Practice Of Medicine Research Articles

Financial medicine: A multi-dimensional concept moving towards contextually specific working definitions for use in the South African prehospital setting

IntroductionThe phenomenon that has been described as Financial Medicine has been occurring within the South African Healthcare sector for at least the last decade. Despite the ongoing effect of this phenomenon, there is no organised body of knowledge or formulated working definitions to guide knowledge sharing and theorisation within this research focus area. The practice of Financial Medicine exerts a deleterious effect on the South African prehospital healthcare system, and represents an area in dire need of focused research efforts. Establishing appropriate working definitions and associated taxonomy is an important first step in supporting further research efforts into this aspect of South African prehospital healthcare systems. MethodsA qualitative research methodology following a constructivist grounded theory design was used. Participants voluntarily consented to be enrolled into one-on-one in-depth interviews, and were selected using purposive and theoretical sampling techniques. Data was subjected to validated coding procedures and analysed using the constant comparative analysis approach, analytical diagramming, and supported by researcher theoretical sensitivity. ResultsA working definition for Financial Medicine is provided. Six new terms are introduced, with associated working definitions, namely Financial Medicine Practices, Treatment-based profiteering, Cost-of-care-aversion, Personal-gain-at-patient-expense, Money-racketeering-in-healthcare, and Impoverishing-healthcare-earning. ConclusionThe working definitions and suggested taxonomy presented in this article are the first step in formally conceptualising and theorising the phenomenon of Financial Medicine, in order to support further research and collaboration in this space.

Flexible endoscopic intubation in emergency medicine: A mixed-methods needs assessment.

This needs assessment aimed to improve understanding of flexible endoscopic intubation training and practice in emergency medicine (EM), providing insights to educators and practice leaders seeking to improve education and practices. We conducted a multicenter, mixed-methods needs assessment of emergency physicians (EPs) incorporating focus groups and a survey. Focus groups comprised community EPs, academic EPs, and resident EPs. We analyzed focus group transcripts using grounded theory, qualitatively describing EM endoscopic intubation. The qualitative analysis shaped our survey instrument, which we deployed in cross-sectional fashion. We report survey data with descriptive statistics. Focus groups with 13 EPs identified three themes: indications for use of endoscopic intubation, factors impacting a physician's decision to endoscopically intubate, and attaining and maintaining endoscopic intubation competency. Of 257 surveyed EPs (33% response rate), 79% had received endoscopic intubation training during residency, though 82% had performed this procedure 10 or fewer times in their career. Despite 97% acknowledging the necessity of competency, only 23% felt highly confident in their ability to perform endoscopic intubation. Participants (93%) reported scarce opportunities to perform the procedure and identified factors believed to facilitate competency acquisition and maintenance, including opportunities to perform endoscopic intubation in practice (98%), local champions (93%), and performing nasopharyngoscopy (87%). While most EPs acknowledged the importance of competency in endoscopic intubation, they reported scarce procedural opportunities and commonly expressed low confidence. Further research is needed on this topic, and we propose avenues to enhance education and practices related to endoscopic intubation. These include development of robust procedural curricula, support of local champions, and incorporating nasopharyngoscopy into EM practice.

GARLIC: Nature's potent antifungal and antibacterial ally - cream formulation and evaluation

In the pursuit of effective and safe treatments for infectious diseases, herbal remedies have garnered significant attention due to their diverse phytochemical composition and potential therapeutic properties. This study aimed to explore the phytochemical profile and evaluate the antibacterial and antifungal properties of herbal garlic extracts. Traditional natural products continue to be sought after for their bioactive compounds, which offer promising avenues for therapeutic intervention in both human and veterinary medicine. Our investigation not only sheds light on the regional variation of stomach disease occurrence, highlighting the role of dietary factors, but also underscores the importance of herbal preparations in medicinal practice. By combining various plant classes, herbal formulations can exert localized effects upon application, penetrating the skin or mucous membranes to target underlying conditions. The effectiveness of these combined medications may lie in their synergistic mechanisms, offering a comprehensive therapeutic approach. This research contributes valuable insights into the potential of herbal remedies as adjuncts or alternatives to conventional treatments, paving the way for further exploration in infectious disease management and prevention strategies.

