Journal of Clinical Case Studies Reviews & Reports
Journal of Clinical Case Studies Reviews & Reports is an open access peer-reviewed journal from the publishers of Scientific Research and Community (SRC) which publishes articles in the form of written, video and power-point presentations from the arena of Clinical Case Studies Reviews & Reports. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Articles can be submitted through online from https://www.onlinescientificsresearch.com/submit-online or can send through an e-mail with attachment for clinicalreports@onlinescientificresearch.info
Ivermectin is Potential Game Changer in COVID-19
Ivermectin is an FDA-approved broad spectrum anti-parasitic agent that in recent years we, along with other groups, have shown to have anti-viral activity against a broad range of viruses. Ivermectin, stopped the SARS-CoV-2 virus growing in cell culture within 48 hours. The causative agent of the current COVID-19 pandemic, SARS-CoV-2, is a single stranded positive sense RNA virus that is closely related to severe acute respiratory syndrome corona virus (SARS-CoV). Studies on SARS-CoV proteins have revealed a potential role for IMPα/β1 during infection in signal-dependent nucleocytoplasmic shutting of the SARS-CoV Nucleocapsid protein that may impact host cell division In addition, the SARSCoV accessory protein ORF6 has been shown to antagonize the antiviral activity of the STAT1 transcription factor by sequestering IMPα/β1 on the rough ER/Golgi membrane Taken together, these reports suggested that ivermectin’s nuclear transport inhibitory activity may be effective against SARS-CoV-2.
Copyright (c) 2020 Journal of Clinical Case Studies Reviews & Reports https://creativecommons.org/licenses/by-nc-nd/4.0
Sprengel’s deformity is a rare condition characterized as abnormally congenital high riding scapula. The deformity occurs due to inadequate descending of the scapula from the C5-T1 position caudally to the T2-T7 level.
COVID-19 the Use of Tocilizumab: A Case Report
Introduction: Coronavirus disease 2019 (COVID-19) is a modern and rapidly growing pandemic due to a novel coronavirus, SARS-CoV-2. The severity of this new virus strongly correlates with patients with advanced age or with underlying medical conditions. Those with advanced or severe symptoms from this virus are currently being treated with a trial of tocilizumab, an inhibitor of inflammatory responses including the cytokine Interleukin-6 (IL-6). As of current research there is no published clinical data supporting the use of this medication as treatment for this virus but have been discussed in anecdotal reports illustrating positive outcomes in COVID-19 infected patients. Case Presentation: A 28-year-old obese and diabetic female presents to the emergency department with symptoms of shortness of breath, chills, and cough after being medically treated at a local urgent care facility one week prior. She endorsed worsening respiratory symptoms, fevers, and diaphoresis at the time and was eventually intubated and admitted to the ICU due to respiratory failure and having a strong clinical suspicion for COVID-19. Nasopharyngeal swab for SARS-CoV-2 was positive. The patient rapidly deteriorated despite treatment with hydroxychloroquine and underwent septic shock. Due to refractory treatment, the patient was administered a trial of tocilizumab and the patient had a remarkable clinical improvement over the next 12 hours, ultimately resulting in extubation. A combined regimen of tocilizumab, broad spectrum antibiotics, and a second course of hydroxychloroquine allowed the patient to make a full recovery. Discussion: Given the novelty of SARS-CoV-2, evidence-based therapeutic strategies have not yet been developed. At this time, there are no medications approved by the US Food and Drug Administration (FDA) to treat COVID-19, per the Centers for Disease Control and Prevention (CDC). Supportive care measures include supplemental oxygen and mechanical ventilatory support when indicated. There are however several investigational COVID-19 treatment agents being evaluated and numerous clinical trials underway. Of the investigational agents being evaluated, hydroxychloroquine with or without azithromycin and IL-6 pathway inhibitors, such as tocilizumab, are being heavily studied due to positive anecdotal evidence. Currently, no guidelines outlining the use of these investigational agents exist. Individual institutions are encouraged to develop protocols for off-label use of these agents.
