Journal of Medicine and Healthcare 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 Medicine and Healthcare. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Article acceptance will be in the form of research, review, case reports, analysis, magazines, editorials, opinion, communications, mini-review, short communications, picturized, book review, video type and power point presentations (PPTS). Articles can be submitted through online from https://www.onlinescientificresearch.com/submit-online or can send through an Email with attachment for medicine@onlinescientificresearch.info, jmhc@onlinescientificresearch.net
The Importance of a Holistic Intervention in Stroke: Guiar en DCA Project
When a patient is discharged from the hospital after suffering a stroke, they often face a significant lack of information about the next steps and the available resources that can improve their quality of life. This situation leads to a host of social, economic, familial, occupational, and even healthcare-related problems that must be addressed. For this reason, the Freno al Ictus Foundation created a project in 2023 to provide direct support to patients and their families, offering comprehensive assistance in the phases following the stroke.
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Metastatic Urothelial Carcinoma of Occult Primary Origin Revealed by a Necrotic Inguinal Lymph Node: A Rare Case Report
Introduction: Occult primary urothelial carcinoma is an extremely rare entity that may present as isolated lymph node involvement without visible bladder or ureteral lesions, making diagnosis particularly challenging. Case Presentation: We report the case of a 91-year-old man presenting with a left inguinal swelling evolving over four years. Examination revealed a necrotic, fistulized mass with no urothelial lesions on cystoscopy. Biopsy showed a poorly differentiated carcinoma (CK7+/CK20+/p63+/p40+/GATA3−), initially suggesting squamous differentiation, but the lymphatic distribution and suspicious ureteral thickening supported an occult urothelial origin. A multidisciplinary management approach was undertaken. Systemic chemotherapy was not initiated due to age and comorbidities. Local wound care and antibiotic therapy led to partial improvement and clinical stabilization without visceral progression. Discussion: This case illustrates the diagnostic complexity of dedifferentiated urothelial carcinomas with atypical immunohistochemical profiles. Loss of GATA3 expression, though uncommon, does not exclude urothelial origin, especially in high-grade tumors. Presentation as isolated inguinal lymphadenopathy is exceedingly rare. Conclusion: Diagnosis of occult urothelial carcinoma requires multidisciplinary collaboration and careful integration of clinical, radiological, and pathological data. In elderly or frail patients, a conservative, symptom-oriented approach is often the most appropriate. Reporting such rare cases is essential to improve understanding of the atypical presentations and dissemination pathways of urothelial carcinoma.
Investigating the Association Between Maternal Infection and Inflammation and Child Autistic Traits in a Large Population BasedCohort Study
Objective: Maternal immune activation during pregnancy has been proposed as a mechanism linking prenatal inflammatory exposures to autism pathogenesis. While preclinical and epidemiological studies suggest a role for maternal inflammation and infection, findings in population-based cohorts are inconsistent. This study examined the associations between multiple prenatal inflammatory exposures and autistic traits, accounting for gene-environment interactions in the general pediatric population. Methods: We leveraged data from 5.075 mother-child dyads participating in Generation R. a population-based pregnancy cohort in the Netherlands. Prenatal inflammatory exposures included 1) maternal serum cytokines; 2) high-sensitivity CRP: 3) self-reported fever during pregnancy; 4) a maternal polygenic score for CRP: and 5) a methylation profile score of CRP in cord blood. Child autistic traits were measured with the Social Responsiveness Scale at mean ages 16 and 13 years. Linear mixed models were applied to estimate associations adjusted for maternal, child and technical covariates. Interaction terms tested whether child polygenic score for autism moderated associations. Results: No significant associations were observed between prenatal inflammatory exposures and autistic traits, both as a continuous measure and above a clinical threshold. No evidence was found for interactions between prenatal inflammatory exposures and the child polygenic score for autism in influencing autistic traits. Conclusion: Our findings suggest that typical fluctuations in maternal inflammation are unlikely to represent a major pathway linking prenatal environment to autism risk. We found no evidence that gene-environment interactions conferred additional risk for autistic traits.
