Issue Of Medicine Research Articles

Diagnostic value of PCR analysis of synovial fluid for the diagnosis of Lyme borreliosis in dogs

Lyme borreliosis, also known as Lyme disease, is a chronic multiorgan disease of humans and animals transmitted by ticks of the Ixodidae family and caused by a group of spirochetes Borrelia burgdorferi sensu lato. Dogs are one of the most susceptible animal species to Lyme disease. Symptoms of the disease in dogs can range from mild lameness and fever to more severe and potentially life-threatening conditions, such as kidney damage and neurological disorders. Due to the variety of clinical manifestations and the lack of a universal diagnostic approach, veterinarians often face difficulties in accurately diagnosing the disease. Therefore, improving the algorithms for diagnosing Lyme borreliosis in dogs remains an urgent issue for practical veterinary medicine. The article describes and analyzes data on two cases of dogs from Kyiv (Ukraine) that presented with musculoskeletal disorders, including lameness, swelling of the knee joints, and tenderness, which raised suspicion of Lyme borreliosis. The diagnostic tests used to confirm the diagnosis of Lyme borreliosis included clinical blood test, C-reactive protein test, cerebrospinal fluid cytology, enzyme-linked immunosorbent assay for IgM and IgG antigens to Borrelia burgdorferi sensu lato, computed tomography and PCR analysis of synovial fluid for the presence of Borrelia burgdorferi sensu lato DNA. As a result, the clinical blood test, C-reactive protein test, and cerebrospinal fluid cytology were not diagnostically important for the diagnosis of Lyme borreliosis. In both cases, serological tests for antibodies to Borrelia burgdorferi sensu lato were not positive. Computed tomography showed the development of an inflammatory process in the knee joints with the formation of osteophytes, enthesophytes, sclerosis of the articular surfaces, and an increase in the volume of synovial bursa. The final diagnosis of Lyme arthritis in both dogs was established by PCR analysis of synovial fluid from the affected joints for the presence of Borrelia burgdorferi sensu lato DNA. This study emphasizes the importance of considering Lyme borreliosis as a potential cause of musculoskeletal disorders in dogs. We also propose an expanded algorithm for the diagnosis of Lyme borreliosis in dogs with a pronounced symptom complex of Lyme arthritis using the method of PCR analysis of synovial fluid to detect the DNA of Borrelia burgdorferi sensu lato spirochetes. Key words: Lyme borreliosis in dogs, clinical cases, diagnosis, polymerase chain reaction, Borrelia burgdorferi sensu lato.

Survey Validation for Measuring Perceptions of Work-Related Factors That Influence Career Paths of Men and Women in Academic Anesthesiology.

Women's underrepresentation in positions of leadership in medicine has been attributed to environmental, structural, motivational, and situational factors. The purpose of this study was to design and validate a survey instrument based on these constructs, using a sample of men and women anesthesiologists from 3 urban academic medical centers. Following institutional review board review, survey domains were defined based on a literature review. Items were developed, and content validation was performed by external experts. Anesthesiologists at 3 academic institutions were invited to complete the anonymous survey. Validation measures were performed on the collected responses, including reliability, convergent, and discriminant validity. In addition, differences between men and women respondents were evaluated. Content validation by external experts yielded 38 items with 5-point Likert scales, defining 3 constructs: environmental (14 items), structural (13 items), and motivational (11 items) factors, with single-item measures on situational factors. Content validity indices used Cohen's Kappa coefficients, with 0.85 as the acceptance cutoff. Two hundred seventy-four anesthesiologists in 3 academic institutions received the online survey. One hundred fifteen responses were received (42% response rate), yielding 103 complete survey responses, of which 86 cases included gender. Cronbach's α reliability estimates for the environmental, structural, and motivational scale scores were .88, .84, and .64, respectively, after scale revision. Evidence of convergent (Pearson's r = 0.68; P < .001) and discriminant validity (Pearson's r = 0.017; P = .84) confirmed theoretical expectations. Gender group differences showed statistically significant differences in perceptions toward environmental but not toward structural and motivational factors. The iterative design and validation processes yielded a 3-scale survey instrument with parsimonious item sets. The preliminary evidence of construct validity and reliability fills a gap in the instrumentation literature for assessing gender issues in medicine. Findings were consistent with theoretical expectations. Women are more likely than men to experience challenges in the work environment for career advancement. No differences were found between men and women on perceived resources and overall motivation factors. Investigations should continue with larger and more diverse samples and medical specialties.