Giant Anterior Urethral Stone Complicated by Acute Urinary Retention and Bilateral Hydronephrosis: A Rare Case Report and Management Approach
Introduction: Urethral lithiasis is a less common urological pathology and accounts for about 0.3-2% of the urinary stones; this always occurs in conditions of anatomical or functional alterations of the urethra and might cause severe lower urinary tract symptoms, acute retention of urine, and serious complications. Case Presentation: We report the case of a 59-year-old hypertensive male presenting with an 8-year history of progressive LUTS complicated by bilateral lumbar pain, intermittent hematuria, and acute urinary retention. In this case, physical examination and imaging showed a large (24 x 16-mm) urethral stone obstructing the penile urethra, severe hydronephrosis on both sides, a number of diverticula involving the bladder wall, and two small stones within the bladder. The acute urinary retention was relieved by emergency cystostomy, and definitive surgery consisted of urethrolithotomy via the perineal approach and endoscopic removal of the bladder stones. Bilateral double-J stents were placed to relieve the hydronephrosis. The postoperative recovery was uneventful, with complete normalization of renal function. Spectrophotometric analysis revealed the stone to be predominantly composed of calcium oxalate monohydrate, which helped in the institution of preventive measures such as dietary modifications, increased hydration, and alkalinization of urine. Conclusion: This case highlights the difficulties of diagnosing and managing anterior urethral lithiasis, most especially large-size calculi complications. Early management, together with individual prophylaxis, ensures the avoidance of recurrences while preserving renal function.
Copyright (c) 2025 Journal of Clinical Case Studies Reviews & Reports https://creativecommons.org/licenses/by-nc-nd/4.0
“Obstruction but no Obstruction” – Case Report of a Giant AnteriorUrethral Calculus with a Brief Review of Literature
Penile urolithiasis (urethral stones) is an uncommon entity accounting for 1-2% of all urolithiasis. A 40 year male presented with complaints of dysuria & straining during micturition for 6 days and vague discomfort over the urethral meatus for the last four months, on further investigation the diagnosis of a giant penile urethral calculus was made. The patient underwent meatotomy with retrieval of a 4x2x2 cm calculus. This case is being reported due to the uncommon nature of this entity, the perplexing nature of its presentation and to add to the scarce literature available on this rare disease entity.
Determinants of Insecticide-Treated Bed-Net: Knowledge, Attitude, and Practice in a Malaria-Endemic District of Ethiopia
Background: Insecticide-treated bed nets (ITNs) remain a cornerstone of malaria control, yet their population-level impact depends on sustained household ownership and correct use. Evidence on determinants of ITN uptake in rural Ethiopia remains limited. This study assessed knowledge, attitudes, and practices (KAP) regarding ITNs and identified factors associated with net possession and utilization in Dodicha Kebele, a malariaendemic district. Methods: A community-based cross-sectional survey was conducted from 14 January to 17 February 2023. Using systematic random sampling, 124 of 183 households were interviewed using a semi-structured questionnaire, and sleeping spaces were inspected with an observation checklist. Descriptive statistics summarized KAP indicators. Associations between socio-demographic variables and ITN outcomes were assessed using chisquare (χ²) tests and odds ratios (OR) with 95% confidence intervals. Results: Household respondents were predominantly female (71/124, 57.3%); mean age was 36.0 ± 1.2 years (range 16–80). ITN ownership was 61.3% (76/124), with a median of one net per owning household. Consistent use was reported by 54.0% and occasional use by 24.0% of owners. Households with an educated spouse were significantly more likely to own ≥1 ITN (OR = 2.6, 95% CI 1.3–5.3, p < 0.01). Prior health education on ITNs was predictive of ownership (70.7% vs 46.9%; OR = 2.7, 95% CI 1.3–5.9, p = 0.008). Utilization was significantly higher where >1 net was available (100% vs 70.7%, p < 0.001). Knowledge of mosquito bites as the primary mode of malaria transmission was independently associated with ITN use (p < 0.05). Conclusion: ITN coverage in Dodicha Kebele falls below national targets, with substantial gaps between ownership and effective use. Household education—both formal schooling and targeted ITN training—emerged as key determinants. Strengthening behavior-change communication and ensuring provision of at least two nets per household could significantly enhance protective coverage in malaria-endemic settings.
