Medical Research Research Articles

Assessing the prevalence and impact of preserved ratio impaired spirometry in low-income and middle-income countries: a post-hoc cross-sectional analysis

More than 90% of the morbidity and mortality from chronic respiratory disease occurs in low-income and middle-income countries (LMICs), with substantial economic impact. Preserved ratio impaired spirometry (PRISm) is a prevalent lung function abnormality associated with increased mortality in high-income countries. We aimed to conduct a post-hoc analysis of a cross-sectional study to assess the prevalence of, the risk factors for, and the impact of PRISm in three diverse LMIC settings. We recruited a random, age-stratified and sex-stratified sample of the population in semi-urban Bhaktapur, Nepal; urban Lima, Peru; and rural Nakaseke, Uganda. Quality-assured post-bronchodilator spirometry was performed to American Thoracic Society standards and PRISm was defined as a forced expiratory volume in one second (FEV1) of less than 80% predicted with a FEV1/forced vital capacity ratio of 0·70 or more. We used t tests and χ2 analyses to assess the relationships between demographic, biometric, and comorbidity variables with PRISm. Multivariable logistic models with random intercept by site were used to estimate odds ratios (ORs) with 95% CIs. 10 664 participants were included in the analysis, with a mean (SD) age of 56·3 (11·7) years and an equal distribution by sex. The prevalence of PRISm was 2·5% in Peru, 9·1% in Nepal, and 16·0% in Uganda. In multivariable analysis, younger age (OR for each decile of age 0·87, 95% CI 0·82-0·92) and being female (1·37, 1·18-1·58) were associated with increased odds of having PRISm. Biomass exposure was not consistently associated with PRISm across sites. Individuals with PRISm had impairment in respiratory-related quality of life as measured by the St George's Respiratory Questionnaire (OR by decile 1·18, 95% CI 1·10-1·25). The prevalence of PRISm is heterogeneous across LMIC settings and associated with age, female sex, and biomass exposure, a common exposure in LMICs. A diagnosis of PRISm was associated with worse health status when compared with those with normal lung function. Health systems in LMICs should focus on all spirometric abnormalities as opposed to obstruction alone, given the disease burden, reduced quality of life, and size of the undiagnosed population at risk. Medical Research Council.

Evaluation and Management of Idiopathic Unilateral Footdrop.

We evaluated patients who were followed after acutely developing single-sided footdrop and improving with conservative management or spontaneously. In 2019 and 2020, ten patients were retrospectively evaluated for unilateral weakness of the lower extremity in the form of absent dorsiflexion at the ankle joint and were given a diagnosis of footdrop without etiologic cause. Patients were followed for 18 months. Patients were evaluated for acute footdrop of the affected extremity with electromyography, lumbar spine magnetic resonance imaging (MRI), knee MRI, peripheral MRI neurography, and noncontrast brain MRI. Each patient was evaluated for a history of COVID-19 infection during the past year. Patients with any identified cause were excluded. Initial evaluation of muscle strength revealed 0/5 by the Medical Research Council muscle testing scale. In two patients, muscle strength was 3/5 at month 6 and in eight patients it was 4/5. Muscle strength of all of the patients improved to 5/5 at 1 year. Six patients were dispensed an ankle-foot orthosis, and nine patients performed physical therapy. Electromyography identified significant neuropathy at the level of the common peroneal at the fibular head in all of the patients. Compared with peroneal nerve stimulation below and above the fibular head in the lateral popliteal fossa, a 50% reduction in sensory amplitude and motor conduction slowing greater than 10 m/sec were present. Knee MRI revealed no masses, edema, or anatomical variations at the level of the fibular head. Spontaneous resolution of unilateral acute footdrop without an etiologic cause can occur within 1 year.

