Medicine Literature Research Articles

Structure-property Relationships Reported for the New Drugs Approved in 2023.

Drug-like properties play pivotal roles in drug adsorption, distribution, metabolism, excretion, and toxicity. Therefore, efficiently optimizing these properties is essential for the successful development of novel therapeutics. Understanding the structure-property relationships of clinically approved drugs can provide valuable insights for drug design and optimization strategies. Among the new drugs approved in 2023, which include 31 small-molecule drugs in the US, the structureproperty relationships of nine drugs were compiled from the medicinal chemistry literature, in which detailed information on pharmacokinetic and/or physicochemical properties was reported not only for the final drug but also for its key analogs generated during drug development. The structure- property relationships of nine newly approved drugs are summarized, including three kinase inhibitors and three G-protein-coupled receptor antagonists. Several optimization strategies, such as bioisosteric replacement and steric handle installation, have successfully produced clinical candidates with enhanced physicochemical and pharmacokinetic properties. The summarized structure- property relationships demonstrate how appropriate structural modifications can effectively improve overall drug-like properties. The ongoing exploration of structure-property relationships of clinically approved drugs is expected to offer valuable guidance for developing future drugs.

Rates of Reporting and Analyzing Race and Ethnicity in Athlete-Specific Sports Medicine Research: A Systematic Review.

Race- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear. To determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature. Systematic review; Level of evidence, 4. Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, articles published by the 3 journals of the American Orthopaedic Society for Sports Medicine between 2017 and 2021 were considered for inclusion. Original sports medicine research studies that focused on athletes were included. Outcome measures included reporting and analysis of patient demographics (age, sex, race, ethnicity). Studies that included demographic variables in a multivariate analysis or that performed a race-/ethnicity-based stratified analyses were considered to have analyzed that variable. Studies that reported and/or analyzed patient demographics were examined. Chi-square tests were performed to determine statistical significance. A total of 5140 publications were screened, and 842 met the inclusion criteria. Age and sex were well reported (84.1% and 87.0%, respectively), while race (3.8%) and ethnicity (2.0%) were poorly reported. There was no difference in rates of reporting age, sex, race, or ethnicity between the American Journal of Sports Medicine (AJSM), the Orthopaedic Journal of Sports Medicine (OJSM), or Sports Health: A Multidisciplinary Approach (Sports Health). The rate of analysis was also calculated as a percentage of the studies that reported that variable. Of the studies that reported age, 38.5% analyzed age. Using this method, 26.2% of studies analyzed sex, 40.6% analyzed race, and 17.6% analyzed ethnicity. Although there was no difference in the overall rate at which studies from the 3 journals analyzed ethnicity, Sports Health studies analyzed age (P = .044), sex (P = .001), and race (P = .027) more frequently than studies published in AJSM and OJSM. Of the studies that analyzed race, most of those studies (8/13, 61.5%) found significant race-based differences in reported outcomes. This systematic review demonstrated that race and ethnicity are poorly reported and analyzed in athlete-specific sports medicine literature, despite the fact that a majority of studies analyzing race found significant differences between racial groups. Improved reporting of race and ethnicity can determine whether race- and ethnicity-based differences exist in patient interventions to ameliorate disparities in patient outcomes.

Straddling the Line Between In Vitro and Ex Vivo Investigations.

