Traditional Health Care Research Articles

Integrating traditional and allopathic child health: A healthcare transformation opportunity.

Numerous forums both domestically and internationally have discussed integration of allopathic and traditional healthcare. In South Africa, using traditional child healthcare is popular practice. If properly controlled, integrating this aspect of traditional child-health with allopathic healthcare may be advantageous to communities that use both healthcare systems. Allopathic and traditional healthcare remain separate organisations in South Africa despite efforts and discussions to integrate them. The study sought to explore the integration of traditional and allopathic child healthcare from the perspectives of children's caregivers and traditional healthcare practitioners. The study was conducted in a semi-urban area in the city of Tshwane. An exploratory qualitative research study was conducted using semi-structured interviews to collect data from 11 traditional healthcare practitioners and 15 children's caregivers who were sampled using snowball and convenient sampling respectively. The participants expressed their understanding of the usage of traditional healthcare practitioners in the care of children as well as their support for integration, and further indicated its necessity. Religion and its effects in health-seeking behaviour were cited as a factor in why there has not been greater integration between the two healthcare systems. The undocumented and undisclosed use of traditional healthcare potentially hinders the delivery of therapeutic healthcare. As such, integrating the two systems is essential to ensure patients' safety. This article highlights understanding of culture congruence and safe child healthcare that may be brought forward by the integration of the two healthcare systems.

Haemodialysis Patients' Experiences on Complementary and Alternative Therapies: A Qualitative Study

Background: The term complementary and alternative therapies refers to a broad range of medical and healthcare procedures that are outside the purview of traditional medicine. Despite gaps in the scientific evidence to support its use and difficulties in regulating and integrating it into traditional healthcare procedures, the use of complementary and alternative therapies is constantly rising. Aim: This study aims to explore the experiences of complementary and alternative therapies among haemodialysis patients. Material and Methods: The study was carried out by adopting the qualitative descriptive research method. Semistructured qualitative interviews, with 17 haemodialysis patients, were analyzed with qualitative content analysis. Data saturation was reached during interviews, and audio recordings were verbatim transcribed. Both researchers independently identified key topics, which were subsequently discussed and evaluated simultaneously. Results: We identified 4 overarching main themes in this setting: (1) Seeking Control over Health (to have control over their health status); (2) Relief from negative symptoms (to get rid of the negative symptoms they experience; (3) Hope (in the hope of feeling healthy again); and (4) Fear (in which they are afraid to tell health professionals and are afraid of not receiving support). Conclusion: This study showed that haemodialysis patients seek complementary and alternative therapies because of having control over their health, relief from negative symptoms, hope to feel healthy again, and fear of telling health professionals and receiving support. It is recommended that health professionals should provide information about the safety and possible side effects of these therapies and practice patient-centered treatment through active communication during the treatment process.

Exploration of Industrial, Traditional, and Pharmaceutical Applications of Diversity Rich Genus Trigonella: A Comprehensive Review

The Trigonella genus, encompassing Trigonella foenum gracum L. and other species, exhibits annual growth patterns and thrives in arid and semiarid environments worldwide. India stands at the forefront of Trigonella diversity, showcasing its adaptability to challenging climatic conditions. This meticulous review consolidates existing scientific literature to provide a comprehensive evaluation of the Trigonella genus, emphasizing its nutritional value, traditional uses, and therapeutic applications. Particularly, its significance in traditional medicine systems such as Indian Ayurveda, Tibetan, and Chinese medicine is highlighted, shedding light on its profound cultural and medicinal implications. Morphological distinctions, etymology, vernacularity, and habitat preferences specific to the Trigonella genus are also discussed. Additionally, this study explores the economic potential of Trigonella, underscoring its pivotal role in ensuring food security and healthcare within local communities. Furthermore, it emphasizes the importance of safeguarding traditional healthcare practices and fostering biodiversity conservation efforts by examining the traditional knowledge and utilization of endemic plants worldwide. By offering insights into the diverse species within the Trigonella genus, their cultural significance, and medicinal potential, this review significantly contributes to our comprehension of these invaluable resources and their far-reaching implications for human well-being.