Association Between Occlusal Wear Facets and Undiagnosed Sleep Bruxism in Adult Dental Patients
Background: Teeth grinding can occur during sleep and may remain unknown due to the absence of overt symptoms and lack of conscious awareness. Over time, repetitive actions can subtly alter the physical appearance of the teeth's tops, either in terms of appearance or texture. People might not be aware of these slight variations, but they might allude to other nighttime practices. The study examines the relationship between occlusal wear facets and undiagnosed sleep bruxism in adult dental patients, focusing on how tooth wear can serve as a clinically predictive indicator. Methods: The cross-sectional study was conducted between May 2025 and January 2026 within the dental clinics of Islamabad, using convenience sampling. A sample of 385 adult patients who completed a self-report Oral Behaviour Checklist (OBC) and a Tooth Wear Index (TWI) were administered the clinical assessments. The statistical analysis of the data was conducted using SPSS Version 26, which included descriptive statistics, t-tests, ANOVA, Pearson correlation, and linear regression to determine the correlations between oral behaviours and occlusal wear. Results: Out of the 385 respondents, 194 (50%) were male and 191 (50%) were female. Both the Oral Behaviour Checklist (OBC) and the Tooth Wear Index (TWI) showed higher scores in males than in females (p < 0.01) There was consequently a significant positive correlation between tooth wear scores and oral behaviour ( r = 0.312 p < 0.001 ) Another critical variable was age, where older adults showed higher scores in both indices (p < 0.01) . Linear regression analysis revealed that scores on OBC were highly predictive of scores on TWI ( B = 0.94 , p < 0.001 ). Caffeine use and smoking status had a significant correlation with specific health-related issues, including the presence of TMJ issues and the frequency of headaches ( p < 0.001 ). Conclusion: These results indicate that self-reported oral behaviours are strongly related to occlusal wear, suggesting that tooth wear could be a clinical marker of undiagnosed sleep bruxism. Implementing regular occlusal wear screening during dental facility visits may help identify and treat dental issues at an earlier stage, thereby preventing long-term dental damage.
Current Trends in Healthcare Quality in the United States: Innovations, Challenges and Future Directions
The landscape of healthcare quality in the United States is undergoing a profound transformation. Driven by technological innovation, policy reform, and shifting consumer expectations, healthcare providers are reimagining how care is delivered, measured, and experienced. This paper explores the most significant trends shaping healthcare quality in 2024 and beyond, including the rise of personalized medicine, the integration of artificial intelligence (AI), the expansion of value-based care models, and the prioritization of patient experience. It also examines systemic challenges such as workforce shortages, economic pressures, and persistent health disparities. Through acomprehensive analysis of current developments, this paper aims to provide insight into the evolving nature of healthcare quality and the strategies needed to ensure equitable, efficient, and patient-centered care across the United States.
Empowering Women’s Health: A Comprehensive Review of Reproductive, Maternal and Preventive Care Strategies
Women’s health includes biological, social, and gender-based factors, as well as clinical medicine. The complicated interrelationships of biological, social, and gender-based factors and clinical medicine have an effect on reproductive rights, prevention care, and access to care. Even as progress continues with maternal health care, contraceptive technologies, and disease prevention, there are still disparities, especially in low-income areas of the world where access to essential reproductive health care is limited, and where maternal mortality still does not reach the levels of minimal. Global health priorities shift as non-communicable diseases (NCDs), including breast cancer and cardiovascular diseases (CVD), have climbed to the forefront of global public health. Prevention care using early interventions, vaccinations, and periodic screening can help burden reduction. However, there are barriers to women’s access to health care and prevention care such as institutional injustices, cultural barriers, and resource burdens, in particular for racial and ethnic minorities. Even as these benefits are unshared equitably, advancing technology in digital health, telemedicine, and assisted reproductive technologies (ART) provide opportunities to help bridge gaps. This review presents the successes, issues, and direction of maternal, reproductive and preventive healthcare programs. The analysis of the interaction between access to healthcare, gender inequalities, and policy responses highlights the need for interdisciplinary approaches to implement equitable, gender-responsive healthcare interventions worldwide.
A Systematic Comprehensive Review and Synthesis of Different Mechanisms of Action for Scoliosis Braces in English and FrenchLiterature
A very wide variety of braces have been developed around the world during the last decades. This diversity often complicates therapeutic decisions. It is, therefore, more pragmatic to categorize braces based on their mechanisms of action. This study aims to identify and classify these mechanisms into three categories: passive, active, and secondary. To achieve this, a comprehensive review of existing literature in both English and French was conducted following the PRISMA diagram. 1575 articles were identified. After removing duplicates, 69 articles were found to highlight 24 mechanisms of action: comprising 12 passive, 6 active, and 6 Secondary. 12 Passive Mechanisms are Including: 1. Concave to convex tissue transfer under T10, 2. Rib-cage/spine coupling patterns between T2-T10, 3. plane geometry, 4. solid geometry, 5. Three-point system or derotation torque, 6. Derotation on Z axis, 7. global bending, 8. regional bending, 9. mobility under the brace, 10. Unloading, 11. recentering of the apical nucleus, and 12. sagittal normalization. 6 Active Mechanisms are Including: 1. vertebral growth modulation, 2. rebalance stress distribution, 3. active pulling, 4. active pushing, 5. elastic forces, 6. Ponseti-type intervention. 6 Secondary Mechanisms are Including: 1. vital capacity, 2. material tolerance, 3. closures, 4. Physiotherapy & gait modification, 5. Management, 6. Monitoring. Generic braces are a testament to the geographical schools of thought and research experiences from which they originate. The ideal brace remains nameless, as it represents a balanced choice of action mechanisms, striving for a compromise between effective three-dimensional correction and patient tolerance.
