Traditional Medical Treatment Research Articles

MIGRAINE

Background Migraine is a prevalent neurological disorder characterized by chronic headaches, significantly impacting the global population. This comprehensive review aims to advance the understanding of migraine pathogenesis and treatment, focusing on molecular markers and novel therapeutic strategies. Material Molecular markers such as calcitonin gene-related peptide (CGRP) and their role in migraine development. Traditional medical treatments and emerging therapeutic strategies, including neuromodulation, are analyzed for their effectiveness and limitations. Clinical studies and imaging techniques are leveraged to identify key mechanisms and triggers in migraine pathology. Approximately 95% of people experience a headache at some point, with migraines being a significant contributor. Migraine is recognized by the World Health Organization as one of the top ten causes of disability globally, particularly affecting women. CGRP is identified as a crucial factor in migraine development. Inhibitors targeting CGRP have shown significant effectiveness in managing migraines. Other molecular markers, including proinflammatory cytokines and neurotransmitters, are discussed for their roles in pain transmission and migraine pathophysiology. Traditional treatments, such as triptans and NSAIDs, are evaluated alongside new therapies, including CGRP inhibitors and neuromodulation techniques. Neuromodulation, involving devices like external trigeminal nerve stimulators, shows promise in migraine management. Genetic markers associated with familial hemiplegic migraine (FHM) and common migraine forms are reviewed. Recent genome-wide association studies (GWAS) have identified several genetic variants linked to migraine susceptibility. Conclusion This presentation enhances the understanding of migraine pathogenesis and introduces novel therapeutic possibilities. By focusing on molecular markers like CGRP and exploring advanced treatment options, the study aims to improve migraine management and patient care. The findings underscore the need for continued research and innovation in migraine treatments to reduce the global burden of this debilitating condition.

Perception, Attitude, and Treatment Behaviour of The Community Towards Mental Disorders in Banyumas Raya

Introduction: The stigma associated with mental disorders continues to have negative value in Indonesian society, which can influence treatment decisions. This project is aimed at evaluating the public’s perceptions, attitudes, and behavior toward treatment of mental disorders in Banyumas Raya. Methods: This was a quantitative cross-sectional study with 410 respondents who had completed questionnaires on mental health perceptions (Mental Health Knowledge Schedule, MAKS), attitude assessment (the Community Attitudes toward Mental Illness, CAMI), and behavior of choosing traditional treatment or medical treatment in October–November 2022. A descriptive analysis was used, and the relationship was assessed using the chi-square test. Result: Descriptive analysis reveals that 273 (66.6%) respondents live in Banyumas, 167 (40.7%) are senior high school graduates, and 175 (42.7%) have an income of Rp. 1,000,000-Rp. 3,000,000. Bivariate analysis revealed a significant relationship between knowledge and behavior (p<0.05; CI. OR: 0.251). Conclusion: Respondents with a high level of knowledge are more likely to engage in medical behavior.

Inclusive Exploration of Harmonizing and Alternative Treatments for Hypothyroidism

: A clinical syndrome known as hypothyroidism occurs due to a shortage of thyroid hormone as a result of decreased production, abnormal distribution, or no action of thyroid hormones. The most typical clinical symptoms included are dry skin, hair loss, weight gain, painful-prolonged periods, infertility, balance problems, slow speech, bradycardia, hypothermia, fatigue, anxiety & depression, joint pain, and indigestion. Basically, age, gender, the severity of the ailment, and a few other factors affect the various signs and symptoms of hypothyroidism. The limitations of allopathic modalities necessitate the investigation of alternative treatment options. Future healthcare initiatives for the poor world will increasingly depend on CAM approaches to these concerns because lifestyle, diet, obesity, lack of exercise, and stress are significant contributing factors to the development of hypothyroidism. This review's objective is to provide information on herbs as well as complementary and alternative medications which are grouped into five major domains: Biologically Based therapies, Manipulative body-based therapies, Mind body-based therapies, and the whole Medical system. These have traditionally been used to treat thyroid dysfunction. The distribution of diseases in emerging nations is altering as a result of globalization. Hence the existing and potential roles of CAM techniques in the general practice of medicine are illustrated in these approaches. Scientists are being compelled to consider traditional herbal medical treatments and CAM therapy in order to combat adverse medication occurrences, high treatment costs, and compliance problems thus described in this review paper.