Exploration of traditional Ethno-gynaecological knowledge: advances to ethnobotanical studies from indigenous communities of Neelum Valley in the Himalayan Region

The indigenous communities of the Kashmir region are exclusively dependent on medicinal plants for the treatment of various gynecological disorders. Due to the remoteness and unavailability of modern medications, indigenous communities still use traditional healthcare practices to cure various diseases related to women. The specific objective of this study is to document the traditional ethno-gynecological knowledge in Neelum Alley. Field visits were conducted from April to November 2023 to gather data on medicinal plants used for gynecological problems. Both questionnaires and group discussions were used to collect the data. The gathered data was analyzed using a variety of quantitative metrics, such as use value (UV), and relative frequency citation (RFC). A total of 45 plant species belonging to 22 families were collected from the study area. Herbs made up the majority of the medicinal plants employed by indigenous populations (91.1%), whereas leaves, the most often used plant part, contributed 22.22%. Among medicinal plants, Geranium wallichianum had the highest use value (1.41), whereas Arnebia benthamii had the highest relative frequency citation (0.80). This study emphasizes how important it is to preserve traditional knowledge, pointing out that younger people are losing understanding due to a lack of interest. The documentation of traditional ethno-gynecological knowledge is crucial for the preservation, discovery of novel medications, and sustainable conservation of vulnerable medicinal flora.

Bridging Tradition and Modern Pharmacology of Bergenia ciliata (Haw.) Sternb: A Review

Bergenia ciliata, a perennial rhizomatous herb holds a special place in the traditional herbal healthcare system due to its diverse therapeutic uses and potentials. Validation of its efficacy with scientific investigation is a prerequisite of any prospective herbal resource. The plant is a rich source of various bioactive chemical compounds. The present review is an attempt to consolidates comprehensive information sourced from 100 different literatures, exploring the plant's distribution, phytochemistry, traditional medicinal uses, and pharmacological activities specially focusing on some prevalent diseases of present day. The herb’s antimicrobial, anticancer, antiulcer and antidiabetic properties signify its potential in modern pharmacology. The review underscores B. ciliata's relevance in drug development and nutraceutical formulations, bridging age-old wisdom with contemporary healthcare solutions. Further exploration into its bioactive compounds and clinical applications promises innovative avenues in therapeutic intervention.
 Keywords: Bergenia ciliata, perennial rhizomatous herb, traditional herbal healthcare, age-old wisdom

Antioxidant potential of alkaloids and polyphenols of Viola canescens wall using in vitro and in silico approaches.

Background: V. canescens Wall, a plant renowned for its ethno-medical properties, was investigated in this study for its antioxidant potential based on its wide therapeutic applications in traditional healthcare systems. The study aimed to assess the antioxidant potential of the plant extract/fractions and to predict the active phytochemicals using computational techniques. Methods: Five fractions were obtained from the crude methanolic extract of Viola canescens, and six concentrations (25, 50, 75, 100, 125, and 150μg/mL) were prepared for each fraction. The antioxidant activity of these fractions was evaluated using the Tetraoxomolybdate (VI) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. In-silico docking studies and molecular dynamic simulations were conducted to further elucidate the molecular interactions underlying the antioxidant activity. Results: The aqueous extract of V. canescens exhibited significant antioxidant and free radical scavenging activity against DPPH. Additionally, the crude flavonoid extract demonstrated moderate activity with IC50 value of 57.863μg/mL, indicating potent inhibition of cell growth. In-silico docking studies revealed a strong interaction between emetine and the aromatase protein, suggesting its potential as an antioxidant. Conclusion: The study findings highlight the antioxidant potential of V. canescens extract, indicating its suitability as a source of natural antioxidants. These results suggest its potential application in pharmaceutical preparations aimed at harnessing antioxidant properties for therapeutic purposes.

