Medical Research Articles

Hepatoprotective Potential of Indian Medicinal Plants.

The liver is essential for both the body's removal of waste materials and the metabolism of nutrients, it is critical for sustaining general health. However, a number of factors, including viral infections, immune system malfunctions, cancer, alcohol intake, and drug toxicity, are contributing to the rising prevalence of liver problems. Alternative approaches to liver disease treatment are being investigated due to the potential limitations of conventional medical treatments. In this regard, the possible hepatoprotective effects of medicinal plants containing bioactive chemicals high in antioxidants have drawn attention. This review's objective is to provide an overview of the Indian medicinal plants' therapeutic value. A variety of databases, including PubMed, Web of Science, Scopus, Academic Journals Embase, Google Scholar, and Science Direct, were searched for relevant literature using keywords such as "hepatoprotective," "hepatotoxins," "medicinal plants," and "phytoconstituents". This article focuses on plant-based medicines that guard against oxidative stress and pollutants, highlighting the potential of herbal remedies as alternatives to traditional liver disease treatments. Reviewing the hepatoprotective qualities of a number of medicinal plants, such as Ginkgo biloba, Woodfordia fruticosa, Thymus quinquecostatus, and Terminalia arjuna, offer more details about their effectiveness. Terminalia arjuna: Preclinical research demonstrates a 30-40% decrease in liver enzyme levels and a 50-60% rise in antioxidant indicators; clinical trials reveal a 25-30% decrease in liver enzyme levels. Thymus quinquecostatus: Research on animals shows a 35-45% decrease in liver enzymes, and preliminary clinical findings indicate a 20-30% improvement in liver function. Woodfordia fruticosa: Although clinical evidence is not as strong as preclinical trials, early investigations indicate a 25-35% improvement in liver enzymes and a 50-60% reduction in liver damage indicators. Ginkgo biloba: Shown enhanced liver function and a 40-50% decrease in liver enzymes; clinical trials have also shown improvements in liver enzymes and a 20-30% decrease in fibrosis markers in NAFLD patients. In conclusion, the increased prevalence of liver diseases emphasizes the necessity for nonconventional therapeutic options. Medicinal plants, as opposed to conventional medicines, have promising hepatoprotective effects with fewer adverse effects since they include bioactive substances such as sterols, anthocyanins, terpenoids, saponin glycosides, and polyphenolics. Clinical trials have shown the potential of some plant medications to support liver health. For example, clinical trials have demonstrated the effectiveness of Picrorhiza kurroa in treating liver disorders including viral hepatitis, with a notable decrease in liver enzyme levels. Xanthones found in Garcinia mangostana have been shown in preclinical and clinical trials to have liver-protective qualities, enhancing liver function and lowering oxidative stress indicators. Clinical research has demonstrated that citrus medica helps people with liver problems by reducing inflammation and improving liver function. Anthocyanin-rich Vaccinium myrtillus (Bilberry) has been shown to lower oxidative stress and enhance liver enzyme profiles in fatty liver disease patients. These plant-based medicines can greatly enhance the treatment arsenal for liver ailments by addressing the underlying causes and symptoms of liver diseases. In order to substantiate their role in hepatoprotection, future research should concentrate on verifying these findings through additional clinical trials.

Association of clinical knowledge with patient care ownership among resident physicians: a nationwide cross-sectional study in Japan

