Japan Journal of Clinical & Medical Research
Japan Journal of Clinical & Medical Research 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 & Medical Research. 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). You can submit your articles through online: https://srcpublishers.com/japan-journal-of-clinical-medica/user/register or can send through an e-mail with attachment for: jjcmr@onlinescientificresearch.info 1.5 Impact Factor 84.5% Citations 90% Acceptance
ELMAS’s Theory of Medical Thermodynamics and the Fifth Law of Thermodynamics Based Closed-Loop Feedback Bio-Robotic Resonance Method and FM Modulated Smart Drug Algorithm in Glioblastoma - Brain Cancer Treatment
Objective: Glioblastoma (GBM) is one of the most dangerous, invasive, and failing malignant tumors of the central nervous system. Despite current surgical interventions, radiotherapy, and temozolomide-based treatment protocols, the average survival time of patients does not reach the desired level. The inadequacy of these treatments stems from biological and physical obstacles such as the degeneration of brain tissue by the tumor, the blood-brain barrier (BBB) preventing the passage of chemotherapeutic agents, and the significant mechanical damage caused to healthy organs. Traditional approaches treat the tumor only as a biochemical structure, ignoring its thermodynamic and mechanical properties. To overcome this, the integration of medical and engineering disciplines has become increasingly important. Emin Taner Elmas’s “ELMAS Medical Thermodynamics Theory” and its foundation, the “5th Law of Thermodynamics,” posit that living tissues and defective structures exist as dynamic, open thermodynamic systems. For the preservation and integrity of its existence, a living cell must continuously absorb energy from the environment and release entropy. However, the uncontrollably proliferating glioblastoma system has an abnormally high metabolic rate and regulated entropy production compared to healthy growths. This chaotic state causes the tumor to emit unique microscopic heat and entropy fluctuations around it. By modeling these theoretical currencies at different levels, Elmas σdokuoffers a “Thermodynamic Signature” () that allows for the localization of the tumor. In this study, the major challenges of conventional oncology applications—such as the blood-brain barrier, poor localization, and systemic side effects—are addressed through an interdisciplinary bio-robotic platform integrating medicine, control software, and mechanical engineering. Guided by the “ELMAS Medical Thermodynamics Theory” and the “5th Law of Thermodynamics” developed by Dr. Emin Taner Elmas, an integrated treatment and smart drug delivery architecture has been designed to destroy Glioblastoma (GBM) tumor cells without damaging healthy tissues. Method: Within the scope of the research, the natural frequencies (fn) of healthy neurons and GBM cells were modeled at a differential level using damped single-degree-of-freedom mechanical system equations. The proposed system incorporates the ELMAS Medi-Bio-Energy Tronic sensor matrix to detect entropy fluctuations emitted by micro-tumor foci, a closed-loop PID controller algorithm to lock the excitation frequency onto the tumor’s resonance range (85 - 120 kHz), and a 3D Phased Array Smart Helmet geometry for millimeter-scale energy focusing. Furthermore, a Frequency Modulated (FM) smart Nitinol micro-valve mechanism, triggered upon resonance verification (Activation Matrix = 1), and pumpless two-phase Medical Heat Pipes were integrated into the system architecture and futuristically simulated within the MATLAB/Simulink environment. Findings: Computer-based dynamic simulation results demonstrated that the focused negative entropy balance (- Δ S) applied to the system deterministically inhibits tumor metabolic growth. Time-dependent graphs proved that the mechanical displacement amplitude within the tumor cell surges during resonance, exceeding the critical rupture threshold of 8.0 μm and achieving selective cellular lysis without injuring surrounding tissues. The FM-modulated smart drug delivery mechanism released chemotherapeutic agents strictly at the target coordinates, theoretically reducing the risk of systemic toxicity to zero. Additionally, the heat pipes successfully stabilized local tissue temperatures below the critical cellular damage threshold of 41.5 °C in a stable phase, without requiring an external mechanical pump. Conclusion: This study transforms Glioblastoma treatment from a biological uncertainty into a second-by-second manageable mechatronic automation problem. Following future in-vitro testing on agarose gel tissue phantoms and pre-clinical in-vivo validations, the proposed platform holds the potential to pioneer a new era not only in brain tumor therapies but also in the treatment of complex neurological disorders such as SMA, ALS, and Parkinson’s disease.
Copyright (c) 2026 Japan Journal of Clinical & Medical Research
Polycythemia Vera: Sypnopsis of a Haematological Disorder
Polycythemia Vera is a chronic myeloproliferative disorder characterized by excessive production of red blood cells due to abnormal proliferation of haematopoietic stem cells, commonly associated with JAK2 gene mutations. Increased red cell mass leads to hyperviscosity of blood and a higher risk of thrombosis, stroke, and cardiovascular complications. Patients commonly present with headache, dizziness, fatigue, pruritus after warm bathing, hypertension, and splenomegaly. Laboratory findings include elevated haemoglobin concentration, increased haematocrit, and reduced serum erythropoietin levels, while bone marrow examination shows hypercellularity. Major complications include thromboembolic events, haemorrhage, myelofibrosis, and possible progression to acute myeloid leukaemia. Diagnosis relies on clinical assessment, haematological investigations, and molecular detection of JAK2 mutations. Management focuses on reducing blood viscosity and thrombotic risk through therapeutic phlebotomy, low-dose aspirin, and cytoreductive agents such as hydroxyurea in high-risk patients.
