gastrointestinal complications, particularly diarrhea, have been relatively understudied and often overlooked. This publication delves into the management of gastrointestinal challenges, with a focus on diarrhea, in individuals living with SCA. The pathophysiology of SCA is intrinsically linked to gastrointestinal complications, and diarrhea is a common manifestation of this condition. This abstract publication outlines the key elements discussed in the full-length work, which includes the clinical presentation of diarrhea in these patients, the diagnostic tools used to evaluate the condition, and various management strategies to alleviate symptoms and enhance the overall quality of life for affected individuals. The paper emphasizes the importance of patient education, offering healthcare professionals valuable insights into how to inform and support patients in managing their conditions effectively. It also highlights the need for continued research to further our understanding of gastrointestinal challenges in SCA and to identify potential areas for future therapeutic interventions. Ultimately, the comprehensive management of diarrhea in individuals with SCA is vital for their overall well-being. This publication serves as a valuable resource for healthcare providers, researchers, and caregivers in addressing the gastrointestinal challenges that accompany SCA, ultimately working toward a better quality of life for those affected by this condition.

Performance of health care service area definitions for capturing variation in inpatient care and social determinants of health.

To quantify the degree to which health care service area (HCSA) definitions captured hospitalizations and heterogeneity in social determinants of health (SDOH). Geospatial data from the Centers for Medicare and Medicaid Services, the Census Bureau, and the Dartmouth Institute. Drive-time isochrones from MapBox. Area Deprivation Index (ADI) data. 2017 inpatient discharge data from Arizona, Florida, Iowa, Maryland, Nebraska, New Jersey, New York, and Wisconsin, State Emergency Department Databases and State Inpatient Databases, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality; and Fee-For-Service Medicare data in 48 states. Cross-sectional, descriptive analysis. The capture rate was the percentage of inpatient discharges occurring in the same HCSA as the hospital. We compared capture rates for each HCSA definition for different populations and by hospital type. We measured SDOH heterogeneity using the coefficient of variation of the ADI among ZIP codes within each HCSA. HCSA definitions captured a wide range of inpatient discharges, ranging from 20% to 50% for Public Use Microdata Areas (PUMAs) to 93%-97% for Metropolitan Statistical Areas (MSAs). Three-quarters of inpatient discharges were from facilities within the same county as the patient's residential ZIP code, while nearly two-thirds were within the same Hospital Service Area. From the hospital perspective, 74.7% of inpatient discharges originated from within a 30-min drive and 90.1% within a 60-min drive. Capture rates were the lowest for teaching hospitals. PUMAs and drive-time-based HCSAs encompassed more homogenous populations while MSAs, Commuting Zones, and Hospital Referral Regions captured the most variation. The proportion of hospital discharges captured by each HCSA varied, with MSAs capturing the highest proportion of discharges and PUMAs capturing the lowest. Additionally, researchers face a trade-off between capture rate and population homogeneity when deciding which HCSA to use.

Experiences of participant and public involvement in an international randomized controlled trial for people living with dementia and their informal caregivers