PurposeBoth clinical knowledge and patient care ownership (PCO) are crucial to the provision of quality patient care and should be acquired during training. However, the association between these two concepts is under-examined. Here, we conducted a nationwide cross-sectional study to investigate the association between clinical knowledge and PCO among resident physicians in Japan.MethodsFrom January 17 to March 31, 2024, we conducted an anonymous, online, self-administered survey for a series of PCO research projects. The survey targeted medical residents who took the General Medicine In-Training Examination (GM-ITE). The mean of the Japanese version of the PCO Scale was used as outcome variable. The primary explanatory variable was total GM-ITE score, while the secondary explanatory variables were GM-ITE category scores in medical knowledge. We conducted multivariable linear regression analysis, controlling for postgraduate years, sex, number of assigned inpatients, weekly working hours, type of hospital, and size of hospital.ResultsWe included 1836 participants in our statistical analysis. Multivariable linear regression analysis revealed that after adjustment for possible confounders, GM-ITE total scores showed a significantly negative association with PCO in the highest score quartile (adjusted mean difference − 0.20, 95% confidence interval (CI) -0.33 to -0.07, compared with the lowest score quartile). Additionally, after controlling for possible confounding factors, scores for symptomatology and clinical reasoning showed a dose-dependent negative association with PCO (adjusted mean difference − 0.17, 95% CI -0.30 to -0.03 for the highest score quartile compared with the lowest score quartile). No significant dose-dependent associations were found for the other categories.ConclusionsThese findings suggest the presence of potential challenges in the simultaneous fostering of clinical knowledge and PCO during residency training. This underscores the need for educators to actively engage in the reconsideration of current postgraduate training strategies, with the aim of effectively cultivating both clinical knowledge and PCO among medical residents.

China’s national continuing medical education program for general practitioners: a cross-sectional survey (2016–2023)

BackgroundPursuing excellence in healthcare delivery systems is an ongoing process. In this process, continuing medical education (CME) is essential for medical professionals to maintain high standards of patient care. In China, where the healthcare sector is undergoing considerable reforms and faces challenges owing to socioeconomic development and demographic shifts, an effective CME system is vital for general practitioners (GPs).MethodsA cross-sectional survey of CME programs was conducted between 2016 and 2023. The external characteristics of the programs were systematically gathered and statistically analyzed. The programs were subsequently subjected to a competency-based assessment by using the six core competencies outlined by the American Board of Medical Specialties and the Accreditation Council for Graduate Medical Education as a framework. Furthermore, keywords were extracted for the CME program names based on the International Classification of Primary Care. Visual analysis was performed via VOSviewer software, facilitating a content-based evaluation of the programs.ResultsA total of 6,607 items were obtained. A total of 3,815 CME programs were subjected to statistical analysis, and 2,895 CME programs were comprehensively evaluated for content and capability. A diverse range of CME providers were identified, with hospitals and publishing/education companies being the primary providers. Since 2019, a significant increase in online CME offerings has been noted. However, the regional distribution of the CME programs was uneven, with Shanghai, Zhejiang, and Beijing leading but western China lagging. Furthermore, most programs focused on patient care and medical knowledge in competency-based CME evaluations, with less emphasis on interpersonal and communication skills. Content-based CME evaluations revealed that the teaching focus is the diagnosis, treatment, and primary care management of elderly patients and chronic diseases such as diabetes and hypertension.ConclusionsOur findings underscore the essential role of CME in equipping GPs with the competencies required to navigate the evolving landscape of medical knowledge and practice, suggesting a more systematic, relevant, and individualized approach to training GPs. Therefore, there is an opportunity to increase the quality of primary care and contribute to the Healthy China 2030 Plan.

The case of Wellness Valley: promoting physical activity and exercise medicine for a sustainable health care system

ABSTRACT Today’s health care systems primarily focus on treating noncommunicable diseases (NCDs) rather than preventing them. Currently, this approach is not sustainable and requires innovative transformations to face the challenges posed by the aging population, the increasing NCD prevalence, widespread physical inactivity, and growing obesity rates. Regular physical activity and exercise improve quality of life and are effective for the prevention and treatment of numerous NCDs and to reduce health care costs. Physical activity promotion and exercise medicine thus represent cost-effective solutions for a sustainable model of health. The Wellness Valley initiative in Emilia-Romagna, Italy, exemplifies this model by fostering active, healthy lifestyles. In Wellness Valley, physical activity is promoted through multi-stakeholder initiatives of education and engagement, and exercise medicine is supported in the medical community through continuous education and dedicated infrastructure, such as certified health-promoting gyms. With these initiatives in place, the population of Wellness Valley is more physically active compared to the Italian national average. Overall, shifting health models toward preventative strategies centered on healthy active lifestyles and exercise can increase physical activity levels and contribute to alleviating the growing burden of NCDs on health care systems.