Impact of Early-Life Antibiotic Exposure on the Risk of Childhood Obesity: A Systematic Review and Meta-Analysis
Background: Childhood obesity is a growing global health challenge linked to long-term metabolic, cardiovascular, and psychosocial consequences. Emerging evidence suggests that early-life antibiotic exposure, a common disruptor of gut microbiota during critical developmental windows, may increase the risk of overweight and obesity. Objective: To systematically evaluate and quantify the association between antibiotic exposure in the first two years of life and the subsequent risk of overweight or obesity in childhood, with subgroup analyses by antibiotic type, timing, and sex. Methods: A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to January 15, 2025, without language restrictions. Eligible studies included prospective or retrospective cohorts assessing systemic antibiotic exposure in children aged ≤24 months with later overweight/obesity outcomes. Data were extracted independently by two reviewers, and study quality was assessed using the Newcastle–Ottawa Scale (NOS). Random-effects models were used to generate pooled effect estimates, with heterogeneity assessed via I² statistics. Results: Three high-quality cohort studies (n = 365,306 participants) from China, Canada, and the USA met inclusion criteria. Antibiotic exposure within the first 24 months was consistently associated with increased BMI z-scores and higher odds of overweight/obesity. The largest study (n = 362,550) showed a dose–response relationship, with incremental BMI increases per additional antibiotic course (p < 0.001). Broad-spectrum antibiotics were linked to slightly higher BMI z-scores compared to narrow-spectrum agents, and cephalosporins/macrolides exhibited stronger associations. A sex-specific effect was noted in one study, with significant risk elevation among boys (aOR = 5.35, 95% CI: 1.94–14.72). Moderate heterogeneity was observed (I² range: 38–52%), but the direction of effect remained consistent across subgroups. Conclusion: Early-life antibiotic exposure, particularly broad-spectrum and repeated courses, is associated with an increased risk of overweight and obesity in childhood. These findings highlight the need for cautious antibiotic prescribing in infancy as part of obesity prevention strategies. Future research integrating microbiome profiling is warranted to elucidate causal pathways and identify high-risk subgroups.
Impact of Preoperative Nutritional Status on Wound Healing Outcomes in Patients Undergoing Abdominal Surgery
Background: Postoperative healing of the wound is a critical component of post-surgery recovery and may be impacted by various patient-related conditions. The recovery of surgical procedures can be affected in areas that experience common nutritional deficiencies. Although there is current global awareness regarding its role, there is a lack of research explaining this relationship in the Pakistani population. This research examines the relationship between preoperative nutrition and postoperative wound healing in patients under surgery in tertiary care hospitals in Islamabad. Methods: This study was a prospective cohort study carried out between February and June 2025. A convenience sampling of 387 adult patients who had an abdominal surgery was recruited. The data collection was conducted using a structured questionnaire that contained demographic and detailed information on the variables, including the Nutritional Risk Screening (NRS 2002) and postoperative wound outcomes, as assessed by the Southampton Wound Assessment Scale (SWAS). Statistical analysis was performed using SPSS v.26. Descriptive statistics, t-tests, ANOVA, Pearson correlation, and linear regression tests were employed to investigate the relationship between nutritional risk and wound healing. Results: The nutritional risk scores were significantly higher among females (M = 7.18, SD = 1.34) than males (M = 6.88, SD = 1.22), p = 0.021. Nutritional risk was significantly but weakly related to scores on the SWAS (r = 0.116, p = 0.022), indicating that the worse the nutritional status, the poorer the healing outcome. Regression analysis confirmed that nutritional risk was a significant predictor of wound severity (p = 0.022). The wound scores were higher in older age groups, but the nutritional risk did not vary significantly between age categories. Conclusion: The research suggests a significant correlation between inadequate preoperative nutritional status and delayed wound healing. Patients with poor dietary status had unfavourable postoperative outcomes. This evidence suggests conducting a regular nutritional screening process to enhance postoperative recovery and alleviate surgical wound complications among patients undergoing abdominal surgery.
Navigating the Mind: The Intersection of Technology and Mental Health in the 21st Century
The rapid advancements in technology have profoundly transformed the landscape of mental health care in the 21st century. From telemedicine to wearable health trackers, artificial intelligence, and virtual reality-based therapies, technology is redefining how mental health is understood, accessed, and managed. While these innovations offer immense opportunities for early diagnosis, personalized care, and the destigmatization of mental health issues, they also present unique challenges. This paper explores the evolving relationship between technology and mental health, emphasizing both its potential and pitfalls. It advocates for a balanced integration of technology into mental health care with evidence-based practices, ethical guidelines, and a human centered approach to ensure that technology serves as an enabler rather than a deterrent to mental well-being.