Correlative Indexes in Prediction of Survival in Refractory Metastatic Lung Adenocarcinoma. The Role of Liquid Biopsy to Assess Survival
In refractory metastatic lung adenocarcinoma, liquid biopsy can provide valuable insights into survival, particularly in identifying resistance mechanisms and monitoring treatment response. For example, circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) can reveal EGFR mutation status. Heterogenous tumors are defined based on their genomic signature consisting of a variety of biomarkers. Aa major problem, remains as we are unable to translate a “target response” to a “clinical response”. This problem would be even further complicated by implementing targeted therapies that can cause resistance by inducing mutations in the DNA as well as enhancing the process called “selective advantage” of the resistant cells. Since the resistance of the tumor correlates with the patient’s survival, using liquid biopsy can detect early resistance and therefore predict prognosis.
A Case Report on the Child with Two Coins Ingested ForeignBodies in the Esophagus During the Lockdown in COVID 19Pandemic
A 4-year-old child presented to the emergency department with an acute onset of dysphagia and vomiting. A plain X-ray soft tissue neck lateral view revealed a double circular opacity in the cervical oesophagus consistent with an ingestion of multiple foreign bodies. Preoperative planning and SARS-CoV2 testing is of particular importance for the pediatric population and if testing cannot be performed, patients in all age groups should be handled as though they are positive for COVID-19, and appropriate precautions should be taken. The child was taken to the theatre for rigid pharyngo-oesophagoscopy and removal of the coins. After the first coin was removed subsequent endoscopic examination revealed a second coin at the same location. This extremely rare case of two ingested coins becoming impacted with perfect radiological alignment, we would therefore advocate having a low threshold for performing a ‘second look’ endoscopy after removal of the first foreign body with postoperative X-rays.
Reversible Aggravation of Neurological Deficits after TransforaminalEpidural Steroid Injection in a Patient with Undiagnosed SpinalDural Arteriovenous Fistula
Here we present a case of a 77-year-old man who underwent an epidural steroid injection complicated by delayed monoplegia and urinary incontinence. An MRI showed T2 hyperintensity at the conus along with small serpentine vessels surrounding the spinal cord. An angiogram was performed which showed a spinal dural arteriovenous fistula (SDAVF) with prominent draining vein at the right L3 level. The patient underwent repeat laminectomy and disconnection of spinal dural fistula after failed endovascular repair. His symptoms slowly improved after the lumbar decompression and physical therapy. SDAVF remains a diagnostic challenge. Epidural injection is contraindicated in these patients due to venous hypertension resulting in possible conus ischemia. SDAVF must be considered in the differential diagnosis when unexpected neurological complications occur after epidural steroid injection.
Diabetes and Neurologic Diseases in a Developing Country
In the present clinical and observational study we have analyzed sixteen patients with type II diabetes, ranging from 56 to 88 years-old., and showing blood hypertension (84%) %), cardiovascular diseases (43%), memory disorder (43%), Parkinson disease (31%), Headaches (25%),. Sleep disorders (18%), gait disturbances (18%), language disorders (18%), dizziness and vertigo (12%), cervicogenic headache (12%) liver diseases (12%), gastrointestinal disease (12%) arthritis (12%), respiratory diseases (6%), Alzheimer disease (6%), and previous cerebrovascular accident (6%). We have diagnosed six mixed syndromes of diabetes and Parkinson disease (37%), three patients with diabetes and Alzheimer disease (18%) two cases with diabetes, blood hypertension and Alzheimer disease (12%) and two case with diabetes and cervicogenic headaches (12%). The pathophysiological mechanisms involved are described in each case. A relationship of diabetic patient lifestyle with environmental conditions, low socioeconomic status and family history is postulated.