Tissue engineering research fundamentally relies on experiments to advance knowledge, utilizing various models for research on both humans and animals. With scientific progress, experimental models have become increasingly complex over time. This complexity sometimes blurs the distinction between categories, making terminology less consistent. In biomedical research, three overarching terms are commonly used to characterize experimental environments: in vitro, ex vivo, and invivo. While in vitro translates from Latin as "in glass," referring historically to experimental conditions in a test tube or petri dish, invivo experiments occur within a living organism's natural environment. Conversely, ex vivo originates from living tissue outside its host environment while striving to maintain conditions as close to the host surroundings as possible. In the tissue engineering and regenerative medicine (TE&RM) community, there needs to be more clarity between in vitro and ex vivo terminology, with historical definitions sometimes disregarded and new terms often introduced without rigorous scientific justification. At this juncture, the question arises of when to refer to experiments as in vitro or ex vivo or whether the terms may be used synonymously in some instances. Moreover, what criteria must ex vivo experiments meet to be legitimately defined as such? This perspective is intended to address questions that would assist the TE&RM community in better understanding the differences between in vitro and ex vivo models. Impact Statement In the tissue engineering & regenerative medicine literature, the terms "in vitro" and "ex vivo" are often used interchangeably to describe experiments. This interchangeable usage can lead to a compromised interpretation of research results and, consequently, misleading scientific conclusions and teachings. This perspective aims to provide clarity on the various definitions of experimental designs. It also highlights the issue of using terms with inconsistent meanings that have origins dating back to the distant past. It's important to note that scientific definitions constantly evolve, and there is a scientifically rooted responsibility to evaluate and rethink the current state of affairs critically.

Validating, Implementing, and Monitoring Machine Learning Solutions in the Clinical Laboratory Safely and Effectively.

Machine learning solutions offer tremendous promise for improving clinical and laboratory operations in pathology. Proof-of-concept descriptions of these approaches have become commonplace in laboratory medicine literature, but only a scant few of these have been implemented within clinical laboratories, owing to the often substantial barriers in validating, implementing, and monitoring these applications in practice. This mini-review aims to highlight the key considerations in each of these steps. Effective and responsible applications of machine learning in clinical laboratories require robust validation prior to implementation. A comprehensive validation study involves a critical evaluation of study design, data engineering and interoperability, target label definition, metric selection, generalizability and applicability assessment, algorithmic fairness, and explainability. While the main text highlights these concepts in broad strokes, a supplementary code walk-through is also provided to facilitate a more practical understanding of these topics using a real-world classification task example, the detection of saline-contaminated chemistry panels.Following validation, the laboratorian's role is far from over. Implementing machine learning solutions requires an interdisciplinary effort across several roles in an organization. We highlight the key roles, responsibilities, and terminologies for successfully deploying a validated solution into a live production environment. Finally, the implemented solution must be routinely monitored for signs of performance degradation and updated if necessary. This mini-review aims to bridge the gap between theory and practice by highlighting key concepts in validation, implementation, and monitoring machine learning solutions effectively and responsibly in the clinical laboratory.

Integrating the Thrifty Genotype and Evolutionary Mismatch Hypotheses to understand variation in cardiometabolic disease risk

Abstract More than 60 years ago, James Neel proposed the Thrifty Genotype Hypothesis to explain the widespread prevalence of type 2 diabetes in Western, industrial contexts. This hypothesis posits that variants linked to conservative energy usage and increased fat deposition would have been favored throughout human evolution due to the advantages they could provide during periods of resource limitation. However, in industrial environments, these variants instead produce an increased risk of obesity, metabolic syndrome, type 2 diabetes, and related health issues. This hypothesis has been popular and impactful, with thousands of citations, many ongoing debates, and several spin-off theories in biomedicine, evolutionary biology, and anthropology. However, despite great attention, the applicability and utility of the Thrifty Genotype Hypothesis (TGH) to modern human health remains, in our opinion, unresolved. To move research in this area forward, we first discuss the original formulation of the TGH and its critiques. Second, we trace the TGH to updated hypotheses that are currently at the forefront of the evolutionary medicine literature—namely, the Evolutionary Mismatch Hypothesis. Third, we lay out empirical predictions for updated hypotheses and evaluate them against the current literature. Finally, we discuss study designs that could be fruitful for filling current knowledge gaps; here, we focus on partnerships with subsistence-level groups undergoing lifestyle transitions, and we present data from an ongoing study with the Orang Asli of Malaysia to illustrate this point. Overall, we hope this synthesis will guide new empirical research aimed at understanding how the human evolutionary past interacts with our modern environments to influence cardiometabolic health