The Impact of Long-Term Occupational Radiation Exposure on Thyroid Health Among Radiographers in Oman
The accumulative long occupational radiation exposure experienced by radiographers and the following consequential adverse effects have been an alarm for years. Health concerns included radiation induced skin injury, cataract development, cardiovascular and thyroid disorders. Thyroid and bone marrow are particularly sensitive to ionizing radiation. Long-term exposure to radiation can significantly impact thyroid functions, leading to various thyroid disorders over time. This study aimed to evaluate the relation between long term exposures to ionizing radiation and the increased risk of thyroid dysfunction over time among radiographers in Oman. This was confirmed by analysis of thyroid hormones measurement; mean serum levels of T3 (triiodothyronine) (2.5 ± 0.9 pmol/L, p < 0.05 ) and T4 (thyroxine) (5.1 ± 1.22 pmol/L, p<0.01) which showed significant drops as compared to normal level range. A significant increase in the mean serum TSH (thyroid stimulating hormone) levels of the subjects of the study r(16.5 plus/minus 1.22 * m(IU) / L, p < 0.001) as compared to the normal level range. Our results suggest prolonged exposure can lead to damaging effects of the thyroid gland and this could be explained by structural and functional changes in the thyroid tissue. Understanding the pathogenesis of these disorders is crucial for developing strict protective guideline measures for radiographers.
Unusual Case of Annuloaortic Ectasia - A Case Report
Annuloaortic ectasia is a rare cardiovascular condition characterized by aneurysmal dilatation of aortic annulus and ascending aorta resulting in aortic insufficiency. As the ascending aorta enlarges, the risk of aortic rupture or dissection also rises. As per our knowledge, ascending aorta aneurysm more than 9cm without dissection or rupture has scarcely been reported.
Perioperative Management of Difficult Airway
Introduction: It is widely recognized that the two most important tasks for anaesthetists are the management of a difficult airway and the maintenance of oxygenation. Problems related to difficult airways are known to be the primary cause of life-threatening anaesthesia-related accidents, they are one of the main sources of legal issues in the United Kingdom Défense Societies registries and in the American Society of Anaesthesiologists (ASA) closed claims. That is why difficult airway management is one of the most demanding duties for anaesthetists, and it provides a continuous challenge in addressing and solving potentially life-threatening problems. Although the incidence of the most critical situation in airway management, "cannot intubate, cannot oxygenate." is low at 0.0019-0.04%, its occurrence can have severe consequences and up to one-third of anaesthesia-related deaths are due to failure to intubate and ventilate including tracheal or oesophageal injury, aspiration, and sever hypoxemia, which can cause irreversible brain damage and lead to death. Clinical Features of airway obstruction, respiratory arrest, Teaching post graduates basic airway manoeuvres like head-tilt/chin-lift. Predictors of difficult airway Key parts of the examination of patients include neck mobility, mouth opening, teeth/jaw alignment, shorter horizontal distance, retrognathia, Mallampati score, thyromental distance. Specific tests like modified Mallampati, lemon test, Wilson score SARI score have been recommended as predictors Measurements of airway can help identify issues like limited neck extension, micrognathia. Preparation of patients with difficult airway- airway management equipment ie airway cart It also covers basic airway adjuncts like oropharyngeal airways and nasopharyngeal airways. Finally, it introduces advanced airway devices like laryngeal mask airways and describes how to size them appropriately. Fibreoptic intubating bronchoscope Basic vital parameters monitor- Management of airway, to follow the ASA difficult airway algorithm strategy used for managing difficulties and management of complication arising out non intubations situations.
Surgical Innovations and Instrumentation 3D Printed Human Laryngeal Model: A Tool for Laryngeal Framework Surgery Training
Objective: To develop and pilot test a 3D-printed human laryngeal model designed for laryngeal framework surgery training, aimed at enhancing the skills of ENT specialists and residents. Methods Design: Surgical Innovation Setting: Tertiary Government Training Hospital Participants: Consultants and Residents of the Department of ORL-HNS Results: This surgical innovation described the step-by-step production of a 3D-printed human larynx which was used as a model for an advanced laryngeal workshop by ENT residents, consultants, and phonosurgeons. It was evaluated to be easy to use and effective in simulating different laryngeal framework surgeries such as Isshiki Thyroplasty Types I to IV. Conclusion: The 3D-printed human larynx may be used as a tool for laryngeal framework surgery training during workshops for ENT specialists.
What’s New in the Estimation of SPF and UVA-PF?
Up to very recently the assessment of SPF was performed “in vivo” by ISO 24444 standard, while for UVA-PF ISO 24443 “in vitro” standard was used, which still needed and empirical coefficient derived from the SPF “in vivo” to normalize the results. Since some years ago, ethical critics have been made to the fact that human beings were submitted to UVA radiation to evaluate the SPF. The European Community recommended replacing those standards with new ones that allow all determinations to be made in vitro. But, as simple it may seem the purpose, it could not be achieved because there was no good correlation between the results obtained by spectrophotometry and those obtained from human panels. Since December 2024, after an extended circular test performed in Europe monitored by the ISO/TC 217, Cosmetics Committee validated the new standards ISO 23675 (In vitro determination of Sun Protection Factor (SPF)) and ISO 23698 (Measurement of sunscreen efficacy by diffuse reflectance spectroscopy). With horizon 2025, these new ISO standards will replace the actual ones into the European Community and later, most probably, within Mercosur and America in general. Due to their complexity, to be implemented they need expensive equipment and thorough training of technical personnel. Prudence would indicate preparing in time for the changes. If not, our enterprises (specially the smaller and those who are not internationalized and producing sun care cosmetics) will be handicapped. In this paper we try to present the new techniques, emphasizing the equipment needed. We do also an explicit critic on the fact that they are based on an irradiation source (Xenon arc) designed only for the 40o latitude of the northern hemisphere, compatible with the mediterranean summer sun in Europe, but not representative at other latitudes.