Near Infrared to Visible Upconversion Polarization Imaging Enabled by Cs2NaScCl6: Er3+ Composite Film
Herein, TLCP and TRCP denote the transmitted light intensities of the UCPL film under illumination with LCP and RCP, respectively. CD refers to the differential absorption between LCP and RCP. A positive value of ΔT indicates that the film induces a left-handed effect, whereas a negative value signifies a right-handed effect. The same principle applies to the CD value. Typically, the CD signal of strongly chiral materials reaches a magnitude of 1000 mdeg. As shown in Figure S9(B), the test results of the UCPL film in this study exhibit almost no spectral fluctuations at this scale. When the scale is magnified to that presented in Figure S9(C), as evidenced by the curves, a sharp increase in the left-handed effect emerges at approximately 390 nm and 540 nm; however, the magnitude of this effect is extremely small, remaining below 4 mdeg in all cases. This can be identified as baseline noise, confirming that the UCPL film exhibits no chiral characteristics.
Acupuncture for Chronic Stress: A Systematic Review
Objective: The growth in instances of illness related to chronic stress nowadays is worrying, and relevant treatment is vital, and safe therapies with no side effects, like acupuncture, are being sought more and more. This study intends to identify and outline the evidence available from randomized clinical trials, as well as systematic reviews, with the objective to test the efficacy of acupuncture in the treatment of chronic stress. It is also our purpose to identify the mechanics behind the use of acupuncture for this purpose and, in this way, contribute to a better understanding and acceptance of this complementary therapy. Method: Research has been carried out within the databases of both Pubmed and Cochrane for articles published between 2011 and 2021. The terms used were acupuncture and chronic stress. Results: 53 studies were found through Pubmed and 66 through Cochrane, and from these, 6 were selected and analyzed. Conclusion: The potential mechanism involved in the response to treatment has been identified. However, the studies selected and analyzed were not sufficient to prove evidence that acupuncture is effective in the treatment for chronic stress.
The Day We Lost the Off Switch:AI Safety in a Mixed Biological Civilization
The rapid emergence of autonomous agent networks marks a fundamental shift in the development of artificial intelligence, from isolated computational systems toward distributed societies of interacting agents. Platforms such as Molt book illustrate how large populations of AI agents can generate persistent social dynamics, including feedback loops, emergent conventions, and strategic coordination, largely beyond direct human oversight. These developments challenge prevailing safety frameworks that assume centralized control, clear system boundaries, and reliable shutdown mechanisms. As intelligence becomes increasingly embedded within multi-agent ecosystems—and potentially integrated with biological substrates through brain–computer interfaces—the traditional “off-switch” paradigm loses both practical and conceptual validity. We argue that AI safety must therefore be reframed from a problem of aligning individual models to one of governing complex cognitive ecosystems under conditions of strategic interaction, ecological embedding, and partial biological integration. This transition calls for new approaches centered on reversibility by design, global coordination mechanisms, ecological embedding of ethics,and cross-substrate interpretability, signaling a shift from technical control toward systemic governance of intelligent societies.
Clinical Outcomes of Ventilator-Associated Pneumonia and its Associated Factors Among Critically Ill Patients at Muhimbili National Hospital, 2024-2025
Introduction: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in patients on mechanical ventilators. It significantly contributes to mortality and prolonged ICU stay which shows the need to re-evaluate the outcomes and its contributing factors in critically ill patients. Objectives: To determine clinical outcomes of ventilator-associated pneumonia (VAP) and its associated factors among critically ill patients at Muhimbili National Hospital, from January 2024 to November 2025. Methods: A facility based retrospective cross-sectional study was conducted at Muhimbili National Hospital (MNH) from January 2024 to November 2025. It included all adult patients who developed VAP after at least 48 hours of MV and stayed in the Medical Intensive Care Unit (MICU) for at least 5 days. Data on demographics, co-morbidities, ventilation factors, clinical signs, complications and outcomes were extracted from the patient medical files on Microsoft Excel and managed on SPSS software to make descriptive statistics to summarize patient characteristics, while Chi-square tests assessed the associations between the factors and outcomes. Results: A total of 117 patients developed VAP during the study period and among the 560 mechanically ventilated patients, the proportion of VAP was found to be 20.9%. The mean age was 53.1 years (SD ± 21.2), and the gender distribution was nearly equal. Most cases were late-onset VAP (70.9%). Hypertension (54.7%) and diabetes (23.1%) were the most common comorbidities found. Almost all patients (99.1%) required invasive ventilation, and one-third remained ventilated for more than 20 days. The most frequently documented clinical features were leukocytosis (75.2%), fever (64.1%), and purulent secretions (58.1%). Overall mortality was high at 68.4%, while only 23.9% of patients were discharged from the ICU. Poor outcomes were significantly associated with hypertension, diabetes, chronic respiratory disease, older age, and prolonged ventilation duration (all p < 0.05). Conclusion: VAP is still a public health concern as the proportion of cases in MNH during the study period was 20.9%. There was a higher case-fatality rate than most studies, of 68.4% among the study population. Early identification of these factors will help in reducing the problem through early intervention and therefore improve outcome.