Estimates of the burden of human rabies deaths and animal bites in India, 2022–23: a community-based cross-sectional survey and probability decision-tree modelling study

Reliable and recent data of human rabies deaths and animal bites are not available in India, where a third of global cases occur. Since there is a global target of eliminating dog-mediated human rabies by 2030, understanding whether the country is on track is essential. We aimed to estimate the animal-bite burden and the number of human rabies deaths in India. We conducted a community-based nationwide cross-sectional survey with a multistage cluster-sampling design from March 2, 2022 to Aug 26, 2023, covering 60 districts in 15 Indian states. The head of the household or an adult family member was interviewed to collect information about animal-bite history in family members, receipt of anti-rabies vaccination (ARV), and death following animal bite in the family. Annual animal-bite incidence along with 95% CIs were estimated after applying the sampling weights and adjusting for clustering. We estimated annual human rabies deaths using a decision-tree probability model with parameters from the community survey and laboratory data on rabies positivity among suspected rabid dogs. Of the 337 808 individuals residing in the 78 807 households surveyed, 2052 gave a history of animal bite, mostly (1576 [76·8%]) due to dogs in the past 1 year. The weighted and adjusted annual incidence of animal bite was 6·6 (95% CI 5·7-7·6) per 1000 population, translating into 9·1 million bites nationally. Annual dog-bite incidence was 5·6 (4·8-6·6) per 1000. Among people who had been bitten by a dog, 323 (20·5%) did not receive ARV, and 1043 (66·2%) received at least three doses. Nearly half (615 [49·1%]) of the 1253 individuals who received one dose did not complete their full course of vaccination. We estimated 5726 (95% uncertainty interval 3967-7350) human rabies deaths occurring annually in India. Although there was a substantial decline in human rabies deaths over the past two decades, to eliminate dog-mediated human rabies by 2030, India needs to fast-track its actions by adopting a focused one-health approach. Integrating human and animal surveillance, ensuring timely administration of full course of post-exposure prophylaxis, and accelerating dog vaccination across the country are crucial steps towards this goal. Indian Council of Medical Research.

Practices and Barriers in Developing and Disseminating Plain-Language Resources Reporting Medical Research Information: A Scoping Review.

The intent of plain-language resources (PLRs) reporting medical research information is to advance health literacy among the general public and enable them to participate in shared decision-making (SDM). Regulatory mandates coupled with academic and industry initiatives have given rise to an increasing volume of PLRs summarizing medical research information. However, there is significant variability in the quality, format, readability, and dissemination channels for PLRs. In this scoping review, we identify current practices, guidance, and barriers in developing and disseminating PLRs reporting medical research information to the general public including patients and caregivers. We also report on the PLR preferences of these intended audiences. A literature search of three bibliographic databases (PubMed, EMBASE, Web of Science) and three clinical trial registries (NIH, EMA, ISRCTN registry) was performed. Snowball searches within reference lists of primary articles were added. Articles with PLRs or reporting topics related to PLRs use and development available between January 2017 and June 2023 were identified. Evidence mapping and synthesis were used to make qualitative observations. Identified PLRs were quantitatively assessed, including temporal annual trends, availability by field of medicine, language, and publisher types. A total of 9116 PLRs were identified, 9041 from the databases and 75 from clinical trial registries. The final analysis included 6590 PLRs from databases and 72 from registries. Reported barriers to PLR development included ambiguity in guidance, lack of incentives, and concerns of researchers writing for the general public. Available guidance recommendations called for greater dissemination, increased readability, and varied content formats. Patients preferred visual PLRs formats (e.g., videos, comics), which were easy to access on the internet and used short jargon-free text. In some instances, older audiences and more educated readers preferred text-only PLRs. Preferences among the general public were mostly similar to those of patients. Psychology, followed by oncology, showed the highest number of PLRs, predominantly from academia-sponsored research. Text-only PLRs were most commonly available, while graphical, digital, or online formats were less available. Preferred dissemination channels included paywall-free journal websites, indexing on PubMed, third-party websites, via email to research participants, and social media. This scoping review maps current practices, recommendations, and patients' and the general public's preferences for PLR development and dissemination. The results suggest that making PLRs available to a wider audience by improving nomenclature, accessibility, and providing translations may contribute to empowerment and SDM. Minimizing variability among available guidance for PLR development may play an important role in amplifying the value and impact of these resources.