BackgroundThis study was initiated and co-designed by a Participant and Public Involvement (PPI) group attached to HOMESIDE, a randomized controlled trial that investigated music and reading interventions for people living with dementia and their family caregivers across five countries: Australia, Germany, Norway, Poland, and the UK. The aim was to capture experiences of PPI across the five countries, explore the benefits and challenges of PPI in dementia research, and identify contributions made to the study.MethodsWe surveyed PPI members and academic researchers who collaborated on the HOMESIDE study. The survey was co-designed through consultation with PPI members and academics, alongside a small scoping literature review. Survey questions covered four topics: (1) expectations for PPI, (2) perceived contributions of PPI to the research study, (3) benefits and challenges of PPI, and (4) recommendations for future PPI in dementia research.ResultsThere were 23 responses, representing 50% of the PPI members (n = 16) and 29% of academics (n = 7). PPI was found to be beneficial to the research and individuals involved. Contributions to the research included supporting recruitment and publicity, advising on the design of participant-facing materials, guiding the design and delivery of the interventions, and identifying cultural differences affecting research delivery. PPI members benefited from building connections, sharing experiences and receiving support, learning about dementia and research, and gaining new unexpected experiences. Academics learned about the realities of living with dementia, which they felt informed and grounded their work. Several challenges were identified, including the need for clear expectations and objectives, inconsistency of PPI members across research stages, limitations of meeting online versus in-person, scheduling difficulties, and language barriers.ConclusionsThis study identifies important considerations for implementing PPI within dementia studies and international healthcare research more broadly. Our findings guided the development of five recommendations: (1) involve PPI members as early as possible and throughout the research process; (2) create a space for constructive criticism and feedback; (3) have clear tasks, roles, and expectations for PPI members; (4) involve PPI members with a diverse range of experiences and backgrounds; and (5) embed infrastructure and planning to support PPI.

Artificial Intelligence and ChatGPT: Physician Friend or Foe?

ChatGPT is a language model trained on massive volumes of Internet data. It attempts to imitate human text and can perform various roles in healthcare and health research. The program enables users to tap into vast amounts of information and understand words in context. ChatGPT can access large amounts of data and computing techniques to make predictions and string words together meaningfully. This article discusses the history of artificial intelligence, provides an example of using artificial intelligence to obtain prior authorization, and discusses the ethical considerations of this exciting new technology.

Unveiling Diabetes: Categories, Genetics, Diagnostics, Treatments, and Future Horizons.

Diabetes mellitus is a global epidemic affecting millions of individuals worldwide. This comprehensive review aims to provide a thorough understanding of the categorization, disease identity, genetic architecture, diagnosis, and treatment of diabetes. The categorization of diabetes is discussed, with a focus on type 1 and type 2 diabetes, as well as the lesser-known types, type 3 and type 4 diabetes. The geographical variation, age, gender, and ethnic differences in the prevalence of type 1 and type 2 diabetes are explored. The impact of disease identity on disease management and the role of autoimmunity in diabetes are examined. The genetic architecture of diabetes, including the interplay between genotype and phenotype, is discussed to enhance our understanding of the underlying mechanisms. The importance of insulin injection sites and the insulin signalling pathway in diabetes management are highlighted. The diagnostic techniques for diabetes are reviewed, along with advancements for improved differentiation between types. Treatment and management approaches, including medications used in diabetes management are presented. Finally, future perspectives are discussed, emphasizing the need for further research and interventions to address the global burden of diabetes. This review serves as a valuable resource for healthcare professionals, researchers, and policymakers, providing insights to develop targeted strategies for the prevention, diagnosis, and management of this complex disease.

Bibliometric Analysis of Research in Pediatrics Related to Virtual and Augmented Reality: A Systematic Review.

The amount of research exploring the use of virtual reality [VR] and augmented reality [AR] technologies in health care has exploded. This has resulted in a massive body of work, making it difficult to obtain all of the research. The objective of this study was to map out and put together the scientific output of research and global trends in virtual and AR in pediatrics. Publications were collected from the Web of Science [WoS] database. The R tool was used to categorize and evaluate the research outputs, as well as the most productive and influential countries, journals, institutions, authors, articles, subject areas, and the latest research themes. The most utilized and co-occurring keywords were also examined. Texts, tables, and images were used to assess and describe the retrieval of findings. The research was based on information from 7423 publications. The strongest growth in publications occurred in 2020. The most productive and influential country was the USA. The journal was Pediatrics, the author was G Riva, and the institution was the University of Washington. The most frequently occurring keywords were simulation, rehabilitation, and stroke. The main research themes were therapy, surgical education, and rehabilitation. Pain, stroke, anxiety, depression, fear, dementia, and neurodegenerative illnesses were all common medical issues investigated. VR studies have mainly focused on surgical education or procedures, simulation technologies, and neurological conditions. Neurological conditions are linked to balance, gait, and rehabilitation, reflecting the prevalence of these disease groups. This article provides a thorough overview of VR and AR studies in the healthcare field. This work will allow academics, policymakers, and practitioners to gain a deeper understanding of the evolution of VR and AR studies in the healthcare field and its potential practical implications. Future VR and AR research should focus on bridging the gap between VR and AR healthcare research and clinical applications. Emerging trends in related fields, such as navigation, rehabilitation, stroke, dementia, and VR exposure therapy, should be given special attention.