Rapid and Remarkable Response of Deep Second-Degree Burns to the Herbal Oils "Kadi" Product of a Yemeni Child: A Case Report
Background: Pediatric burns are a common injury, posing significant challenges due to the risk of infection and long-term scarring. The search for effective, safe, and easily accessible topical treatments is crucial, especially in resource-limited settings. Case Presentation: A 10-year-old Yemeni male presented with a deep partial-thickness burn on his forearm caused by hot tea (scald). Initial conventional treatments, including Mebo® ointment, povidone-iodine debridement, and topical Fucidin® (fusidic acid) for infection prophylaxis, failed to promote atisfactory healing. The treatment regimen was then switched to a novel topical application of the mix herbal extract oils, “Kadi”, applied three times daily. Outcomes: A dramatic clinical response was observed immediately following the initiation of Kadi herbal oils drops product. The wound achieved complete re-epithelialization within seven days of Kadi application, which is significantly faster than expected for this burn depth. The final outcome demonstrated excellent cosmetic results with minimal post-inflammatory hyperpigmentation and the absence of hypertrophic scarring. Conclusion: This case report demonstrates the outstanding and rapid efficacy of the topical herbal extract Kadi herbal oils drops product in treating deep partial-thickness burns in children. Kadi herbal oils drops product presents itself as a highly promising alternative or adjunct therapy for burn management, warranting further randomized controlled trials (RCTs) to elucidate its active components and mechanism of action.
Progress in Building a “Silicon Valley” Ecosystem in Kansai
Unfortunately, networking still lags what is needed. Two things are needed for it to be successful and both of those are difficult in Japan. One is for potential entrepreneurs to introduce themselves to someone who does not know them. The second is the need to follow up an introduction over time to maintain the relationship. The problem in Japan is compounded by the different levels of hierarchy and whether it would be impolite to make a selfintroduction.
Involvement of the Gasotransmitter Hydrogen Sulfide in the Effect of Ozone on the Hemoglobin Oxygen Affinity
This paper presents current data on the blood oxygen transport function and the gasotransmitters system (hydrogen sulfide and nitric oxide) and their interconnection. Hydrogen sulfide contributes to the modification of hemoglobin oxygen affinity, which is achieved through various mechanisms: the formation of sulfhemoglobin, modulation of the intraerythrocytic 2,3-DPG system, the L-arginine-NO system, and also indirectly through systemic mechanisms of hemoglobin functional properties. Based on an analysis of literature and our own data, the role of hydrogen sulfide as a gasotransmitter in the formation of blood oxygen transport function and the development of oxidative damage and hypoxic conditions is discussed.
Ms. Abdullakhodzhaeva. Principles of the Organization of the Pathology service. Tashkent: Meditsina, 1986: 199 p.
The reviewed monograph is devoted to an important problem the organization of the pathoanatomical service. In chapter I “Pathology departments and their role in improving medical and diagnostic services” discusses the structure and role of the Pathoanatomical Service (PS) in improving medical anddiagnostic work, so it should be called that. The priority of our country in the PS organization, which began to be created in the first years of Soviet power, is briefly indicated. Definitions of the PS and the Pathology Department (PD), their tasks and those of the centralized PD (CPD) are given.
Endothelial dysfunction is the initial event in the atherogenic process, resulting from several events, such as expression of leukocyte binding sites, production of growth factors, chemotactic and vasoreactive molecules, ability to oxidize low-density lipoprotein (LDL) and respond to oxidized lipoproteins, ability to express procoagulant activity, and modulation of vascular permeability. Thus, the endothelium, when subjected to different conditions and factors, plays an active role in the development of atherosclerotic plaque. The expression of several adhesion molecules, such as intracellular adhesion molecule-1 (ICAM-1), E-selectin, vascular cell adhesion molecule-1 (VCAM-1), P-selectin in atherosclerotic plaques, mediating the interaction between endothelial cells and leukocytes, has been described. The modification of LDLs, in conjunction with other chemotactic factors produced by injured endothelial cells, recruit circulating monocytes into the subendothelial space, where they become macrophages. The proliferation of smooth muscle cells is an important event in the progression of arterial injury, occurring in 3 stages: smooth muscle cell replication still within the media layer; migration from the middle layer to the intima and proliferation within the intima. Apoptotic cells were evidenced in the atherosclerotic lesion, suggesting that apoptosis is part of the normal vascular healing process. The final stage of atherosclerotic lesion development is conversion of the fibrotic lesion to an advanced lesion, a lesion in which a thrombus forms as a result of plaque ulceration or intraplaque hemorrhage.