Clinical results of carpal tunnel Re-release revision surgery and synovial wrap for recurrent carpal tunnel syndrome

IntroductionCarpal tunnel syndrome is a challenging condition when conventional carpal tunnel revision surgery fails to alleviate symptoms. This study aims to assess the outcomes of combining carpal tunnel revision surgery with a synovial wrap for cases of recurrent carpal tunnel syndrome in patients who had adhered median nerve, with a minimum 1-year follow-up. Patients and methodsA retrospective analysis was conducted on 10 patients (mean age: 73.7 years, nine females and one male) who underwent treatment for recurrent carpal tunnel syndrome. The approach involved carpal tunnel revision surgery coupled with a median nerve synovial wrap. Patients were followed up for a minimum of 1 year. The procedure involved harvesting a 3.5 cm × 4 cm section of the flexor synovial membrane with a distal ulnar pedicle, which was then wrapped around the adherent site of the median nerve. Physical assessments included the pain visual analogue scale (VAS), Tinel sign in the carpal tunnel, thenar muscle atrophy, the Semmes-Weinstein monofilament test (SW test), manual muscle test (MMT) as assessed on the 5-point British Medical Research Council Scale (5/5, normal; 0/5, absent), and the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire. The physical variables were compared before surgery and at final follow-up. ResultsAll patients showed some improvement in SW test. The MMT for the abductor pollicis brevis showed significant improvement at final follow-up (3 for four patients, 4 for four patients, and 5 for two patients) compared to pre-surgery assessments (2 for six patients, 3 for two patients, and 4 for two patients). The mean VAS score and DASH score at final follow-up (13.0 ± 10.3, 19.3 ± 12.7, respectively) were significantly lower than those recorded before surgery (76.5 ± 11.1, 52.4 ± 17.1, respectively). The Tinel sign and the thenar muscle atrophy significantly improved from before surgery to final follow-up. ConclusionCarpal tunnel release with a synovial wrap demonstrated significant improvements in muscle strength, pain relief and function. The synovial wrap method is an effective procedure for treating recurrent carpal tunnel syndrome.

Generative artificial intelligence usage by researchers at work: Effects of gender, career stage, type of workplace, and perceived barriers

The integration of generative artificial intelligence technology into research environments has become increasingly common in recent years, representing a significant shift in the way researchers approach their work. This paper seeks to explore the factors underlying the frequency of use of generative AI amongst researchers in their professional environments. As survey data may be influenced by a bias towards scientists interested in AI, potentially skewing the results towards the perspectives of these researchers, this study uses a regression model to isolate the impact of specific factors such as gender, career stage, type of workplace, and perceived barriers to using AI technology on the frequency of use of generative AI. It also controls for other relevant variables such as direct involvement in AI research or development, collaboration with AI companies, geographic location, and scientific discipline. Our results show that researchers who face barriers to AI adoption experience an 11 % increase in tool use, while those who cite insufficient training resources experience an 8 % decrease. Female researchers experience a 7 % decrease in AI tool usage compared to men, while advanced career researchers experience a significant 19 % decrease. Researchers associated with government advisory groups are 45 % more likely to use AI tools frequently than those in government roles. Researchers in for-profit companies show an increase of 19 %, while those in medical research institutions and hospitals show an increase of 16 % and 15 %, respectively. This paper contributes to a deeper understanding of the mechanisms driving the use of generative AI tools amongst researchers, with valuable implications for both academia and industry.