Telemedicine in the Management of Patients with Diabetes Mellitus Results of an 18-Month Follow-Up
Introduction: Increasing number of patients with type 2 diabetes mellitus places growing demands on patient management. Addressing this issue requires the integration of innovative technologies, including telemedicine. Parameters can be measured in a home environment (self-monitoring of blood glucose, blood pressure, ecg, weight, oximetry, spirometry) by the patients themselves, with the data transmitted via suitable technology. Methodology: Prospective, Non-Interventional, Clinical Study Conducted Under Routine Clinical Practice Conditions In a Diabetology Outpatient Clinic. Results: A total of 216 patients were included in the telemedicine follow-up: 109 women (51.66%) and 102 men (48.34%). The average usage duration of the telemedicine kit was 8.8 months. Postprandial blood glucose levels showed the greatest improvement after six months of intervention; over time, glucose levels slightly increased but remained below baseline values. HbA1c levels (baseline 7.83% DCCT) improved initially (6.85% DCCT) and remained in the optimal range for 18 months. Among telemedicine kit users, 42.5% achieved HbA1c < 7% DCCT, while 23.3% had HbA1c > 9% DCCT, Women experienced greater weight reduction (from 85.30 kg to 84.0 kg, -1.53%) compared to men (from 98.26 kg to 97.46 kg, -0.83%). Blood pressure was the most frequently monitored parameter, with most patients maintaining values within the optimal range. Conclusion: The transmission of data allows physicians to actively adjust treatment and recommendations without the immediate need for in-person visits, thereby reducing the time required for making relevant medical decisions and implementing them for patients.
Covid-19 in Hospitalized Patients with Type 2 Diabetes Treated by Metformin: A Systemic Review and Retrospective Analysis
Objectives: Metformin is a widely prescribed oral antihyperglycemic agent used as first line therapy for type 2 diabetes mellitus. Therefore, there has been growing interest in the role of metformin in treating various inflammatory conditions. The aim of this analysis is to determine whether treatment with metformin is associated with lower mortality in those infected by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Method: A single-center retrospective study, carried out at the 5th Department of Internal Medicine in University Hospital in Bratislava. A total of 133 diabetic patients hospitalized with confirmed COVID-19, from 14th November 2020 to 7th May 2021, were grouped into metformin and no-metformin groups according to the diabetic medications used prior to hospitalization. The demographics, characteristics, laboratory parameters, treatment and clinical outcome in these patients were retrospectively assessed, Results: Age and chronic microvascular complications of diabetes were significant risk factors for the mortality of COVID-19. There was no difference in the type of oxygen therapy, blood count and inflammatory markers in blood among patients taking metformin prior to hospitalization and patients with other antidiabetic treatments. Conclusion: The analysis showed that metformin treatment was not associated with lower mortality, thus justifies the implementation of prospective studies to understand the mechanism and causality.
Gut Microbiota and Comprehensive Analysis of Drug Resistance Mechanisms in Tuberculosis
Tuberculosis (TB) remains one of the most serious infectious diseases globally, and the emergence of drug-resistant strains has complicated treatment efforts significantly. In recent years, the gut microbiota, an essential component of the human microecosystem, has garnered widespread attention for its impact on various diseases, including tuberculosis. This review aims to explore the relationship between gut microbiota and drug resistance in TB, analyzing potential mechanisms and discussing the latest research findings in this field. By understanding the interplay between gut microbiota and mycobacterial resistance, we hope to shed light on novel therapeutic strategies and improve clinical outcomes for TB patients facing drug-resistant infections.
Frequency and Distribution of ABO and Rh (D) Blood Group Phenotype, Allele Frequencies and Genotypes Among Blood Donorsin South Wollo, Northeast, Ethiopia
Background: For safe blood transfusion services, understanding ABO blood group and Rhesus factor distribution at local levels is very essential. Objective: To determine the frequency of phenotype, allele and genotypes of ABO and Rhesus (D) blood group in South Wollo, Ethiopia. Materials and Methods: A cross-sectional document review was done using data from September 2019 to March 2023. The Chi-square test was used to assess the variations in the distribution of blood groups based on sex and locations, as well as to compare the observed and expected frequencies with data from various sites in Ethiopia. The frequencies of alleles and genotypes were calculated under Hardy-Weinberg assumption. Result: 16,318 participants with median age of 26 years were included in the study, 11,924 males. The most common blood groups were O (40.4%) and Rh (D) positive (90.7%). Allele of It and 1°1° were the predominant allelic and genotypic frequency respectively. In the case of Rh the dominant allele D was the most common. ABO and Rh frequency differ significantly across different sites. However, there is no difference in the ABO and Rh blood groups between the current study and other sites of Ethiopia as well as between observed and expected blood groups frequencies. Conclusion: the most and the least blood groups were O and AB respectively. The distribution of ABO and Rh blood groups varies among different locations. No significance difference of ABO and Rh blood groups between present study and other areas of Ethiopia.