Biological puzzles solved by using Streptococcus pneumoniae: a historical review of the pneumococcal studies that have impacted medicine and shaped molecular bacteriology.

The major human pathogen Streptococcus pneumoniae has been the subject of intensive clinical and basic scientific study for over 140 years. In multiple instances, these efforts have resulted in major breakthroughs in our understanding of basic biological principles as well as fundamental tenets of bacterial pathogenesis, immunology, vaccinology, and genetics. Discoveries made with S. pneumoniae have led to multiple major public health victories that have saved the lives of millions. Studies on S. pneumoniae continue today, where this bacterium is being used to dissect the impact of the host on disease processes, as a powerful cell biology model, and to better understand the consequence of human actions on commensal bacteria at the population level. Herein we review the major findings, i.e., puzzle pieces, made with S. pneumoniae and how, over the years, they have come together to shape our understanding of this bacterium's biology and the practice of medicine and modern molecular biology.

Avulsion and Soft Tissue Injuries of the Ulnar Collateral Ligament in Children and Adolescents.

Although pediatric medial epicondylar fractures and apophysitis are well studied, patterns of subapophyseal avulsion and ligamentous injuries of the medial elbow in this population merit investigation to inform optimal treatment strategies. To describe the occurrence and demographic correlates of ulnar collateral ligament (UCL) avulsion and soft tissue injuries of the pediatric and adolescent elbow. Cross-sectional study; Level of evidence, 3. An institutional review board-approved review was conducted to identify consecutive patients with medial elbow injuries treated in a tertiary pediatric sports medicine practice between 2016 and 2021. Radiographs were obtained during injury evaluation, and patients with nondisplaced medial epicondylar apophysitis and complete epicondylar fracture were excluded, resulting in 150 patients with soft tissue injuries occurring distal to the medial epicondyle apophysis (subapophyseal) for study. Radiographs were evaluated for bony avulsion of the UCL from either the medial epicondyle proximally or the ulnar sublime tubercle distally. Injuries without radiographic evidence of bony avulsion, but with clinical examination findings consistent with ligamentous injury, were classified as radiographically negative UCL injuries, and magnetic resonance imaging (MRI) was performed to further evaluate these injuries if moderate to severe medial swelling of the elbow or significant concern for medial structural injury was present on examination. These MRI scans were evaluated to classify the UCL injury and assess for periosteal or cartilaginous avulsions. A total of 150 patients (mean age, 12.5 ± 3.4 years; 70 female), 55% (150/274) of the entire medial elbow injury population, had a subapophyseal injury. Of these patients, 62 had a bony avulsion detected on radiograph, and 88 had a radiographically negative injury. In addition to the 62 radiographic avulsions, the 61 MRI scans obtained on those radiographically negative injuries revealed 33 complete UCL disruptions, resulting in 63.3% (95/150) of patients sustaining a complete ligamentous disruption. With the MRI scans, 37 (61%) cases of cartilaginous or periosteal avulsion of the UCL were diagnosed. Overall, 66% of all 150 subapophyseal injuries had a bony, cartilaginous, or periosteal UCL avulsion. Patients with cartilaginous (mean age, 10.3 years) and bony (mean age, 10.6 years) avulsions were younger than those with central ligament injury (mean age, 14.2 years) or periosteal (mean age, 14.2 years) avulsions (P = .005). There was a significant association between the mechanism of injury and the location of UCL tear identified on MRI scans: traumatic falls were associated with distal tears, and throwing injuries were associated with proximal tears (P < .001). UCL central ligament and avulsion lesions may be frequently diagnosed after injury to the pediatric medial elbow, the majority of which are complete injuries, and may require MRI for diagnosis. The mechanism of injury may predict the location of ligamentous injury, and osteocartilaginous avulsions are more likely to present at younger ages than injuries to the soft tissue of the UCL or periosteum. The prevalence of these injuries merits further investigation into best protocols of nonoperative treatment or surgical repair techniques and outcomes.