Comparing observed and preferred instruction in robotic surgery

BackgroundThe unique setup of robotic surgery challenges the traditional instructional dynamic between surgical learners and teachers. Previous studies have posited difficulties such as reliance on observational learning and ease of takeover. However, we lack understanding of how these instructional challenges manifest and are perceived by learners. Improving instruction has the potential to optimize education and performance in robotic surgery. MethodsIn this qualitative study, we conducted robotic case observations and learner interviews focusing on instruction in robotic surgery. We deductively generated codes in a theory-informed manner after review of the instructional literature in surgery, medicine, and other fields. We applied these codes in a rigorous directed content analysis of field notes and transcripts to identify themes. ResultsThirty-eight faculty, fellows, and residents participated in 10 robotic cases and 20 semistructured interviews. Observed practices on the basis of case observations differed substantially from preferred practices on the basis of interview data. Using 37 codes, we identified 4 main themes related to instruction in robotic surgery: contextualization, individualization, autonomy, and multimodality. We contrasted observed and preferred instruction in each of these areas to generate instructional considerations that may better align preferences and practices. ConclusionsWe observed several suboptimal instructional practices that contradicted preferred ways of learning. We suggested robotic-specific instructional considerations such as using multimodality to promote active learning and to reduce ambiguity. We also provided considerations applicable to all types of surgery, such as to include rationale to promote learning consolidation and to frame operative steps to allow trainees to plan their participation.

Assessing the impact of history of medicine research: A scientometric and altmetric analysis.

After conducting a comprehensive literature search of two medical electronic databases, PubMed and Embase, as well as two citation databases, Web of Science Core Collections (WoS) and Scopus, we aimed to conduct an Altmetric and Scientometric analysis of the History of Medicine literature in medical research. The following software tools were used for analyzing the retrieved records from PubMed and Embase databases and conducting a collaboration analysis to identify the countries involved in scientific medical papers, as well as clustering keywords to reveal the trend of History of Medicine research for the future. These software tools (VOSviewer 1.6.18 and Spss 16) allowed the researchers to visualize bibliometric networks, perform statistical analysis, and identify patterns and trends in the data. Our analysis revealed 53,771 records from PubMed and 54,405 records from EMBASE databases retrieved in the field of History of Medicine by 105,286 contributed authors in WoS. We identified 157 countries that collaborated on scientific medical papers. By clustering 59,995 keywords, we were able to reveal the trend of History of Medicine research for the future. Our findings showed a positive association between traditional bibliometrics and social media metrics such as the Altmetric Attention Score in the History of Medicine literature (p < 0.05). Sharing research findings of articles in social scientific networks will increase the visibility of scientific works in History of Medicine research, which is one of the most important factors influencing the citation of articles. Additionally, our overview of the literature in the medical field allowed us to identify and examine gaps in the History of Medicine research.

Effects of CO₂ on the occurrence of decompression sickness: review of the literature.

Inhalation of high concentrations of carbon dioxide (CO₂) at atmospheric pressure can be toxic with dose-dependent effects on the cardiorespiratory system or the central nervous system. Exposure to both hyperbaric and hypobaric environments can result in decompression sickness (DCS). The effects of CO₂ on DCS are not well documented with conflicting results. The objective was to review the literature to clarify the effects of CO₂ inhalation on DCS in the context of hypobaric or hyperbaric exposure. The systematic review included experimental animal and human studies in hyper- and hypobaric conditions evaluating the effects of CO₂ on bubble formation, denitrogenation or the occurrence of DCS. The search was based on MEDLINE and PubMed articles with no language or date restrictions and also included articles from the underwater and aviation medicine literature. Out of 43 articles, only 11 articles were retained and classified according to the criteria of hypo- or hyperbaric exposure, taking into account the duration of CO₂ inhalation in relation to exposure and distinguishing experimental work from studies conducted in humans. Before or during a stay in hypobaric conditions, exposure to high concentrations of CO₂ favors bubble formation and the occurrence of DCS. In hyperbaric conditions, high CO₂ concentrations increase the occurrence of DCS when exposure occurs during the bottom phase at maximum pressure, whereas beneficial effects are observed when exposure occurs during decompression. These opposite effects depending on the timing of exposure could be related to 1) the physical properties of CO₂, a highly diffusible gas that can influence bubble formation, 2) vasomotor effects (vasodilation), and 3) anti-inflammatory effects (kinase-nuclear factor and heme oxygenase-1 pathways). The use of O₂-CO₂ breathing mixtures on the surface after diving may be an avenue worth exploring to prevent DCS.