Dissecting the surgeon's personality: cross-cultural comparisons in Western Europe.

The surgeon's personality contributes to variation in surgical decision-making. Previous work on surgeon personality has largely been reserved to Anglo-Saxon studies, with limited international comparisons. In this work we built upon recent work on gastrointestinal surgeon personality and aimed to detect international variations. Gastrointestinal surgeons from the UK and the Netherlands were invited to participate in validated personality assessments (44-item, 60-item Big Five Inventory; BFI). These encompass personality using five domains (open-mindedness, conscientiousness, extraversion, agreeableness and negative emotionality) with three subtraits each. Mean differences in domain factors were calculated between surgeon and nonsurgeon populations from normative data using independent-samples t-tests, adjusted for multiple testing. The items from the 44-item and 60-item BFI were compared between UK and Dutch surgeons and classified accordingly: identical (n = 16), analogous (n = 3), comparable (n = 12). UK (n = 78, 61.5% male) and Dutch (n = 280, 65% male) gastrointestinal surgeons had marked differences in the domains of open-mindedness, extraversion and agreeableness compared with national normative datasets. Moreover, although surgeons had similar levels of emotional stability, country of work influenced differences in specific BFI items. For example, Netherlands-based surgeons scored highly on questions related to sociability and organization versus UK-based surgeons who scored highly on creative imagination (p < 0.0001). In a first cross-cultural setting, we identified country-specific personality differences in gastrointestinal surgeon cohorts across domain and facet levels. Given the variation between Dutch and UK surgeons, understanding country-specific data could be useful in guiding personality research in healthcare. Furthermore, we advocate that future work adopts consensus usage of the five factor model.

CORRELATION ANALYSIS OF NORMAL AND JAUNDICE-RELATED BIRTHS: A COMPARATIVE STUDY IN GENERAL HOSPITAL AGBOR (SEMI-URBAN) AND FEDERAL MEDICAL CENTER ASABA (URBAN), 2013-2022

This paper investigates the correlation between normal births and jaundice-related births at General Hospital Agbor and Federal Medical Center Asaba for the years 2013-2022. Utilizing Pearson correlation analysis, the research aimed to assess the relationship between these variables in semi-urban and urban healthcare settings. Results indicate a moderate to weak positive correlation, with numerical values revealing a Pearson correlationcoefficient of 0.5234 for General Hospital Agbor and 0.3086 for Federal Medical Center Asaba. Beyond establishing the strength of this correlation, the paper unveils practical implications. A moderate positive relationship is observed in the semi-urban location, suggesting that as the number of normal births increases, jaundice-related births may also rise moderately. Conversely, the urban location displays a weak positive relationship, implying a milder association between normal and jaundice-related births. These findings highlight the nuanced nature of the correlation in different healthcare contexts. Practically, this research contributes valuable insights for healthcare practitioners, policymakers, and researchers. Understanding the varying degrees of correlation informs targeted interventions and resource allocation. For instance, in semi-urban areas, emphasis on early detection and management of jaundice-related cases may be crucial. Meanwhile, in urban settings, the weaker correlation signals the need for a comprehensive approach, possibly focusing on factors beyond birthing patterns. In conclusion, this paper not only quantifies the correlation between normal and jaundice-related births but also underscores its practical significance in diverse healthcare landscapes. The numerical values substantiate the identified relationships, offering a quantitative basis for decision-making and intervention strategies

A short responsive interaction scale: construction and preliminary reliability and validity