DIGITAL HEALTH TOOLS FOR BREASTFEEDING MOTHERS: A COMPARATIVE REVIEW BETWEEN NIGERIA AND THE US

This comparative review evaluates and compares the impact and adoption of mobile apps and digital platforms, including Babyroo, in supporting breastfeeding mothers in Nigeria and the US. Breastfeeding is crucial for infant health and development, yet many mothers face challenges and require support. Digital health tools, such as mobile apps and online platforms, offer a promising solution to provide information, guidance, and support to breastfeeding mothers. Nigeria and the US were chosen for comparison due to their different healthcare systems, cultural norms, and levels of technological adoption. The review examines the features, accessibility, and effectiveness of digital health tools, particularly Babyroo, in supporting breastfeeding mothers in both countries. The findings reveal that digital health tools play a significant role in supporting breastfeeding mothers in both Nigeria and the US. Babyroo, in particular, offers a range of features such as breastfeeding tips, tracking tools, and online communities for mothers to connect and share experiences. However, the adoption of these tools varies between the two countries. In Nigeria, where access to healthcare services is limited, digital health tools like Babyroo can bridge the gap and provide essential support to breastfeeding mothers. In contrast, in the US, where healthcare services are more accessible, digital health tools serve as a supplement to traditional healthcare services, offering convenience and additional resources for breastfeeding mothers. Overall, the review highlights the potential of digital health tools, such as Babyroo, in supporting breastfeeding mothers globally. However, it also emphasizes the importance of context-specific approaches and the need for further research to understand the impact and effectiveness of these tools in different cultural and healthcare settings.
 Keywords: Digital Health, Tools, Breastfeeding, Mothers, Comparative.

Exploring patient referral practices of traditional healthcare practitioners in Soshanguve, Gauteng Province, South Africa.

It may be necessary for healthcare professionals to refer patients to other professionals and institutions that are able to provide the care needed by patients, depending on the severity each case presents, healthcare requirements, and resources available to offer care. In healthcare generally, patient referral is standard procedure; however, in South Africa, referral patterns between allopathic and traditional healthcare practitioners are unknown, and this is a problem yet to be addressed. The study objective was to explore patient referral practices from the perspectives of traditional healthcare practitioners of South Africa. A qualitative, exploratory and descriptive design was employed to collect data from 11 traditional healthcare practitioners who were sampled using snowball sampling. An individual semi structured interview schedule was used to collect data. Content analysis was used to analyze the data. Patient referral was common practice in traditional health practices, however not reciprocal between the traditional and allopathic healthcare. Several indications for patient referral to allopathic healthcare practitioners included management of chronic conditions amongst others. Patient referral being an important part of healthcare practices should be promoted and regulation and traditional health practices improved to promote safe referral practices and curb unsafe self-referrals by patients.

Bridging Healthcare Horizons: Illuminating Pakistani Medical Students' Perspectives on Telemedicine

Purpose: In the evolving landscape of global healthcare, telemedicine stands out as a beacon of progress, offering enhanced accessibility. Nowhere is its impact more critical than in the rural expanse of Pakistan, where traditional healthcare struggles to reach. This research delves into the minds of Pakistani medical students, a cohort pivotal in steering the future of healthcare delivery in the country.
 Methodology: The research design for your study can be described as cross-sectional or survey research, focusing on understanding the telemedicine exposure, interest levels, and plans for future utilization among Pakistani medical students across 20 medical schools.
 Target Population: The target population in your study comprises Pakistani medical students enrolled in the 20 medical schools included in the study.
 Findings: Among the 396 students surveyed, 24% boasted prior exposure to telemedicine, while a noteworthy 52% expressed unwavering intentions to incorporate it into their future medical practices. Notably, 73.8% of those with prior exposure were resolute in their commitment to using telemedicine, compared to 43% without prior exposure. Among the undecided students, 21% had been exposed previously, shedding light on the profound influence of exposure on shaping future intentions.
 Unique Contribution to Theory, Policy, and Practice: This research goes beyond the surface exploration of medical students' attitudes towards telemedicine; it makes a distinctive contribution to theoretical frameworks, policy development, and practical implications. The study acts as a theoretical cornerstone by shedding light on the intricacies of the awareness gap within this demographic. From a policy perspective, the findings provide policymakers in Pakistan with a nuanced understanding of the current state and future potential of telemedicine integration into the healthcare system. The practical implications are profound, emphasizing the urgent need for early education in telemedicine to prepare the next generation of healthcare professionals for the challenges and opportunities presented by an evolving healthcare landscape.