Exploring the mechanisms and current status of acupuncture in alleviating tumor metabolism and associated diseases: Insights from the central nervous system and immune microenvironment

Acupuncture, as a traditional Chinese medical treatment, has garnered increasing attention in recent years in fields such as tumor metabolism, the central nervous system, and the immune microenvironment. This paper aims to explore the fundamental principles, mechanisms, and research status of acupuncture therapy for tumor-related diseases. Firstly, we introduce the basic principles of acupuncture therapy, including the theories of meridians and its theoretical basis in tumor treatment. Secondly, we systematically review the mechanisms of acupuncture therapy for tumor-related diseases, discussing how acupuncture alleviates side effects such as pain, depression, fatigue, and gastrointestinal discomfort caused by conventional treatments through modulation of the immune microenvironment, central nervous system, and endocrine system. Subsequently, we discuss the current research status of acupuncture therapy for tumor-related diseases, as well as the application of current research methods and technologies in elucidating acupuncture mechanisms. Additionally, by combining clinical practice with different types of tumor-related diseases as experimental subjects, we demonstrate the application effectiveness and clinical practice experience of acupuncture in tumor treatment. Finally, a comprehensive assessment of acupuncture therapy for tumor-related diseases is provided, summarizing its limitations and prospecting future directions, including interdisciplinary collaboration and personalized treatment. In conclusion, acupuncture, as a feasible adjunctive therapy, is closely related to the central nervous system and the immune microenvironment, holding potential significant value in tumor treatment.

Development and Feasibility of a Novel Comprehensive SPARKS Physiotherapy Protocol for Somatic Tinnitus Associated with Cervical and Temporomandibular Dysfunction: A Randomized Controlled Trial

Abstract Context: Somatic tinnitus is the conscious perception of auditory sensation in the absence of an external stimulus, characterized by buzzing, ringing, hissing, or whistling noises which can affect the quality of life. It may be caused by cervical and temporomandibular joint (TMJ) dysfunction. To date, there is no comprehensive physiotherapy protocol to manage somatic tinnitus with cervical and TMJ dysfunction. However, there is little evidence about individual physiotherapy approaches and no comprehensive integrated protocol exists for managing tinnitus holistically. Aims: This study aimed to develop and assess the feasibility of an integrated SPARKS physiotherapy protocol for individuals suffering from somatic tinnitus. Settings and Design: This feasibility study involved 22 participants clinically diagnosed with somatic tinnitus and were randomly assigned to either a control group or an experimental group. Materials and Methods: The integrated protocol was developed to manage somatic tinnitus using manual therapy, exercises, and virtual reality. The outcomes were assessed on days 1 and 28 using a tinnitus handicap inventory (THI), sleep disorder questionnaire (SDQ), and neck Bournemouth questionnaire (NBQ) to evaluate tinnitus symptoms, sleep quality, pain reduction, and neck disability. Results: Analysis demonstrated significant improvement in all three outcomes in the experimental group (P < 0.05). Between-group analysis of THI (P = 0.0001), SDQ (P = 0.0108), and NBQ (P = 0.0001) indicates a statistically superior improvement in the experimental group, in comparison to the control group (P > 0.05). Conclusions: This novel SPARKS physiotherapy protocol for somatic tinnitus has demonstrated superior effectiveness in managing tinnitus compared to traditional medical treatments and it shows a promising and safe multimodal approach.

Applications of leech therapy in medicine: a systematic review.

Leech therapy (LT) is one of the most widely used treatment methods in traditional medicine. The present study aimed to systematically review clinical trials regarding the effects of LT on the prevention and healing of different diseases. To identify all relevant published studies, we conducted a comprehensive search of PubMed, Scopus, and Web of Science databases without any temporal or geographical constraints until April 2023. To categorize the articles, five stages were considered. The PRISMA checklist and Cochran's bias analysis tool were used. In total, 12 trials that met the inclusion criteria were studied. The results of the studies showed that LT has had successful outcomes in treating different conditions. These included hormonal and metabolic complications, cardiovascular problems, and inflammatory-based diseases. "Leech therapy" is a traditional medical treatment used successfully to control and treat various conditions. Although this method can have complications, it is possible to benefit from this low-cost and low-complication treatment by taking preventive measures.

A Thematic Synthesis of the Experiences of Social Prescribing Among Patients in the UK.