Hyperprolactinaemia in Men: A Review of Clinical Presentation,Diagnosis and Treatment
Hyperprolactinaemia is one of the commonest non-diabetes endocrine disorder seen by Endocrinologists. Prolactin is a polypeptide hormone secreted by the anterior pituitary gland. Its main physiological role is in milk production. Hyperprolactinaemia is more common among females and there is paucity of literature on hyperprolactinaemia among men. The causes of hyperprolactinaemia include physiological causes (such as sleep), drugs, sellar masses, including prolactinoma, other endocrine disorders such as hypothyroidism. The clinical presentation in males results from the disruption of the hypothalamus-pituitary-testicular axis and mass effect. It is an important and often overlooked cause of hypogonadism in males. Men usually present with macroprolactinomas with accompanying symptoms of mass effect such as visual impairment. Diagnosis of hyperprolactinaemia is made from relevant symptoms and signs and confirmed by immunoassay of the serum prolactin. Other relevant investigations need to be done to identify the potential causes of the disorder. Magnetic resonance imaging is the radiological investigation of choice to visualize the pituitary. Treatment of hyperprolactinaemia in males is dependent on aetiology and symptomatology. Some medications may need to be stopped or changed. Pharmacotherapy with dopamine agonists is the first line treatment of prolactinomas. Symptomatic cases of prolactinomas with drug resistance or drug intolerance are referred for surgery or radiotherapy.
Distal Peri-Arterial Sympathectomy: The Over-Ratted Option inManagement of Peripheral Cyanotic Disorders
Background: Digital ischemia in upper and lower extremity, with ulceration and gangrene can be a manifestation of Raynaud’s phenomenon (RP). The early manifestation of Raynaud’s may be informed of ischemic pain and numbness, cold intolerance and in severe cases manifested as ulceration and gangrene. Aim of the study: to evaluate the results of digital sympathectomy in cases of severe ischemia of digits manifesting as digital ulceration and ischemic pain refractory to medical treatment. Patient and method: Distal sympathectomy of the ulnar and radial arteritis of the affected limb. Results: The patient developed dramatic improvement of symptoms, we were surprised for patient satisfaction and appreciation. We touched firmly the affected finger and the patient was smiling. On follow up, no return of annoying symptoms. Conclusion: Distal sympathectomy is a safe and perfect solution in management of peripheral cyanotic disorders, Raynaud’s, causalgia, digital ischemia.
Hemophagocytic Lymphohistyocytosis associated with Hoghkinlymphoma
Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation and tissue destruction due to abnormal immune activation. This is a hyper inflammatory/dysregulated immune state caused by the uncontrolled proliferation of activated lymphocytes and histiocytic with massive release of inflammatory cytokines. Secondary HLH is associated with, and thought to be emerged by malignant and non-malignant diseases. Malignant disorders associated with secondary HLH include lymphoma, acute lymphocytic leukemia, acute myeloid leukemia, and syndrome. Many physicians in most cases make delayed diagnosis of HLH. HLH-associated cHL is an uncommon condition that can cause severe systemic symptoms acting as the perfect mimic of septic shock, deviating the clinical eye toward treating with antibiotics and not addressing in a timely manner the real aetiology of the patient’s condition.
Constrictive Pericarditis: A Rare Cause of Pulmonary Hypertension
Constrictive chronic pericarditis is a rare form of chronic heart failure representing 0.2-0.4%, and is an even rarer cause of pulmonary hypertension PH type 2. When attempting to differentiate CP from restrictive cardiomyopathy, the presence of severely elevated pulmonary arterial pressure is used as a diagnostic criterion ruling against CP. the case of a child aged 07 who was followed for a long time for pulmonary hypertension is reported. an ultrasound examination with a hemodynmic study allows us to correct the diagnosis of constrictive pericarditis complicated by PH by stenosis aquise of the pulmonary veins.