Evaluating Experts’ Perspectives on Utilizing mHealth for Data Services in HIV Program Implementation in Cameroon

<i>Introduction</i>: The widespread adoption of mobile health (mHealth) technology has become a crucial aspect of healthcare delivery, particularly in regions with limited access to traditional healthcare systems. Cameroon, a Central African nation grappling with a high prevalence of HIV/AIDS, presents a suitable context for mHealth interventions. This study aims to assess expert opinions on the application of mHealth for data services in implementing HIV programs in Cameroon. <i>Methods</i>: Employing a mixed-methods approach, we utilized a quantitative cross-sectional design (via a survey questionnaire) and a qualitative design (through in-depth interviews). The purposive sample technique was employed to recruit health specialists from diverse organizations and healthcare facilities across the country. <i>Results</i>: Analysis of responses from mHealth experts revealed that 76% held a positive perspective on using mHealth for data services in HIV program implementation in Cameroon, while 24% expressed a negative opinion. Statistical analysis did not reveal a significant association (p = 0.265) between qualifications and perspectives on mHealth. Monitoring and Evaluation (M&E) experts exhibited a notable association (94.1%) with positive perspectives on mHealth utilization. In contrast, IT specialists and public health experts demonstrated slightly lower percentages (78.6% and 60%, respectively). <i>Conclusion</i>: Experts in mHealth conveyed optimism about using mHealth to provide data services for implementing HIV programs in Cameroon. The study discovered that mHealth users' perceptions were positively correlated with age group and work position. However, there was no discernible relationship between the attitudes of mHealth users and gender or educational attainment.

A review of the integration of virtual reality in healthcare: implications for patient education and treatment outcomes

This paper examines the integration of VR into healthcare settings, focusing on its transformative impact on patient education, treatment outcomes, and future perspectives. Virtual reality (VR) technology has emerged as a groundbreaking tool in healthcare, offering immersive and interactive solutions for patient education, therapy, rehabilitation, and mental health interventions. Key findings from research and practice underscore the effectiveness of VR-based interventions in enhancing patient engagement, comprehension, and retention of medical information, as well as improving treatment adherence, reducing anxiety, managing chronic pain, and enhancing rehabilitation outcomes. Despite technical challenges, such as hardware limitations and data security concerns, the importance of integrating VR into healthcare for optimizing patient care and clinical outcomes cannot be overstated. The future of VR in healthcare holds promise, with continued advancements in technology, interdisciplinary collaboration, and expansion of applications beyond traditional healthcare domains. By addressing challenges and fostering innovation, VR has the potential to revolutionize patient-centered care, shape the future of healthcare delivery, and improve overall well-being

Telemedicine in diabetic eye care: A meta-analysis of its effectiveness in underserved populations

Telemedicine has emerged as a promising tool in diabetic eye care, particularly for underserved populations facing barriers to accessing traditional healthcare services. This meta-analysis aims to evaluate the effectiveness of telemedicine interventions in managing diabetic eye conditions within underserved communities. Through a systematic review of existing literature, encompassing diverse telemedicine approaches such as remote screening, teleconsultation, and telemonitoring. These studies were conducted across various regions with underserved populations, including rural areas, low-income urban neighborhoods, and underserved ethnic groups. The meta-analysis revealed significant improvements in several key outcome measures. Firstly, telemedicine interventions led to increased rates of early detection of diabetic retinopathy and other diabetic eye complications, facilitating timely intervention and preventing progression to more severe stages of the disease. Secondly, telemedicine facilitated better access to specialist care, overcoming geographical barriers and reducing the burden of travel for patients. Thirdly, telemedicine interventions were associated with improved patient compliance with follow-up appointments and treatment regimens, leading to better long-term management of diabetic eye conditions. Moreover, subgroup analyses revealed that telemedicine was particularly effective in reaching vulnerable populations such as elderly individuals, those with limited mobility, and ethnic minorities, thereby addressing disparities in healthcare access. Telemedicine holds great promise as an effective tool for diabetic eye care in underserved populations, offering a scalable and cost-effective approach to improving access to timely screening, diagnosis, and management of diabetic eye conditions. Further research and implementation efforts are warranted to optimize telemedicine interventions and ensure equitable access to quality eye care for all.