Developing the Society of Obstetric Medicine Australia and New Zealand (SOMANZ) Hypertension in Pregnancy Guideline 2023: Guideline development approaches, challenges and contextual considerations

AbstractThe Society of Obstetric Medicine Australia and New Zealand (SOMANZ) Hypertension in Pregnancy Guideline 2023 is the first evidence‐based guideline for hypertensive disorders of pregnancy that has been developed to the standards of the Australian National Health and Medical Research Council (NHMRC). This article describes the methodology, challenges and considerations in developing the guideline and includes details on group composition, literature search, evidence synthesis and development of recommendations. We also discuss several practical considerations and challenges related to contextual issues, topics of interest and resources available for guideline developers working with similar jurisdictions or topics.

Development of Protocol for the Indian Council of Medical Research (ICMR) task force study to strengthen the implementation of National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) in tribal population.

Understanding the health culture of tribal community is important as health problems among tribal communities and their care is influenced by sociocultural factors, which will help in the implementation of health services. The conventional way of improving the access for the general populations may not suit the tribal populations owing to their distinct culture and owing to health systems factors as well. A stepwise process was followed for the development of a protocol to study to strengthen the implementation of National Programme for Prevention and Control of Non-Communicable Diseases. The study was planned to be carried out across six tribal districts of India. A detailed protocol was built around Implementation Research Logic Model, primarily as a method for planning, executing, reporting, and synthesizing the implementation.

Chest wall resection and reconstruction for primary chest wall sarcomas: Analysis of survival, predictors of outcome, and long-term functional status

ObjectivesWe aimed to analyze survival, predictors of outcome, and the long-term functional status of patients with a diagnosis of primary chest wall sarcoma who undergo chest wall resection and reconstruction. MethodsWe analyzed a prospectively maintained database, including all patients operated on between 2008 and 2021. The primary outcome measures were overall and disease-free survival and analyses were employed to determine the risk factors for poor survival and recurrence. ResultsOne hundred thirty-nine patients were included, 55% were men. The majority (96%) had an R0 resection and 75.1% had no postoperative complications up to 30 days postprocedure; median length of hospital stay was 7 days (range, 6-10 days). Median overall and disease-free survival was 58.8 and 53.6 months, respectively. For those alive, at long-term follow-up, 80% had a Medical Research Council dyspnea score of 0 and Karnofsky index >80%. Survival and mortality rates were better in chondrosarcomas compared with nonchondromatous sarcomas (P < .05). Previous history of radiotherapy, previous history of cancer, the type of sarcoma (Ewing's or soft tissue), the need for adjuvant treatment and tumor grade were significant predictors of mortality and recurrence on univariate testing. Extended resection, a higher number of ribs removed, and the incidence of postoperative complications were significantly associated with a worse postoperative Medical Research Council dyspnea score. ConclusionsCareful patient selection and multidisciplinary decision making is crucial. This leads to clear resection margins, good overall, and disease-free survival and good functional outcomes.

Comparison of functionality, physical activity, cardiac and respiratory parameters between patients with mood disorders and healthy controls

Background The cardiorespiratory effect in mental illnesses has recently received much attention. However, the cardiovascular and pulmonary effects of mood disorders have not been clearly demonstrated. Aims This study aims to compare individuals with mood disorders and healthy people in terms of exercise capacity, functionality, respiratory muscle strength, pulmonary function, dyspnoea and physical activity level. Method This cross-sectional study involved 30 patients with mood disorders and 35 age- and gender-matched healthy individuals. Exercise capacity (6-Minute Walk Test (6MWT), 3-Minute Step Test (3MST)), functionality (vertical jump test, functional reach test), respiratory parameters (respiratory muscle strength, pulmonary function test), dyspnoea (Modified Medical Research Council Dyspnoea Scale) and physical activity level (Short-Form International Physical Activity Questionnaire (IPAQ)) were evaluated. Results 6MWT results (P &lt; 0.001) and functional test scores (vertical jump test, P = 0.006; functional reach test, P &lt; 0.001) were significantly lower, and heart rate recovery after 3MST (P &lt; 0.001) was higher in mood disorder patients. Although patients' respiratory parameters were lower than healthy individuals, only measured and predicted respiratory muscle strength (P &lt; 0.001), peak expiratory flow rate litres (P &lt; 0.001), forced vital capacity predicted (P = 0.010) and forced expiratory volume in 1 s predicted (P = 0.002) values were statistically significantly different. Dyspnoea with activities was higher in patients (P &lt; 0.001). Patients spent more time sitting (IPAQ, P &lt; 0.001), but overall physical activity levels were similar between the two groups (P &gt; 0.05). Conclusions Patients with mood disorders had decreased exercise capacity and pulmonary function, lower functionality scores and respiratory muscle strength, and increased dyspnoea. Exercise-based rehabilitation protocols are recommended for the management of risk factors affecting the mood disorder patients' cardiorespiratory status.