Social prescribing connects patients to resources or activities to meet their non-medical needs. In the UK, it is often implemented in primary care. In the social prescribing pathway, patients are directed to link workers to identify suitable solutions for their needs such as art workshops or welfare benefit guidance. Social prescribing marks a notable transition from traditional medical treatments to more comprehensive strategies focusing on holistic health and wellbeing strategies. Insights from patient experiences can improve the development of social prescribing to better meet their needs. This understanding can aid in improving the delivery and outcomes of social prescribing. To synthesise qualitative research on the experiences of social prescribing among patients in the UK. A qualitative systematic review - using thematic synthesis for peer-reviewed papers focused on experiences of social prescribing users in the UK. An exhaustive search was performed in six databases: ASSIA, CINAHL, EMBASE, MEDLINE, PSYCINFO, and SOCIAL SCIENCE CITATION INDEX via Web of Science. The CASP tool for qualitative research was used for quality assessment and PRISMA 2020 Checklist was used to ensure the report transparency. Titles and abstracts of 1,269 papers were screened. In total, 85 papers were full text-screened, and 19 studies were included in the review. Five analytical themes were developed from these papers: (a) Searching for hope in times of adversity; (b) Variability in temporal responsiveness; (c) Feeling supported and empowered by the social prescribing pathway; (d) Sustained change from a positive response; (e) Misalignment producing no response. Patients might experience lasting advantages from social prescribing if it aligns with their needs and expectations. Results highlighted the importance of matching social prescribing referral with patients' readiness to engage. Therefore, it is recommended that healthcare professionals evaluate patient suitability prior to beginning a social prescribing referral.

Predicting Long-Term Engagement in mHealth Apps: Comparative Study of Engagement Indices.

Digital health care apps, including digital therapeutics, have the potential to increase accessibility and improve patient engagement by overcoming the limitations of traditional facility-based medical treatments. However, there are no established tools capable of quantitatively measuring long-term engagement at present. This study aimed to evaluate an existing engagement index (EI) in a commercial health management app for long-term use and compare it with a newly developed EI. Participants were recruited from cancer survivors enrolled in a randomized controlled trial that evaluated the impact of mobile health apps on recovery. Of these patients, 240 were included in the study and randomly assigned to the Noom app (Noom Inc). The newly developed EI was compared with the existing EI, and a long-term use analysis was conducted. Furthermore, the new EI was evaluated based on adapted measurements from the Web Matrix Visitor Index, focusing on click depth, recency, and loyalty indices. The newly developed EI model outperformed the existing EI model in terms of predicting EI of a 6- to 9-month period based on the EI of a 3- to 6-month period. The existing model had a mean squared error of 0.096, a root mean squared error of 0.310, and an R2 of 0.053. Meanwhile, the newly developed EI models showed improved performance, with the best one achieving a mean squared error of 0.025, root mean squared error of 0.157, and R2 of 0.610. The existing EI exhibited significant associations: the click depth index (hazard ratio [HR] 0.49, 95% CI 0.29-0.84; P<.001) and loyalty index (HR 0.17, 95% CI 0.09-0.31; P<.001) were significantly associated with improved survival, whereas the recency index exhibited no significant association (HR 1.30, 95% CI 1.70-2.42; P=.41). Among the new EI models, the EI with a menu combination of menus available in the app's free version yielded the most promising result. Furthermore, it exhibited significant associations with the loyalty index (HR 0.32, 95% CI 0.16-0.62; P<.001) and the recency index (HR 0.47, 95% CI 0.30-0.75; P<.001). The newly developed EI model outperformed the existing model in terms of the prediction of long-term user engagement and compliance in a mobile health app context. We emphasized the importance of log data and suggested avenues for future research to address the subjectivity of the EI and incorporate a broader range of indices for comprehensive evaluation.