Effect of a workplace-based learning program on clerkship students’ behaviors and attitudes toward evidence-based medicine practice

ABSTRACT In clinical clerkship (CC), medical students can practice evidence-based medicine (EBM) with their assigned patients. Although CC can be a valuable opportunity for EBM education, the impact of EBM training, including long-term behavioral changes, remains unclear. One hundred and nine fourth- and fifth-year medical students undergoing CC at a medical school in Japan attended a workplace-based learning program for EBM during CC (WB-EBM), which included the practice of the five steps of EBM. The program’s effect on the students’ attitudes toward EBM in CC was assessed through questionnaires. A total of 88 medical students participated in the program. Responses to the questionnaire indicated high satisfaction with the WB-EBM program. The most common theme in students’ clinical problems with their assigned patients was the choice of treatment, followed by its effect. Based on the responses in the post-survey for the long-term effects of the program, the frequency of problem formulation and article reading tended to increase in the ‘within six months’ group comprising 18 students who participated in the WB-EBM program, compared with the control group comprising 34 students who did not. Additionally, the ability to self-assess problem formulation was significantly higher, compared with the control group. However, among 52 students who participated in the WB-EBM program more than six months later, EBM-related behavioral habits in CC and self-assessments of the five steps of EBM were not significantly different from those in the control group. The WB-EBM program was acceptable for medical students in CC. It motivated them to formulate clinical questions and enhanced their critical thinking. Moreover, the WB-EBM program can improve habits and self-evaluations about EBM. However, as its effects may not last more than six months, it may need to be repeated across departments throughout CC to change behavior in EBM practice.

Homogenization Construction of Three-Level Teaching Bases for General Practice Medicine Under the Internet+ Model

Homogenization Construction of Three-Level Teaching Bases for General Practice Medicine Under the Internet+ Model

#1377 Evaluation of state-wide health system implementation of renal supportive care shows substantial net benefits

Abstract Background and Aims In 2016, the New South Wales (NSW) Health system implemented a service to make the principles and practice of palliative medicine comprehensively available to patients receiving chronic kidney disease (CKD) care across NSW. Summative evaluation of the economic value that this multi-disciplinary State-wide RSC service provided following implementation was prospectively planned in the domains of patient experience and economic value. This abstract reports the first cost-benefit analysis of a RSC service. Method De-identified patient-level data was extracted from the NSW Renal Supportive Care Register (a linked dataset comprising admitted patient, non-admitted patient, emergency department episodes and death registrations). Data was compared between 2015/16, prior to implementation of the State-wide RSC service; and 2018/19, following settled operation of the service. A cost-benefit analysis model was constructed to estimate the economic value of the RSC service between 2015/16 and 2018/19; and the projected value to 2029/30 under different scenarios. Multivariate Cox regressions were estimated to measure survival benefits, and a polynomial regression model was employed to estimate the impact of RSC on the share of patients receiving dialysis. Results Considering the actual impact of the NSW RSC service; in 2015/16, 5% (n = 443) of all ESKD patients, (defined as receiving dialysis &amp;gt;3 months, non-dialysis conservative care or in receipt of a functioning transplant) received any RSC service. By 2018/19, 16% (n = 1460) of all ESKD patients had received RSC within NSW. The proportion of patients receiving RSC from a non-dialysis conservative care or dialysis context remained stable between 2015/16 and 2018/19 at 41% and 29% respectively. Patients receiving RSC were estimated to have increased survival by 3-21 weeks, depending on patient characteristics, compared to the scenario of no RSC service. Considering the projected value of ongoing RSC services; scenarios with different assumptions were modelled. Assuming that the proportion of patients receiving different ESKD modalities and the costs of care remained stable, the RSC service would deliver a net financial benefit to the commissioning health system (avoided costs of service minus RSC costs) of ${\$}$109 million Australian Dollars (AUD), with a return on investment of 212%, compared to the scenario of no RSC service. When the economic value for the whole NSW community from increased survival benefit was included, the projected value was ${\$}$275 million AUD, with return on investment of 535%. The projected economic value of RSC was modelled under scenarios of increasing access to the service by ESKD patients (Figure). Increasing RSC access from the achieved 16% to 20% of ESKD patients was projected to deliver maximal economic value, with a 3% fall in ESKD patients receiving dialysis, increasing survival benefit (${\$}$221 million AUD) and economic value ${\$}$94 million AUD. As access to RSC expands further, modelling indicates that additional dialysis substitution becomes less likely but benefits still accrue from survival up to a maximum viable rollout of 50% of the ESKD population receiving RSC, when survival benefits plateau. Conclusion Economic evaluation of this implementation of the Statewide RSC service across NSW Health shows it has been associated with both a net economic benefit and survival benefits four years after implementation. It is projected to provide an economic value of ${\$}$275 million AUD over ten years, which would increase with greater participation of ESKD patients suitable for RSC.