Techquity: digital pathways to reach all people for medical research

Techquity: digital pathways to reach all people for medical research

Shibasaburo Kitasato (1853-1931): Pioneer of Japanese Medicine and Global Immunology Innovator.

Shibasaburo Kitasato (1853-1931), a pivotal figure in modern Japanese medicine, made groundbreaking contributions to bacteriology and immunology. His achievements include pure cultivation of the tetanus bacillus and the development of serum therapy, which continue to influence modern immunology and vaccination strategies. Kitasato established the Institute for Infectious Diseases in Japan, the Kitasato Institute, played a crucial role in establishing the Keio University School of Medicine, and served as the first president of the Japan Medical Association. His international collaboration with Robert Koch and Emil von Behring elevated Japan's status in global medical research. Kitasato's research philosophy emphasizes clinical applicability and passionate pursuit of effective topics, inspiring the generation of prominent Japanese medical researchers. This study highlights Kitasato's life, work, and enduring impact on medical research, education, and healthcare administration. Kitasato's legacy, commemorated on the new 1000-yen banknote in 2024, continues to serve as an inspiration for contemporary medical professionals worldwide.

A Review on Synthesis and Biological Activities of 2‐Aminophenol‐Based Schiff Bases and Their Transition Metal Complexes

ABSTRACT2‐Aminophenol‐based Schiff bases and their metal complexes have drawn a lot of interest because of their wide range of biological activity and their uses in several fields. These Schiff bases are synthesized through the condensation of 2‐aminophenol and various carbonyl compounds, and metal complexes formed easily by coordinating Schiff bases with transition metal ions possess a wide range of intriguing properties that have rendered them promising candidates in biomedical research. These compounds have a diverse array of captivating biological properties including antibacterial, antifungal, anticancer, and antioxidant actions. Their versatile nature and potential for tailored modifications hold the promise for innovative biomedical applications. Compared to standard antibiotics and other studied compounds, C2, C8–C11, and C116 complexes, along with L16 and L17 ligands, exhibit the highest antibacterial activity, while C3 and C115 complexes demonstrate the highest antifungal activity. The metal chelate formation of the ligands enhanced the antimicrobial activity by increasing their lipophilic nature. C66, C76, and C112 complexes and L39 ligand showed higher anticancer activity than standard anticancer drugs. The metal complexes have higher anticancer activity than the ligand due to improved permeability and cellular uptake. The anticancer activity of the complexes is related to the substituents of the Schiff base ligands. In compounds containing an electron‐withdrawing group (e.g., Cl or Br or NO2), the activity is obviously better than others. Ligands L1–L3 and L5, L6, and L32 demonstrated the most potent antioxidant activity, surpassing both metal complexes and standard conventional antioxidants. The ligands showed greater antioxidant activity than the metal complexes due to their capability of donating free protons to scavenge free radicals. More study is needed to fully explore the potential of 2‐aminophenol‐based Schiff bases and their transition metal complexes for the development of new drugs. This review summarizes different synthetic methods, biological activities, and the structure–activity relationship. This study aims to conduct further research on 2‐aminophenol‐based Schiff bases and their metal complexes.