Study of the Effect of Cyclophosphamide and Doxorubicin on the Progress of Pregnancy and Histomorphological Structure of the Ovaries of White Rats
The article is devoted to the study of changes in the course of pregnancy and final outcomes against the background of the introduction of cyclophosphamide and doxorubicin to pregnant female white rats, as well as morphohistological changes developing in organs against the background of the introduction of cyclophosphamide and doxorubicin. The results of the studies showed that the duration of pregnancy in pregnant females receiving cyclophosphamide at a dose of 10 mg / kg decreased by 27.1% compared with the control group, the prenatal weight of animals decreased by 39.3% compared with the control group, and the postnatal weight decreased by 33.4%. The difference between prenatal and postnatal weight was 56.8%. The number of cubs decreased by 40.6%, and their weight by 43.9% compared with the number of cubs in the control group. When cyclophosphamide was prescribed at a dose of 20 mg / kg, the changes that occurred in the mother and offspring during pregnancy were more serious. In pregnant rats given doxorubicin at a dose of 2.5 mg/kg twice a week from the 8th day of pregnancy, the duration of pregnancy was 18.5% shorter compared to females in the control group, the prenatal weight of the animals decreased by 28.2% compared to the control group, and the postnatal weight by 29.9%. The difference between prenatal weight and postnatal weight was 25.4%. The number of pups also decreased by 29.8% compared to the number of pups in the control group. The birth weight of pups also decreased by 27.3% compared to the control group. These parameters decreased more significantly with the introduction of doxorubicin at a dose of 5 mg/kg. In pregnant rats given cyclophosphamide at a dose of 10 mg/kg and doxorubicin at a dose of 2.5 mg/kg from the 8th day of pregnancy for 1 week, the duration of pregnancy was reduced by 50.5%. The prenatal weight of the animals decreased by 50.2% compared to the control group, and the postnatal weight by 47.7%. The difference in prenatal and postnatal weight was 57.6%. A decrease in the number of pups by 90.1% was noted. The weight of the pups at birth also decreased by 50.7%. Against the background of the combined administration of cyclophosphamide at a dose of 20 mg/kg and doxorubicin at a dose of 5 mg/kg, the pregnancy did not end normally, and since the birth of cubs was not observed, the number of cubs was not determined, and since cubs were not born, it was not possible to determine their weight. When studying the histomorphological changes developing in the ovaries against the background of the administration of cytostatics to female rats for a week, it was shown that destructive changes, leukocyte infiltration and cellular edema are observed in the organs.
Endometriosis A Missed and Complicate Diagnosis: Case Report of Ureteral Endometriosis
Ureteral endometriosis is a rare and under diagnostic condition, defined as “the silent killer” of the kidney. The incidence of ureteral endometriosis varies from 0, 1% to 1 %. Although it is relatively a rare and uncommon pathology, affecting a very small number of women of reproducing age, it is of particular importance because of its silent and severe loss of renal function towards renal failure. Despite its presentation, both intrinsic and extrinsic ureteral endometriosis, present a diagnostic and therapeutic challenge. Aim: The purpose of our presentation is to turn the attention of the clinicians toward rare conditions in order to provide an accurate approach for differential diagnosis and lead to accurate therapeutic procedures. Method: we will represent a case report of a 42 years’ woman diagnosed with extrinsic ureteral obstruction and hydronephrosis of the right kidney, suspected for metastasis from cervical or endometrial carcinoma. She undergoes surgical procedures that relieve the obstruction. The pathological examination diagnosed extrinsic ureteral endometriosis. After six months the patient was suspected again for extrinsic ureteral obstruction and is under examinations for further diagnosis and treatment. Conclusions: Although the preoperative diagnosis is essential for an appropriate surgical approach, the diagnosis of ureteral endometriosis is sometimes negligible and missed because of the unclear clinical signs and because they do not display typical symptoms. In these conditions recurring cases become frequent, making the treatment difficult and complicate.
Evaluation of the Relationship Between Menstrual Symptoms and Eating Attitudes in University Students in Turkey
Detecting cracks in concrete surfaces is critical for structural health monitoring. However, traditional methods show limited effectiveness due to their high costs, time-consuming processes, and vulnerability to human error. This situation reveals the need for innovative methods to produce faster, more economical, and more reliable results. This study developed an optimized convolutional neural network (CNN) model that works on low-resolution images and has a four-layer lightweight architecture. The proposed model demonstrated superior performance with an accuracy rate of 98.1% and provided distinct advantages over traditional methods regarding computational efficiency. In addition, using image segmentation techniques, crack areas are visually highlighted, and users are offered easy evaluation. The proposed model provides economical, fast, and accessible monitoring by eliminating the need for expensive hardware. In this way, structural health monitoring processes have become more effective and applicable on a larger scale. The study proposes an innovative solution that saves both time and cost in engineering applications by adopting modern artificial intelligence techniques for crack detection of concrete surfaces.