#2067 Prediction of gastrointestinal bleeding hospitalization risk in hemodialysis using machine learning techniques

Abstract Background and Aims INitiativeS on advancing Patients’ outcomes In REnal disease (INSPIRE) is an academia and industry collaboration set forth to identify critical investigations needed to advance the practice of medicine in nephrology. Gastrointestinal bleeding (GIB) is one of the most common types of bleeding events in the kidney dialysis population [1]. We aimed to develop a model to predict GIB hospitalization risk in a hemodialysis (HD) patient within 180 days. We evaluated advanced machine learning algorithm (XGBoost) and compared it to traditional machine learning algorithm (logistic regression) modeling techniques. Method We used data from a kidney care network from 2017 through 2020. We included data from adult dialysis patients (age ≥18 years). GIB related hospitalization was defined based on international classification of diseases (ICD) diagnosis codes recorded as the primary, secondary, or tertiary discharge reason for hospitalization. Two distinct models were created using XGBoost and logistic regression algorithms and using the same dataset. Both models were evaluated using metrics such as area under the receiver operating curve (AUROC), accuracy, sensitivity, and specificity. Missing data was imputed using mean for quantitative data and mode for qualitative data. The dataset then was randomly divided into 60% training, 20% validation and 20% test dataset. The test data, comprising unseen patients and data was used to evaluate the performance of the model. This means that the model had never encountered the test data during its learning phase, which included training the model and then validating the model. Results The incidence of 180-day GIB hospitalization was 1.12% in the HD population (n = 5 116 with GIB hospitalization/ n = 451 653 without GIB hospitalization), and consistent in the unseen test dataset (n = 465 with GIB hospitalization/ n = 38586 without GIB hospitalization). The XGBoost model showed higher predictive performance compared to logistic regression (Table). The AUROC was 0.72 (95% confidence interval (CI) 0.69, 0.74) for the XGBoost model. In comparison, the AUROC was 0.615 (95% CI 0.60, 0.64) for the logistic regression model. Specificity was 67% versus 58% for the XGBoost model versus logistic regression model respectively. However, sensitivity for both the models was 65%. The top predictors for major GIB were consistent in both models for many factors, yet some factors showed different importance on outcome prediction (Fig. 1). Higher risk of GIB hospitalization was associated with older age, lower ferritin levels, and recent all-cause hospitalizations in both models. The XGBoost showed high importance on outcome prediction for lower hemoglobin and higher serum 25 hydroxy (25OH) vitamin D values, and the logistic regression model showed high importance for higher amounts of saline delivered during an HD treatment and lower intact parathyroid hormone (iPTH) levels. Conclusion We found advanced machine learning prediction modeling (XGBoost) appears suitable for identifying a HD patient at risk for a GIB hospitalization in the next 180 days, and outperforms traditional machine learning (logistic regression) modeling techniques. Although both models showed identical sensitivity, the XGBoost model had higher specificity. Prospective testing is needed to confirm the model's performance. The association between bone mineral metabolism markers and GIB hospitalization risk is unexpected and warrants further investigation.