Investigating Coexistence and Extinction in a Four-Species Trophic System Using Random Matrix Theory
Random matrix theory has played a pivotal role in understanding the complexity of biological systems, especially in elucidating the stability and coexistence of species in ecological communities. In this study, we apply random matrix theory at a trophic level consisting of four species with different initial populations. We incorporate varying interaction probabilities, denoted as p, to explore how the structure and strength of interspecific interactions affect species persistence and extinction rates. By modeling the system’s dynamics through a suite of mathematically derived equations and generating adjacency matrices under different values of p, we produce multiple scenarios that highlight the interplay between cooperation and competition. Our numerical simulations yield a series of graphs illustrating the likelihood of coexistence, extinction trajectories, and the effect of interaction intensity. The results underscore the delicate balance between competition and mutual benefit, shedding light on conditions in which biodiversity is maintained or lost. In our ensuing discussion, we reflect on theoretical implications, potential applications in conservation biology, limitations of our approach, and directions for future research.
Causal links between 1,400 Human Blood Metabolites and Non Alcoholic Fatty Liver Disease Via Mendelian Randomization Study
Background: For safe blood transfusion services, understanding ABO blood group and Rhesus factor distribution at local levels is very essential. Objective: To determine the frequency of phenotype, allele and genotypes of ABO and Rhesus (D) blood group in South Wollo, Ethiopia. Materials and Methods: A cross-sectional document review was done using data from September 2019 to March 2023. The Chi-square test was used to assess the variations in the distribution of blood groups based on sex and locations, as well as to compare the observed and expected frequencies with data from various sites in Ethiopia. The frequencies of alleles and genotypes were calculated under Hardy-Weinberg assumption. Result: 16,318 participants with median age of 26 years were included in the study, 11,924 males. The most common blood groups were O (40.4%) and Rh (D) positive (90.7%). Allele of 1º and II° were the predominant allelic and genotypic frequency respectively. In the case of Rh the dominant allele D was the most common. ABO and Rh frequency differ significantly across different sites. However, there is no difference in the ABO and Rh blood groups between the current study and other sites of Ethiopia as well as between observed and expected blood groups frequencies. Conclusion: the most and the least blood groups were O and AB respectively. The distribution of ABO and Rh blood groups varies among different locations. No significance difference of ABO and Rh blood groups between present study and other areas of Ethiopia.
Examination of Sexual Hormone Levels of the Hypothalamus- Pituitary- Gonad Axis and the Influence of Methadone Dose in the Treatmentof Chinese Heroin Addicts
Background: Sexual function decline in male heroin addicts during methadone maintenance treatment (MMT) is a problem, and the link between methadone doses and sex hormone levels in this group is unclear. This cross-sectional study explored HPG axis hormone levels and their association with methadone doses in Chinese MMT treated heroin addicts. Methods: All participants provided blood samples. Sexual hormones, including testosterone (T), progesterone (P), prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2), were measured using radioimmunoassay (RIA). The relationship between different methadone doses ("<=30 mg/d", "31-60mg/d", and ">=61 mg/d") and sex hormones was analyzed via general linear modeling (GLM). Results: The study included 103 male heroin addicts receiving methadone maintenance treatment (MMT) and 79 healthy male controls. No significant differences were found in the levels of all sex hormones among different methadone doses (all P>0.05). After adjusting for age and the duration of MMT, no significant associations were detected between different methadone doses and the six hormone levels. Conclusion: No dose - response relationship was observed for the six hormone levels. The significance of considering the independence of methadone dose effects on the HPG axis hormone levels of heroin addicts in MMT should be carefully evaluated.
Influences of Smoking and Contraception on Women’s Ability to become Pregnant in Ghana: Evidence from 2022 Demographicand Health Survey
Background: Women currently using hormonal contraceptive are more likely to smoke. It appeared the link between smoking and the lungs is well-known, but the link between smoking, contraception and women's ability to become pregnant is less. Objective: The study aimed at investigating the influences of smoking and contraception on women's ability to become pregnant in Ghana. Methods: Data were extracted from the 2022 DHS. Frequency distribution and binary logistic regression were used to analyse the data. The sample was 34663. The ethical clearance to conduct the 2022GDHS was taken from both Ghana Health Service Ethical Review Committee and ICF Institutional Review Board. The frequency distribution was used to summarise socio-demographic characteristics of the participants. The Pearson's chi-squared test of independence was used to test the hypotheses postulated in the study to either confirm or reject the null hypothesis. The binary logistic regression was used to identify from the various explanatory variables thus, smoking and contraception those that are related to women's ability to become pregnant. Results: The study revealed that more than ninety-nine per cent (99.2%) of the participants do not smoke cigarettes. It was revealed that more than sixty per cent (66.2%) of the participants were currently not using any contraceptive method. Frequently smoking cigarettes every day was statistically significant related to women's ability to become pregnant at p<0.001, ( OR = 5.176 ,9596Cl| [2.744-9.764]). Frequently uses other type of tobacco every day as statistically significant at P = 0.006 OR = 0.057 95%CI [0.007-0.445]). Conclusions: The study recommends that laws and policies should be enacted to support and ensure comprehensive contraceptive information and services dissemination to all segments of the population especially disadvantaged and marginalised populations in their access to these services.