Topic Modeling Analysis of Chinese Medicine Literature on Gastroesophageal Reflux Disease: Insights into Potential Treatment

Topic Modeling Analysis of Chinese Medicine Literature on Gastroesophageal Reflux Disease: Insights into Potential Treatment

Evaluation of retracted articles in the field of emergency medicine on the web of science database

BackgroundThe retraction of articles stands as the most significant mechanism employed to uphold the integrity of science, particularly in flawed studies. ObjectivesThis study aims to explore the reasons for article retractions in the field of emergency medicine and elucidate the problems arising from such retractions. The goal is to identify parameters in retracted articles that compromise scientific knowledge and raise awareness. Material and methodsRetracted articles within the emergency medicine category were analyzed and assessed using the Web of Science database. The study sought to address the following questions: 1. In which year or years were the most articles retracted? 2. In which journals were the retracted articles published? 3. What is the distribution of topics in retracted articles? 4. What are the reasons for the retraction of articles? 5. What is the time difference and citation count between the publication and retraction years of the articles? ResultsThe study delved into reasons for article retractions, types of retracted articles, and other relevant factors. A total of 61 retracted articles were examined and analyzed, revealing an increasing trend in the rate of article retractions over the years. The majority of retracted articles occurred in 2023, with the highest retraction rate identified in the “Emergency Medicine International” journal. On average, articles were retracted 356 days after publication. Reasons for retracted articles included concerns related to data, authorship issues, plagiarism, duplication, and biased or fraudulent peer review. ConclusionsThis study provided an examination of retracted articles in the field of emergency medicine, highlighting a noteworthy increase in retractions due to various reasons. Despite retractions, it was observed that the citation counts of retracted articles increased. The growing number of retracted articles and frequent citations pose potential dangers from a scientific perspective, as citing retracted articles damages scientific integrity. The study underscores the importance of understanding the reasons for retracted articles and preventing the spread of such incidents in emergency medicine literature. The results, analyzed within various variables, indicate the need for further research and solutions, guiding future research efforts and contributing to the literature.

Ziabetus (Prediabetes): A Harbinger of Critical Stage in the Continuum of Glucose Metabolism Disorder: A Review

Background: Prediabetes is a metabolic condition characterized by blood glucose levels higher than normal but below the threshold for diabetes mellitus. It represents a critical stage in the progression towards type 2 diabetes mellitus (T2DM) and is associated with an increased risk of cardiovascular disease and other complications. The two major pathophysiologic defects responsible for losing glucose tolerance are insulin resistance and β-cell glucose insensitivity, both appearing in subjects of Intermediate Hyperglycaemia. In classical literature, Unani physicians have described the initial symptoms and factors leading to the pathology, the risk factors are described in terms of ‘Su-e-mizaj’ as per the concept of Tibb. So, it is considered in the context of Ziabetus which is described as a disease that develops due to Sue-mizaj haar (abnormal hot temperament). The symptoms mentioned in Unani medicine are increased frequency of micturition (ants and flies are attracted to urine), increased thirst, nocturia, dryness of mouth and whole body, fatigue, loss of weight, malaise, and cramps in lower extremities. The modern drug-based approach for the management of Intermediate Hyperglycaemia is associated with inherent drawbacks, including toxicity, tolerability, cost, and efficacy. Objective: The purpose of this review is to provide an in-depth understanding of prediabetes concerning the classical literature of Greek medicine based on the analysis of certain parameters like etiopathophysiology, current diagnostic criteria, risk factors, and evidence-based management strategies. By synthesizing findings from epidemiological studies, and clinical trials, this paper aims to enhance understanding of prediabetes and facilitate effective preventive measures and interventions. Keywords: Prediabetes, Intermediate hyperglycaemia, Impaired Glucose Tolerance, Impaired Fasting Glucose, Insulin Resistance.