  Background: Responsive interactions among caregivers and newborns are essential for positive and optimal growth and development. The aim of this cross-sectional study was to develop and validate a short responsive interaction tool (SRIS) to assess caregiver responsiveness of newly delivered mothers. Methods: The SRIS consists of twenty elements that are used to classify new-born handling, interactions, consoling techniques, engagement, and distress. High reliability and internal consistency were shown in the data gathered from 257 mothers (Cronbach's alpha=0.8354). The scale's one-dimensional structure was discovered through construct validity analysis, demonstrating the consistency of the scale's evaluation of response interactions. Results: The results indicate that the valid and reliable instrument for gauging the responsiveness of caregivers during their initial contact with neonates. It provides a useful and approachable method with possible uses in healthcare settings and research for evidence-based parenting interventions. Conclusions: To improve the tool's generalizability and usefulness in fostering early childhood development and parental engagement, further research is necessary to validate it across a variety of contexts.  

Horizon of Healthcare: AI's Evolutionary Journey and Future Implications

This meta-analysis offers a comprehensive review of the literature surrounding the integration of Artificial Intelligence (AI) in healthcare. Drawing upon an extensive array of scholarly articles, research papers, and industry reports, this study synthesizes the current state of knowledge regarding AI's applications, challenges, and future directions within the healthcare sector. The analysis encompasses various dimensions of AI implementation, including diagnostic assistance, treatment optimization, patient management, and administrative streamlining. Additionally, it examines the methodological approaches employed in AI healthcare research, assessing the efficacy and reliability of AI-driven interventions across diverse medical domains. Furthermore, this meta-analysis explores the ethical, legal, and social implications associated with AI adoption in healthcare, shedding light on issues of data privacy, algorithmic bias, and patient autonomy. Through a systematic examination of existing literature, this study elucidates key trends, knowledge gaps, and emerging research directions in the evolving intersection of AI and healthcare, providing valuable insights for policymakers, practitioners, and researchers alike.

MortalityMinder: Visualization and AI Interpretations of Social Determinants of Premature Mortality in the United States

MortalityMinder enables healthcare researchers, providers, payers, and policy makers to gain actionable insights into where and why premature mortality rates due to all causes, cancer, cardiovascular disease, and deaths of despair rose between 2000 and 2017 for adults aged 25–64. MortalityMinder is designed as an open-source web-based visualization tool that enables interactive analysis and exploration of social, economic, and geographic factors associated with mortality at the county level. We provide case studies to illustrate how MortalityMinder finds interesting relationships between health determinants and deaths of despair. We also demonstrate how GPT-4 can help translate statistical results from MortalityMinder into actionable insights to improve population health. When combined with MortalityMinder results, GPT-4 provides hypotheses on why socio-economic risk factors are associated with mortality, how they might be causal, and what actions could be taken related to the risk factors to improve outcomes with supporting citations. We find that GPT-4 provided plausible and insightful answers about the relationship between social determinants and mortality. Our work is a first step towards enabling public health stakeholders to automatically discover and visualize relationships between social determinants of health and mortality based on available data and explain and transform these into meaningful results using artificial intelligence.

Perspectives of patients in relation to the role of the general practice pharmacist: a systematic review and meta-synthesis of qualitative studies