The Erythrocyte Sedimentation Rate (ESR) in Veterinary Medicine: A Focused Review in Dogs and Cats.

The erythrocyte sedimentation rate (ESR) measures the rate at which erythrocytes aggregate and sediment in a fixed time in an anticoagulated blood tube and is expressed as a speed (mm/h). The ESR is still widely used in human medicine mainly as a modified or alternate method to the original Westergren. In veterinary medicine, it was employed in the 1940s-1960s after which it was gradually abandoned or rarely employed. More papers using the Westergren method have been published in dogs rather than in cats. In recent years, the test has regained importance. This narrative review describes the principle of ESR, which is related to the increase in a few acute response proteins such as fibrinogen, immunoglobulin M, and α2-macroglobulin which act to aggregate RBCs. Reference intervals were established for dogs and cats for the original and modified Westergren method. The ESR is mainly used to detect inflammatory conditions derived from infection, urinary or orthopedic disorders, and also miscellaneous diseases. The application of the modified ESR is supported by appropriate reference intervals; however, further studies are needed to assess the influence of age, sex, and breed both for dogs and cats.

The Global Challenge of Campylobacter: Antimicrobial Resistance and Emerging Intervention Strategies.

Antimicrobial resistance (AMR) in Campylobacter species, particularly C. jejuni and C. coli, poses a significant public health threat. These bacteria, which are commonly found in livestock, poultry, companion animals, and wildlife, are the leading causes of foodborne illnesses, often transmitted through contaminated poultry. Extensive exposure to antibiotics in human and veterinary medicine creates selection pressure, driving resistance through mechanisms such as point mutations, horizontal gene transfer, and efflux pumps. Resistance to fluoroquinolones, macrolides, and tetracyclines complicates treatment and increases the risk of severe infections. Drug-resistant Campylobacter is transmitted to humans via contaminated food, water, and direct contact with animals, highlighting its zoonotic potential. Addressing this challenge requires effective interventions. Pre-harvest strategies like biosecurity and immune-based methods reduce bacterial loads on farms, while post-harvest measures, including carcass decontamination and freezing, limit contamination. Emerging approaches, such as bacteriocins and natural antimicrobials, offer chemical-free alternatives. Integrated, multidisciplinary interventions across the food chain are essential to mitigate AMR transmission and enhance food safety. Sustainable agricultural practices, antimicrobial stewardship, and innovative solutions are critical to curbing Campylobacter resistance and protecting global public health. Our review examines the dynamics of antimicrobial resistance in Campylobacter and presents current strategies to mitigate Campylobacter-related AMR, offering valuable insights for antimicrobial control in the poultry industry.

Pharmacodynamic Profiling of Amoxicillin: Targeting Multidrug-Resistant Gram-Positive Pathogens Staphylococcus aureus and Staphylococcus pseudintermedius in Canine Clinical Isolates.

The rising threat of antimicrobial resistance (AMR) is a global concern in both human and veterinary medicine, with multidrug-resistant (MDR) pathogens such as Staphylococcus aureus and Staphylococcus pseudintermedius presenting significant challenges. Background/Objectives: This study evaluates the effectiveness of amoxicillin against these MDR pathogens in canine isolates using pharmacokinetic and pharmacodynamic parameters. Methods: Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and mutation prevention concentration (MPC) were assessed. Additionally, time-kill assays and post-antibiotic effect (PAE) assessments were performed. Epidemiological cutoff (ECOFF) values were established for both species to guide therapy. Results: S. aureus had a higher resistance rate (35.89%) than S. pseudintermedius (15.27%), with MIC50 values of 0.50 μg/mL and 0.25 μg/mL, respectively. The MPC analysis revealed that S. pseudintermedius required higher antibiotic concentrations (16.11 μg/mL) to prevent mutations compared to S. aureus (2.20 μg/mL). Time-kill assays indicated that higher amoxicillin dosages caused faster bacterial reduction. The PAE analysis showed extended post-treatment bacterial suppression at elevated doses, particularly against S. aureus. Conclusions: Species-specific amoxicillin dosing strategies are necessary due to differing resistance and susceptibility profiles between S. aureus and S. pseudintermedius. High-dose amoxicillin therapy is recommended to achieve optimal therapeutic outcomes for resistant SA, while slightly adjusted dosing can manage S. pseudintermedius infections. These findings provide essential insights for veterinary antimicrobial stewardship, underscoring the need for tailored therapeutic approaches to minimize AMR development while ensuring effective infection control.