Phytochemical and Antioxidant Investigations of Extracts from the Leaves of Macaranga heterophylla (Müll. Arg.) (Euphorbiaceae), A Medicinal Species used in Côte d'Ivoire

Aims: This work aims to investigate the phytochemical composition and antioxidant potential of the leaves of Macaranga heterophylla. Methodology: For this purpose, phytochemical screening by detection tests and thin layer chromatography (TLC), determination of total phenols content, total flavonoids content and condensed tannins content, and assessment of antioxidant potential by DPPH and reducing power tests were carried out on aqueous crude extracts, ethanolic crude extracts and selective extracts of the leaves of M. heterophylla. Results: The percentage yields obtained with ethanol (70%) (28.90 and 24.70% for the ethanolic decoction and ethanolic macerate respectively) are higher than those obtained with water (24.30 and 21.10% for the aqueous decoction and aqueous macerate respectively). The phytochemical screening highlighted the presence of several phytochemical families such as phenolic compounds (coumarins, flavones, tannins), quinones, sterols and polyterpenes, saponosides, glycosides, cardiotonic glycosides and oligosaccharides. Quantitative analysis of total phenolics, total flavonoids and proanthocyanidols showed that their respective levels in the leaves of M. heterophylla varied depending on the solvent and the extraction technique. Concerning total phenolics, the aqueous decoction and ethanolic macerate gave the best total phenol contents (129.04 ± 9.53 and 119.82 ± 2.63 mg EAG/g DM respectively); for total flavonoids, the aqueous decoction gave the best content (33.03 ± 1.61 mg EQ/g DM), while for condensed tannins, the aqueous macerate gave the best content (0.87 ± 0.02 mg ECT/g DM). With regard to DPPH antioxidant activity, the results showed that the ethanolic decoction has more pronounced antioxidant activity than the aqueous decoction, while the aqueous macerate showed better antioxidant activity than the ethanolic macerate. Concerning the reducing power test, the opposite trend was observed. Conclusion: The present study demonstrated that M. heterophylla is a concentrate of secondary metabolites with antioxidant properties, which would explain its use in traditional medicinal practice.

MACRO- AND MICROELEMENT COMPOSITION OF THE HERB AND ROOTS OF HAPLOPHYLLUM DAURICUM (L.) G. DON.

Haplophyllum dauricum is a rich source of lignans with antitumor activity. It has been actively used in the practice of Traditional medicine. In addition to lignans, the chemical composition of the species is represented by coumarins, flavonoids, alkaloids and essential oils. However, the composition of the elements of the species, which are necessary for the development of quality criteria of medicinal plants, has not been studied before. In this regard, the purpose of the work was to study the content of macro- and microelements in the aboveground and underground parts of Haplophyllum dauricum of the flora of Buryatia and Transbaikal territory. The content of the following elements was determined by inductively coupled plasma atomic emission spectrometry: Li, Be, Na, Mg, Al, P, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Sr, Zr, Mo, Cd, Sb, Te, Ba and Pb. The content of Hg was determined by the "cold steam" method using an atomic absorption analyzer. According to the obtained data, Haplophyllum dauricum is a rich source of calcium, potassium, magnesium and phosphorus, which were dominant. Among the microelements, iron and titanium were in highest concentration, which were accumulated mainly in the underground part of the plant. The content of heavy metals did not exceed the maximum permissible concentration established by the State Pharmacopoeia of the Russian Federation.