Effective Prevention and Treatment of Tumors Leads to the Cessation of the Oncological Process. Normalization of the Functions of Various Organs Leads to an Increase in the Life Expectancy of the Organism
Currently, a method known as “Check-up” is known [1]. Checkup is a comprehensive examination of the body, which is selected according to the request of each patient. Depending on the program, the check-up may include blood tests, ultrasound, MRI, CT, cardiogram, consultations with specialists, including dentists, phlebologists or other specialized doctors. As a rule, a check-up includes an examination of all major body systems: cardiovascular, endocrine, digestive, respiratory, nervous.
Scrap the System and Start Anew: How to Fix American Healthcare
The healthcare system in America is unsustainable. Healthcare already represents almost one-fifth of our nation’s GDP and this figure is only projected to grow more as the baby boomer generation fully retires. The cost of healthcare and the weight that it puts on the rest of our society and federal budget is well understood as one of the biggest problems America faces today. But identifying this as a problem is the easy part. The difficult part is figuring out what we could do about it that would be bold enough to truly change our trajectory.
Improving Patient Outcomes in Clinical Skills and SimulationBased Education: A Realist Review Examining Contributions of XR Immersive Technologies
Background The paper aims to examine circumstances that lead to improvement of patient outcomes by contribution of XR immersive technologies in clinical skills and simulation-based education. The realist approach that is fundamentally concerned with theory development and refinement of complex interventions is adopted to enable development of new knowledge and highlight success and areas of development [1-3]. Methods/ Design Quality guidance and checklist of ‘RAMESES’ (Realist and meta-review Evidence Synthesis: Evolving Standards) were used to gain an understanding of the different contexts of how interventions worked. A realist review included secondary data analysis using a database search of MEDLINE, CINAHL, BNI, EMBASE, PubMed and Google Scholar. Main terms used were ‘digital technology’ ‘XR in Healthcare/Extended Reality’ and their related synonyms. Once key data were extracted realist analysis was undertaken to identify impact of context and underlying causal mechanisms that can lead to different outcomes. Realist and meta-narrative review approaches are relatively new approaches to systematic review and are theory driven, guiding the process from the beginning, with data extraction and synthesis being key aspects of theory refinement [4]. Much of the focus being on interactions between interventions, Context (C), Mechanism (M) and Outcomes (O) configuration, aim to identify patterns and refine the theory. Results Literature search initially provided 179 inclusion-relevant papers. 37 studies that were primarily focused on research-related immersive experiences were chosen for data extraction. Context of emerging technologies in selected studies included: • Virtual Reality (VR) • Augmented Reality (AR) • Mixed Reality (MR) • Extended Reality (XR) These were then themed through connections and chains of inference into the following categories: • Skills • Knowledge • Quality • Personal Characteristics • Learner Experiences • Cost-Benefit & Justification • Patient Safety • Affective Outcomes The above approaches enabled narrative development to generate new knowledge and identified best applications of XR immersive technologies in clinical skills training and simulation-based education to enhance timely, technology assisted appropriate and cost effective learning to improve patient outcomes. Discussion Characteristics of the immersive experiences contribute to healthcare outcomes. The complexities of these experiences can also enhance learner skills. The foundations of Artificial Intelligence (AI) are built on data, discovery, diversity of learning an assumption that human thinking can be reduced to logical steps that can be mechanised [3]. Replication of human intelligence, exist in various forms such as computing machines, rules based, machine learning, input, and output data, such as software development and smart phones. Arguably, AI evidence standards, safety and harms show failures around ‘clinical benefits for patients’ suggesting that solutions are human and not technical [2].
Nasal Reconstruction in Darker Skin: Is the Subunit Principle Valid?!
The Subunit principle of Aesthetic Nasal Reconstruction is well known among Reconstructive surgeons and it is considered to be the excellence of care. It advocates to reconstruct a nasal defect as per the specific subunit, placing the suture line at a border of one subunit and its adjacent within the nasal surface. Individuals with skin types III to V are prone to hyperpigmentation, hypertrophic scars, keloids and obvious suture marks. Applying the Subunit principle in these darker complexion patients would not be sufficient. In fact, it would result in a scarred nose with a patch. With our frequent experience in such cases, it was very important to revisit the mentioned principle. In darker complexion individuals requiring significant part of their nose to be reconstructed, a consideration should be given to entire nasal unit reconstruction. This would allow placing the seams at junction with adjacent regions (cheek, lip) rather than within the nose and much acceptable aesthetic outcome.