The Sociolinguistic Implications of Body Marks in Ngwaland

Africa has a rich culture of body markings, which is an integral part of its society, history and traditions. Body markings were and are both temporary and permanent modifications of the body, which transmit complex messages about identity and social status. In some African communities, body markings were like wearing one’s identity card on the face or having them printed on one’s skin. The study was carried out in Isiala Ngwa in Abia state, where a corpus of about 30 different body marks was documented and 20 participants were interviewed on the types, motivation, cultural significance, ranking, perception of body marks and reasons for the subsequent decline in the use of indigenous body marks in the Ngwa society. The data collection method involved semi-structured interviews, participant observation and formal conversations on the history and use of body marks in the target group. The Semiotic theory of identification was used as the basic framework for the analysis. The research findings reveal that body markings in Ngwaland are sources of traditional medical intervention, aesthetics/beautification, spiritual fortification/protection, identification, preventing death through reincarnation and warding off aggression. The work concludes that the undeniable roles of body marks in Ngwa land cannot be allowed to go into extinction, as the story of the Ngwa people would be incomplete without body marks, which is the window through which political, social and religious organizations in the past were dissected. Thus, a sociolinguistic, anthropological and documentary approach to body markings in Ngwa land is necessary towards the exploration and preservation of traditional communication patterns, identity formation and semiotic values of this aspect of embodiment.

Regenerative Medicine: Tissue Engineering and Stem Cell Therapy

Regenerative medicine is an emerging field in the medical sciences, focusing on restoring the function of damaged tissues and organs through innovative techniques such as tissue engineering and stem cell therapy. This article explores key aspects of tissue engineering and stem cell therapy, highlighting their potential to revolutionize traditional medical treatments. Tissue engineering involves the use of specially designed biomaterial scaffolds that support the growth and differentiation of stem cells into functional tissues. Stem cell therapy, on the other hand, offers novel approaches for treating various degenerative diseases and injuries by harnessing the regenerative capabilities of stem cells to repair or replace damaged tissues. The article also examines the major challenges in the development and application of regenerative therapies, including issues of safety, efficacy, and ethics. Furthermore, recent advancements in tissue engineering techniques and stem cell therapies are highlighted, showcasing promising results in clinical trials and preclinical applications. With the potential to transform healthcare paradigms, this field continues to attract the attention of scientists, clinicians, and regulators, although many challenges remain before these techniques can be widely adopted in clinical practice. The article concludes that multidisciplinary collaboration and further research are essential to overcoming existing barriers and maximizing the benefits of these regenerative therapies.

Metformin reduces testosterone level in type 2 diabetes mellitus patients and its therapy by traditional medicine

BackgroundType 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and hyperglycemia. Metformin, a commonly prescribed treatment for T2DM, is known for its effectiveness in improving glycemic control. Recent studies suggest that metformin may also influence testosterone levels in male patients, a hormone crucial for male reproductive health, muscle mass maintenance, and overall quality of life. Medicinal plants were traditionally used for influencing the testosterone level in the body which may be given as a therapy for the side – effects of metformin tablet. ObjectiveTo assess the impact of metformin treatment on testosterone levels in male patients with T2DM compared to non-diabetic males, and to evaluate the potential implications of traditional medical treatments in managing the consequences of reduced testosterone levels. MethodsThis study is a prospective observational investigation conducted among a total of 60 patients,divided into two groups: 30 males taking metformin as a hyperglycaemic agent with T2DM and 30 males without any diabetic treatment. This study was be carried out in different outpatient department of Shri Mahant Indiresh Hospital, Patel Nagar, Dehradun to assess the level of testosterone in male patients with T2DM taking metformin and in non-Diabetic participants. Based on these findings, potential traditional medicines methods for reducing testosterone levels were summarized. ResultsIt was demonstrated that male patients with T2DM undergoing metformin treatment exhibited significant reduction in testosterone serum levels compared to non-diabetic patients. Several plants were examinedand, and clinical studies were conducted on them. It was discovered that these plants have been effective in increasingtestosterone level, suggesting their potential use as therapy for patients. ConclusionThis study shows reduction in the testosterone levels, which may lead to low sex drives and induction of low testosterone induced erectile dysfunction. While metformin is used to treat T2DM, it decreases testosterone levels, which negatively impacts the patients' quality of life. So, there is essential need to further study the effect of metformin on testosterone levels in patients with T2DM. Additionally, plants that may be useful in increasing the testosterone levels should be studied further for their beneficial characteristics and potential therapeutic applications.

Calculation of the Variable Costs of Traditional Medical Treatment for the Example of Hypergastric Disease

Calculation of the Variable Costs of Traditional Medical Treatment for the Example of Hypergastric Disease

New Frontiers in the Treatment of Patients with HER2+ Cancer and Brain Metastases: Is Radiotherapy Always Useful?

