Journal of Clinical Medicine and Regenerative Medicine
Editor-in-Chief William C Cho Professor Department of Clinical Oncology Queen Elizabeth Hospital Hong Kong Journal of Clinical Medicine and Regenerative Medicine is an open-access, peer-reviewed journal dedicated to research and developments in clinical medicine, regenerative medicine, biomedical sciences, and related interdisciplinary fields. The journal provides a platform for researchers, academicians, physicians, clinicians, healthcare professionals, and biomedical scientists to share innovative research, clinical applications, translational advances, and emerging trends in medicine and regenerative healthcare. The journal welcomes submissions in the form of Letter-to-Editor, Conference Proceedings, Research, Review, Case Reports, E-Books, Editorials, Opinions, Short Communications, Mini-Reviews, Book Reviews, Video Articles, and PowerPoint Presentations (PPTs). Call for Papers: Special Issue on Regenerative Medicine in the Clinic: From Innovation to Patient Care Journal of Clinical Medicine and Regenerative Medicine invites researchers, scientists, academics, physicians, clinicians, healthcare professionals, biomedical researchers, and experts from related disciplines to contribute original and high-quality manuscripts to our upcoming Special Issue on “Regenerative Medicine in the Clinic: From Innovation to Patient Care.” This Special Issue focuses on the translation of regenerative medicine innovations from laboratory research into clinical practice and patient care. Contributions addressing stem cell-based therapies, tissue engineering, regenerative therapies, cell and gene therapies, biomaterials, organ regeneration, tissue repair, personalized regenerative medicine, clinical trials, translational medicine, and emerging therapeutic approaches are particularly encouraged. The Special Issue also welcomes research exploring challenges and opportunities in the clinical implementation, safety, efficacy, accessibility, and long-term outcomes of regenerative medicine. You can submit articles online from https://srcpublishers.com/clinical-medicine-and-regenerati/user/register or can send through an e-mail with attachment for clinicalmedicine@onlinescientificresearch.info 0.5 Impact Factor 84.5% Citations 65% Acceptance
Multidisciplinary Team Management of a Krukenberg TumorPresenting with Pleural Effusion: A Case Report
Krukenberg tumors are a distinct form of ovarian metastasis, most commonly originating from gastrointestinal malignancies. Because primary lesions are often clinically silent, patients may present with atypical manifestations that delay diagnosis. We report a young woman who presented with isolated pleural effusion and was subsequently diagnosed with poorly differentiated gastric adenocarcinoma with ovarian and peritoneal metastases. The etiology was clarified through a multidisciplinary team (MDT) approach, and combination therapy incorporating immunotherapy, targeted therapy, and chemotherapy resulted in marked clinical improvement. This case underscores the importance of considering metastatic gastrointestinal malignancies in the differential diagnosis of unexplained exudative pleural effusion with elevated tumor markers in young women and highlights the value of MDT-driven strategies in expediting diagnosis and guiding individualized management in advanced disease.
Copyright (c) 2026 Journal of Clinical Medicine and Regenerative Medicine
Dialogue Between Competence and Progression Growth Factorsand Astroglial-Conditioned Media on Nucleic Acid and Erk1/2Expression During Astroglial Cell Proliferation and Differentiationin Culture
Growth factors are classified in competence growth factors and progessing growth factors, as reported in a papaer by Stiles and Antonisse, published on 1970. The competence growth factors, including basic fibroblast growth factors (bFGF) and PDGF, are protein that switch from G0 phase to G1 phase of the cell cycle. The progression growth factors, including EGF, IGF-1 and insulin are proteins that, during S phase of the cell cycle, stimulate DNA biosynthesis by activating the enzymes DNA polymerase, thymidine kinase and timidilate synthetase. The aim of this present investigation is to study the cross-talk between exogenous growth factors and endogenous growth factors released from astroglialconditionedmedia on DNA labeling and ERK ½ expression in astrocytes in an in vitro model. To better clarify mechanism of astroglial cell proliferation /differentiation in culture, incorporation of [methyl-3H]-thymidine in astroglial cell cultures was investigated. Astrocytes cultures were pre-treated withepidermal growth factor (EGF), insulin (INS), insulin-like growth factor-I (IGF- I), and basic fibroblast growth factor (bFGF) and subsequently with astroglialconditioned media (ACM). In particular, the incorporation of [methyl-3H]-thymidine into DNA showed a significant increase in ACM from 15 days in vitro(DIV) cultures in 30 DIV astrocytes after12 h pre-treatment with growth factors. The results of enhancement in DNA labeling after pre- treatment with EGF orINS in 30 DIV astrocytes cultures and subsequent addition of ACM from 15 DIV cultures, indicate that the involvement may depend on extra cellular signalregulated kinase (ERK1) activation. In addition, the present study seeks to elucidate the interactions between the competence growth factor bFGF and/or estrogen 17b-estradiol and the progressiongrowth factor EGF, IGF-1 and insulin on GFAP and vimentin expression in astroglial cultures under different experimental conditions. Pretreatment for 24hrwith bFGF subsequent exposure for 36hr estradiol and EGF, IGF-1 or INS was markedly increased, when the cultures where treated with two or three growthfactors. Our data demonstrate estradiol-growth factor cross-talk during astroglial cell proliferation and differentiation in culture. In summary, the environment created by astroglial cultures can regulate their own proliferation and differentiation, through the release of soluble mediatorsfinally acting on their genomic program. This may be relevant in vivo, when scheduled events related to brain development are regulated by astrocyte-derived growth factors controlling neuronal and glial architecture from the postnatal period until the adulthood.