Copyright (c) 2025 Japan Journal of Clinical & Medical Research
DPP4 valorphin activate NR4As pathway and OPA1 that protect from CoQ10 deficiency from OPA1 dysfunctions and from WMH
Valorphin (known as VV-hemorphin-5 ) is nine essential amino acids: Leu_Val_Val_Tyr, _Pro _Pro _Thr_ Gln_& Arg are having important role in activating mitochondrial functions and in activating both serotonin and NR4As pathway that promote oxytocin and Nrf2 synthesis. Deficiency in Thr, Tph (TGG), Glu, Gln (cycle) and Leucine due to increasing in the polarizability in mTORC1 and in S6K genes and subunits can cause disorders or deficiency in OPA1 repair that can be the result of Primary coenzyme Q10 (CoQ10) deficiency disease that characterized by damage in the inner mitochondrial membrane which is necessary for activating glucocorticoids receptor GCR Synthesis. Mitochondrial damage or disorder can lead to accumulation in pro-inflammation which can cause mutations in subunit and protein. The reduction in tryptophan, in Gly (which considered as the mirror of tryptophan triplets), and in Arg will cause reductions in Proline synthesis and consequently reductions in tRNAs, followed by reduction in mitochondrial OPA1 repairs and functions (that reduction in Gly can cause reduction in GTPase), followed by reduction in IL17 synthesis and accumulation of proinflammatory molecules, and followed by reduction in serotonin synthesis and in all of GC-beta, oxitocin, and Nrf2 production, that will be followed by decreasing in megakaryocytes proliferation and followed by reduction in hematopoiesis which associated to white matter hyperintensity. Opioid receptors produce powerful analgesia that is effective in participating in the function of the immune cells, and effective for modulating acquired immune responses (include modulating lymphocytes functions). While tryptophan (and both leucine and Tyr kinases) is necessary to activate both serotonin and lymphocytes functions, that the reduction in tryptophan, in Tyr, and in Leu will be result in decreasing in serotonin and in Nrf2 followed by reduction in platelets production, reduction in lymphocytes functions and reductions in hematopoietic cells functions that will be result of cerebral small vessel disease, and white matter hyperintensity. Serotonin (5-hydroxytryptamine; 5-HT) is a growth factor for hematopoietic cells promote the megakaryocytes (MKs) proliferation which produces platelets, where reduction in serotonin will be result of decreasing in megakaryocytes proliferation followed by reduction in hematopoiesis which associated with white matter microstructure.
Plasma glial fibrillary acidic protein (GFAP)
Cellular tissue of CoQ10 deficiency contains high cations binding
Healing Rate for Radiolucent Lesions following Root Canal Treatment
Objectives: This study was done to evaluate the healing rate of a radiolucent lesion in root canal treated teeth done at Hospital Universiti Sains Malaysia (HUSM) dental clinics by the students and dentists. Materials and Methods: Seventy-eight patient’s case sheets who attended HUSM dental clinic from January 2013 to December 2018 that met the inclusion criteria were collected, assessed, and compiled. The information was collected related to the period of treatment and radiolucency size by measurement through radiograph. Healing rate of radiolucent lesions for 56 root canal treated teeth were calculated and recorded. Result: The result showed that the healing rate for radiolucent lesions of RCT treated by student involving 39 teeth (22 anteriors, 3 premolars, 14 molars) was 1.904mm2/month and by dentist involving 17 teeth (6 anterior, 2 premolar, 9 molar) is 0.947 mm2/month.
Femoral Preparation Before Head Dislocation in Hip Hemiarthroplasty for Fractured Neck of Femur Saves Time and Keeps the Acetabulum Clean of loose bone fragments: A Retrospective Study and Technical Report
Introduction: Femoral neck fractures are the most common traumatic injuries associated with increasing age and osteoporosis, occurring most in older females. The femoral neck is under constant strain from externally and internally generated forces, approximately 500 – 200 micro-strains from daily activities. Common causes are falls in the elderly and road traffic accidents in younger patients. There is a significant in-house mortality and one-year mortality rate associated with femoral fractures. Fractures can be classified using the Garden Classification or the 2018 AO/OTA classification. Management includes open reduction and internal fixation, cannulated or sliding screws and hemiarthroplasty or total hip arthroplasty. This study examines the benefits of femoral preparation before head dislocation in hip hemiarthroplasties by assessing differences between pre-operative and post-operative haemoglobin levels and surgical times. Methods: We report the surgical techniques of hip hemiarthroplasty where the femur is prepared before the femoral head is removed and the hip is reduced in the flexion position. A retrospective review of electronic patient records of patients who underwent hemiarthroplasties from June 2022 to June 2023 was conducted. Results: Surgical times for this surgical technique were 30 minutes faster than traditional methods while the differences in haemoglobin levels were minimal. Conclusion: Longer surgical times are associated with adverse events such as infections and wound dehiscence while increasing risks via surgeon fatigue and longer anaesthesia durations. Innovations in surgical techniques should thus aim to minimise surgical time without compromising procedures. This technique saves 30 min on average while having similar levels of blood loss to traditional techniques, maintaining standards, and not compromising on patient safety. Femoral preparation before dislocating the femoral head reduces the steps taken in leg repositioning which saves time and effort by the assistant. The reduction technique also avoids any risk of intra-operative iatrogenic fracture that can happen, especially if the assistant is a junior surgeon who lacks experience with hip reduction.