Medical Problems of Chronic Hypoxia in Highlanders Living on the Tibetan Plateau.

Ri-Li Ge. Medical problems of chronic hypoxia in highlanders living on the tibetan plateau. High Alt Med Biol. 00:00-00, 2024.-Health issues at high altitudes arise due to the lower atmospheric pressure and subsequent reduction in the partial pressure of oxygen in ambient air. While much research has been published on health problems of lowlanders who move to high altitudes, less is known about the medical challenges faced by long-term and permanent high-altitude residents, especially in the Qinghai-Tibetan plateau. In this review, we briefly summarized the chronic hypoxia-related health issues in highlanders, focusing on the specific population of the Qinghai-Tibetan plateau. It deals with important health problems for highlanders, including the main disease categories, from chronic mountain sicknesses and pulmonary hypertension (PH) to kidney, neurocognitive impairments, perinatal problems, and congenital heart defect. However, the most hallmark of disorders is excessive erythrocytosis associated with specific symptoms and signs, and high-altitude heart disease is characterized by excessive PH, right ventricular hypertrophy, and right heart failure. We also provide information on potential treatment strategies, including some traditional Tibetan medical practices and also a combination of Western medicine and traditional Chinese medicine to prevent and treat these conditions effectively. This mini-review is heavily based on a couple of decades of research carried out by Chinese high-altitude medical research groups at the Qinghai-Tibetan Plateau. We believe that this review will provide valuable perspective to researchers whose study interest and base lie in high altitude.

Online resources for ankle sprains : AGerman language web analysis

With the Internet as the main source of information for health content, the quality of websites with medical information is of high importance. This study analysed 250 websites on acute ankle sprain (ASD), one of the most common musculoskeletal disorders, for their quality and readability. Based on the results, aguide for patients was created. The quality of the websites was assessed using a25-item content score and the EQIP36 score for medical information material. The reading level could be determined using the Flesch-Kincaid index and the calculated readability. The best three websites were evaluated in auser survey. Of the 250 websites recorded 77 were included in the study. The quality of these varied significantly, with none achieving the maximum score. Sources in the healthcare system showed higher quality, while commercially influenced sites were below average in terms of completeness of content. Only 14% of the websites reached the recommended reading level. Asignificant negative correlation was found between completeness of content and readability. The user survey showed amixed level of satisfaction and participants with previous medical knowledge were more critical than laypersons. Online resources about ASD are suboptimal and differ considerably. Deficiencies in content, readability and structure were identified, which limit the effective use by patients. Health information publishers should work harder to improve the comprehensibility and quality of the information provided.

The 6th Year of the Study of Human Medicine is Mainly Orientated to Practice: a Pilot Study with a Digital Logbook