The Impact of Kundalini Awakening on Personal Life andPsychotherapeutic Practice
The process of kundalini awakening has all the elements of an extraordinary experience. In this article, the author will show that from his research and experience this process of spiritual awakening can be seen as a benevolent developmental step for individuals. The process of kundalini awakening has a profound impact on yogis and meditators around the world. Different reports circulate varying from disturbing disintegrating experiences to blissful ones. In this article, Kundalini awakening is described as a natural process of activating dormant energy in the CNS. During Kundalini awakening the neutral observer, the witness, the container is awakened as part of the process. This article describes the spontaneous awakening of the author during an intensive Vipassana retreat. It took years to digest the impact of this experience. And while doing so, a natural integrating in the Psycho-therapeutic practice of the author evolved. The central insight is to cultivate the neutral internal observer. The neutral observer stance creates opportunities for beneficial and endurable change. Clients are trained to become aware of their feelings and (hidden) thoughts without reacting to them. By doing so clients learn how to contain dysfunctional emotions and transform them into functional emotions. For all of this neutral observing is the key ingredient.
Menstrual Hygiene Management- A Study among Adolescent Girlsin Five Schools in Bo District, Sierra Leone
Menstruation can place significant impacts on girl’s health and education if they are not properly informed about effective menstrual hygiene management. The present study was undertaken to assess the knowledge and practices of menstrual hygiene among adolescent girls in five schools in Bo district, Sierra Leone and to assess the restrictions practiced by them during menstruation. A cross sectional study design was carried out among 103 in November 2019. A self-administered structured questionnaire at schools was used for data collection. Data was collected regarding their knowledge about menstruation, from where they get information and practices followed to maintain menstrual hygiene, problems faced while attending school during menstruation and facilities available in school, etc. The analysis part was done with the help of SPSS version 25. Age of respondents varied between 12-21 years with the mean age of 16.5. 69.9% of the girls don’t know from were menstrual bleeding occurs. Majority of the girls are using sanitary pads as absorbent during menstruation. 42.7% of the girls said they have been restricted from praying when seeing their menses and 49.5% of the girls said they feel their school is uncomfortable to keep hygiene during menstruation. The findings led to the conclusion that the girls have deficient knowledge and inadequate practices regarding menstruation and its management.
Remission of Type 2 Diabetes from a Reduced Carbohydrate Dietwith Digital Behavior Change Support: 15-month Case Study
Type 2 diabetes is a global burden affecting over 400 million people across the world. The prevalence of type 2 diabetes is growing, driven by a sedentary lifestyle and unhealthy eating habits. In community settings, less than 1 in 1,000 people achieves type 2 diabetes remission. In the UK, adults eat 300% the recommended intake of added sugar in the diet. People diagnosed with type 2 diabetes are treated with diet and exercise before progressing to medications including metformin and insulin. Studies have highlighted the therapeutic benefits of carbohydrate restriction on health conditions including obesity, type 2 diabetes and epilepsy. The goal of this study is to assess the effects of a behavioral change intervention on primary markers of HbA1c and weight. This paper presents the case of a 72-year-old adult living in England diagnosed with type 2 diabetes in 2015 and referred to a digital behaviour change app (Low Carb Program) in 2018. The results of this study suggest lifestyle and behavior changes can be maintained with the assistance of a digital health app. This case study may lay groundwork for future research on technological and lifestyle approaches to manage type 2 diabetes.
When Psychiatric Outpatients Feel Non-Thoracic Chest Pain: AStudy on the Relevance of Anguish
Anguish is understood as a negative feeling causing intense discomfort in the thoracic region that translates into physical sensations of pain, tightness, pain, hole or compression. Objectives: This study investigated whether anguish contributes to psychopathological field by identificating symptoms and comorbidities and by relationship between the feeling and the psychiatric diagnosis of depression and anxiety. Method: The eligible 100 participants treated at a large psychiatric institution in Brazil were assigned to the experimental groups (with anguish + without anguish + doubt) by an interview about experiences of anguish. The BSI, DSQ-40, HADS, HAM-A, STAI and MINI were used to investigate the objetives of the study. Results: Patients who experienced anguish showed significant diferences in the groups related to symptoms and comorbidities, somatization, fears, depressed mood, gastrointestinal symptoms and neurovegatative symptoms scored higher in the anguish group than in the other groups. Regarding to the second hypothesis inferential analysis found that depression had 3.64 more times to have a relationship with anguish than anxiety. Conclusions: The present study supports existing evidence that feelings of anguish have relevance to the field of psychiatry. The results presented point to this relevance.