Morphometry of adult cricoid cartilage in Nepalese cadavers: a cross-sectional observational study

Background: Cricoid cartilage is crucial during endotracheal intubation, yet its dimensions in the Nepali population remain uncharacterized. This study aimed to measure cricoid cartilage dimensions in adult Nepalese. Methods: A total of 105 cadavers (75 males, 30 females) were dissected at *** Medical Campus, Nepal. Measurements of outer and inner transverse and anteroposterior diameters, as well as heights of the cricoid arch and lamina, were taken using digital vernier calipers. Statistical analyses included gender comparisons and correlations with age. Results: The mean age of the 105 cadavers studied was 34.11 years (SD = 12.08). The measurements of outer anteroposterior diameter, outer transverse diameter, inner anteroposterior diameter, inner transverse diameter, arch height and lamina height were respectively 22mm (SD=4), 21mm (SD=4), 18mm (SD=3), 17mm (SD=3), 9mm (SD=3) and 24mm (SD=4). Inner AP (p = 0.009) and inner TR (p = 0.021) measurements correlated significantly with age. Males had significantly larger cricoid cartilage dimensions than females (p &lt; 0.001). Conclusions: This study provided essential data for selecting appropriately sized endotracheal tubes in Nepalese patients, reducing airway complications. It underscored the need to tailor medical devices to local anatomical variations, supporting advancements in biomechanical modeling and medical research.

The Importance of Statistics in Medical Healthcare

Abstract: Statistical principles play a fundamental role in shaping the landscape of medical science by providing a structured framework for analyzing data, drawing conclusions, and making informed decisions in healthcare settings. In the realm of medical research, statistical principles are crucial for designing experiments, interpreting results, and ensuring the reliability and validity of findings. Key statistical concepts like hypothesis testing, confidence intervals, regression analysis, and survival analysis are extensively utilized in medical studies to assess the effectiveness of treatments, understand disease patterns, and evaluate healthcare interventions. These principles enable healthcare professionals to make evidence-based decisions, tailor treatments to individual patient needs, and continuously improve the quality of care provided to patients. The role of statistics in medical research starts at the planning stage of a clinical trial or laboratory experiment to establish the design and size of an experiment that will ensure a good prospect of detecting effects of clinical or scientific interest. Statistics is again used during the analysis of data (sample data) to make inferences valid in a wider population. In simple situations computation of simple quantities such as P-values, confidence intervals, standard deviations, standard errors or application of some standard parametric or nonparametric tests may suffice.

A visualized and bibliometric analysis of cancer vocational rehabilitation research using CiteSpace

BACKGROUND: There are numerous publications on cancer vocational rehabilitation, visual techniques can help medical researchers and social workers be more familiar with the state of this field. OBJECTIVE: To summarize cancer vocational rehabilitation research, we applied visualized and bibliometric analysis to enable medical workers and social workers to identify evolving patterns of knowledge among articles and research trends, understand the current research status of vocational rehabilitation of cancer, and carry out further research on hot topics. METHODS: Based on a review of 933 papers on cancer vocational rehabilitation published in the Web of Science Core Collection, this study used Citespace software to systematically and objectively describe cancer vocational rehabilitation. RESULTS: Since 2003, the field of cancer vocational rehabilitation began to sprout. The most published and most cited country, institution, author and cited journal were the United States, University of Amsterdam, Angela G. E. M. de Boer, and Psycho-Oncology, respectively. The three most frequently cited keywords were breast cancer, quality of life and cancer survivor. The three keywords with the largest spike in citations were cohort, absence and symptom. Conducting randomized controlled trials or prospective cohort studies to help cancer survivors return to work, and using qualitative methods to understand the vocational rehabilitation experiences or perceptions of cancer survivors or medical staff are hotspots in this field. CONCLUSIONS: Cancer vocational rehabilitation has attracted the attention of researchers all over the world. Future studies may focus on other cancer types and explore more high quality interventions.