Treatment Modalities for Hemophilia Type A
Hemophilia Type A is a genetic disorder caused by inheriting an X chromosome from the parents. It causes an individual to produce an ineffective factorVIII, diminishing the blood's clotting ability. Patients with Hemophilia Type A experience uncontrollable bleeding episodes, unexplained bruising, joint pain,or, in more extreme cases, bleeding in the brain. When patients present with a family history of Hemophilia, physicians will order testing to determine if thedisorder is a possible etiology of abnormal bleeding episodes. Testing is essential because symptomology alone is not enough to diagnose Hemophilia A. Other bleeding disorders, such as different types of Hemophilia or Von Willebrand, present similarly in patients. Even with no reported family history, Hemophilia A should be considered as a potential diagnosis for spontaneous bleeding episodes because specific individuals acquire the disorder. Physicians need to ruleout all potential causes of symptoms, regardless of their commonality, to ensure the patient receives proper and timely treatment. Therefore, Doctors shouldorder a PTT, a PT, and a clotting factor test to determine the patient's clotting ability and, if abnormal, identify a clotting factor deficiency. After determining a patient has Hemophilia Type A, a treatment plan may consist of replacing clotting factors through medications and injections, as well as managing symptoms at home. Again, without proper testing and diagnosis, prolonged absence of treatment can lead to the patient developing potentially life-threatening problemsor complications that could significantly decrease their quality of life. While the current treatments are effective at preventing clotting episodes in some, more research is needed to determine a more effective solution to increase the patient's quality of life.
Clinical Differentiation of Gilbert Syndrome, Crigler-NajjarSyndrome and β-Thalassemia Trait
Unconjugatedhyperbilirubinemia in adolescents and young adults has to be differentiated clinically as it is associated with different clinical presentation , most commonly Gilbert syndrome (GS) – a benign hereditary bilirubin conjugation defect – versus increased bilirubin production from mild hemolytic disorders such as β-thalassemia trait, with the rare Crigler-Najjar syndromes as important considerations . This publication is made to educates clinicians and medical students. Basic laboratory tests and clinical clues will be important. Liver function tests (LFTs) and hemolysis markers (complete blood count, reticulocyte count,lactate dehydrogenase, etc.), followed by targeted tests such as hemoglobin electrophoresis for hemoglobinopathies and provocative tests (fasting or rifampicintest, phenobarbital trial) for conjugation defects We emphasize how inexpensive investigations can confirm the diagnosis, avoiding unnecessary costly workups.Key distinguishing features of GS, Crigler-Najjar type 2, and β-thalassemia trait – including typical bilirubin levels, hematologic indices, genetic basis, andmanagement – are summarized in a comparative table. Early recognition of these benign conditions is crucial for patient reassurance, appropriate counseling(e.g. for carrier traits), and preventing unwarranted interventions. To distinguish Gilbert syndrome, Crigler-Najjar (type 2), and β-thalassemia trait, one should understand the clinical and laboratory profile of each:
Features of Pathogenetic Mechanisms of Skin Hyperpigmentation: A One-Moment Cross-Sectional Research
Introduction Despite the uniqueness of the melanin pigment system, where the final outcome of pigmentation is formed through the interaction of two types of cells (melanocytes and keratinocytes), researchers have made certain progress in partially understanding the mechanisms of melanogenesis and patient therapy. Undoubtedly, the most significant clinical implications pertain to pigmentation disorders primarily associated with melanin. Objective of the Research To study the levels of lipoproteins of various classes in patients with hyperkeratosis and their role in the formation of skin hyperpigmentation. Methods The research involved 50 women living in Rostov-on-Don, average age 42.3±1.1 years, divided into two groups: 25 people with skin hyperpigmentation, average age 41.52±1.68 years, undergoing treatment in the dermatology department; 25 people - practically healthy (PH) individuals - during medical examinations, average age 43.57±1.43 years. The content of total cholesterol (TC), triacylglycerides (TG), HDL was determined by the enzymatic colorimetric method using the ChronolabAG kits (Switzerland), LDL - by the turbidimetric method, very low density lipoproteins (VLDL) - by the calculated TG/5 method. Statistical processing of the obtained data was performed using Microsoft Office Excel 2007 (Microsoft Corp., USA) and Statistica 10.0 (StatSoft Inc, USA). The data are presented as M±m, where M is the mean value of the feature, m is the mean error of the feature, and also as an expression of the frequency of occurrence of the feature in absolute values (n) and percentages (%). The significance of differences between subgroups was assessed using Student's T-criterion. Correlation analysis was performed to determine the relationships between different parameters. The threshold level of statistical significance was p < 0.05. The Mann-Whitney criterion was used for comparative analysis of absolute differences in samples. Results During the study of the metabolic features of lipoprotein metabolism in patients with hyperpigmentation, an increase in the level of individual lipoprotein classes was noted compared to the control group. The level of total cholesterol, TG, LDL, VLDL was statistically significantly increased, and a tendency towards a decrease in HDL was revealed. Thus, the content of TC in patients with hyperpigmentation was statistically significantly different from the control, by 18.64% (p = 0.148), which suggests that cholesterol is used to build cell membranes. Against this background, a higher content of TG was noted - by 18.1% (p = 0.393), which are obviously used to maintain cell energy costs. It should be noted that the concentrations of atherogenic fractions of VLDL, LDL in hyperpigmentation were higher than in the control: VLDL - by 18.13% (p = 0.352) and LDL - by 44.93% (p = 0.044). Which is obviously associated with increased cholesterol esters entering the epidermal tissue. However, HDL values tended to decrease in the main group compared to the control. Conclusion It was found that patients with hyperpigmentation have statistically significantly increased levels of individual lipoprotein classes, such as LDL, VLDL, as well as TG and TC. This is probably an indicator of the constant need of cells to synthesize membrane lipids and maintain increased cellular metabolism, which is necessary for increased regeneration of the epidermis. Further study of the level of blood plasma lipoproteins and analysis of changes in their fractions will reveal the pathogenetic mechanisms of skin hyperpigmentation, as well as reveal the predictors that contribute to its formation.