Brain metastases (BM) pose a significant challenge in the management of HER2+ breast cancer since almost 50% of patients with HER2+ breast cancer develop brain tumors. The complex process of brain metastases involves genetic mutations, adaptations and mechanisms to overcome the blood-brain barrier. While radiotherapy is still fundamental in local therapy, its use is associated with cognitive adverse effects and limited long-term control, necessitating the exploration of alternative treatments. Targeted therapies, including tyrosine kinase inhibitors, monoclonal antibodies, and antibody-drug conjugates, offer promising options for HER2+ breast cancer patients with BM. Clinical trials have demonstrated the efficacy of these agents in controlling tumor growth and improving patient outcomes, posing the question of whether radiotherapy is always the unique choice in treating this cancer. Ongoing research into novel anti-HER2 antibodies and innovative combination therapies holds promise for advancing treatment outcomes and enhancing patient care in this clinical scenario. This narrative review provides a comprehensive overview of traditional medical treatments, molecularly targeted therapy and investigational agents in the management of HER2+ breast cancer with BM, highlighting the evolving landscape and potential future directions in treatment strategies to improve patient survival and quality of life.

Analysis of the coupling coordination between traditional Chinese medicine medical services and economy and its influencing factors in China.

The coordinative relationship between medical treatment and the economy is an important part of promoting the sustainable and healthy development of a social economy, and it is conducive to promoting the coordinated development of the two systems. Based on constructing a comprehensive evaluation index system for the relationship between traditional Chinese medicine medical services and economic development, the entropy method, coupling coordination model, and Tobit model are used to calculate the comprehensive development level, coupling coordination degree, and influencing factors of the two systems in 31 provinces of China from 2015 to 2021. Suggestions are proposed for the coordinated development of traditional Chinese medicine medical services, and economy. The results showed that the development level of traditional Chinese medicine was higher than that of social and economic development, the relative development gap between the two systems was gradually narrowed, and the coupling coordination degree increased steadily; however, the regional differences were large. The relative development level and coupling coordination degree of each region show a development pattern of eastern > central > western > northeast; the coupling coordination degree of the two systems in the spatial region was positively correlated and was enhanced year by year. From the perspective of influencing factors, the level of economic development is the decisive factor in the coupling and coordination between traditional Chinese medicine medical treatment and the social economy. Factors such as human capital and health level in traditional Chinese medicine have an inhibitory effect on the coordinated development of the two systems. So, China should focus on optimizing the regional allocation of traditional Chinese medicine medical personnel, improving the quality of medical services, and enhancing the health level of medical personnel.

Weight loss treatment for COVID-19 in patients with NCDs: a pilot prospective clinical trial

COVID-19 comorbid with noncommunicable chronic diseases (NCDs) complicates the diagnosis, treatment, and prognosis, and increases the mortality rate. The aim is to evaluate the effects of a restricted diet on clinical/laboratory inflammation and metabolic profile, reactive oxygen species (ROS), and body composition in patients with COVID-19 comorbid with NCDs. We conducted a 6-week open, pilot prospective controlled clinical trial. The study included 70 adult patients with COVID-19 comorbid with type 2 diabetes (T2D), hypertension, or nonalcoholic steatohepatitis (NASH). Interventions: a restricted diet including calorie restriction, hot water drinking, walking, and sexual self-restraint. Primary endpoints: COVID-19 diagnosis by detecting SARS-CoV-2 genome by RT-PCR; weight loss in Main group; body temperature; C-reactive protein. Secondary endpoints: the number of white blood cells; erythrocyte sedimentation rate; adverse effects during treatment; fasting blood glucose, glycosylated hemoglobin A1c (HbA1c), systolic/diastolic blood pressure (BP); blood lipids; ALT/AST, chest CT-scan. In Main group, patients with overweight lost weight from baseline (− 12.4%; P < 0.0001); 2.9% in Main group and 7.2% in Controls were positive for COVID-19 (RR: 0.41, CI: 0.04–4.31; P = 0.22) on the 14th day of treatment. Body temperature and C-reactive protein decreased significantly in Main group compared to Controls on day 14th of treatment (P < 0.025). Systolic/diastolic BP normalized (P < 0.025), glucose/lipids metabolism (P < 0.025); ALT/AST normalized (P < 0.025), platelets increased from baseline (P < 0.025), chest CT (P < 0.025) in Main group at 14 day of treatment. The previous antidiabetic, antihypertensive, anti-inflammatory, hepatoprotective, and other symptomatic medications were adequately decreased to completely stop during the weight loss treatment. Thus, the fast weight loss treatment may be beneficial for the COVID-19 patients with comorbid T2D, hypertension, and NASH over traditional medical treatment because, it improved clinical and laboratory/instrumental data on inflammation; glucose/lipid metabolism, systolic/diastolic BPs, and NASH biochemical outcomes, reactive oxygen species; and allowed patients to stop taking medications.Trial Registration: ClinicalTrials.gov NCT05635539 (02/12/2022): https://clinicaltrials.gov/ct2/show/NCT05635539?term=NCT05635539&draw=2&rank=1.