Influential literature in tennis medicine and science

This study examined the most influential peer-reviewed journal articles and books in tennis medicine and science based on citations (C). Systematic searches were performed to extract authors, titles, year, journal, C, and research focus for the top cited publications indexed in Google Scholar (GS). The top 100 articles had high numbers of citations (85 to 1,164) and citation rates (3 to 41 C/year) that were similar between tennis medicine and science, with fewer citations to tennis books. The influence of tennis research has increased over the last decade, with citations and citation rates were higher than was previously reported (Knudson, 2012). The study confirmed important research topics and journal outlets and identified influential authors. Influential tennis research continues to focus on injuries, physiological and psychological factors, with recent increases in analytics and business aspects of the sport.

Dance-specific eligibility of vocational ballet students - examinations at a governmental training institution for classical ballet

During their training, pre-professional ballet students are confronted with physical stresses comparable to those of competitive sports. In competitive sports, there are mandatory and binding aptitude tests to ensure that the growing athlete meets the requirements. In ballet, there are no such mandatory examinations preceding the start of training. For adult professional dancers, musculoskeletal ideals could be isolated from the dance medicine literature. However, only a few studies describe musculoskeletal characteristics of pre-professional ballet students. It is neither known at what age a student should meet the ideal measurements for an adult nor what deviations from the ideal can be considered normal. This study aims to describe sociodemographic and musculoskeletal characteristics of pre-professional ballet students and discusses to what extent they already meet or deviate from dance-specific eligibility criteria for adult professional ballet dancers. In this study, n = 414 female and n = 192 male students of John Cranko School (JCS) were seen by an experienced orthopaedist and dance physician. Mean age was 13.9 years (SD 3.5, range 5-22 years). Their medical history was taken (age; nationality; start of ballet/training) and a physical examination was performed (height/weight; symmetry of shoulder girdle, spine, waist triangles; pelvic tilt; tibial torsion; range of motion of base of index finger joint, spine, hips, ankle and base of great toe joint). Subsequently, the results of this study were compared with suitability criteria for adult professional ballet dancers that had been isolated from the dance medicine literature for a previous article. Examinees were from 49 different nations. 34.6% of the female subjects (≥16 years) were between 165 and 170 cm and 33.3% of the male subjects (≥18 years) were between 178 and 185 cm tall. 45.0% of those examined showed low body weight (<10th percentile, BMI <18.5 kg/m²). The trunk of 61.0-84.8% of those examined was erect and symmetrical. 25.2% had scoliosis. Half (53.5%) were found to have a bilateral external rotation of the hips of at least 60°, and 68.7% had a bilateral internal rotation between 20 and 50°. 87.3% exhibited a bilateral tibial torsion between 15 and 40°. A bilateral en dehors of 90° was calculated for 25.0%. In 9.1% of those examined, the upper ankle joints presented a dorsiflexion of at least 25°, and in 70.2%, a plantarflexion of at least 70° was seen. In 88.0%, the metatarsophalangeal joint of the great toe was 90° (f) and 80° (m) on both sides. The results of this study showed that pre-professional ballet students fulfil many characteristics of adult professional ballet dancers. High values already among young age groups suggest a ballet-specific selection. Nevertheless, not all students fulfil the theoretical "ideal measurements" for professional classical ballet. These anatomical limits should be considered individually in training to protect the growing pre-professional ballet dancer. The high ballet-specific anatomical demands, but especially the large number of students with a low body weight, underline the necessity of mandatory aptitude tests at the beginning and regular check-ups in the course of training to avert compensatory mechanisms and their consequential damage and to screen for eating disorders and disorders of eating behaviour.