Rapid neurogenic differentiation of human mesenchymal stem cells through electrochemical stimulation

The neurogenic differentiation of human mesenchymal stem cells (hMSCs) has been substantially handicapped with the choice of chemical or electrical stimulations for long durations. We demonstrate an innovative strategy of stimulation with <1.0 V for <200 s to achieve hMSCs differentiation towards neural progenitor cells within 24 h and their commitment towards differentiation to neurons on day 3 with the use of three-electrode electrostimulation. Stimulated hMSCs (ES hMSCs) showed elevated expression of neural-specific markers and mitochondrial membrane potential. A voltage bias of ±0.5 V and ±1.0 V did not show any adverse effect on cell viability and proliferation, whereas cells stimulated with ±1.5 V showed an upsurge in the dead cell populations. With the progression of time after stimulation, a rise in mitochondrial membrane potential (MMP, ΔΨ M) was observed in the ES hMSCs and thereby generating intracellular reactive oxygen species (ROS), acting as a key messenger to induce neuronal differentiation. The stratagem may provide insightful handles to circumvent neurodifferentiation impediments, a focal issue for regenerative medicine.

Right Care, Right Now: Bringing More Critical Care to Boarding Patients in the Emergency Department.

Right Care, Right Now: Bringing More Critical Care to Boarding Patients in the Emergency Department.

How a GI Fellow Found a Following: Harnessing the Power of Social Media for Education and Fun.

Over the past fifteen years, social media has become a central part of nearly all aspects of society, including the broad field of healthcare. Over the past two years, I (the author) have created a social media platform on which I have produced video content that educates and entertains about numerous issues in healthcare and medicine. These videos have gained popularity, enabling me to develop a following of over 1 million people. With this social media platform, I have been able to educate both patients and medical trainees, dispel medical misinformation, and display a more human side of physicians in order to help patients and other healthcare workers gain a new, positive perspective on healthcare. Since users of social media typically have a limited attention span, education using social media can be challenging, though it can also be empowering since its reach can be far more extensive than what physicians typically experience in a clinical setting. Since the growing presence of social media can no longer be ignored by physicians and other healthcare professionals, it is imperative that it is understood as the powerful tool that it is for patient education and wellness.

Investigation of the crystal structure, supramolecular architecture and in-silico myelofibrosis inhibition of a triazole derivative: a structural and theoretical approach

One of the most significant issues in contemporary medicine and pharmacy is the search for efficient, low-toxic anticancer medicines. In this contrast, present work involves the synthesis of 6-(4-bromophenyl)-3-(pyridin-4-yl)-7H-[1,2,4]triazolo[3,4-b[1,3,4]thiadiazine compound and its characterization using various spectroscopic techniques. Structural and Hirshfeld surface analysis inferred that the crystal packing is stabilized by several intra and intermolecular interactions, their nature and strength are corroborated by the quantum theory of atoms in molecules analysis. The H···H and C-H···N strong intra and intermolecular hydrogen bond interactions resulted in the formation of S(5), S(6) self-motifs and R22(10), R66(42) supramolecular ring motifs. Further, the electronic properties of the molecule were obtained using the density functional theory. The charge distribution on the molecular surface are analyzed using the molecular electrostatic potential map and Fukui analysis. The intramolecular hyper conjugations, and charge delocalization in the compound are analyzed by natural bond orbital analysis. The docking studies revealed that the molecule might possess potential anticancer activity against Janus tyrosine kinase 2 protein compared to pacritinib, and in silico ADMET pharmacokinetic properties indicate adherence to Lipinski's rule of five for favorable safety profiles.

Comparable Effects on Healing between Autologous Diabetic Adipose-Derived Stem Cells and Allogeneic Normal Counterparts.