ABSTRACT This paper investigates the potential of sound therapy as a complementary treatment for fertility issues. It delves into the physiological and psychological benefits of sound therapy, explores specific hertz frequencies that promote reproductive health, and provides empirical evidence supporting its efficacy. The study aims to offer a holistic understanding of how sound can serve as a non-invasive, supportive treatment for couples facing fertility challenges.
Copyright (c) 2025 Journal of Clinical Medicine and Regenerative Medicine
Managing Severe Acute Myeloid Leukimia with Collaborative Medical and Nursing Interventions: Case Study
ABSTRACT Assessment: An 82-year-old patient diagnosed with Acute Myeloid Leukemia (AML) was admitted to the Emergency Department with a hemoglobin level of 3.1 g/dL, requiring immediate blood transfusion. The assessment included routine blood lab tests, chest X-ray, ECG, physical examination, general condition evaluation, and Glasgow Coma Scale (GCS) scoring, which indicated full consciousness. Diagnosis: Based on the assessment conducted, the nursing diagnoses identified are ineffective peripheral tissue perfusion, risk for bleeding associated with decreased red blood cell (RBC) levels, risk for infection due to compromised immunity, and risk for decreased cardiac output related to the patient's history of heart disease. Planning: The following are the targeted implementations for the identified nursing diagnoses. Ineffective peripheral tissue perfusion, nurse would administer blood transfusion as per the physician's advice. Risk for bleeding, nurse would monitor for any signs of bleeding, report if bleeding occurs, and manage bleeding if present. To prevent infection, nurse would measure temperature at each shift, apply aseptic techniques, and ensure proper nutritional management. Risk for decreased cardiac output, nurse would collaborate with a cardiovascular specialist and monitor for symptoms of shortness of breath or chest pain.
Meditation a Fast Way to Reduce Fear and Stress
The meditation claims that it leads to better anti-inflammatory response and healthy aging by proper telomerase regulation. There are also benefits and positives in physical and mental health. The variety of diseases to be studied should be increased. It affects immunology, genetics and various aspects of physical and mental health including depression, substance abuse, eating disorders, conflict between couples, anxiety disorders and obsessive-compulsive disorder. Sit quietly and focus on your natural breathing or a word or mantra that you repeat silently. Let thoughts come and go without judgment and focus your attention on the breath or mantra. Physical sensations. Notice subtle physical sensations like itching or tingling without judgment and let them go. Pay attention to each part of your body sequentially from head to toe. Sensory. Pay attention to sight, sound, smell, taste and touch. Name them without judgment, such as “sights”, “sounds”, “smells”, “tastes” or “touch” and let them go. Human beings have between 12,000 and 50,000 thoughts per day, and 80 percent of them are negative. Emotional experiences deeply affect our physical states, for example, when we feel anger, our eyes close and our face burns. The training has positive effects on the physical and mental health of adults, such as reducing mood and anxiety disorders, distress and blood pressure. Magnetic alternating current stimulation applied at different frequencies (beta, theta and gamma) while theta and beta-tACS caused participants to rate emotional images as more pleasant (higher valence), while only theta-tACS reduced subjective arousal ratings (more calm). Regular practitioners have younger and brighter skin due to freedom from fear and stress.
Evaluation of the Effectiveness of Pharmaceutical Counselingon Therapeutic Outcomes of HIV/AIDS Patients at WaihaongCommunity Health Center
Introduction HIV/AIDS is a global health problem. Over the past 30 years, HIV/AIDS rates have increased at an alarming rate, ranking among the top 10 diseases posing a global burden. Pharmacists play a crucial role in HIV/AIDS control, including through drug counseling. Pharmacist counseling is crucial for improving patient adherence, which impacts therapy outcomes, including viral load levels and quality of life Material and Methods The study was conducted using a cross-sectional method, using questionnaires to assess patient quality of life and compliance. A retrospective approach, reviewing patient medical records, was used to determine viral load levels. The data was then processed using SPSS 's chi-square method Results A study of 234 HIV patients found that the frequency of pharmacist counseling significantly correlated with therapeutic outcomes, including viral load levels and patient quality of life. However, no significant association was found between frequency and patient adherence to therapy Conclusions: Counseling by pharmacists can impact therapeutic outcomes for HIV patients; therefore, providing effective counseling is crucial. Pharmacists should also consider providing other professionals to support consultations whenever the patient needs them, not just every three months for patients on multi-month dispensing.