Presentations, management and outcomes of postoperative bariatric patients seen in the emergency department

BackgroundBariatric surgery is becoming increasingly common and postoperative patients often present to the emergency department (ED) with complications. We sought to describe the presenting complaints, management, and outcomes of postoperative bariatric surgery patients seen in the ED. MethodsWe conducted a health records review of 300 consecutive postoperative Roux-en-Y bypass surgery patients who presented to two tertiary care EDs of a major bariatric surgery center within one year of surgery. Cases were identified using a data analytic tool, and two evaluators abstracted clinical variables, imaging, treatments, and outcomes using the electronic health record. Attending emergency physicians verified the data and an experienced bariatric surgeon interpreted the computed tomography (CT) results and surgical procedures. ResultsWe included 300 patients with mean age 43.0 years, 89.7% female. Of these, 70.0% presented within 30 days of surgery and 41.7% were admitted to hospital. ED treatments included intravenous fluids (67.0%), antiemetics (53.3%), and analgesia (61.9%). Patients presenting within 30 days of surgery were more likely to undergo a CT (74.3% vs 63.3%; p = 0.06) and to have clinically important CT findings (31.9% vs 6.6%; p ≤0.001). More of the ≤30-day patients were admitted to hospital (46.2% vs 31.1%; p = 0.02). While a higher proportion of patients presenting after 30 days underwent a procedure, a large number of those were not directly related to bariatric surgery, such as appendectomy and cholecystectomy. Of the 34 patients undergoing a procedure, the majority presented with abdominal pain (76.5%). ConclusionThis is the first detailed health records review of postoperative bariatric patients seen in the ED in the emergency medicine literature. Those presenting with abdominal pain were more likely to undergo CT abdomen and a surgical procedure. Similarly, those presenting within 30 days of surgery were more likely to have significant CT findings and require hospital admission. Others presenting with primarily nausea and vomiting may improve with ED symptom management and be discharged home with bariatric team follow-up.

337 Bridging the Literacy Gap for Surgical Consents: An AI-Human Expert Collaborative Approach

INTRODUCTION: Despite the importance of informed consent in healthcare, the readability and specificity of consent forms often impedes patients’ comprehension. Health literacy is linked to patient outcomes, making it essential to address these issues. METHODS: Consent forms from multiple institutions were assessed for readability and simplified using GPT-4, with pre- and post-simplification readability metrics compared using nonparametric tests. Independent reviews by medical authors and a malpractice defense attorney were conducted. Finally, GPT-4's potential for generating de novo procedure-specific consent forms was assessed, with forms evaluated using a validated 8-item rubric and expert subspecialty surgeon review. RESULTS: Analysis of 15 academic medical centers' consent forms revealed significant reductions in average reading time, word rarity, and passive sentence frequency (all P &lt; 0.05) following GPT-4-faciliated simplification. Readability improved from an average college freshman to an 8th-grade level (P = 0.004), matching the average American's reading level. Medical and legal sufficiency consistency was confirmed. GPT-4 generated procedure-specific consent forms for five varied surgical procedures at an average 6th-grade reading level. These forms received perfect scores on a standardized consent form rubric and withstood scrutiny upon expert subspeciality surgeon review. CONCLUSIONS: This study demonstrates the first AI-human expert collaboration to enhance surgical consent forms, significantly improving readability without sacrificing clinical detail. Moreover, the framework we utilize here can be employed broadly to improve the accessibility of all patient-facing literature in medicine, emphasizing clear communication and mitigating disparities related to health literacy barriers. Ensuring AI technologies are safely incorporated into clinical practice is crucial to reach a wide range of patients, including the most vulnerable.

Time to Reflect on Return to Sport Timing Following ACL Reconstruction.

The time of return to sport following anterior cruciate ligament (ACL) reconstruction is a commonly discussed topic within clinical settings and the sports medicine literature. Emerging science has demonstrated protective effects of delaying the time of sport clearance on athlete reinjury. Though a single time cutoff is unlikely to be applicable for all athletes, large inconsistencies in the time of return to sport clearanceare present in both the literature and withinprescribed clinical protocols. A multitude of patient factors, such as perceived function, objective function, confidence, post-operative goals, among others, are vital for how athletes are progressed and released for sport participation. This Current Opinion article is constructed to discussthe time to return to sport after ACL reconstruction-factors that may influence timing decisions, how time is assessed within the scientific literature-and to promote discussion on this common topic within the sports medicine and athletic communities. The aim of the article is not to establish defined clinical time cutoffs for this population.