Knowledge, attitude, and practice of Iranian adults toward Persian Medicine: a national survey

BackgroundPrevious researches conducted in both developed and developing countries have demonstrated a rising trend in the utilization of complementary and alternative medicine. The World Health Organization has underscored the importance of studying the prevalence and determinants of such alternative practices. This study delves into the knowledge, attitudes, and practices of Iranian adults towards Persian medicine, a distinct form of complementary and alternative medicine, through a national survey for the first time.MethodsA total of 2882 Iranian adults (aged ≥ 15 years) were randomly chosen from all regions. Data were gathered through structured door-to-door interviews using a survey questionnaire, wherein cases were selected randomly based on postal codes, and interviewers completed the forms at the participants’ residences.ResultsApproximately 46% of the subjects exhibited familiarity with Persian Medicine. The study revealed that the primary sources of knowledge about Persian Medicine were family, relatives, and friends, with only 2.9% indicating medical staff as their source of information. Furthermore, the study indicated that 21% of participants expressed a strong interest in using Persian Medicine, while 30.3% did not. When comparing Persian medicine to modern medicine, respondents indicated that Persian medicine is more cost-effective and has fewer side effects, yet modern medicine is more widely used globally; although, the majority responded “I don’t know” to other questions. The results also demonstrated that approximately 37% of the participants had a history of Persian Medicine utilization in their lifetime.ConclusionThis study revealed that Iranian adults have low reliable knowledge (from medical staff, Persian medicine books and other publications) and limited familiarity with Persian medicine, with about one third of the participants expressing disinterest (attitude) and over half of them having not utilized this form of medicine (practice).

Telehealth and Telemedicine: Regulatory and Medicolegal Landscape.

Telehealth and telemedicine experienced remarkable growth during and after the recent COVID-19 pandemic. Telehealth is generally defined as nonclinical services that employ telecommunication technology. Telemedicine refers more specifically to remote clinical services including diagnosis, monitoring, and treatment. Nuclear medicine is no exception in employing telemedicine increasingly in clinical practice for image interpretation and treatment consultation and care delivery supervision. There is no doubt that soon, the use of tele-nuclear medicine will increase, comparable to the employment of telecommunication in other fields of medicine. We review the medicolegal and regulatory aspects of the evolution in the clinical practice of medicine through telehealth and telemedicine.

Hepatitis-B immune status and vaccination in Family Medicine Practice: A retrospective study

Hepatitis-B immune status and vaccination in Family Medicine Practice: A retrospective study

The prospect of social medicine in South Africa

The term “médecine sociale” (social medicine in English) was first coined in 1848 during the French Revolution by Dr. Jules Guérin. It is a branch of medicine that focuses on the impact of social and economic conditions on health, disease, and the practice of medicine, with the intention of creating a healthier society. It is an interdisciplinary program between medicine and social sciences, expected to equip medicine with the knowledge and skills needed for analyzing the social causes of health and illness, akin to how the alliance between medicine and laboratory sciences provided insights into the biological, chemical, and physical bases of diseases. Social medicine is also interconnected with social determinants of health. While social determinants of health specifically target social and environmental conditions that affect health, social medicine has a broader scope, encompassing the entire social context of health, including societal structures and cultural factors. In the post-apartheid era, social medicine could play an important role in transforming the healthcare system to ensure equity and inclusivity, leading to improved health outcomes. This would require re-engineering the education of health professionals in South Africa at both undergraduate and postgraduate levels, as practiced in many parts of the world. This will assist South Africa in joining the global movement of social medicine for the promotion of human rights and social justice in medicine, and a better understanding of the impact of social factors on the aetiology and management of medical disorders in the 21st century.

The maintenance of mexican traditional medicine practices among mexicans in southern Arizona