HIV/AIDS, Pharmacist Counseling, Therapeutic Outcome
The Relationship between Education Level and TherapeuticOutcomes of Patients using Metformin alone and in Combinationin Ambon City
Diabetes mellitus (DM) is a chronic disease caused by problems with the pancreas to produce sufficient amounts of insulin or the body cannot use the insulin it produces properly. Socio-demographic variables such as education level, age, gender, socioeconomic such as employment and medical costs, and frequency and amount of medication are some of the factors that can affect a patient's adherence to taking medication. By knowing these factors, people at risk of developing diabetes can take preventive measures by controlling other factors related to diabetes. The purpose of the study was to evaluate the effect of DMT2 patients' education level on adherence in the use of single and combination metformin drugs, analyze differences in therapeutic outcomes, find out what factors affect therapeutic outcomes and analyze the patient's quality of life. Methods: This study involved 300 DM respondents using a cross-sectional approach that met the inclusion criteria. Data were collected through the MMAS-8 questionnaire (Morisky 8-item drug adherence scale) and EQ-5D Value set Indonesia, and were equipped with medical records. Then the Chi-Square test was used to see the relationship between education level and compliance, the Mann-Whitney non- parametric test to analyze the difference in therapeutic outcomes with the type of therapy and to see the relationship between the patient's quality of life and the type of therapy, and the Cox Regression test to determine the factors that determine the level of education to the therapeutic outcome. The results showed the relationship between education level and patient compliance (p value = 0.291), the difference in therapy results with the type of therapy in the final GDP group that was treated using single and combination metformin (p=0.013 value) while in the Cholesterol group (p=0.036 value). Determinants of education level on therapeutic outcomes for elementary school (p=0.214), junior high school (p=0.428), high school (p=0.789), high compliance (p=0.665), moderate compliance (p=0.136), type of therapy (p=0.624), Age (p=0.085), Male (p=0.948), Female (p=0.959), Private Worker (p=0.830), Entrepreneur (p=0.330), Civil servants (p= 0.499), as well as the relationship between quality of life and the type of therapy (p=0.300). Conclusions: There was no significant relationship between education levels and patient compliance. The difference in therapy outcomes with the type of therapy in patients from the final GDP and cholesterol therapy outcomes group was significant. There was no significant relationship between the quality of life and the determinants of the treatment outcome were not significant.
Diabetes Mellitus, Education Level, Metformin
Analysis of Drug Management in Relation to Drug Availability andPatient Satisfaction at Community Health Centers in Ambon City
Abstract Health services are an effort that can be implemented individually or simultaneously within an organization with the aim of maintaining and improving health, preventing and curing disease, and restoring the health of individuals, families, groups, and communities. The government's efforts to realize public health development include establishing Community Health Centers (Puskesmas). Puskesmas provide promotive, preventive, curative, and rehabilitative [1]. One of the determining factors for the success of services at Puskesmas is the availability of adequate medicines. The management of drug supplies and disposable medical materials is a series of cyclical activities, starting from selection, needs planning, procurement, receipt, storage, distribution, destruction and withdrawal, control, and administration [2]. The purpose of this study is to determine how the drug management process includes planning, procurement, storage, distribution and recording, to determine the level of drug availability, to analyze the relationship between drug management and the level of drug availability and to analyze the relationship between drug availability and patient satisfaction in Ambon City community health centers. Methods This research method involved 150 respondents. This research is quantitative research with a descriptive analytical design using a cross-sectional approach, namely measuring the variables of drug management, drug availability, and patient satisfaction at the same time to see the relationship between variables. The results of the study showed a correlation between drug management and the level of drug availability at the community health center, with the results of the Spearman coefficient test of ρ = 0.83. Drug management also correlated with patient satisfaction with a Spearman correlation of ρ = 0.86. Drug availability had a strong and significantly positive relationship with patient satisfaction with a Spearman correlation of ρ = 0.88. Conclusions From the results of the study, it can be concluded that the drug management process includes planning, procurement, storage, distribution and recording in Ambon city health centers is carried out well, Planning has an average score of 3.71, Procurement has an average score of 3.64 Storage has an average score of 3.60, Distribution has an average score of 3.63, and recording has an average score of 3.72. The level of drug availability in Ambon city health centers is included in the good category with an average score of 87%. There is a strong and significant positive correlation between drug management and the level of drug availability, drug management with patient satisfaction and drug availability with patient satisfaction.