Current Status of Patent Research on Medical Micro-nano Robot

Abstract: Micro-nano robots have broad applications in sewage purification and DNA testing. Micro- nano robots have significant potential in the medical field， as they have higher therapeutic efficiency and safety than conventional treatment methods. Meanwhile, micro-nano robots provide a new method for treating many diseases. Therefore, as an emerging medical method, the development trend of micro-nano robots is receiving increasing attention. This study aims to provide a new approach to treating diseases that reduces the costs and risks of traditional medical treatments. This paper introduces the operation mechanism of micro-nano robots, summarizes representative patents of micronano robots in medicine, summarizes the classification according to the different driving modes, and analyzes their advantages, disadvantages, and uses. Through the investigation of many micro-nano robots, the current medical micro-nano robots are summarized and analyzed as generally challenging to prepare, difficult to control accurately, with a low degree of intelligence, and poor accuracy. Finally, the future development trend of medical micro-nano robots is overlooked. Optimizing the preparation method can significantly reduce the production cost of micro-nano robots. Mixing and driving modes can drive the micro-nano robots more efficiently. Improving the intelligence of micro-nano robots can allow them to perform more complex tasks. Improved imaging techniques allow for more precise control of the micro-nano robots. Finally, the article forecasts that micro-nano robots will develop towards the trends of non-toxic, intelligent, and controllable directions.

The role of online hemodiafiltration with endogenous reinfusion in the treatment of systemic lupus erythematosus activity resistant to conventional therapy.

Lupus is a diverse autoimmune disease with autoantibody formation. Lupus nephritis carries a grave prognosis. Complement involvement, namely, C1q deficiency, is linked to activity and renal involvement and could help in their assessment. LN therapies include plasma exchange, immune adsorption, and probably hemodiafiltration with online endogenous reinfusion (HFR), together with traditional immunosuppressive therapies. The aim of this study was to evaluate the role of HFR in improving signs and symptoms of systemic lupus erythematosus (SLE) activity and laboratory parameters in cases not responding to traditional immunosuppressive therapy. A controlled clinical study was conducted on 60 patients with lupus from Group A that was subdivided into two groups: cases 1 (47 patients), those who received traditional medical treatment, and cases 2 (13 patients), those who underwent HFR in addition to medical treatment. Group B consisted of two subgroups: control 1, composed of 20 healthy age- and sex-matched volunteers, and control 2, consisting of 10 cases with different glomerular diseases other than lupus. Serum C1q was determined before and after the HFR as well as induction by medical treatment. Disease activity was assessed using SLEDAI-2K with a responder index of 50; quality of life was assessed using SLEQOL v2, and HFR was performed for the non-responder group. C1q was lower in cases. It can efficiently differentiate between SLE patients and healthy controls with a sensitivity of 81.67% and a specificity of 90%. It can also efficiently differentiate between SLE patients and the control 2 group (non-lupus patients with renal glomerular disease) with a sensitivity of 83.33% and a specificity of 100%. C1q was more consumed in proliferative lupus, and correlated with anti-ds DNA, C3, and C4. C1q efficiently discriminates lupus patients and correlates with proliferative forms. HFR might ameliorate lupus activity and restore C1q.

Cingulotomy for Intractable Pain: A Systematic Review of an Underutilized Procedure.