An activatable near-infrared fluorescent probe with large Stokes shift for visualizing peroxynitrite in Alzheimer’s disease models

Alzheimer’s disease (AD), characterized by its incurable nature and prevalence among the elderly, has remained a focal point in medical research. Increasing evidence suggests that peroxynitrite (ONOO−) serves as a crucial biomarker for the diagnosis of AD. In this study, we present a novel, easily available, high-yield, and cost-effective near-infrared (NIR) fluorescent probe, CDCI-ONOO. This probe utilizes a coumarin-dicyanoisophorone conjugate as the fluorophore and diphenylphosphinic chloride as the recognition site, enabling the detection of ONOO− both in vitro and in vivo. Upon interaction with ONOO−, CDCI-ONOO exhibits a distinct maximum emission peak at 715 nm with a substantial Stokes shift of 184 nm. The probe demonstrates excellent selectivity and sensitivity (LOD = 144 nM), along with noticeable colorimetric and fluorescence changes after the reaction. Comprehensive analyses using high-performance liquid chromatography (HPLC), high-resolution mass spectrometry (HRMS), and density functional theory (DFT) calculations confirm that the reaction with ONOO− restores the initially quenched Intramolecular Charge Transfer (ICT), resulting in the formation of CDCI-OH, a product that emitting fluorescence in the near-infrared region. Furthermore, we demonstrated the successful application of CDCI-ONOO for ONOO− detection in neuronal cells and imaging of ONOO− in the brains of mice. These findings underscore the potential of CDCI-ONOO as a near-infrared fluorescent probe for in vivo ONOO− detection, offering a significant avenue for advancing our understanding of AD pathology and diagnosis.

Raising the Academic Authority of Clinical Experience: The Department of Internal Medicine at Keijo Imperial University and Its Periodical Imsangnaegwahak.

This paper examines the periodical Clinical Internal Medicine published by the Department of Internal Medicine at Keijo Imperial University in colonial Korea. Previous studies on medical research at Keijo Imperial University have primarily focused on preclinical departments such as anatomy, hygiene, pharmacology, and microbiology which produced knowledge that supported Japan's imperialistic expansion. This approach has overlooked the research contributions of clinical departments, often viewing the roles of preclinical and clinical departments through a dichotomy between research versus clinician training. However, Clinical Internal Medicine demonstrates that the Department of Internal Medicine at Keijo Imperial University was actively engaged in research. By analyzing the purpose and content of Clinical Internal Medicine, this paper reveals that its publication was an effort by the Department of Internal Medicine to address the demand for practical knowledge among clinicians practicing outside the university. At the same time, it reflects a commitment to enhancing the academic value of clinical experience and critiques the blind pursuit of experimental medicine in the Japanese medical community in the 1920s and 1930s. The case of the Department of Internal Medicine at Keijo Imperial University illustrates the transformation of clinical experience into "worthy" academic knowledge in colonial Korea. Based on these findings, this paper provides insights into the role of clinical departments at Keijo Imperial University in research and post-graduation education.

Ethnomedical Study of Traditional Medicinal Plants for Cough and Tuberculosis (TB) of the Helong Tribe on Semau Island, Kupang Regency, East Nusa Tenggara