Digital learning resources are in increasing demand, especially in the light of the planned reform of the medical licensing regulations for 2028. In a pilot project, we digitised and evaluated a logbook for students in their practical year (PJ).The aim of this study is to evaluate the digital and non-digital PJ logbooks.Based on a printed PJ logbook, a digital PJ logbook was developed as a web app. The implementation was performed using the commercial enterprise knowledge management system Confluence (Atlassian Corporation, Sydney, Australia), which allows responsive design, integration with the university's user directory, and incorporation of corporate design. Student satisfaction (n=34) was assessed using questionnaires and a 5-level Likert scale. Additionally, students self-assessed their skills at the beginning and end of the rotation before (n=49) and after (n=34) the introduction of the digital logbook by grade points.The majority of students found the digital logbook to be an intuitive and a valuable addition. In the stationary setting, the introduction of the digital logbook led to a significant improvement in self-assessed skills by 0.73 grade points at the beginning (p<0.001) and 0.78 grade points at the end of the rotation (p<0.001). In the operating theatre, there was only a significant improvement of 0.47 grade points at the beginning of the rotation (p=0.027).The evaluation demonstrates that the digital PJ logbook is well-received by students and significantly improves their self-assessed skills. The observed increase in self-assessed skills could be attributed to the introduction of the digital logbook and its contents, although other factors, such as the engagement of the instructors, cannot be excluded. Future modifications are planned to make the logbook more appealing.

Chinese and western medicine treatment of myocardial fibrosis drugs.

Myocardial fibrosis (MF) is a common pathological manifestation of many cardiovascular diseases, such as myocardial infarction, myocardial ischemia, and sudden cardiac death. It is characterized by excessive proliferation and activation of fibroblasts, transformation into myofibroblasts, and, eventually, excessive deposition of the extracellular matrix, resulting in heart damage. Currently, modern drugs such as angiotensin-converting enzyme inhibitors, diuretics, and β-blockers can improve myocardial fibrosis in clinical treatment, but their therapeutic effect on this disease is limited, with obvious side effects and high cost. Traditional Chinese medicine (TCM) has the advantages of multiple targets, low cost, and few side effects. Traditional Chinese medicines, such as Salvia miltiorrhiza, Astragalus, and Angelica extracts, and patent Chinese medicines, such as Qiliqiangxin capsules, Shenqi Yiqi dropping pills, and Tongxinluo capsules, can improve myocardial fibrosis. In this review, current Chinese and Western medicine methods for treating myocardial fibrosis are discussed. The signaling pathways and targets of Chinese and Western medicine are involved in the treatment of myocardial fibrosis. This review aimed to provide valuable insights and ideas for both clinical treatment and basic research on myocardial fibrosis.

Utilization of Cannabidiol in Post-Organ-Transplant Care.

Cannabidiol (CBD) is one of the major phytochemical constituents of cannabis, Cannabis sativa, widely recognized for its therapeutic potential. While cannabis has been utilized for medicinal purposes since ancient times, its psychoactive and addictive properties led to its prohibition in 1937, with only the medical use being reauthorized in 1998. Unlike tetrahydrocannabinol (THC), CBD lacks psychoactive and addictive properties, yet the name that suggests its association with cannabis has significantly contributed to its public visibility. CBD exhibits diverse pharmacological properties, most notably anti-inflammatory effects. Additionally, it interacts with key drug-metabolizing enzyme families, including cytochrome P450 (CYP) and uridine 5'-diphospho-glucuronosyltransferase (UGT), which mediate phase I and phase II metabolism, respectively. By binding to these enzymes, CBD can inhibit the metabolism of co-administered drugs, which can potentially enhance their toxicity or therapeutic effects. Mild to moderate adverse events associated with CBD use have been reported. Advances in chemical formulation techniques have recently enabled strategies to minimize these effects. This review provides an overview of CBD, covering its historical background, recent clinical trials, adverse event profiles, and interactions with molecular targets such as receptors, channels, and enzymes. We particularly emphasize the mechanisms underlying its anti-inflammatory effects and interaction with drugs relevant to organ transplantation. Finally, we explore recent progress in the chemical formulation of CBD in order to enhance its bioavailability, which will enable decreasing the dose to use and increase its safety and efficacy.

Controversies around the treatment of peritoneal metastases of colorectal cancer.