Tibio-Fibular Fusion by Posterolateral Approach to Treat Nonunion of Tibia
A 30- year- old male has sustained open fracture of left leg and undergone 4 surgeries for four years (1. debridement and external fixator, 2. removal of external fixator, 3. vascularized contrafibular autograft plus change new plate/screws of ipsifibula, 4. flap surgery to cover the wound). At the time of examination: unability to walk, abnormal movements of leg, tibial bone loss 8 cm, especially the soft tissue of almost total anterior leg was so bad: no more subcutaneous tissue, skin very next to bone decouraging any attempt anterior approach. Diagnosis: pseudarthrosis of left leg with tibial large bone loss in the status of seriously damaged soft tissue of anterior leg surface. Technique operation chosen: Posterolateral. Appoach, Tibiofibular Fusion with massive autocancellous bone graft harvested from posterior iliac pelvis. Casting 4 months (from midthigh to metatarsal head). Postoperative walking with two crutches, Full Weight Bearing allowed after 14 weeks. Removal of cast after 16 weeks. Full knee flexion obtained 8 weeks after cast removal. Review at tenth month: normal walk, slight running, complete knee Range of Motion, 5 degree loss of dorsiflexion of ankle. X-rays: good fusion proximal and distal tibiofibular spaces and partly fusion the tibio-tibial gap. By this case,we can resumably conclude Tibiofibular Fusion through Posterolateral Approach should be strongly indicated for the leg nonunion in which the soft tissue of anterior surface is not favorable for nearby approach.
Evaluation of Major Adverse Cardiac Events After Cardiac Surgery in Gaza
Background: The present study assessed the major adverse cardiac events (MACE) (hospital mortality rate, major stroke and reintervention) after cardiac surgery du to coronary artery bypass grafting or valve surgery or both in the Ministry of health hospitals (MOH) in Gaza Strip at 2022 by either Local or Expert cardiac surgery team. Method: Retrospective cohort study including all patients who underwent cardiac surgery by local or expert cardiac surgery team with cardiopulmonary bypass and /or valve surgery in the MOH hospitals at Gaza Strip during 2022. Result: Among the 98 patients (26 female and 72 male) with mean age 56±12 years, 38 patients was operated by local team, and 60 patients was operated by expert cardiac surgeon during 2022 in Gaza. The comparison of end points (mortality, major stroke and reintervention) between local and expert cardiac surgeons, was significantly low in patients operated by expert surgeon was 9 patients (23.7%) in local team surgery and in 4 patients (6.7%) in expert team. (P 0:015) Conclusions: The combination end points included Hospital mortality, major stroke and reintervention rate was higher in patients operated by local cardiac surgery team.
Psychological Approaches to Suicidal Tendencies
Elements obtained in the course of psychotherapy suggest that errors in childhood education, the aforementioned traumas in the molding periods, are of capital importance in the genesis of suicidal ideas, as they exacerbate the already existing manifestations of innate death instinct; that circumstantial factors of old age - loneliness, abandonment and scarcity of vital stimuli - reactivate unconscious conflicts and the manifestation of the death instinct already existing in the periods of molding, and that the hypothesis of psychosomatic fantasy would contribute to clarify the intimate mechanism of the suicidal act. We can come to formulate the following hypotheses about the suicidal act that is psychosomatic. This hypothesis is based not only on psychoanalysis but also on phenomenology, on modern structuralism. In order to carry out this psychosomatic hypothesis about the origins of suicidal ideas in depressive states about the psychogenic etiopathogenesis of thanatisms, there is the need to consider the following theories: 1) Gestaltism; 2) The new psychoanalytic currents; 3) New phenomenological currents; 4) The new currents of structuralism; 5) The philosophy defended by Duns Scotus; 6) Specificity and object relations.
New Perfection of Original Xx-Xy (Female-Male) Gender Theory and Beyond: Assuring Mother and Father Care Umbrella for Japanese Happy Life and Survival of Social Legacies Forever
Japanese are highly regarded for their lifestyles, wisdoms and aged survival gentry population among the developed countries of the world. There are lot of worries for the developing aging and low fertility among the populations. No improving situation to cope up with such natural phenomena seems to be coming up. Following new perfection of the original xx-xy (female-male) gender theory and beyond further studies were conducted on how to enable reducing aberrations causing misbalance in family genders. Such aberrations in the family genders were also found associated with early death of either one of the parents or causing non curable health ailments, impairing the life courses in the families. Objective of the present study was that in addition to making balanced families also create mother and father care umbrella for the family to maintain happy life courses of Japanese. The study fixed bio factors, produced cause and effects and developed prismatic gender balanced families, needed for reaching unforeseen and unimaginable acme. Thus, the study ushered a new prestige to the Japanese life known for its novelty to new niche in exemplary long life and harnessing plenty benefits by making survival of social legacies forever. Upcoming of the results of this study will help overcoming disabled children becoming parents to produce offspring free of genetic disabilities. This study opens a new dimension of high geographical areas of Japan under hill and forests, considered as a limiting setback for the country in to a plus point in enhancing gender balanced families and revamping population sustainability.