Abstract Introduction The integration of general practice pharmacists (GPPs) into general practice across the United Kingdom (UK) and internationally has been tested and supported through different initiatives.[1] The intention of this integration was to address issues relating to primary care workforce and workload.[1] However, there is limited evidence available on the views of patients about the GPP role.[1] Aim To synthesise qualitative research evidence on patients’ views of the GPP role in general practice. Methods A systematic, qualitative meta-synthesis was undertaken. A search of six electronic databases (Medline, Embase, Scopus, Web of Science, IPA and CINAHL) was conducted from the date of inception to May 2023; reference lists of included studies were also reviewed. Inclusion criteria were peer-reviewed studies which addressed the views of patients about the GPP role in general practice, in the English language, had used qualitative methods for data collection and analysis; no date restrictions were applied. Findings and verbatim quotes relevant to patients’ views were extracted. This was followed by applying the thematic synthesis approach of Thomas and Harden to the extracted data.[2] The Critical Appraisal Skills Programme (CASP) checklist was used to assess quality of the included studies.[2] The review protocol was registered with PROSPERO (CRD42023423623). Results Eight qualitative studies were included, of which five were conducted in the UK and three in Australia. Most studies used interviews to collect data (n=6). The total number of participants was 139 and sample sizes across studies ranged from 7 to 34. Two main analytical themes were generated. The first theme related to perceptions of the GPP role such as benefits (patients believed the GPP increased their knowledge and adherence to medications, rationalised drug therapy, and improved health outcomes) and challenges (patients felt that because GPPs were only available for specific hours every week and on certain days, this was a disadvantage) for patients. The second theme related to attitudes towards the GPP role such as acceptance (acceptability levels of the GPP and their role in general practice among patients were high and no objections were reported when patients were asked to meet with the GPP) and disappointment (some patients were not happy about the way in which medication review was conducted or its outcome). Overall, included studies demonstrated high methodological quality, meeting all or at least seven of the 10 criteria of the CASP checklist.[2] Conclusion The findings have shown that there were benefits and challenges associated with the GPP role, along with acceptance and disappointment. The method adopted (i.e. qualitative meta-synthesis) is considered an essential technique for informing practice, policy, and research in healthcare and pharmacy, and has highlighted patients’ views in this study. However, our searches only retrieved studies published in English. Thus, it is possible that there are relevant studies in other languages which have not been identified. Further work is needed to assess patients’ views on the role of the GPP and how this relationship can be developed.

Privacy-Preserving Data Sharing Platform

In today's data-driven healthcare landscape, the secure sharing of sensitive medical information is essential for improving patient care, facilitating medical research, and advancing healthcare outcomes. However, ensuring the integrity, confidentiality, and privacy of patient data poses significant challenges, particularly in the context of big data environments. This presents a comprehensive framework for privacy-preserving data sharing in healthcare, leveraging a combination of cryptographic techniques, encryption, and secure computation protocols. The framework encompasses various privacy-preserving mechanisms, including Differential Privacy with Data Perturbation, Secure Multi-Party Computation (SMPC), and Homomorphic Encryption, to protect sensitive healthcare data from unauthorized access and disclosure. By implementing state-of-the-art privacy-preserving techniques, the framework aims to enable secure data sharing among multiple parties while complying with regulatory requirements such as HIPAA and GDPR. Additionally, the paper discusses the project scope, which includes cryptography, encryption, decryption, integrity, confidentiality, privacy, policies, procedures, security, and secure data sharing infrastructure. The proposed framework provides a practical solution for healthcare organizations and research institutions to collaborate on data-driven initiatives while safeguarding patient privacy and maintaining trust. Evaluation of the framework's effectiveness and performance metrics is conducted to validate its feasibility and efficacy in real-world healthcare settings. Keywords: Privacy-preserving data sharing, Differential Privacy, Data Perturbation, Secure Multi-Party Computation (SMPC)

Hypertension, depression, and health-related quality of life among hospitalized patients in Afghanistan.

In recent decades, hypertension has become the foremost risk factor for disability-adjusted life years (DALYs). The presentstudy investigated the relationship between quality of life, depression, and hypertension among hospitalized patients in Afghanistan. A cross-sectional survey was administered from September 3, 2022, to February 2, 2023, in the Herat and Mazar-e-Sharif provinces of Afghanistan (N = 2059). The prevalence of depression symptoms was 65.8%, and hypertension was 20.9%. Multiple regression analysis indicated that moderate physical functioning, poor role-physical, higher bodily pain, poor general health, poor social functioning, lower role-emotional, and poor mental health significantly predicted depression. Multiple regression analysis indicated that moderate quality of life, poor physical functioning, higher bodily pain, lower energy/fatigue, and depression significantly predicted hypertension. The findings of the present study offer valuable insights for healthcare providers, policymakers, and researchers in developing targeted interventions and policies to enhance the well-being of individuals facing the challenges of depression and hypertension. The prevalence of hypertension and depression was high among patients in the Herat and Mazar-e-Sharif provinces of Afghanistan. Patients with hypertension had poor mental and physical quality of life. Hospitals should therefore implement regular screening for depression and offer psychological counseling for vulnerable patients with hypertension.