Pain management is a critical aspect of cancer treatment and palliative care, where pain can significantly impact quality of life. Chronic pain, which affects a significant number of people worldwide, remains a prevalent and challenging symptom for patients. While medications and psychosocial support systems play a role in pain management, surgical and radiological interventions, including cingulotomy, may be necessary for refractory cases. Cingulotomy, a neurosurgical procedure targeting the cingulate gyrus, aims to disrupt neural pathways associated with emotional processing and pain sensation, thereby reducing the affective component of pain. Although cingulotomy has shown promise in providing pain relief, particularly in patients refractory to traditional medical treatment, its use has declined in recent years due to advancements in non-destructive therapies and concerns about long-term efficacy and patient suitability. Modern stereotactic methods have enhanced the precision and safety of cingulotomy, reducing associated complications and mortality rates. Despite these advancements, questions remain regarding its long-term efficacy and suitability for patients with limited life expectancy, particularly those with cancer. A comprehensive systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, aimed at providing insights into the efficacy, potential benefits, and limitations of this neurosurgical procedure in managing intractable pain. An electronic search of PubMed, Embase, Scopus, and Web of Science was conducted with open database coverage dates. The review focused on outcomes such as pain intensity and quality of life. The inclusion criteria encompassed human studies of any age experiencing intractable cancer or non-cancer pain, with cingulotomy as the primary intervention. Various study designs were considered, including observational studies, clinical trials, and reviews focusing on pain and cingulotomy. Exclusion criteria included non-human studies, non-peer-reviewed articles, and studies unrelated to pain or cingulotomy. This review highlights the efficacy of stereotactic anterior cingulotomy in managing intractable pain, particularly when conventional treatments fail. Advanced MRI-guided techniques enhance precision, but challenges like cost and expertise persist. Studies included in this review showed significant pain relief with minimal adverse effects, although the optimal target remains debated. Neurocognitive risks exist, but outcomes are generally favorable. Expected adverse events include transient effects like urinary incontinence and confusion. Reoperation may be necessary for inadequate pain control, with a median pain relief duration of three months to a year. A double stereotactic cingulotomy appears to be safe and effective for refractory pain.

Post-Covid-19 syndrome – a new challenge with an unknown end

The long-term effects of SARS-CoV-2 infection (or the so-called post - COVID - 19 syndrome) have a lasting physical, psycho-social and socio-iconic impact on survivors and their relatives and especially among some specific work groups (e.g. health workers). Concomittant chronic diseases (obesity, hypertension, diabetes mellitus and respiratory disorders) also affect patients' ability to work and their return to work. Globally, between 30% and 50% of those infected with COVID-19 experience long-term symptoms of COVID (long Covid, LC), with over 85% of patients of working age. Various author collectives report that symptoms of long-term COVID (a total of 203 of which the most frequent are dyspnea on exertion and at rest, fatigue, cognitive dysfunction, asthenia, arthralgias and myalgias, sleep disorders, cough), which can last up to 9 and more months after an infection, hinder and delay the return to work (RTW), reduce the patients' ability to work, force them to return to work with restrictions (reduced working hours, changed duties at the workplace, etc.), to change their job or lose it. Returning to work after a post-critical illness is often delayed or does not occur at all, causing an impact on the overall quality of life among survivors and their families (the so-called "family syndrome"). Some patients (especially those who have had severe COVID or have been hospitalized in an intensive care unit) are forced to take periodic sick leave and delay their return to work for at least 5 weeks from the onset of symptoms of COVID-19, such as the main cause is fatigue or weakness. Social functioning was assessed as impaired, as up to 90% of survivors did not reach their functional level 6 months after intensive care unit (ICU) discharge. Differences in return to work are based on mean age of patients (better outcomes are seen in younger patients), country (presenteeism is common in China, where the best RTW outcomes have been reported) and social policy (not all US employees are entitled to paid sick leave). A large proportion of patients (up to 64.4%) reported moderate to severe financial difficulties and an inability to cover the costs of research or treatment. Some authors recommend specific rehabilitation for patients after acute COVID-19 to restore physical and neuropsychological performance and to improve performance. Patients have better outcomes following an integrative health approach that combines traditional medical treatment, non-pharmacological treatments including physical therapy, and behavioral and lifestyle changes.

Cutting‐Edge Achievements of Inner Ear Drug Delivery Systems

The intricate physiological structure of the inner ear presents challenges for traditional medication treatment strategies, including systemic adverse responses, trouble penetrating the blood–labyrinth barrier, and low local cochlear concentration, resulting in poor therapeutic outcomes. An intriguing tactic that is extensively developed over decades is utilizing drug delivery systems to transport medication molecules to the inner ear. Herein, the challenges associated with inner ear delivery are discussed, cutting‐edge achievements in inner ear drug delivery systems are emphasized, including nano‐, micro‐, and macrocarriers, and finally opportunities to leverage advanced technologies to improve existing drug delivery strategies are highlighted.