Ethnobotanical Exploration of Traditional Medicinal Plants Among the Rural Inhabitants of District Muzaffarabad, Kashmir Himalayan Region

Indigenous knowledge provides insights into the therapeutic properties of medicinal plants used in local communities for basic healthcare. This research focuses on documenting the medical knowledge of rural communities that rely on medicinal plants in their traditional healthcare practices in the district of Muzaffarabad, Kashmir Himalayas. A field survey was carried out in 2022 and 2023 to collect data on wild medicinal plants. Informants were selected at random to learn about indigenous medical practices through semi-structured interviews and group discussions with 95 informants. The ethnomedicinal data were quantitatively analyzed using indices of use value (UV) and relative frequency citation (RFC). The study area documented 57 medicinal plants from 34 different families. Polygonaceae was the most dominant family, contributing 14.03% to medicinal plants, followed by Lamiaceae (10.52%) and Rosaceae (7.01%). Among medicinal plants, communities predominantly used herbs (64.91%) and leaves (29.09%) to treat several health problems. Mentha longifolia had the highest reported use value (1.71), and Bergenia ciliata had the highest recorded RFC value (0.72). Rural inhabitants continue to rely on wild medicinal plants as their primary source of medication. The transmission of indigenous knowledge to descendants is steadily declining and is primarily limited to healthcare practitioners and the elderly. These communities have kept important indigenous knowledge, which must be preserved for sustainable resource management and conservation. A more extensive field exploration is required to discover all of the indigenous knowledge in rural areas of Kashmir.

Project CHARIOT: study protocol for a hybrid type 1 effectiveness-implementation study of comprehensive tele-harm reduction for engagement of people who inject drugs in HIV prevention services

BackgroundPeople who inject drugs (PWID) remain a high priority population under the federal Ending the HIV Epidemic initiative with 11% of new HIV infections attributable to injection drug use. There is a critical need for innovative, efficacious, scalable, and community-driven models of healthcare in non-stigmatizing settings for PWID. We seek to test a Comprehensive-TeleHarm Reduction (C-THR) intervention for HIV prevention services delivered via a syringe services program (SSP).MethodsThe CHARIOT trial is a hybrid type I effectiveness-implementation study using a parallel two-arm randomized controlled trial design. Participants (i.e., PWID; n = 350) will be recruited from a syringe services program (SSP) in Miami, Florida. Participants will be randomized to receive either C-THR or non-SSP clinic referral and patient navigation. The objectives are: (1) to determine if the C-THR intervention increases engagement in HIV prevention (i.e., HIV pre-exposure prophylaxis; PrEP or medications for opioid use disorder; MOUD) compared to non-SSP clinic referral and patient navigation, (2) to examine the long-term effectiveness and cost-effectiveness of the C-THR intervention, and (3) to assess the barriers and facilitators to implementation and sustainment of the C-THR intervention. The co-primary outcomes are PrEP or MOUD engagement across follow-up at 3, 6, 9 and 12 months. For PrEP, engagement is confirmed by tenofovir on dried blood spot or cabotegravir injection within the previous 8 weeks. For MOUD, engagement is defined as screening positive for norbuprenorphine or methadone on urine drug screen; or naltrexone or buprenorphine injection within the previous 4 weeks. Secondary outcomes include PrEP adherence, engagement in HCV treatment and sustained virologic response, and treatment of sexually transmitted infections. The short and long term cost-effectiveness analyses and mixed-methods implementation evaluation will provide compelling data on the sustainability and possible impact of C-THR on comprehensive HIV prevention delivered via SSPs.DiscussionThe CHARIOT trial will be the first to our knowledge to test the efficacy of an innovative, peer-led telehealth intervention with PWID at risk for HIV delivered via an SSP. This innovative healthcare model seeks to transform the way PWID access care by bypassing the traditional healthcare system, reducing multi-level barriers to care, and meeting PWID where they are.Trial Registration: ClinicalTrials.gov NCT05897099. Trial registry name: Comprehensive HIV and Harm Prevention Via Telehealth (CHARIOT). Registration date: 06/12/2023.