Adipose-derived stem cell (ASC) therapy is considered a promising strategy for improving impaired wound healing, especially in diabetics. Although the therapeutic potential of allogeneic ASCs from healthy donors is naturally limited, that of autologous ASCs from diabetic patients is questionable. The aim of this study was to investigate the impact of diabetic ASCs in the treatment of diabetic wounds. Diabetic ASCs (DMA) and nondiabetic ASCs were isolated from db/db and C57BL/6J mice, and characterized by immunocytochemistry, proliferation, differentiation, and gene expression assays. The effects of both ASCs on healing were investigated using 36 male 10- to 12-week-old db/db mice. Wound size was measured semiweekly until day 28, and histologic and molecular analyses were performed at day 14. Both ASCs had fibroblast-like morphology and were CD44 + /CD90 + /CD34 - /CD45 - at passage 4. Compared with nondiabetic ASCs in vitro, DMA proliferative capability was restored by passage 4 ( P > 0.05). Although DMA osteogenesis was attenuated ( P < 0.01), both ASCs had similar adipogenesis and expressions of PPARγ/LPL/OCN/RUNX2 ( P > 0.05). In vivo experiments showed that, compared with phosphate-buffered saline control, both ASCs are comparable in improving wound healing ( P < 0.0001), angiogenesis ( P < 0.05), epithelial cell proliferation ( P < 0.05), and granulation tissue formation ( P < 0.0001). In both in vitro and in vivo murine models, DMAs have shown a comparable therapeutic capacity to normal ASCs in promoting diabetic wound healing by improving angiogenesis, reepithelialization, and granulation tissue formation. These results support clinical applications of autologous ASCs in diabetic wound treatments. This work has particular surgical relevance as it highlights a theoretical and clinical pathway to use diabetic patients' own ASCs to treat their wounds, bypassing any concerns of cross-host sourcing issues in regenerative medicine.

Assessment of Differentiated Thyroid Carcinomas in French Polynesia After Atmospheric Nuclear Tests Performed by France

Due to the amount of iodine 131 released in nuclear tests and its active uptake by the thyroid, differentiated thyroid carcinoma (DTC) is the most serious health risk for the population living near sites of nuclear tests. Whether low doses to the thyroid from nuclear fallout are associated with increased risk of thyroid cancer remains a controversial issue in medicine and public health, and a misunderstanding of this issue may be associated with overdiagnosis of DTCs. This case-control study was conducted by extending a case-control study published in 2010 that included DTCs diagnosed between 1984 and 2003 by adding DTCs diagnosed between 2004 and 2016 and improving the dose assessment methodology. Data on 41 atmospheric nuclear tests conducted by France between 1966 and 1974 in French Polynesia (FP) were assessed from original internal radiation-protection reports, which the French military declassified in 2013 and which included measurements in soil, air, water, milk, and food in all FP archipelagos. These original reports led to an upward reassessment of the nuclear fallout from the tests and a doubling of estimates of the mean thyroid radiation dose received by inhabitants from 2 mGy to nearly 5 mGy. Included patients were diagnosed from 1984 to 2016 with DTC at age 55 years or younger and were born in and resided in FP at diagnosis; 395 of 457 eligible cases were included, and up to 2 controls per case nearest by birthdate and matched on sex were identified from the FP birth registry. Data were analyzed from March 2019 through October 2021. The radiation dose to the thyroid gland was estimated using recently declassified original radiation-protection service reports, meteorological reports, self-reported lifestyle information, and group interviews of key informants and female individuals who had children at the time of these tests. The lifetime risk of DTC based on Biological Effects of Ionizing Radiation (BEIR) VII models was estimated. A total of 395 DTC cases (336 females [85.1%]; mean [SD] age at end of follow-up, 43.6 [12.9] years) and 555 controls (473 females [85.2%]; mean [SD] age at end of follow-up, 42.3 [12.5] years) were included. No association was found between thyroid radiation dose received before age 15 years and risk of DTC (excess relative risk [ERR] per milligray, 0.04; 95% CI, -0.09 to 0.17; P = .27). When excluding unifocal noninvasive microcarcinomas, the dose response was significant (ERR per milligray, 0.09; 95% CI, -0.03 to 0.02; P = .02), but several incoherencies with the results of the initial study reduce the credibility of this result. The lifetime risk for the entire FP population was 29 cases of DTC (95% CI, 8-97 cases), or 2.3% (95% CI, 0.6%-7.7%) of 1524 sporadic DTC cases in this population. This case-control study found that French nuclear tests were associated with an increase in lifetime risk of PTC in FP residents of 29 cases of PTC. This finding suggests that the number of thyroid cancer cases and the true order of magnitude of health outcomes associated with these nuclear tests were small, which may reassure populations of this Pacific territory.