Exploring China’s Social Credit System in Relation to Digital Latform Ratings Cultures in Westernised Democracies
Social media platforms and apps have become increasingly important tools for governance and the centralisation of information in many nation states around the globe. In China, the government is currently piloting a social credit system in several cities in an ambitious attempt to merge a financial credit score system with a broader quantification of social and civic integrity for all citizens and corporations. China has already begun to experiment with metrics and quantification of the value and virtue of its citizens, going beyond the function of measuring workplace performance and health-related self- tracking to measuring one’s purchasing and consumption history, interpersonal relationships, political activities, as well as the tracking of one’s location history. China has also already begun to apply a reward and punishment system that rewards those who comply with the Chinese government’s ideals and punishes those who deviate from them. Although there are no such ambitiously unified systems currently proposed in Western liberal democratic countries, some aligned structures and cultures of social media use are already well in place. This article seeks to offer a comparative examination of the structures and cultures of China’s social credit system with those which are already present and in place in Western liberal democratic countries. While it may be convenient to digitise everyday social, political and economic life, China’s social credit system brings about a vision of what may be to come, should democratic countries continue to do so without stricter data use policies in place.
A Rare Coexistence: Pulmonary Langerhans Cell Histiocytosis and Pulmonary Tuberculosis in a Young Male
Pulmonary Langerhans Cell Histiocytosis (LCH) is a rare disorder affecting the lung parenchyma with an unclear underlying cause. The condition is marked by isolated or multiple proliferations of histiocytes, which resemble dendritic Langerhans cells in phenotype. The progression of LCH varies significantly, ranging from isolated eosinophilic granulomas in the bone to widespread involvement of multiple organs. Although rare, LCH has been observed in conjunction with other conditions, like pulmonary tuberculosis. We describe an uncommon case involving a 34-year-old male patient who presented with fever, dry cough, and progressively worsening dyspnea, accompanied by an unintentional weight loss of 15 kg over the preceding 20 days. He was diagnosed with both pulmonary tuberculosis (TB) and Pulmonary Langerhans Cell Histiocytosis (P-LCH). The diagnosis was corroborated by radiological imaging, which displayed multiple nodules and small cysts in the upper and middle lung lobes on both sides, consistent with P-LCH. Additionally, sputum CBNAAT testing confirmed the presence of Mycobacterium tuberculosis.
Jq1 Induces Apoptosis of Ovarian and Endometrial Endometrioid Carcinoma Cells by Downregulating C‑Myc Sex
Although ovarian endometrioid carcinoma (OEC), frequently associated with endometrial endometrioid carci‑ noma (EEC), is often diagnosed at an early stage, the prognosis remains poor. The development of new, effective drugs to target these cancers is highly desirable. The bromodomain and extra‑terminal domain (BET) family proteins serve a role in regulating transcription by recognizing histone acetylation, which is implicated in several types of cancer. BET inhibitors have been reported as promising cancer drugs. The present study aimed to assess the role of JQ1, a BET inhibitor, in ovarian and endometrial cancers. The sensitivity of OEC and EEC cell lines to JQ1 was assessed using cell viability and colony formation assays. Additionally, western blotting and cell cycle assays were performed to evaluate changes in c‑Myc expression and apoptosis markers. Cell proliferation and colony formation assays revealed significant tumor suppression in both OEC and EEC cell lines in response to JQ1 treatment. Furthermore, treatment with JQ1 induced a decrease in c‑Myc expression and an increase in apoptosis markers, such as cleaved PARP and the cell population in the sub‑G1 phase, in both OEC and EEC cell lines. The findings of the present study indicate that JQ1 may induce cell death through c‑Myc inhibi‑ tion and could be a potentially novel therapeutic agent in the treatment in OEC and EEC. However, the direct mechanism, has not been fully elucidated, warranting further investigation.