Cultural and medical anthropologists continue to highlight research on mental illness, but rarely integrate evolutionary, biological, and comparative perspectives. Medieval physicians like al-Razi, considered to be one of the first practitioners of psychotherapy, is known for his many works on melancholia and madness. He believed that sadness emerged due to an attachment to perishable things, or having lost something that one had possessed, which affected the balance between body and soul. Ibn-Sina linked the physiological and psychological illnesses together. The use of religious practices that included prayers and ritualistic prayers in affecting spiritual, psychological, physiological, and moral health, through listening to religious poetry and verses from the Qur’an, and supplication. The use of medicinal plants was practiced in ancient and modern medicine, as well as in complementary and alternative medicine. This paper will describe many methods, practices and techniques for treating madness in general, and mania specifically, using medicinal plants.
Automation of University Education: A Technological Revolutionto Shape an Advanced Digital Future
University education automation involves applying modern technologies such as artificial intelligence, data analysis, and machine learning to facilitate and enhance the educational process. This technological revolution represents a fundamental shift in how education is delivered, enabling a more personalized and efficient learning experience for students. The benefits of university education automation include increased access to educational content, improved time management, and reduced operational costs for educational institutions. It also helps provide educational tools such as remote learning platforms, learning management systems, and interactive applications that enhance engagement and academic achievement. Challenges in this process include issues related to security and privacy, ensuring educational quality, and adapting to rapid technological changes. Therefore, the success of university education automation requires close collaboration between educational and technology institutions to ensure accurate and effective academic performance assessment. Ultimately, university education automation contributes to shaping an advanced digital future, providing new learning opportunities and enhancing the efficiency of higher education.
A Study on the Impact of Corporate Management Leadership onOrganizational Performance, Innovation Capability, and EmployeeSatisfaction
This study explores the comprehensive impact of corporate management leadership on organizational performance, innovation capability, and employee satisfaction. Through a literature review, it is found that leadership not only directly influences organizational performance but also enhances corporate competitiveness indirectly by shaping an innovation culture, optimizing management models, and motivating employee behavior. Based on these findings, this paper suggests that corporate managers optimize leadership strategies to balance performance growth, innovation development, and employee well-being to achieve sustainable business operations. This study not only enriches the practical application of leadership theory but also provides empirical evidence and practical guidance for corporate management.
The Glymphatic System of the Brain is Significantly Burdened byDentogenic Problems and Oral Toxins
It is a fact that the head forms a functional unit. Two important areas, the oral cavity and the brain, cannot be considered separately. In order to maintain a healthy environment, as in the rest of the body, the production of toxins should be equal to or lower than their removal by the lymphatic system. However, if there are so many toxins or toxin productions in the mouth area that the lymphatic drainage of the head is overloaded, the detoxification of the brain by the glymphatic system is no longer guaranteed, and the brain suffers. Without the recognition and treatment of this pathogenetic connection, brain diseases will inevitably increase.
Accessory Caveatted Uterine Mass: A Case Report
Accessory caveatted uterine mass (ACUM) represents a new verity of mullein anomaly that is usually located at the level of insertion of round ligament and is probably related to a dysfunction of female Gebrnaculum. ACUM is described in literature as an accessory isolated caveatted uterine mass which is lined by endometrium but with no communication to normal uterine cavity. Usually it protrudes from a normally shaped and functional uterus and mostly is located on lateral uterine wall below the insertion of round ligament. Till now this condition is not included in ESHRE Classification system and because of this it is not so commonly diagnosed, these patients are usually presented with severe dysmenorrhea and chronic pelvic pain and some report showed coincidence of ACUM and endome-triosis in 5-6%of patients which are usually less than 30 years old [1].