Identifying Subgroups of Youth Suicide Decedents Based on Clinical Profiles of Psychiatric and Medical Diagnoses: A Latent Class Analysis

PurposeTo identify risk subgroups of youth suicide decedents using demographic and clinical psychiatric and medical diagnostic profiles to inform tailored youth suicide prevention efforts. MethodsThis study linked Ohio Medicaid and death certificate data for Medicaid enrolled youth aged 8–25 years who died by suicide between January 1, 2010, and December 31, 2020 (N = 511). Latent class analysis was used to identify distinct clinical risk subgroups. ResultsThree latent classes were identified. Internalizing problems were common across all classes, but especially prevalent in class 1, the High Internalizing + Multiple Comorbidities group (n = 152, 30%). A prior history of suicidal behavior was confined to class 1 decedents, who were otherwise characterized by substance misuse, and multiple psychiatric and medical comorbidities. Class 2 decedents, the Internalizing + Externalizing group (n = 176, 34%), were more often younger, male, Black, and unlikely to have a history of substance misuse. Decedents in class 3, the Internalizing + Substance Misuse group (n = 183, 36%), were more often older and likely to have a history of substance misuse, but unlikely to exhibit other externalizing problems. DiscussionInternalizing psychopathology is particularly common among youth who die by suicide, with comorbid externalizing psychopathology, substance misuse, and medical problems contributing to youth suicide risk. Because less than a third of youth who die by suicide have a prior history of recognized suicidal thinking or behavior, universal screening for youth suicide risk should be considered, particularly in younger children, and efforts to integrate suicide prevention in traditional health care settings should be prioritized.

Health care use experiences of ethnoculturally diverse immigrant older adults: a meta-ethnography

PurposeCurrent and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?Design/methodology/approachThe authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological s and s in Social Gerontology that yielded 17 papers eligible for review.Findings“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.Originality/valueThe authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.

Healthcare Monitoring-based IoT framework for heart disease detection and classification

Background: Chronic diseases like diabetes, heart disease, and cancer pose significant global health challenges, contributing to a substantial portion of worldwide mortality. Diagnosing heart disease, with its diverse signs and symptoms, remains a complex task. The growing market for connected wearable devices presents opportunities for leveraging Internet of Things (IoT) technologies in healthcare. However, diagnosing and managing heart disease effectively remains a critical concern due to its high fatality rates. Integrating IoT into the traditional healthcare system holds promise for enhancing patient outcomes, particularly for those with heart disease. Methods: A Healthcare Monitoring-based IoT framework (HM-IoT) has been developed to enable continuous monitoring of heart disease patients, eliminating the need for manual feature extraction. This framework facilitates real-time monitoring of heart failure patients through IoT-enabled devices. Data encryption using the Enhanced Encryption Standard algorithm ensures the security of patient information within the cloud platform. An Artificial Neural Network (ANN) model is employed to classify encrypted data, promptly alerting healthcare professionals to abnormal physiological conditions. Results: Evaluation in Matlab revealed impressive processing capabilities, with decryption and encryption rates of 1085 milliseconds and 1075 milliseconds, respectively. Data protection level reached 91%, while the Security Rate level attained 99%. Performance metrics, including Accuracy (98%), Sensitivity (96%), Specificity (98%), and Precision (99.4%), demonstrated the reliability of the system in detecting potential instances of heart disease. Conclusion: The Healthcare Monitoring-based IoT framework represents a significant advancement in smart healthcare solutions for heart disease management. By integrating IoT technologies with healthcare infrastructure, the framework enables real-time monitoring, enhancing prognostic capabilities and facilitating timely interventions.

Acceptability and Satisfaction of Patients and Providers With Telemedicine During the COVID-19 Pandemic: A Systematic Review.