Regulation of oxidative stress and lipid peroxidation induced by epinephrine: The corrective role of L-Glutamic acid

Oxidative stress is related to the development of metabolic and chronic diseases. Mitigation and prevention of the oxidative stress influence remain one of the most pressing issues in biology and medicine. The objective of the research was to examine and compare the role of the glutamic acid, both individually and in combination with pyridoxine, in mitigating the oxidative stress effects elicited by epinephrine. Biochemical methods (determination of the activity of antioxidant enzymes, alanine and aspartate aminotransferases, lipid peroxidation products) and statistical methods were used in the research. The findings indicate that the additional use of L-glutamic acid, both individually and in combination with pyridoxine, allows the body to reach control values or approach them to a greater extent than in groups of animals that did not receive these substances. In particular, such data were found for the following indicators: restored glutathione, lipid hydroperoxides (third experimental group), glutathione peroxidase, thiobarbituric acid reactive substances (second and third experimental groups), superoxide dismutase (spleen, liver, brain), catalase (liver, brain). In contrast, in the first experimental group, which only experienced stress, the activity of superoxide dismutase (spleen, brain, and liver) and catalase (brain, liver, and lungs) decreased compared to the control and the second and third experimental groups. When modelling epinephrine-induced oxidative stress, L-glutamic acid, both individually and in combination with pyridoxine, demonstrated a mitigating effect on the oxidant-antioxidant imbalance, which is a key factor in the level of oxidative stress. The research has shown the potential application of L-glutamic acid for mitigating and protecting the body during states accompanied by oxidative stress

Suicide attempts among children and adolescents admitted to a Polish Emergency Department: Analysis of epidemiology, circumstances and methods of 154 cases.

Suicide attempts among pediatric patients are currently one of the most critical issues in modern psychiatry and emergency medicine, and constitute a serious public health problem that affects people of almost every age group. It is often emphasized that attempted suicide is a cry for help, and according to international studies, the pandemic year of 2020 massively impacted the frequency of suicide attempts among children. However, such studies have yet to appear in Poland. To characterize the frequency, circumstances and methods of suicide attempts among children and adolescents, and investigate their relationship with coronavirus disease 2019 (COVID-19). The study retrospectively analyzed the medical records of 154 children admitted to the Emergency Department due to suicide attempts between January 2020 and June 2021. No statistical relationship was found between the direct impact of the pandemic and suicide attempts among children and adolescents. However, age and gender influenced the methods used and the frequency of suicide attempts. Females are more likely to attempt suicide than males, and patients as young as 8 tried to take their own lives. Due to the increasing frequency of suicide attempts in children and adolescents, people at particular risk of such behaviors should be identified and provided with effective care. Unfortunately, although the vast majority of pediatric patients who attempted suicide had psychiatric consultations in the past, it did not prevent them from actively trying to end their lives. Furthermore, even children of a very young age are at risk of suicide events.