What is the ideal time to begin tapering opioid agonist treatment? A protocol for a retrospective population-based comparative effectiveness study in British Columbia, Canada

IntroductionOpioid agonist treatment (OAT) tapering involves a gradual reduction in daily medication dose to ultimately reach a state of opioid abstinence. Due to the high risk of relapse and overdose...

Health Care Utilization for Common Shoulder Disorders: Analysis of the 2010–2019 National Patient Sample Data from the Health Insurance Review and Assessment Service in Korea

Background and Objective: The aim of this study was to analyze trends in surgical and non-surgical service utilization for common shoulder disorders in Korea from 2010 to 2019. Methods and Materials: This retrospective, cross-sectional, descriptive study utilized National Patient Sample data from the Health Insurance and Review Assessment Service (HIRA) of Korea. These data constitute a 2% sample out of the entire Korean population and include data for a variety of parameters instrumental for health care research. Patients with at least one medical service use for rotator cuff syndrome or tear, impingement syndrome, or adhesive capsulitis between January 2010 and December 2019 were included. Trends in healthcare utilization by disorder type, patient demographics, seasonal service use, and treatment details were examined. Results: There was an upward trend in the total number of patients and costs for shoulder disorders, from 35,798 patients and USD 5,485,196 in 2010 to 42,558 and USD 11,522,543 in 2019, respectively. The number of patients aged ≥60 and hospital visits increased. March had the highest number of claims. Physical therapy was the most common non-surgical procedure, while nerve block claims more than doubled. Opioid prescription rates also tripled. Surgical treatments were dominated by shoulder rotator cuff repair and acromioplasty. Conclusion: There was a significant increase in healthcare utilization for shoulder disorders, marked by rising costs and patient numbers. The use of nerve blocks and opioids notably increased. These data are valuable for clinicians, researchers, and policymakers.

The Heart Does Not Itch, But it Feels Pain: Three Cases of Kounis Syndrome

Background: Kounis syndrome is defined as the occurrence of acute coronary artery syndrome as a result of activation of inflammatory cells after conditions such as allergy, hypersensitivity, anaphylaxis or anaphylactic reactions. This case reports were presented to provide the latest knowledge on Kounis syndrome, increase awareness of this disease among healthcare providers and researchers, and promote early and appropriate diagnosis and management of this syndrome. Summary of Cases: In the first case, a 45-year-old female patient with no history of coronary artery disease developed anaphylaxis due to a locally applied anesthetic drug. This led to transient coronary artery vasospasm and acute coronary syndrome. In the second case, a 70-year-old male patient with a history of coronary artery disease developed anaphylaxis due to a bee sting. This caused rupture of the coronary artery plaque, resulting in inferior myocardial infarction. In the third case, a 73-year-old male patient with a stent in his coronary artery developed an allergic reaction/anaphylaxis to midazolam, which was administered for sedation before the biopsy procedure. This reaction resulted in restenosis of the old stent and caused an anterior myocardial infarction. Conclusion: Kounis syndrome is a life-threatening condition that requires attention. Ensuring coronary artery patency in the treatment of ischaemia is important to protect cardiomyocyte health and prevent arrhythmias. Ischaemia caused by allergens can be resolved with a combination of antiallergenic treatments. Therefore, for effective management of suspected cases of Kounis syndrome, collaboration between cardiology and allergy-immunology clinics is essential.