Analysis , Drug Management, Drug Availability, Patient Satisfaction
One-Health Approach to Determine and Tackle AntimicrobialResistance in the Human Dairy Interface: A Case of Non-TyphoidalSalmonella and Lactose-Fermenting Enterobacteriaceae
Background Antimicrobial resistance (AMR) is among the top public health concerns globally. Determining the susceptibility pattern of pathogens is important in designing strategies to combat AMR. Thus, this study was designed to determine the AMR pattern of non-typhoidal Salmonella (NTS) and lactose fermenting Enterobacteriaceae (LFE) isolated from the human-dairy interface in the northwestern part of Ethiopia, where such information is lacking. Methods The study analysed 362 samples collected from humans, animals, food (milk) and the environment (sewage). The bacteria were isolated from the samples using standardized bacteriological methods. The antimicrobial susceptibility patterns and extended-spectrum beta-lactamase (ESBL) production ability were screened and confirmed by using the Kirby-Bauer disk diffusion method. The isolates were further characterized enotypically using multiplex polymerase chain reaction targeting the three ESBL-encoding genes. Results A total of 28 and 375 NTS and LFE bacterial isolates were identified. Isolates were more resistant to ampicillin and tetracycline. Forty-six point four and 70.7% of NTS and LFE were multidrug resistant (MDR), respectively. None of NTS and 21.3% of LFE were ESBL-producing. Genotypically, the majority of the isolates (97.5%), which were positive on the phenotypic test, were carrying one or more ESBL encoding genes. In conclusion, a high proportion of the bacterial isolates were resistant to commonly used antimicrobials, MDR, and were positive for ESBL production. Conclusion The findings provide evidence that the human-dairy interface is one of the important reservoirs of AMR traits and intervention points to reduce AMR. Therefore, the implementation of AMR mitigation strategies in a one-health approach is highly needed in the area.
Antimicrobial Susceptibility, Extended-Spectrum Beta-Lactamase, Lactose Fermenting Enterobacteriaceae, Human-Dairy Interface, Multidrug-Resistance, Non-Typhoidal Salmonella, Northwest Ethiopia
Achenef Melaku Beyene Achenef Melaku Beyene
Assessing Symptom Severity and Quality of Life Implications inWomen of Reproductive Age with Uterine Fibroids and RelatedConditions in Lahore
Uterine fibroids (UFs) represent the most common benign neoplasms of the uterus and an important cause of morbidity in women of reproductive age. The study is a cross-sectional study carried out in Lahore, Pakistan, between March and June 2025, to determine the symptom burden and impact on healthrelated quality of life (HRQOL) among women with UFs through a validated Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire. Among the 423 women surveyed, 81 (19.1%) had symptomatic fibroids. Most of these women experienced moderate (66%) and severe (9%) symptoms, especially excessive menstrual bleeding, pelvic pressure, and fatigue. The highest functional impairment was observed in the areas of energy/mood, concern, self-consciousness, and perceived control over daily life. The mean symptom severity score was 52.7 ± 17.3. The multivariate logistic regression model served as the predictors of fibroid diagnosis age 30-40 years, very early menarche (<10 years), and high parity, which highlighting the contribution of reproductive history to UF risk. Social, emotional, and physical functioning was seriously impaired in most of the affected women with over two-thirds of them showing moderate to very important impacts in several HRQOL domains. The results agree with global statistics and show the dire need for early diagnosis, community education, and culturally specific management options to reduce the physical and psychosocial impacts of uterine fibroids in lowand middle-income environments.
Leiomyoma, Symptom Severity, Frequency, Health Related Quality of Life (HRQL), Uterine Fibroid Symptom-Quality of Life Questionnaire (UFS-QoL), Questionnaire
Muhammad Wamiq Masood Muhammad Wamiq Masood
Obstructive Icteric Syndrome in a Patient with a History of Burkitt'sLymphoma
The patient was a 16-year-old male with a history of Burkitt's lymphoma, stage III, diagnosed at 3 years of age and treated with chemotherapy, who presented with fever, productive cough, dyspnea not associated with exertion and altered state of consciousness. On physical examination, patient in regular clinical conditions, generalized icteric tinge. He presented paraclinical findings suggestive of icteric syndrome and an abdominal tomography that reported dilatation of intrahepatic and extrahepatic ducts, so the diagnosis of obstructive icteric syndrome was made. In the case presented, the etiopathogenesis of this patient's diagnosis can be explained by an extrinsic compression of the biliary tract due to a probable recurrence of the underlying pathology 13 years after his diagnosis.
Book Overview: Reversing Osteoarthritis: The 3-Step Strategy toNaturally Healing and Recovering from Pain
Imagine a life where your body feels strong, your joints move freely, and you're no longer dependent on medications or invasive treatments. In Reversing Osteoarthritis, pain specialist Dr. Zeeshan Tayeb introduces a 3-step strategy designed to help you naturally heal your body and reclaim your quality of life.
Side Effects of Metformin in Type 2 Diabetes Mellitus: A SystematicLiterature Review
Background: Metformin is a Biguanide antihyperglycemic medication, is still considered as the best medications, and the first line of treatment either as monotherapy or in combination with other drugs for type 2 diabetes mellitus. Even though metformin has efficacy, very low risk of hypoglycemia and weight gain, and low cost, it also has side effects that can’t be ruled out. The aims of this study to evaluate of side effects of metformin in type 2 diabetes mellitus. Methods: Medline via (via Pub Med) from 2019 until 2024 in English. Term defining side effects of metformin were combined with the term type 2 diabetes mellitus during the search. The studies were chosen based on inclusion criteria. Results: There were 40 patients (53.3%) had gastrointestinal (GI) effects with persistent use of metformin tablet for 7.8 years in average, including epigastric and abdominal pain, nausea, vomiting, diarrhea, and bloating, and the other research showed that Metformin therapy can reduce testosterone levels in males with T2DM who had normalized blood control, that is indicated that the use of metformin may be another reason of the high prevalence of low testosterone levels in males with T2DM, the same thing also happens with vitamin B12 deficiency that there was a graded increase in the likelihood of vitamin B12 deficiency with increasing dose with those treated with > 2000 mg daily at nearly 40 times the odds compared with those not taking metformin. Conclusion: from systematic literature review study, it was found that there are side effects of metformin that cannot be ruled out, such as gastrointestinal (vomiting, diarrhea, bloating), decreased testosterone levels and deficiency vitamin B12.