COVID-19, also known as coronavirus disease 2019, is an extremely contagious viral sicknesscaused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After the first cases of this primarily respiratory viral illness were recorded in Wuhan, Hubei Province, China, in late December 2019, SARS-CoV-2 rapidly disseminated across the globe. Consequently, on March 11, 2020, the World Health Organization (WHO) declared it a global pandemic. The rapid spread of the COVID-19 virus, coupled with subsequent lockdowns and social distancing measures, profoundly disrupted traditional healthcare delivery systems. Amidst the COVID-19 pandemic, telemedicine emerged as a pivotal solution for delivering healthcare services while minimizing exposure to the virus. This study aims to assess patient and provider satisfaction with telemedicine during this unprecedented period. A systematic literature search was conducted on PubMed and Google Scholar using specific MeSH terms and Preferred Reporting Items for Systematic Literature Reviews and Meta-Analyses (PRISMA) guidelines to summarize patient and provider satisfaction concerning telemedicine using all the facts, evidence, and published literature. The analysis showed that although providers were generally satisfied with telemedicine, they were less satisfied than patients due to technical issues and difficulties transmitting documents. Patients reported high satisfaction with telemedicine, citing convenience and cost savings as major benefits. However, a lack of provider compensation was identified as a potential barrier to adoption. Most providers believed that telemedicine was only necessary in emergencieswhile a few recognized its potential for routine care. The study concludes that telemedicine has the potential to improve healthcare access and efficiency, but more research is needed to address technical and reimbursement issues and to determine the appropriate scope of telemedicine use. Overall, the findings of this study can inform future healthcare policies and regulations to ensure that telemedicine is used effectively and to the satisfaction of both patients and providers.

A confirmed case of xylazine-induced skin ulcers in a person who injects drugs in Miami, Florida, USA

BackgroundXylazine is an alpha-2 adrenergic receptor agonist that has emerged as a contaminant in the illicit drug supply of fentanyl. Xylazine use may be suspected in naloxone-resistant overdoses and atypical, chronic wounds in people who use drugs (PWUD). This case is unique because it is the first case to our knowledge describing wound care for a xylazine-induced wound with a confirmatory xylazine test strip (XTS) in the setting of a syringe services program (SSP) and in the state of Florida.Case presentationA 43-year-old woman with a past medical history of severe opioid use disorder and stimulant use disorder presented to a student-run clinic at a Miami SSP for wound care. She had multiple ulcerations diffusely over her bilateral forearms with surrounding erythema and warmth. Seven weeks later, she presented to clinic again for wound care because her wounds had progressed. At this visit, a XTS was used to confirm the presence of xylazine in her urine. Wound care management and harm reduction strategies employed at both visits were informed by best clinical judgement due to lack of formal guidelines at the time. Wound outcomes are unknown as the patient has not returned to clinic.ConclusionsMany PWUD at highest risk for acute and chronic health consequences of xylazine-adulterated fentanyl do not have access to healthcare outside of low barrier clinics and SSPs due to lack of insurance or mistrust of the traditional healthcare system due to stigma. There is an urgent need for access to XTS for PWUD and clinical practice guidelines for the treatment of xylazine-related wounds in outpatient clinics.

Privacy Issues in Electronic Medical Records: A Systematic Review

Background: Recently, there has been a great development in healthcare services, and in the future, it is expected to evolve even more. The incorporation of the latest technologies, such as modern sensors, networks and cloud computing, has revolutionized the traditional healthcare system, one of the most important of these Updates electronic medical records that are a substitute for paper records. Objectives: This paper presents a systematic study of the recent literature on privacy issues faced by electronic medical records (EMR), through which we provide a comprehensive review, analysis and synthesis of research published in the past five years. Methodology: We collected relevant literature published between 2016 and 2021 and reviewed the approved issues, research problems, manuscript scopes, research methodologies, and main findings. 29 studies yielded our final extracted cohort. Conclusions: Using the objective analysis of the extracted cohort, we present a research typology that summarizes the major EMR privacy issues of relevant recent research in this field.