The Helong people in Kupang Regency, NTT Province, have experienced being exposed to cough and tuberculosis (TB). Therefore, it is believed that this community has also long since developed their local knowledge and traditional ways to prevent and treat the disease. In general, this study aims to analyze and find the concept of the Helong Tribe community and ethnomedical practices for the prevention and treatment of cough and tuberculosis (TB). This research is a medical anthropology research using a qualitative research method with an ethnographic approach, which is supported by laboratory research and literature studies. Field research was carried out on Semau Island, NTT Province, involving traditional medicine. The results of the research conducted in the form of interviews with traditional medicine practitioners in the Helong tribe obtained as many as 31 plants used in treatment, and there were 3 plants used to treat cough, including hemorrhagic cough/tuberculosis, namely plants: white banyan (Ficus benjamina L), mesocarp palm fruit (Borassus flabellifer L.) and white flower (Clerodendrum costatum R.Br). The three plants that are suspected to have the ability to treat cough and cough up blood carried out preliminary tests of antibacterial activity against bacteria that generally cause stones, namely Staphylococcus aureus bacteria. The results obtained for ethanol extract of white banyan leaves (Ficus benjamina L) with a concentration of 25% b/v with a diameter of 16.53 mm, 50% b/v with a diameter of 16.33 mm, and 75% b/v with a diameter of 16.56 mm. Mesocarp ethanol extract of palm fruit (Borassus flabellifer L.) At a concentration of 25% b/v with an inhibitory zone diameter of 11.60 mm, a concentration of 50% b/v with an inhibitory zone diameter of 12.30 mm, a concentration of 75% b/v with an inhibitory zone diameter of 13.40 mm, for white flowers (Clerodendrum costatum R.Br) at a concentration of 25%b/v with an inhibitory zone diameter of 9.41 mm, a concentration of 50% b/v of 10.36 mm and a concentration of 75% b/v of 11.24 mm. This means that the three plants have antibacterial activity against Staphylococcus aureus bacteria. Furthermore, for the antibacterial activity test against Mycobacterium tuberculosis bacteria for white banyan plants (Ficus benjamina L.), mesocarp of palm fruit (Borassus flabellifer L.), and white flowers (Clerodendrum costatum R.Br) by the MODS (Microscopically Observed Drug Susceptibility) method, it was obtained that the three plants at concentrations of 250 ppm, 500 ppm, and 1000 ppm were only seen to have the growth of Micobacterium tuberculosis bacteria in the second week. Passive control with INH observation until week IV did not see any bacterial growth, while for negative control in the first week, the growth of Mycobacterium tuberculosis bacteria was seen. It can be concluded that a concentration greater than 1000 ppm is needed for the three plants to inhibit the growth of Mycobacterium tuberculosis bacteria.

EPIDEMIOLOGY OF RESPIRATORY DISTRESS IN PRETERM NEWBORNS ADMITTED WITH RESPIRATORY DISTRESS IN NICU: A CROSS SECTIONAL STUDY

Background:Respiratory distress is one of the most common cause of newborns admitting to NICUs. The objective of this cross-sectional study was to examine the epidemiological profile of preterm neonates with respiratory distress in the NICU. It was carried out from August 2023 to July 2024 at Akash institute of medical sciences and research centre, Devanahalli, Bengaluru Rural. Materials and Methods: This cross-sectional study included 42 neonates under the age of 28 days. Respiratory distress was diagnosed using specific criteria, and detailed clinical assessments were performed to confirm the aetiology. Data on demographics, risk factors, and therapeutic modalities were collected and analysed using SPSS version 25. Results: A total number of 81 neonates are admitted in NICU for respiratory distress, 42 cases were preterm. In those preterm ,late preterm babies 33(79%) had respiratory distress, followed by moderate preterm 5(12%). Males, 23(54.76%) were more prone for respiratory distress compared to females, 19 (45.24%). LSCS ,34 (80.95%)was the major cause for respiratory distress. All cases required oxygen supportbut oxygen prongs was given to 23(54.76%) cases, CPAP was given to 16 (38.05%) cases, 3(7.14%) were mechanically ventilated. Low birth weight infants,24(57%) weremore prone for respiratory distress compared to very low birth weight 11(26%) and extreme low birth weight infants 1 (3%). 15 (35.71%) cases were not having any risk factors but 9 (21.42%) had PIH. TTNB, in 19(45.23%) cases was the most common aetiology for causing respiratory distress. Conclusion: This study underscores the necessity for heightened awareness and specialized care protocols for preterm neonates, particularly those born via LSCS and those with low birth weight, to mitigate the risks and improve outcomes associated with respiratory distress.