Side Effects, Metformin, Type 2 Diabetes Mellitus
The Benefit of Melinjo Peel (Gnetum Gnemon) Ethanol Extract toPrevent Hepatocytes from Damage in Hyperuricemia Rat Model- Induced High Fructose
Introduction: Hyperuricemia can induce a dysfunctional exchange of sodium and calcium in mitochondria which will lead to the production of reactive oxygen species (ROS). ROS plays a role in aging, DNA damage, oxidation, production of inflammatory cytokines, and cell apoptosis. Uric acid metabolism is catalyzed by xanthine oxidase (XO) to produce hydrogen peroxide (H2 O2) which can form scar tissue in the liver. Alt1 and Hgf expression plays a role in reflecting hepatic cell from damage and repair. Method: It was a true experimental study with post-test only control group design using stored biological material of 32 samples, divided into four groups, K0: the control group without treatment; P1: intervention group of 86% fructose and 0.5% CMC; P2: intervention group of 86% fructose and allopurinol; P3: intervention group of 86% fructose and ethanol extract of melinjo peel. Alt1 and Hgf expression determination using real-time PCR (rt-PCR) with Livask method 2–ΔCt. Result: Alt1 expression in hyperuricemia model rats after 10 days of treatment with ethanol extract of melinjo peel was lower than the control group (p=0.001), CMC (p=0.001), and allopurinol (p=0.059). Hgf expression tends to have the same cycling threshold in all groups (p=0.065). There was no correlation between Alt1 expression and Hgf after 10 days of treatment (r=-0.08; p=0.661). Conclusion: The ethanol extract of melinjo peel has the potential to be a hepato-protector in the hyperuricemia model rat by reducing Alt1 expression better than the other treatment groups.
Melinjo Peel Ethanol Extract, Alt1, HGF, Hyperuricemia, Rat
Effectiveness of Pharmacist Counselling on Medication Adherencein Diabetes Mellitus Patients: A Systematic Review
Type 2 diabetes mellitus is a disease with a high prevalence in Indonesia. It is one of the non-communicable diseases that contributes to quite a number of complicating diseases. So type 2 diabetes mellitus must be given appropriate and consistent therapy in order to have an effect that can improve the quality of life of type 2 diabetes mellitus patients themselves. Apart from non-pharmacological therapy, patients with type 2 diabetes mellitus who have been using oral antidiabetic drugs for a long time experience many obstacles in terms of treatment. Therefore, the role of health workers, in this case pharmacists, is needed to provide counselling so that patient compliance with taking medication can be achieved which has an impact on improving the quality of life of diabetes patients.
Pharmaceutical Counselling, Type 2 Diabetes Mellitus, Patient Adherence
Copyright (c) 2024 Journal of Clinical Medicine and Regenerative Medicine
Genetic, Linguistic and Molecular Anthropological Study of theIndian Ocean Littoral in Austronesian Dispersal Across the Pacific
The Indian Ocean region is a critical route/corridor/barrier for the migration and settlement of people whose social, linguistic and genetic ancestry is of interest to anthropologists worldwide. Varying from the ‘little tradition’ of small isolated populations to the ‘great tradition’ of global and admixed heritage, in the field of collating evidences from culture, language and anthropological genetics this paper will examine the ‘Austronesian dispersal’ within the boundaries of the Indian ocean sporadically sprinkled across Pacific islanders. Littoral or near shore settlements may have simply act as ‘gateways’ as would have been the case with pre-historic settlements somewhere near a fresh water source or river bank. Physical environmental changes such as those driven by drastic ecological catastrophes including severe and acute adaptations to climatic and nutritional stressors can leave signatures providing vital clues for the dispersal of humankind. During the last two decades or more, a plethora of genomic information has surfaced tracing the genetic history of an archaic hominin group from ancient DNA. In the light of ensuing works by palaeoanthropologists and evolutionary biologists, the dispersal and migration of people, genes and languages studying human history either directly through their remains or indirectly through tools, pottery or other cultural items have provided concerns over interpretation of archaeological dates. Similarly assessing the reliability of linguistic data which may favour a close correlation between genes and languages, yet at times appear to conflict with genetic evidence. Despite these limitations, several ideas has been put forth concerning the dispersal of modern humans from Africa via the southern route, along the coast of India, eventually reaching Sahul the landmass consisting of Australia and New Guinea, which were connected until rising sea levels separated them about 8000 years ago. This putative “early southern dispersal”, as it came to be known, would now be underwater. From single versus multiple dispersal models molecular anthropologists have re-examined hypotheses about the colonization of the Pacific with different pliable approaches to understand population histories in the context of the ‘Austronesian dispersal’ across the Pacific.