Emergency Department Doppler Assessment of a Central Retinal Artery Occlusion: Case Report.

Vision loss is a symptom found frequently in patients presenting to the emergency department (ED). Central retinal artery occlusion (CRAO) is an uncommon yet time-sensitive and critical cause of painless vision loss in which delayed diagnosis can lead to significant morbidity. Emergency medicine literature documents the ability to diagnose a CRAO using ultrasound by identifying the hyperechoic thrombus-coined the retrobulbar spot sign. We present the case of a patient presenting with painless monocular vision loss for which CRAO was diagnosed in the ED using point-of-care ultrasound enhanced by the utilization of serial Doppler examinations as well as calculation of the central retinal artery resistive index. Despite the pre-existing literature on point-of-care ultrasound investigation of central retinal artery occlusion, there are no emergency medicine case reports describing serial examination of the central retinal artery by spectral Doppler or calculation of arterial resistive index to improve this evaluation and monitor progression of the pathology.

Proparacaine Overuse in Corneal Abrasions at the Emergency Department: A Case Series.

Corneal abrasions are among the most common ophthalmic injuries in the emergency department (ED) and primarily present as severe ocular pain. Topical anesthetics provide temporary analgesia, but overuse is associated with complications including further corneal injury, infection, and vision loss. This case series describes three patients who used a 15-mL bottle of 0.05% proparacaine hydrochloride ophthalmic solution after discharge from the ED and returned within three days with corneal injury and pain. Although the use of topical anesthetics is traditionally discouraged by ophthalmologists, publications in the emergency medicine literature support their use. We review the literature surrounding topical anesthetic use in the ED setting and caution against prescribing patients topical anesthetics for corneal abrasions, particularly without patient counseling and significant restriction of anesthetic supply.

INDIAN COSTUS IN ISLAMIC, AYURVEDA, TCM AND MODERN MEDICINE, A REVIEW ON ANTIMICROBIAL ACTION

Indian Costus species has been mentioned as an herbal remedy for infections in Islamic, Ayurveda and Traditional Chinese Medicine (TCM) literature as well. Using the Indian costus to treat disease is one of the cross-cultural practices, just like cupping therapy and meditation. This would mean that it is safe and beneficial. In the saying (Hadith) of the prophet of Islam, it was prescribed to treat pharyngitis and pleurisy (Ahmad et al., 2009). In TCM, Costus root (Guang Mu Xiang) powder is used to treat gastroenteritis and tenesmus (Nystrom, 2015). In Ayurveda, it is used as a spasmolytic and antiparasitic for intestinal disease (Pandey et al., 2007). Among the pharmacological benefits of costus is the antimicrobial effect. This includes the antibacterial, antiviral, antifungal and antiparasitic action of the substances to be discussed here. We did a focus on the antimicrobial effect in the three systems, compared and concluded findings through modern medicine to verify the evidence here.

Exploring Doctor-Patient Dynamics: The Mediating Role of Doctor's Empathy and the Moderating Effect of Treatment Effectiveness on Doctor-Patient Communication, Trust, and Satisfaction

This research investigates a conceptual model proposing how doctor-patient communication, doctor’s empathy, and treatment effectiveness influence patient-doctor trust and satisfaction. Conducting quantitative analyses of survey responses from 250 participants in the United States, the study tests these hypotheses. The findings demonstrate that effective doctor-patient communication significantly increases patient-doctor trust and satisfaction. Doctor’s empathy is identified as a crucial mediating factor that intensifies this impact of communication on trust. Interestingly, the study reveals a notable moderating effect of treatment effectiveness, suggesting that higher treatment effectiveness diminishes the dependence on a foundation of doctor-patient trust when achieving patient satisfaction. These findings emphasize the interdependent role of empathetic communication and effective treatment in patient care. The research contributes significantly to healthcare and medicine literature, offering valuable insights for researchers and practitioners focused on understanding and improving patient satisfaction, healthcare delivery, and outcomes.