Through the Looking-Glass Door*

In Lewis Carroll’s Alice in Wonderland sequel, Through the Looking-Glass, Alice again enters a mythical world but this time by climbing through a mirror rather than falling into the rabbit’s hole (1). Within the world, she finds a book of poetry with the words written backward so that it can only be read by holding it up to the mirror. Alice wanders through a chaotic world of Queens and characters, narrowly escaping with her life only to awaken back in her armchair, safe in her own house, unclear if the adventures were dreams or reality. Alice’s journey is not unlike those of our patients as they enter the PICU. “Why, it’s a looking-glass book, of course! And if I hold it up to a glass, the words will all go the right way again.” (1) In this issue of Pediatric Critical Care Medicine, Jones et al (2) describe the implementation of a tool to facilitate team collaboration and communication as part of a larger study with a global aim to improve outcomes for critically ill children (2). Modeled after a paper Daily Goals Checklist, daily goals are written on the patient room glass door to prompt and support shared understanding of goal-directed care (3). For patients, the Liber8 Glass Door is their own looking-glass with the information appearing backward to those inside the room. Yet, it is a guide to the chaotic world of pediatric critical care that will help the patient to survive and end up safely home through supporting ICU best practices (4). “‘You couldn’t have it if you did want it,’ the Queen said. ‘The rule is, jam to-morrow and jam yesterday-but never jam to-day.’”(1) Despite knowledge that ICU care bundles similar to PICU Liber8 bundle can hasten liberation from mechanical ventilation and the ICU while improving patient outcomes (5–7), implementation in PICUs remain variable. National guidelines recommend implementing such bundles (8), yet, significant barriers derail successful implementation and/or sustainability, even for those who want it (9). The key strength of the work by Jones et al (2) is their low cost, simple, effective, and feasible tool, which could be adapted for all care settings, coupled with the “how” of implementation (paper reference). Using a straightforward implementation strategy, Pronovost’s 4Es of engagement, education, execution, and evaluation (10), they create an implementation roadmap for any team looking to employ a similar quality improvement intervention. Most remarkably, their solution masterfully maximizes the concept of visibility to all team members, including the family. The goals are shared, standardized, and no one involved in the patient’s care could claim difficulty finding them. “The Red Queen shook her head. ‘You may call it “nonsense” if you like,’ she said, ‘but I’ve heard nonsense, compared with which that would be as sensible as a dictionary!’ (1)” Plenty of pediatric critical care colleagues will, unfortunately, discount sensible projects such as the Liber8 Glass Door, citing a lack of rigorous evaluation, privacy concerns, or believing technological solutions would be better. However, as Red Queens ourselves in pediatric critical care, we stand alongside Jones et al (2) to say that sensible science is exactly what we should be leading, presenting, publishing, and sharing as a scientific community to improve patient care today. The authors outline the limits of their work and address privacy concerns on both institutional and patient levels that would be feasible within many countries including the United States. This article joins numerous others in the pediatric critical care quality improvement and implementation science realm presenting readers with a guide for leading change. Importantly but not surprisingly, like other clinical decision support interventions (11), translating this work to the electronic health record did not improve communication or compliance. “Alice laughed. ‘There’s no use trying,’ she said: ‘one can’t believe impossible things.’ ‘I daresay you haven’t had much practice,’ said the Queen. ‘When I was your age, I always did it for half-an-hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.’ (1)” To accomplish impossible things in pediatric critical care, we need to believe impossible things and realize sometimes it merely takes several simple things all put together to achieve the impossible. Then by utilizing a pragmatic approach based in implementation science, we can accomplish our goals. Engaging families and stakeholders, applying implementation methodology, and measuring our impact and outcomes is necessary to drive ongoing transformation. Studies like those of Jones et al (2) give us roadmaps for implementing change locally. We must also continue our larger learning health networks to examine generalizability of such interventions more broadly, and this collaborative science will allow us to accomplish as many as six impossible things before breakfast.

Tickle Me ECMO…Differences and Outcomes Unearthed for Kids Requiring Extracorporeal Membrane Oxygenation in Severe Acute Respiratory Syndrome Coronavirus 2-Associated Disease.

Tickle Me ECMO…Differences and Outcomes Unearthed for Kids Requiring Extracorporeal Membrane Oxygenation in Severe Acute Respiratory Syndrome Coronavirus 2-Associated Disease.

Genetic Testing for Cardiomyopathies in Japan: Embarking on a Journey of Discovery

Our understanding of the genetic contributions to heart muscle disorders has grown tremendously over the past 4 decades. The impact of genotype on cardiomyopathy diagnosis, prognosis, and treatment is well-recognized, although there remains considerable heterogeneity in approach to cardiomyopathy evaluation, access to genetic testing, availability of molecular-based therapies, and representation of diverse populations in genetic databases across the world. In this issue of the Journal of Cardiac Failure, Kubo and Kitaoka 1 Kubo T, Kitaoka H. Genetic testing for cardiomyopathy in Japan 2022: current status and issues of precision medicine. J Card Fail. Google Scholar provide insight into these issues through their appraisal of the current state of genetic evaluation of cardiomyopathies in Japan.