Molecular Anthropology, Genetic, Linguistic, Archaeological, Migration, Dispersal, Austro-Asiatic, Austronesian, Indian Ocean, Pacific
A Comprehensive Case Report: Managing Severe HemolyticAnemia with Collaborative Medical and Nursing Interventions
Assessment: A 30-year-old woman with severe hemolytic anemia arrived at the ER with a critically low hemoglobin level of 2.1 g/dL, leading to an immediate packed red blood cell transfusion. After stabilization, she was moved to the ICU due to her deteriorating condition. The assessment covered respiratory health, cardiovascular markers, fluid/nutrition balance, physical exam, and X-ray results. Importantly, her Glasgow Coma Scale score showed altered consciousness. Diagnosis: Based on the comprehensive assessment, a range of nursing diagnoses were formulated according to the North American Nursing Diagnosis Association (NANDA) 2021-2023. These included Impaired Gas Exchange due to low Hb levels, Risk for Bleeding stemming from decreased red blood cell (RBC) count, Risk for Infection owing to compromised immunity, Activity Intolerance due to severe anemia, and Anxiety prompted by critical illness and unfamiliar surroundings. Planning: The care plan targeted interventions for each nursing diagnosis. To address Impaired Gas Exchange, we closely monitored respiration and adjusted ventilator settings. For Risk of Bleeding, we took bleeding precautions, handling gently and tracking coagulation. To prevent Infection, we prioritized aseptic methods and temperature checks. For Activity Intolerance, we used Activity Therapy and gradual progression. To ease Anxiety, we applied techniques to reduce psychological stress. Discussion: This case stressed the urgency of interventions for severe hemolytic anemia. The patient's critical state led to immediate PRC transfusion and ICU transfer. Cardiovascular and oxygen-carrying interplay showed in physiological signs. Nursing diagnoses and care planning revealed holistic care needs. Altered GCS and lab values steered interventions, urging interdisciplinary teamwork. Radiography showed heart response to chronic anemia. The discussion emphasized precise assessment, diagnoses, and planning for intricate conditions like severe hemolytic anemia.
Hemolytic Anemia, Red Blood Cell Destruction, Nursing Interventions, Interdisciplinary Collaboration
Pediatric NAFLD - The Increasing Obstacle of The New WorldRetrospective Analysis of COVID-19 Pandemic
Nonalcoholic fatty liver disease (NAFLD) is the presence of excess fat in the liver that occurs without significant alcohol consumption [1]. It is typical for the liver to have a small amount of fat. However, when fat makes up more than 5% to 10% of the liver's weight, it is called fatty liver (steatosis) [2,3].
Relationship of Health Literacy and Self-Management Behaviorin Hypertension Groups in Working Area of Public Health CenterPacellekang Gowa Regency
Background: Hypertension is the main cause of premature death worldwide. Hypertension has become a global, regional, national, and local public health problem. Hypertension requires proper self-management and health literacy in handling it. Methods: Correlational anality descriptive research design using a cross-sectional study approach. Sampling technique using non-probability sampling with purposive sampling technique. The sample obtained is 128 people. Data collection used the HELIA Questionnaire (Health Literacy Instrument for Adults) and the HBP-SCP Questionnaire (High Blood Pressure-Self Care Profile). Results: The results showed that the majority of respondents had low health literacy with a percentage of 56.3% and the majority had poor hypertension management behavior with a percentage of 54.7%. The results of the bivariate test using the Chi-Square test with a significance value of 0.006 <0.05, so that the better a person's health literacy, the better his hypertension self-management behavior. Conclusions: The conclusion of this study is there is a significant relationship between health literacy and hypertension management behavior in the community in the Pacellekang Health Center work area, Gowa Regency
Health Literacy, Hypertension, Hypertension Management Behavior
Study on the Effects of Sound and Music as Medicine onCardiovascular Health
This paper explores the dual impact of Sound frequencies and music on cardiovascular health, analyzing how sound frequencies and musical interventions influence cardiovascular risk factors and outcomes. While environmental factors have been linked to an increase in cardiovascular diseases due to stressrelated mechanisms, Sound frequencies and music therapy offer potential benefits through their calming effects on the autonomic nervous system.
Quality Assessment of the Management of Confirmed COVID-19Cases
Introduction: Health Center of Varis (H.C.V.) from 1/10/2020 has become a COVID 19 clinic. PCR tests were taken and were sent for examination to the microbiological laboratory of the University Hospital ATTIKON. All PCRs were registered at the national COVID 19 registry. The aim of this project is to evaluate the management of COVID 19 + cases in HCV. Materials and Methods: In order to evaluate the way that COVID 19 cases, were managed by health care professionals(H.C.P), of Health Center of Vari (HCV), will be used the national COVID 19 registry. We will use the data as these are recorded, from 1/10/2020 to 15/01/2022. Based on this registry a week report for covid 19 positive tests was sent to health authority. The week positiveness will be calculated for the same time. Data were processed with EXCELL 2007. Results: A. 1/10/2020-27/6/2021 1. Type of Hospitality: Of the total 542 positive cases, 486 (90%), did not require hospitalization but remained at home, 52(9%), required hospitalization at home, and 4(1%), were unclear. 2. Disease Outcome: Of the total of 542 positive cases, 3(1%) ended up, 203(37%) were cured and 305(62%) are still recorded as active cases B. 30/6/2021-15/1/2022 1. Type of Hospitality: Of the total 920 positive cases, 920 (100%), did not require hospitalization but remained at home. None of them 0(0%), required hospitalization, and none of them 0(0%), were unclear. 2. Disease Outcome: Of the total of 920 positive cases, 0(0%) ended up, 40(56%) were cured and 515(44%) are still recorded as active cases. The peak of the 2nd curve took place in the week of 16-22/11/2020, of the 3rd curve in the week from 29/3-4/4/2021 and the peak of the 4th curve in the period in the week from 23/12/2020-1/1/2021. Conclusion E-recording of the data of the patients seen at an outpatient clinic of HCV was necessary in order quality assessment and assurance at the period of Covid 19 Pandemic to be achieved.