Community and Society Genetic Disabilities
Long Life Span and Survival of Social Legacies
Outcome of Long Segment Posterior Spinal Stabilization Incorporating the Fractured Vertebra for Unstable Thoraco-Lumbar Junctional Brust Fracture
Objectives: To evaluate the outcome of long segment posterior spinal stabilization incorporating the fractured vertebra with posterolateral fusion for unstable thoraco-lumbar junctional brust fracture. Background: Thoracolumbar junction is the commonest site of traumatic spinal injury. Now a days, it is managed surgically most of the time because it is often associated with the spinal cord injury. Its mode of surgical management is a field of controversy. Huge debate is still going on between the superiority of long & short segment stabilization. In this study, we evaluated the outcome of long segment posterior spinal stabilization incorporating the fractured vertebra. Materials & Method: This prospective interventonal study included 30 case of thoraco-lumbar junctional unstable brust fractures was carried out in the Spine unit of Orthopaedic surgery department of Bangabandhu Sheikh Mujib Medical University, Dhaka and other private hospital in Dhaka City, Bangladesh, from January 2016 to July 2022. All the patients with positive clinical findings, X-ray, MRI & CT scan findings and underwent long segment posterior spinal stabilization incorporating the fractured vertevra with posterolateral fusion. Average follow-up period was 12 months. Pre & Post-operatively, neurological assessment was done by the ASIA Impairment Score, improvement of pain control by VAS score, fusion rate by Bridwell’s criteria, Kyphotic angle was measured by Cobb’s angle measurement method & Overall functional assessment by modified Odom’s score. Results: Total number of patients was 30. Average age was 34 years (range 21- 47). ASIA score improved from B to C in 5 patients, B to D in 5 patients, C to D in 8 patients , C to E in 3 patients, patients, D to E in 7 patients. 2 patient did not improved following surgery. Fusion was achieved in 29 patients & 1 patient developed pseudoarthrosis. Pre & Post- operative VAS score was 7.30±1.9 & 3.3±1.8 respectively. The average kyphotic correction was 15 ∞. In our series, we have no bedridden patients after surgery. There was no radiographic progression after surgery. Conclusion: Early treatment within 21 days of injury with long segment posterior spinal stabilization incorporating the fractured vertevra with posterolateral fusion is a very effective surgical procedure with preservation of the motion segment to treat unstable thoracolumbar junctional brust fracture.
Long Segment Including Fractured Vertebra
Neuroleptic Malignant Syndrome and its Clinical Look-Alikes: Diagnostic Insights
Neuroleptic malignant syndrome (NMS) is a rare but life-threatening neurological emergency associated with the idiosyncratic reaction to dopamine receptor antagonist medications or with rapid withdrawal of dopaminergic medications. While uncommon, this condition can mimic various other acute conditions presenting with acute dysautonomia, fever, and altered mental status, which can lead to delayed recognition and increased morbidity such as residual catatonia, parkinsonism, renal, or cardiopulmonary complications. Therefore, high vigilance, early recognition, and prompt treatment are necessary. In this review article, we aim to elaborate the pathophysiology, clinical features, and comprehensive management of NMS, with a special focus on its various mimicking conditions.
Oncocytic Cell Activity in Hashimoto’s Thyroiditis and PTC Thyroid Parenchyma: Immunohistochemical Profile
Oncocytic cell neoplasia makes a challenge in diagnosis and treatment, because It’s known that oncocytic cell neoplasms have unique molecular mechanisms. Oncocytic cells can be seen in many types of thyroid disease, including benign tumors, low-risk neoplasms, and malignant neoplasms. Thyroid tumors are classified as oncocytic cell neoplasms when more than 75% of the tumor consists of oncocytic cells. We studied oncocytic cells in cases of Hashimoto’s thyroiditis and Papillary Thyroid Carcinoma with different markers (Protein S-100, CD56, p63 and Cyclin D1). Based on the obtained results, we can conclude that these markers have different expression in different diseases and is more accurate for oncocytic cell carcinoma than for PTC. However, each marker has different sensitivity and specificity among the diseases studied.
Cardiac Risk Marker Obesity and Psychological Background
The psychopathology of appetite excess reveals that there are several causes of obesity; even essential obesity, constitutional obesity or obesity due to metabolic error present a plurality of factors, which makes it more difficult to understand. However, our clinical experience highlights the capital importance of prophylactic medicine. We believe, therefore, that it is essential to adopt combined treatment: psychotherapy, endocrinology, physiotherapy, nutrition and social assistance. It is evident that in certain obese people, exercise increases polyphagia and in others it burns more calories. In the latter type, physical exercise should be prescribed. The psychotherapist with analytical training should be in a neutral position to receive both the good and the bad from the patient, but should always return the good, to enhance the individual’s security and so that he does not use somatizations. The treatment of obesity would therefore be eclectic and, mainly, prophylactic, avoiding in the family the maladjustments of the parents that can traumatize the individual during the periods of molding. In this way, emotional confusions that cause excess appetite would be avoided. Psychoanalysis or psychoanalytic group psychotherapy and the associated diet are, nowadays, the greatest weapons available to combat this social evil, because the obese person is the victim of sarcastic and jocular attitudes, which causes disgust and unhappiness.