Delirium: The Next Vital Sign in the PICU?*

Delirium: The Next Vital Sign in the PICU?*

The hidden potential of glycomarkers: Glycosylation studies in the service of cancer diagnosis and treatment

Changes in the glycosylation process appear early in carcinogenesis and evolve with the growth and spread of cancer. The correlation of the characteristic glycosylation signature with the tumor stage and the appropriate therapy choice is an important issue in translational medicine. Oncologists also pay attention to extracellular vesicles as reservoirs of new cancer glycomarkers that can be potent for cancer diagnosis/prognosis. In this review, we recall glycomarkers used in oncology and show their new glycoforms of improved clinical relevance. We summarize current knowledge on the biological functions of glycoepitopes in cancer-derived extracellular vesicles and their potential use in clinical practice. Is glycomics a future of cancer diagnosis? It may be, but in combination with other omics analyses than alone.

A new pathogenic isolate of Kocuria kristinae identified for the first time in the marine fish Larimichthys crocea.

In recent years, new emerging pathogenic microorganisms have frequently appeared in animals, including marine fish, possibly due to climate change, anthropogenic activities, and even cross-species transmission of pathogenic microorganisms among animals or between animals and humans, which poses a serious issue for preventive medicine. In this study, a bacterium was clearly characterized among 64 isolates from the gills of diseased large yellow croaker Larimichthys crocea that were raised in marine aquaculture. This strain was identified as K. kristinae by biochemical tests with a VITEK 2.0 analysis system and 16S rRNA sequencing and named K. kristinae_LC. The potential genes that might encode virulence-factors were widely screened through sequence analysis of the whole genome of K. kristinae_LC. Many genes involved in the two-component system and drug-resistance were also annotated. In addition, 104 unique genes in K. kristinae_LC were identified by pan genome analysis with the genomes of this strain from five different origins (woodpecker, medical resource, environment, and marine sponge reef) and the analysis results demonstrated that their predicted functions might be associated with adaptation to living conditions such as higher salinity, complex marine biomes, and low temperature. A significant difference in genomic organization was found among the K. kristinae strains that might be related to their hosts living in different environments. The animal regression test for this new bacterial isolate was carried out using L. crocea, and the results showed that this bacterium could cause the death of L. crocea and that the fish mortality was dose-dependent within 5 days post infection, indicating the pathogenicity of K. kristinae_LC to marine fish. Since K. kristinae has been reported as a pathogen for humans and bovines, in our study, we revealed a new isolate of K. kristinae_LC from marine fish for the first time, suggesting the potentiality of cross-species transmission among animals or from marine animals to humans, from which we would gain insight to help in future public prevention strategies for new emerging pathogens.

Միքայել Աստապատեցու՝ Հյուսիսային Արցախի Գանձակի երկու անտիպ ձեռագրեր (18-րդ դարի երկրորդ կես) / Two unpublished manuscripts of Gandzak of Northern Artsakh of Mikael Astapatetsi (the second half of the 18th century)

The activities of the centers of writing formed in various monasteries and churches of medieval Armenia are valued in the development of the Armenian manuscript culture. The writing centers of a number of places, Dadivank (also - Dado), Amaras, Gandzasar, Gtchavank, Khanatsakh, Avetaranots, the village of Khznavar, Charekavank, Parisos Monastery, Yerits Mankants Monastery, St. Hakoba Monastery, Yeghishe Apostle Monastery, the church of St. Astvatsatsin of the village of Arajadzor, Hirher (Herher), Shushi, as well as the north-eastern part of Artsakh were known. Some of the many manuscripts written and rewritten in these writing centers have come down to us. Currently, the manuscripts are kept in the Matenadaran named after Mesrop Mashtots and the Mother See of Holy Etchmiadzin. In our scientific article, we refer to two atypical manuscripts written by Mikayel Astapatetsi in Gandzak (Northern Artsakh) in the second half of the 18th century. One of the manuscripts is called "Gospel" which was written in Persian with Armenian script. There are no miniatures, ornaments in the "Gospel" which are usually present in the sections described by the four evangelists (Matthew, Mark, Luke and John). The name of the customer is unknown. The manuscript describes the sections presented by the four evangelists: "Gospel according to Matthew", "Gospel according to Mark", "Gospel according to Luke", "Gospel according to John". There are some stories about of the birth, baptism, preaching, healings, miracles, crucifixion and resurrection of Jesus Christ written by the apostles. The next rewritten manuscript of Mikael Astapatetsi is called "Medicine". Methods for preparing various medicines from plants, the names of various diseases, the causes, the methods of the treatment, etc. were presented in the manuscript. Thanks to those manuscripts, the idea of centuries-old Armenian traditions, Christian faith, as well as Armenian folk medicine and indisputable facts was spread in some Muslim circles in that difficult period. On the other hand, this manuscript containing the valuable works of Amirdovlat Amasiatsi is an important source for the study of various issues of medieval medicine.