Mexicans in the United States have been reported to maintain practices of Mexican traditional medicine at comparably higher rates than most other populations, including other Latino sub-groups. In this cross-sectional study, we examined the pre- and post-migration traditional medicine practices of first-generation immigrants from Mexico living in southern Arizona. Our objective was to assess how migration affected Mexican immigrants' ethnomedical practices and to better understand the mechanisms and motivating factors for the post-migration maintenance of practice. We designed a survey instrument based off prior qualitative data on traditional medicine practices and translated it into Spanish. The survey measured the rates and frequency of six domains of lay healing practices: herbal medicine, healing foods, self-medication with over-the-counter medicine, and three types of specialty healers (curandero/a, and sobador/a, or partero/a), and asked questions about knowledge sources, reasons for maintaining practice post-migration, and to what extent participants believed the remedies were effective. The research team fielded the telephone-based survey from April 2022 to February 2023 to 300 first-generation adult Mexican immigrants residing in southern Arizona. A series of proportions tests were conducted to examine differences in reliance on lay healing pre- and post-migration as well as to assess differences between women's and men's lay practices. The data indicate a general, but moderated decline in lay medical practices post-migration, with the usage of expert healers declining at much higher rates than the three self-care domains. Women tend to use herbal medicine and healing foods at higher rates than men post-migration. This cross-sectional quantitative study confirms prior research indicating that traditional medicine practices are heavily relied upon by Mexican origin people both pre- and post-migration. These findings suggest that public health messaging and medical providers should better address and harness Mexican immigrants' lay medical practices in order to optimize health in this population.

The study of the influence of &lt;i&gt;Thlaspi arvense&lt;/i&gt; L. on the characteristics of the reproductive system of male rats

Introduction. The development of new effective and safe herbal medicines capable of having a positive effect on reproductive status is an urgent task of domestic pharmacy. Medicinal plants are considered as alternative therapies aimed at increasing testosterone levels and fertility in men. The arsenal of medicinal plants used in traditional medicine for the treatment of diseases in men is mainly represented by phytoadaptogens, most of which have a small resource potential in Russia, therefore, it is relevant to search for plants with a sufficient raw material base and with the potential for cultivation. Thlaspi arvense L. is a promising medicinal plant, as it is widely used in folk medicine as a diuretic, anti-inflammatory, diaphoretic, antihistamine, hemostatic, astringent, has a positive effect on the processes of spermatogenesis and is widely distributed in our country. However, information on the chemical composition and biological activity of Thlaspi arvense L. they are insufficient, which shows the relevance of its further more detailed study in order to substantiate the possibility of application in practical medicine and solutions to the issues of standardization of medicinal plant raw materials.Aim. The study of the influence of Thlaspi arvense L. on the characteristics of the reproductive system of male rats.Materials and methods. The object of the study was an infusion of herbа Thlaspi arvense L. The features of the reproductive behavior of male rats after 21-day administration of the infusion of grass yarutka field were studied using tests that allow quantifying the severity of sexual motivation and sexual activity of males. The viability of spermatozoa in the ejaculate of rats was assessed, the total number of spermatozoa (ACS, million), degenerative and immobile forms (%) was calculated. Morphophysiological parameters of spermatogenesis of rats of control and experimental groups of animals were studied using classical histological methods. The concentration of testosterone in the blood serum of experimental groups of animals was determined by the enzyme immunoassay.Results and discussion. The results obtained allow us to conclude that the fertility of rats has increased against the background of the course administration of the infusion of herbа Thlaspi arvense L., as evidenced by an increase in the testosterone content in the blood, improvement of spermogram indicators and morphophysiological characteristics of spermatogenesis in the testicles of rats. The use of the infusion of herbа Thlaspi arvense L. has a protective effect on spermatogenesis. An increase in the thickness of the spermatogenic epithelium, the diameter of the cross-section of the convoluted seminal tubules and the index of spermatogenesis compared with the control group of animals was revealed. The positive effect of Thlaspi arvense L. on indicators of sexual motivation and sexual activity of male rats is shown.Conclusion. Thlaspi arvense L. is a promising medicinal plant, as it is able to have a positive effect on libido, the number and mobility of spermatozoa, the production of sex hormones, spermatogenesis, as well as on the pituitary-gonadal axis, which is associated with the content of a complex of biologically active substances in it.