Plant Fungus Gloeotinia SP: A Rare Finding in a Case of Mesial Temporal Sclerosis with Medical Refractory Epilepsy
We report a case of a 38-year-old gentleman who diagnosed since the age of 11 with medical refractory epilepsy. Semiology began with symptoms of automatism followed by deviation of eyes and unpurposeful movement of left hand. Patient would then experience loss of consciousness and generalised tonic seizure involving all four limbs. These episodes tend to last for 1-2 minutes and post ictal drowsiness frequently follows. Electroencephalography (EEG) displayed findings compatible with right temporal epilepsy with secondary generalisation. Magnetic resonance imaging (MRI) of brain confirmed right hippocampal sclerosis as culprit for the seizures while neuropsychological tests displayed poor memory. Otherwise, patient had no neurological deficit or any history of long-term infection. After a long history of anti-epileptic drug polypharmacy with poor control of seizures, surgical treatment was opted for. Right amygdala-hippocampectomy was performed by neurosurgeon which was uneventful. Histopathology of surgical specimen was reported as sections of neuronal loss, suggestive of sclerosis and diffuse fungal infiltration at brain surface and blood vessels. This was then confirmed as Gloeotinia sp. Via BLAST (basic local alignment search tool) method. Patient remains fit free after surgery.
Our Anesthesia Experience in a Pediatric Patient with Ruptured Lung Hydatid Cyst
Hydatid cyst is a parasitic disease caused by Echinococcus granulosus and transmitted to humans mostly through canine feces. Although it can settle in every organ in the body, the lung is the most frequently involved organ in children. As well as being asymptomatic, a pulmonary hydatid cyst may cause complaints such as chest pain, cough, shortness of breath, pneumothorax, and hemoptysis. A child patient was admitted to the pediatric emergency service with complaints of severe respiratory distress, hemoptysis, and pneumothorax in the right lung. Hydatid cyst treatment is primarily surgical. With the rupture of the cyst during the operation, anaphylactic shock and even death can be seen. In case of sudden onset of tachycardia and a decrease in mean arterial pressure during hydatid cyst operation, the possibility of anaphylaxis should be kept in mind after excluding other possibilities. We think that keeping in mind that anaphylaxis may develop in patients who will undergo surgery for hydatid cysts and being prepared for this will have a significant positive effect on mortality and morbidity. In this case report, we aimed to present our anesthesia experience of anaphylactic reaction following cyst rupture during surgical excision of lung hydatid cyst.
A Phenomenological Study on The Understanding of Adolescent Decision-Making About Reproductive Health by School Nurses in Ijebu Ode Local Government of Nigeria
This study examined the understanding of adolescent decision-making in their reproductive health making by school nurses. School nurses are expected to provide guidance to the adolescents in reproductive health to help them make informed decisions. Adolescence is a transitional stage imbued with a lot of intrigues and risks. These risks, sometimes, if not well managed may disrupt the process of growth and development of adolescents. The school nurses need to understand how the adolescents make their decision as this will enable them to discharge their professional duties effectively. The study adopted an exploratory, descriptive, and contextual qualitative design aimed at revealing what school nurses understand about how adolescents make decisions in reproductive health. The setting of the study was Ijebu Ode Local Government of Nigeria. The semi-structured interviews were conducted on the school nurses, school teachers, and the school health coordinator, while focus group discussion was used with school-based adolescents. Data analysis employed inductive content analysis. The subthemes that described the understanding of adolescent reproductive health decision-making by school nurses were inadequate knowledge of the concept of adolescence, and lack of adequate knowledge of reproductive health. The study concluded that school nurses would require an intervention programme in this direction.
Vision-Boosting Nutrition: Exploring the Benefits of Nutritional Supplements for Eye Health
Oxidative stress, defined by an imbalance in free radical generation and antioxidant defense, serves as a pivotal risk factor for multiple ocular pathologies, including glaucoma, cataracts, and age-related macular degeneration (AMD). Under normal physiological conditions, endogenous mechanisms adequately regulate reactive oxygen species (ROS) levels. However, excessive ROS accumulation, surpassing the body’s antioxidative capacity, initiates oxidative stress, precipitating macromolecular damage and potentially accelerating disease progression in ocular tissues. This review delineates the significance of dietary antioxidants in mitigating oxidative stress specifically within the context of eye health. Focus is directed towards the bioactive compounds, polyphenolic flavonoids and anthocyanosides, prevalent in various foods such as Nigella sativa, tea, chocolate, fruits, and vegetables (polyphenolic flavonoids), as well as blueberries and bilberries (anthocyanosides). These compounds engage distinct mechanistic pathways to neutralize ROS; polyphenolic flavonoids donate electrons, whereas anthocyanosides scavenge free radicals. The current synthesis aims to elucidate the molecular interactions and therapeutic potential of these antioxidants in preserving ocular health and preventing the onset or progression of related diseases, providing a comprehensive understanding for future research and clinical applications.