Effects of Pomegranate, Myrtle, Quercus Fruit, and Rhus coriaria L Extracts on Bleeding Control in Rat

Background: Management of bleeding is among the major issues in medicine, particularly during surgery. Objectives: This study investigated the effects of Pomegranate peel and flower, Myrtle, Quercus fruit, and Rhus coriaria L extracts on bleeding control in rats. Methods: In this experimental study, 32 male Wistar rats (weighing 200 - 250 g, 8-10-month-old) with free access to sufficient water and food, were randomly divided into four groups: (a) the topical application of the extracts on tail wounds (bleeding time (B.T.) measurement); (b) intraperitoneal injection of the extracts (measurement of prothrombin time (P.T.) and partial thromboplastin time (PTT) in the blood taken from the heart); (c) control group 1 (B.T. measurement on tail wounds without the topical application of the extracts); and (d) control group 2 (no intraperitoneal injection of the extracts, P.T. and PTT measurement in blood drawn from the heart). The animals in all groups received the same care and were kept under standard laboratory conditions, 12:12 h light/dark cycles, and a temperature of 23 ± 2.0°C. The data were analyzed by the one-way ANOVA and Tukey's post-hoc tests. Results: The mean of B.T. in the control group, 3.57 ± 0.20 s, was significantly higher than that in the intervention group (1.56 ± 0.13 s) (P &lt; 0.001). The mean of P.T. in the control group was not significantly different from that in the intervention group (P = 0.499). The mean of PTT in the control group (18.2 ± 24.82 s) was significantly shorter than that in the intervention group (38.00 ± 14.49 s) (P = 0.006). Conclusions: Considering the acceptable coagulant effects of the extracts of Pomegranate peel &amp; flower, Myrtle, Quercus fruit, and Rhus coriaria L. compared to the control group, it can be concluded that these extracts can be suitable adjuvant drugs for controlling bleeding. Although the coagulant effects of these extracts have been mentioned in many traditional medicine texts, human tests are required to reject or confirm their clinical effects.

Medical termination of pregnancy: A global perspective and Indian scenario.

Abortion has always been a vital issue in reproductive and legal medicine. Globally, medical termination of pregnancy (MTP) is allowed primarily on six grounds: (1) to save the life of a woman, (2) risk to the physical and mental health of a woman, (3) pregnancy due to rape or incest, (4) risk of a child being born with a serious fetal anomaly, (5) socio-economic reasons, (6) a woman's request. Most countries have standard legal abortion policies, yet there remains disparity with respect to prohibition, gestational age limit, specific grounds, etc. Abortion laws are constantly changing globally based on regional social and economic viewpoints. Recently, some countries have liberalised their abortion laws, while a few have further restricted theirs. While some countries still completely prohibit MTP. Like some others, India amended its MTP law in 2021. We consider the medico-legal and ethical issues and examine existing MTP laws both globally and as generally applied in India.

A Survey on an Effective Identification and Analysis for Brain Tumour Diagnosis using Machine Learning Technique

The hottest issue in medicine is image analysis. It has drawn a lot of researchers since it can effectively assess the severity of the condition and forecast the outcome. The noise trimming outcomes, on the other hand, have reduced with more complex trained images, which has tended to result in a lower prediction exactness score. So, a novel Machine Learning prediction framework has been built in this present study. This work also tries to predict brain tumours and evaluate their severity using MRI brain scans. Using the boosting function, the best results for error pruning are produced. The Proposed Solution function was then used to successfully complete the feature analysis and tumour prediction operations. The intended framework is evaluated in the Python environment, and a comparative analysis is performed to examine the prediction improvement score. It was discovered that an original MLPM model had the best tumour prediction precision.