In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology. Surgical resection for peritoneal metastases from colorectal cancer (CRC) has been gradually accepted in the medical oncology community. A randomized trial (PRODIGE 7) on cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal origin. Nevertheless, isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the liver. Another tool is required in those patients to achieve more local control of the disease. Surgical groups in peritoneal surgery continue to use HIPEC in their procedures, using other agents than oxaliplatin for peritoneal cavity infusion, such as mitomycin C. These patients present with complex surgical issues to manage, and consequently a large burden of complications has to be anticipated. Therefore, identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

Reducing medical cannabis use risk among Veterans: A descriptive study

BackgroundCanadian Veterans experiencing chronic pain report concerns about accessing accurate information on the risks associated with medical cannabis (MC) use. The Lower Risk Cannabis Use Guidelines (LRCUG) were developed to equip individuals who use cannabis recreationally with safer-use strategies. Many of the harm reduction recommendations for recreational cannabis use are relevant and important considerations for MC use. The primary objective of our study was to assess Canadian Veterans’ awareness of and interest in the LRCUG, and engagement in potential higher-risk MC use behaviours.MethodsCanadian Armed Forces Veterans living with chronic pain (N = 582) were recruited online and through the Chronic Pain Centre of Excellence for Canadian Veterans. Participants completed measures on: cannabis use (never, past, current use), sources of cannabis knowledge, mental health, and awareness of and interest in receiving the LRCUG. Chi-Square and post-hoc analyses characterized the sample and assessed for demographic differences based on cannabis use status and awareness of the LRCUG. Engagement in higher-risk MC use behaviours were aligned to LRCUG recommendations, and detailed descriptively.ResultsVeterans who currently use cannabis were more likely to be unemployed (z = 3.62, p < .01), released as a Non-Commissioned Officer (z = -3.83, p < .01), and unable to work due a disability (z = -3.43, p < .01) than Veterans who do not currently use. Less than 30% of Veterans were aware of the LRCUG, with greater awareness among individuals who currently use cannabis (n = 356). Engagement in higher-risk MC use behaviours that contradicted LRCUG recommendations ranged from ~ 9% to ~ 85%. Approximately 9% of Veterans experienced co-morbid mental health concerns, yet their MC use was not for mental health purposes (LRCUG recommendation #7). Additionally, almost 85% of Veterans engaged in daily MC use (LRCUG recommendation #5). The majority of Veterans who currently use cannabis engaged in two or more higher-risk MC use behaviours (60.2%; LRCUG recommendation #12). Almost half of all Veterans received their cannabis information from a healthcare provider or the internet.ConclusionsOur study suggests the importance of safer use guidelines tailored for MC use. Development of lower-risk MC use guidelines can support prescribing practitioners and Veterans with information needed for safer and better-informed MC use decisions, tailored to patients’ needs and circumstances.

Complementary and Alternative Medicine Use among Dermatology Outpatients in Southeastern Nigeria: A Tertiary Hospital Study

Background: Complementary and Alternative Medicine (CAM) is widely used globally, including among dermatology patients. CAM includes different practices not typically part of conventional medicine and is classified into five categories, including biologically based therapies and mind-body interventions. Despite its popularity, little is known about CAM usage patterns among dermatology outpatients in Southeastern Nigeria. Aim: This study aimed to assess the prevalence, the sociodemographic characteristics of dermatology outpatients using CAM and reasons for its usage. Study Design: Cross-sectional study. Place and Duration of Study: Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria, between August to November 2022. Methodology: We recruited 212 dermatology outpatients through convenient sampling. Data were collected using interviewer-administered structured questionnaires capturing sociodemographics, dermatological conditions, and CAM usage patterns.Data analysis was performed using SPSS™ Version 23.0, with chi-square tests determining associations between variables at a significance level of P &lt; 0.05. Results: Among 212 participants recruited, the prevalence of CAM use was 34.4%. The median age was 28 years, and more females (56.1%) than males (43.9%) used CAM. Acne (17.8%), psoriasis (16.4%), and mycoses (11%) were the most common conditions among CAM users. Biologically based therapies, particularly plant-based products like aloe vera, were the most frequently used CAM. Family recommendations (16%) and perceived safety (12.3%) were key reasons for CAM use. CAM usage was significantly associated with longer disease duration (P &lt; .001). Conclusion: The high prevalence of CAM use among dermatology outpatients in Southeastern Nigeria highlights the need for clinicians to recognize and consider alternative therapies in patient care. Understanding the patterns of CAM use can also guide clinicians in advising patients on safe and evidence-based alternatives. Future research on the efficacy and safety of CAM in dermatology is crucial to develop comprehensive, evidence-based treatment strategies that encompass both conventional and complementary therapies.