Understanding the root of healing and beyond: Exploring the way forward for Alternative Medicine in Nigeria

Complementary and alternative medicine involves medical practices rooted in traditional methods such as herbal remedies and spiritual beliefs. Historical factors influence the practice of alternative medicine in Nigeria. This study examines cultural perceptions, practices, challenges, and integration strategies for alternative medicine in the Nigerian healthcare system. Nigeria, with a population of over 200 million, faces significant health challenges, necessitating robust healthcare systems. Despite having over 80,000 registered doctors, there is a low doctor-to-population ratio of 4,000 to 5,000 people per doctor. Traditional healers practicing under partial regulation significantly contribute to healthcare delivery by using indigenous herbal and spiritual therapies. Challenges in integrating alternative medicine include standardization, limited scientific evidence, stigma, funding constraints, and barriers to access of services . Integration efforts involve creating inclusive healthcare systems that combine traditional and modern approaches, prioritize equitable access, and respect for cultural diversity, developing standardized training, generating scientific evidence, and increasing public awareness. Collaboration among stakeholders, such as healers, healthcare providers, policymakers, researchers, and communities, is essential for successful integration and improved healthcare outcomes. The Nigerian healthcare system can benefit from integrating alternative medicine and promoting holistic and culturally sensitive practices. Overcoming these challenges requires cooperation, evidence-based strategies, and investments in research, leading to more effective healthcare delivery, improved health outcomes, and reduced disparities nationwide. Countries on integration journeys should prioritize collaboration, establish clear regulations, raise public awareness, and invest in research to support the effectiveness and safety of alternative medicine.

Safety and efficacy evaluation of Simo decoction and Arecae semen in herbal medicine practice

ObjectiveThe traditional Chinese patent medicine (TCPM), Simo decoction (Simo decoction oral solution), with its primary ingredient Arecae semen (Binglang, Areca catechu L.), known for its potential carcinogenic effects, is the subject of this study. The research aims to analyze the effectiveness and potential risks of Simo decoction, particularly as a carcinogen, and to suggest a framework for evaluating the risks and benefits of other herbal medicines. MethodsThe study is based on post-marketing research of Simo decoction and Arecae semen. It utilized a wide range of sources, including ancient and modern literature, focusing on the efficacy and safety of Simo decoction. The research includes retrospective data on the sources, varieties, and toxicological studies of Arecae semen from databases such as Pubmed, Clinical Trials, Chinese Clinical Trial Registry, China National Knowledge Infrastructure, WHO-UMC Vigibase, and China National Center for ADR Monitoring. ResultsCommon adverse drug reactions (ADRs) associated with Simo decoction include skin rash, nausea, vomiting, abdominal pain, and diarrhea. However, no studies exist reporting the severe ADRs, such as carcinogenic effects. Arecae semen is distributed across approximately 60 varieties in tropical Asia and Australia. According to the WHO-UMC Vigibase and the National Adverse Drug Reaction Monitoring System databases, there are currently no reports of toxicity related to Arecae semen in the International System for Classification of ADRs (ISCR) or clinical studies. ConclusionRisk-benefit analysis in TCPM presents more challenges compared to conventional drugs. The development of a practical pharmacovigilance system and risk-benefit analysis framework is crucial for marketing authorization holders, researchers, and regulatory bodies. This approach is vital for scientific supervision and ensuring the safety and efficacy of drug applications, thus protecting public health.

Strengthening Bhutanese Traditional Medicine in healthcare service delivery in Bhutan

Bhutanese Traditional Medicine, known as Sowa Rigpa, deeply rooted in the country’s cultural and religious heritage, plays a significant role in healthcare service delivery in Bhutan. This commentary explores the evolution and current landscape of Sowa Rigpa within the context of the nation’s healthcare system. While traditional medicine services have expanded over the years, challenges such as scepticism regarding scientific validity, inadequate infection control measures and concerns about the sustainability of medicinal plants persist. To address these challenges, recommendations, including the integration of modern technology in quality assurance, comprehensive training in infection control, evidence-based practice and conservation efforts for medicinal plants have been adopted. By embracing these strategies, Sowa Rigpa can enhance its efficacy, safety and sustainability, ensuring its continued relevance in meeting the healthcare needs of the Bhutanese population while contributing to the global advancement of Traditional Medicine practices.