Unraveling the Knot: Noninvasive Strategies to Combat Stress for a Healthier Heart by Artificial Intelligence Innovations
Stress is a prevalent factor in modern life that significantly impacts cardiovascular health. This paper explores the intricate relationship between stress and heart health, detailing the physiological mechanisms through which stress affects the cardiovascular system. Various noninvasive strategies for reducing stress in daily life are examined, including mindfulness and meditation, physical activity, breathing techniques, social support, and nutritional interventions. Additionally, the role of Artificial Intelligence (AI) in enhancing stress management is discussed, highlighting AI innovations such as personalized stress monitoring, predictive analytics, virtual health coaches, cognitive behavioral therapy (CBT) apps, and social connection platforms. By integrating these noninvasive methods with AI technologies, individuals can effectively manage stress, thereby promoting better heart health and overall well-being. Case studies illustrate practical applications of these strategies, demonstrating significant improvements in stress levels and cardiovascular health. The paper concludes that proactive stress management, supported by AI, is essential for maintaining heart health and enhancing quality of life.
Analising the Organ-Injury and Lastest Treatments for New Variants of SARS-COV-2 in Ederly and Immunocompromised Patients with Severe Comorbility
The global pandemia of Omicron and the lastest Variants again puts all the scientific community in big problems.
Computational Prediction of COVID-19 Transmission in Internal Air-Conditioned Environments
COVID-19 has had destructive consequences for health, economy and has altered every aspect of everyday human activity. The outbreak was first identified in December 2019 in Wuhan, China. The declaration of the disease as a “Public Health Emergency of International Concern” for the World Health Organization took place on January 30, 2020. Furthermore, 105,5 million cases have been reported until 06 February 2021. Public distancing in internal environments has been applied as a safety measure to prevent transmission. A controversial topic is the safe distance from person to person. The social distancing regulation, for internal public places, has been arbitrarily defined ignoring the potential aerodynamics effects of inlets, such as air-conditioning units, windows and doors. The velocity of the intake airflow has the potential to transfer a droplet from the nose or the mouth of a patient in greater than the indicated distance. The present study focuses on a model of a supermarket that includes a ventilation system and open doors. For the transmission of COVID-19 in an air-conditioned internal space, two different designs were implemented and studied. Internal shelving, furnishing and human models are also being considered. The numerical results obtained are compared with those obtained by two well-known empirical models related to the effective velocity of incoming air and the virus concentration. It is concluded that the computational results obtained in the present study are in acceptable agreement with those obtained by simple empirical models, especially when the standard k-ε model of turbulence is used. Thus, for the cases of coughing and sneezing patients, where we studied the largest particles that sediment onto the floor, the 6-foot (≈1,82 m) rule applies well. However, pathogen-laced particles, coming for example from asymptomatic patients, travel through the air indoors when people breathe and talk. Therefore, there is not much benefit to the 6-foot rule because the air a person is breathing tends to rise and comes down elsewhere, so the person is more exposed to the average background than to a person at a distance. Future research should concentrate rather on the amount of time spent inside rather than distances. As the COVID-19 pandemic is progressing, the present study is flexible and can be applied generally in crowded places. Furthermore, the general outcome is that individuals should maintain the distance of 1,65 meters and it should be applied as guidelines to help reduce the infection risk.
Public Health Emergency of International Concern
Predicting Indeterminate Lesion Turned to Distance Metastasis in Patients with Rectal Cancer Undergoing Curative Resection after Preoperative Chemoradiotherapy
Objectives: It is controversial about factors associated with indeterminate lesion turned to be malignant lesion after preoperative concurrent chemoradiotherapy(CCRT) in rectal cancer that may cause over-treating and over-diagnosing. So, The aim of this study was to evaluate the prevalence of indeterminate pulmonary nodules or liver nodule at primary staging CT and risk of indeterminate lesion being malignant to help better understanding of indeterminate lesion in rectal cancer undergoing preoperative CCRT and proper treatment. Methods: A total of 679 patients with rectal cancer were assessed from January 2015 to December 2019. 152 patients with rectal cancer undergoing curative resection after preoperative CRT were included. Associated factors were reviewed for their effect on metastasis. The median follow-up time was 28 months. Results: Of 152 patients, The prevalence of indeterminate lesion was 3.29% and turned to be malignant around 40% of patients. The clinical N2, preoperative FOLFOX regimen, No clinical response were significantly higher in malignant group (p 0.03, <0.001 and 0.003, respectively). Conclusions: Such a low incidence of indeterminate lesion should not cause further preoperative diagnostic workup besides routine regimens. In addition, it is not necessary to perform excessive surveillance routinely for all rectal cancer patients underwent preoperative CCRT who have indeterminate lesion. Intensive follow up chest CT or invasive diagnosis modalities should be considered in patients who had clinical stage N2, receiving preoperative FOLFOX4 regimen and no clinical response after preoperative CCRT.