DOCTORS DIFFER: A PHILOSOPHICAL PERSPECTIVE

The phrase "Drs differ" acknowledges the inherent uncertainty and variability in medical practice. This paper explores the complexities of medical decision-making through two case studies, highlighting the importance of patient-centered care and the need for nuanced understanding of medical knowledge.

Exploring the contribution of integrated healthcare practices to malaria control in Ghana: perspectives of medical herbalists

BackgroundThe integration of herbal and orthodox medicines has gained momentum in global health, ensuring improved management of infectious diseases like malaria. This study explored the experiences of medical herbalists working in Ghana’s diverse ecological zones to understand the contributions of integrated healthcare to malaria control.MethodsA phenomenological design was employed to conduct in-depth interviews with 19 purposively sampled medical herbalists. Framework analytical approach and Donabedian’s conceptual framework for quality of care were utilised in analysing the data.ResultsFindings revealed high awareness of integrated healthcare practices among participants. Medical herbalists perceived integrated care as instrumental in enhancing malaria management through factors such as improved quality assurance, increased accessibility to integrated health facilities, patient-centred care, follow-up practices, and opportunities for continuous professional development. However, structural and process-related challenges were identified, including inadequate healthcare personnel, medicines, and equipment. Additionally, limited promotional activities, non-comprehensive National Health Insurance Scheme (NHIS), and ineffective referral systems were recognised as barriers hindering the effectiveness of the integrated system and its potential contribution to malaria control.ConclusionAlthough national and health system-based challenges have thwarted the importance of integration on malaria control, medical herbalists feel optimistic about the intervention. To optimise the effectiveness of integrated healthcare in controlling malaria in Ghana would require policy modification and implementation. Future research could focus on developing healthcare frameworks, particularly for malaria, that prioritise quality service delivery within an integrated system.

Nonacademic predictors of China medical licensing examination

BackgroundNational Medical Licensing Examination (NMLE) is the entrance exam for medical practice in China, and its general medical knowledge test (GMKT) evaluates abilities of medical students to comprehensively apply medical knowledge to clinical practice. This study aimed to identify nonacademic predictors of GMKT performance, which would benefit medical schools in designing appropriate strategies and techniques to facilitate the transition from medical students to qualified medical practitioners.MethodsIn 1202 medical students, we conducted the deletion-substitution-addition (DSA) and structural equation model (SEM) analyses to identify nonacademic predictors of GMKT performance from 98 candidate variables including early life events, physical conditions, psychological and personality assessments, cognitive abilities, and socioeconomic conditions. The candidate variables were assessed using psychometrically or cognitively validated and accepted instruments.ResultsWe identified seven nonacademic predictors for GMKT performance. Body mass index (BMI) and working memory reaction time showed direct negative effects on GMKT performance. Psychological and personality features (conscientiousness, state anxiety, and openness to experience) indirectly affected GMKT performance via BMI, while socioeconomic conditions (father’s education and mother’s occupation) indirectly affected GMKT performance by influencing psychological and personality features and further BMI.ConclusionThe identified nonacademic predictors for GMKT performance and their pathways may be useful for improving medical education by strengthening favorable and weakening, rectifying, or compensating unfavorable factors that are modifiable.

Novel Strategies for the Treatment of Lung Cancer: An In-depth Analysis of the Use of Immunotherapy, Precision Medicine, and Artificial Intelligence to Improve Prognoses.