Bromodomain and Extra‑Terminal Domain Protein
Prevalence and Risk Factors to Premature Rupture Membrane through a Study in Jiblah University Hospital, ibb, Governorate, Yemen
Background: Prelabour rupture of membranes (PROM), previously known as premature rupture of membranes, PROM occurs when the leakage of amniotic fluid occurs at least one hour before the initiation of labor. The fetal membranes normally rupture spontaneously during labor probably due to the physical effects of repetitive uterine contraction. Objectives: As no studies have previously been conducted about PROM in Jiblah University Hospital in Ibb governorate, Yemen, we hereby aimed to present first report on prevalence and risks factors contributing and causes of PROM. Methods: This retrospective observational study was conducted in the department of Obstetrics & Gynecology, Jiblah University Hospital in Ibb governorate, from December 2023 to Feb 2024. Data were retrieved from the antenatal ward admission register, case files, theatre records, and neonatal care unit records and reviewed. Descriptive statistics were used to describe data. Chi-square test with a significance level set at p < 0.05 Results: A total of 1350 women of reproductive age between 15 to 56 years were included in the study. With mean (±SD) age of the respondents was 27.5(±6.3) years. At the individual level, 627 (46.4%) of the respondents were 15-25 years old. At the household/community- level with 1063 (78.70%) of the study respondents resided in rural. About 640(47.40%) having more than 3 of family number. Nearly 1075 (79.60%) of them are literate. About 1234(91.40%) had normal blood pressure. Regarding cigarette smoking, 138 (10.20%) smokers and 1212 (89.80%) were non-smokers. Nine hundred and thirty-three (69.10%) of the khat chewing had a history of khat chewing during this pregnancy and 417 (30.90%) of the non-khat chewing. Eight hundred and seventy-two (64.59%) of the urinary tract infection during this pregnancy. On the other hand, all the individual and household/community factors were significantly associated with PROM are family number, vaginitis, urinary tract infection, duration of PROM, abortion where the chi squire test p-value was<0.05. Conclusion: In this study, a family number, vaginitis, urinary tract infection, duration of PROM, abortion are the risk factors for PROM. Recognizing the most common risk factors for PROM will help to increase the awareness about high-risk pregnancy, improve the preventive measures of preterm risk factors and modify preterm care protocol in nurseries.
Genomic Instability with Non- Homologues Chromosomes in Aneuploid Cell Increase Risk Factor for the Development of BreastCancer Patients
Chromosome aberrations (CAs) play an important role in tumor initiation, followed by metastasis. Short-term peripheral blood lymphocyte (PBL) cultures using RPMI-1640 media with 5 % FBS were used to evaluate the frequency of structural and numerical chromosome aberrations in breast cancer patients. Highest frequency of aneuploidy (11.53%) were observed followed by trisomy -21(8.93%) in karyotypes. De-novo mutation involving 12q21 with loss of 16.38 Mbp DNA fragment is the most relevant finding in breast cancer (BC) patients and has not been reported earlier. Secondly, role of trisomy-21 (8.93%) might have increase genetic susceptibility of disease because of “giant satellites”, are the active sites of rRNA sub unit of 18S and 28S. These active sites might have increase gene-expression of truncated protein during tumor Significant increase in the frequency of aneuploidy with increased number of non-homologous chromosome was the striking feature due to increase of non-disjunction event followed by unequal crossing-over and synapse formation by known environmental factors like arsenic. However, the present study is small, but interesting to explore the etiopathology of BC patients associated chromosome instability. However, further study is required to confirm these changes, whether these mutations are either familial (inherited) or spontaneous in nature.
Qualitative Study of Healthcare Seeking Behavior and Development of Behavioural Nudges for a Nutrition Program in Gombe State,Nigeria
Objective: This qualitative study aimed to identify and explain healthcare seeking behaviours among caregivers of young children and apply these findings to develop a mobile phone-based messaging intervention to encourage sustained attendance at a community-based management of acute malnutrition (CMAM) program in Gombe state, Nigeria. Design: Researchers conducted focus group discussions (n=6) and key informant interviews (n=3) with 33 subjects. Transcripts were independently coded and thematic analysis was conducted to gain an understanding of the facilitators, barriers, and motivators shaping caregivers' decisions to attend health services for malnourished children, as well as access to and use of mobile phones. Participants: Focus groups and interviews were conducted with caregivers of children aged 6-59 months living within travelling distance of three CMAM sites in Gombe state, Nigeria. Results: Barriers to seeking health services included high costs; perceptions of poor quality of care, including poor treatment by health workers; and female caregivers' limited autonomy. Despite barriers, participants recommended seeking hospital care for a malnourished child. Participants described widespread mobile phone use and recommended messages emphasising that CMAM services are free, conveying respect for caregivers, and reminding caregivers to continue making an effort to attend the CMAM program even as their child began to appear healthier. Conclusions: This study provides a framework for developing contextually salient behavioural nudges for child health and nutrition programs which, in combination with other community outreach strategies, could help motivate and sustain care seeking behaviour.
GLP-1 Receptor Agonist: Health Care Savings or Healthcare Burden
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a topic of significant interest. Their potential benefits have sparked discussions among healthcare professionals and gained attention on social media. These agents represent a rare convergence of value and controversy in healthcare, with their significant advancements in treating type 2 diabetes mellitus (T2DM) and obesity. Beyond their clinical efficacy, GLP-1 RAs have substantial implications for healthcare economics, influencing both direct medical costs and broader economic outcomes. This article examines the financial impact of GLP-1 RAs, with a particular focus on their cost-effectiveness, healthcare expenditure, and policy considerations, to keep the audience informed and aware of the economic considerations in healthcare.
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