COVID 19 Positive, Quality Assurance, Primary Care
Cost-Benefit Analysis of a Pharmacist’s Contribution in DecreasingAsthma-Related Economic and Health Burden with a Focus onthe Hispanic Population
Asthma stands as one of the most prevalent and costly health conditions in the United States. Asthma affects over 27 million people in the U.S., which translates to approximately 1 in 12 individuals [1,2]. The burden of asthma in the United States is significantly higher among individuals with low income, senior adults, and Black, Hispanic, and American Indian/Alaska Native populations, who exhibit the highest rates of asthma-related fatalities, and hospitalizations [3].
"Galeno" Neurosurgery Device for Brain Herniation aMultidisciplinary Approach to Complexity
Introduction: “Galeno” is the theoretical medical device that I designed for patients with severe stroke and herniated brain. It is shaped like a helmet, 3D printed. The design of this device combines: neurosurgery, neurotechnology, drug delivery and modern knowledge of biomedical engineering and computer science. The goal is to reduce brain edema and optimize homeostasis. Patients with brain herniation often have intracranial injuries and concomitant or habitual damage to other organs. The mortality rate can be between 60% and 84.6% in cases of TBI (traumatic brain injury) with herniated brain. More than 27 million people worldwide are affected by TBI each year. Traumatic brain injuries (TBIs) affect thousands of people in the United States every year. The economic impact of TBIs, in the United States, was estimated to be $ billion in direct and indirect costs. Traumatic brain injury (TBI) is a devastating neurological disease due to its high morbidity and mortality. Decompressive craniectomy (DC) has been used for decades to treat TBI, severe hemispheric strokes, etc. However, although DC is an effective treatment for patients with TBI, the risk of mortality and morbidity remains high, as it alone is not sufficient to ensure successful surgery and patient recovery [1]. “Galeno” medical device was created for the management of brain injury and intracranial hypertension and is placed on the brain via DC to protect, treat and monitor it until cranioplasty.
Exploring Opportunities and Developing Solutions to Address Challenges Being Faced Across Europe
May 19 is the International Day of Family Doctors. Our professional society, SSVPL, is organizing an event called "Krokovačka„ (free translation - Step by step) on his day. The idea of the „Krokovačka“ was born in 2019 at the 24th European WONCA Conference, in Bratislava where SSVPL hosted more than 2300 doctors from all over the World. The event was led by our Olympic gold medalist 50km walk, Matej Tóth. This event is usually organized in Bratislava, but this year we did it a bit differently, also on a local level, in cooperation with the representatives of the municipality of Terňa,my patients and other volunteers.
Therapeutic use of Parasites in the Treatment of InflammatoryBowel Disease
. Helminths are multicellular invertebrates that colonize the gut of many vertebrate animals including humans • This colonization can result in pathology, or it can lead to a commensal, even a symbiotic relationship • Epidemiological data have linked helminth exposure to protection from immune disorders (allergies, autoimmune illnesses, IBD) • Treatment of moderate to severe IBD involves the use of immune modulators, biologics and surgical intervention, which can cause life-threatening complications • Their safety profile makes helminths or helminth products attractive as novel therapeutic approaches to treat IBD
Chronic Kidney Disease and Oxidative Stress
Disturbance of the balance between production of oxygen free radicals (or some other radical species) and activity of antioxidative system of protection causes the so called oxidative stress Protection of an organism from oxygen free radicals implies activity of enzymatic (catalase, SOD, glutathione peroxidase, glutathione reductase etc.) and nonenzymatic (vitamin E. vitamin C. glutathione, uric acid etc.) systems of protection. An organism can tolerate a mild oxidative stress but a higher disturbance between the production of free radicals and the activity of the antioxidative protection results in lipid protein and DNA as well as numerous diseases. In this article we analyze oxidative stress role as an important cofactor contributing to endothelial dysfunction, inflammation, atherosclerosis,glomerulosclerosis, anemia, tubulointerstitial nephritis and ischemia-reperfusion injury to chronic kidney disease patients.
Oxidative Stress, Atherosclerosis, Endothelial Dysfunction, Chronic Kidney Disease, Ischemia-Reperfusion Injury
The Eyes have it: A Case of Ptosis and an Overview
Ptosis, formerly blepharoptosis, has a very broad differential which can make correct and timely diagnosis difficult. This is a fairly common presenting conundrum in a busy clinical practice. A case of ptosis and fatigablity in a young female which evaded diagnosis for nearly two years is presented highlighting some of the diagnostic challenges as well as literature overview and current treatment strategies.