Therapeutic hurdles persist in the fight against lung cancer, although it is a leading cause of cancer-related deaths worldwide. Results are still not up to par, even with the best efforts of conventional medicine, thus new avenues of investigation are required. Examining how immunotherapy, precision medicine, and AI are being used to manage lung cancer, this review shows how these tools can change the game for patients and increase their chances of survival. In the fight against cancer, immunotherapy has demonstrated encouraging results, especially in cases of small cell lung cancer [SCLC] and non-small cell lung cancer [NSCLC]. A key component in improving T cell responses against tumours is the use of immune checkpoint inhibitors, which include PD-1/PD-L1 and CTLA-4 blockers. Cancer vaccines and CAR T-cell therapy are two examples of adoptive cell therapies that might be used to boost the immune system's ability to eliminate tumours. In order to improve surgical results and decrease recurrence, neoadjuvant immunotherapy is being investigated for its ability to preoperatively reduce tumours. Precision medicine tailors treatment based on individual genetic profiles and tumour features, boosting therapeutic efficacy and avoiding unwanted effects. For certain types of non-small cell lung cancer [NSCLC], targeted treatments based on mutations in genes including EGFR, ALK, and ROS1 have shown excellent results. When it comes to optimizing treatment regimens, biomarker-driven approaches guarantee that the patients most likely to benefit from particular medicines are selected. Artificial intelligence [AI] is revolutionizing lung cancer care through increased diagnostic accuracy, prognostic assessments, and therapy planning. Machine learning algorithms examine enormous information to detect trends and forecast outcomes, permitting individualized treatment techniques. AI-driven imaging tools enable early diagnosis and monitoring of disease progression, while predictive models assist in evaluating therapy responses and potential toxicity. The convergence of these advanced technologies holds promise for overcoming the constraints of conventional therapy. Combining immunotherapy with targeted treatments and utilizing AI for precision medicine delivers a multimodal approach that tackles the heterogeneous and dynamic nature of lung cancer. The incorporation of these new tactics into clinical practice demands cross-disciplinary collaboration and continuing study to develop and confirm their effectiveness. The synergistic application of immunotherapy, precision medicine, and AI constitutes a paradigm shift in lung cancer management. These discoveries provide a robust basis for individualized and adaptable therapy, potentially altering the prognosis for lung cancer patients. Ongoing research and clinical studies are vital to unlocking the full potential of these technologies, paving the way for enhanced therapeutic outcomes and improved quality of life for people battling this tough disease.

Experiences of healthcare professionals returning to work post breast cancer diagnosis in China: A descriptive qualitative study

Breast cancer survivors face employment challenges. How to promote BC’s return to work is important for improving their quality of life and promoting recovery. Numerous studies have reported that BC survivors encounter employment challenges due to cognitive limitations, alongside factors. healthcare Professional has a good educational background and a good cognitive level and is also the closest combination of sociocultural tradition and healthcare systems, however, there is a lack of studies on their experience as BC survivors. A descriptive qualitative study was conducted to investigate the experiences of healthcare professionals returning to work following breast cancer diagnosis. 20 doctors and nurses were interviewed face-to-face with a semi-structured interview guide in three municipal hospitals. Four major themes and corresponding sub-themes were extracted from the collected data as follows: (1) Return to Work: Willingness and Conflicts; (2) Cancer Progression Anxiety; (3) Physical and Mental Re-Awareness, including (1) Decreased Physical Ability, (2) Frustration and Diminished Self-Esteem; 4. Reflection and Re-planning, including (1) Past Self-Questioning, (2) Active Life Re-planning, (3) Revitalizing Life’s Value, and (4) Career Changes: Coping and Adapting. This study revealed a positive reintegration into the workforce among participants in China’s healthcare professionals with a notably advanced medical understanding. It implies that, for BC survivors, a combination of rich medical knowledge, a stable work environment, substantial income, and robust support from colleagues and superiors play a positive role in enhancing their adaptability post a breast cancer diagnosis. Additionally, interviewees expressed guilt during sick leave, it was suggested that hospitals implement comprehensive support mechanisms related to leave, acknowledging the imperative need for adequate rest during the treatment period.