Since the Russia–Ukraine war in February 2022, Europe has faced a significant humanitarian challenge, with approximately 6.3 million Ukrainian refugees seeking sanctuary abroad by the end of 2023. Poland has been a major host nation, registering about 1.4 million refugees under the Temporary Protection scheme by mid-2022. Despite efforts to integrate these refugees, challenges such as language barriers, legal complexities and housing persist. The Mental Health and Psychosocial Support (MHPSS) activities are needed; however, the gap exists in their offer. To address these challenges, the MHPSS Course was developed. This 15-day intensive training program aimed to equip professionals with the skills needed to support Ukrainian refugees’ mental health and psychosocial needs. The course included theoretical and practical components, fieldwork and evaluations, involving diverse experts and trainers. The MHPSS Course trained 23 participants, covering topics from humanitarian law to community-based interventions. 74% participants attended more than 80% of the course. The course facilitated networking among MHPSS practitioners in Poland, with participants engaging in ongoing professional collaboration through various platforms. The fieldwork topics encompassed a range of initiatives including legal aid, educational support, creative therapies and specialised mental health services for Ukrainian refugees in Poland. These efforts, led by various organisations, aimed to address the diverse needs of refugees through community-based interventions and targeted support programs. Despite recruitment challenges, the course’s comprehensive approach proved effective in enhancing local capacity for mental health support. The integration of cultural sensitivity and interdisciplinary perspectives enriched the learning experience. Ongoing support and monitoring are essential to sustain the momentum and impact of these efforts.
Abstract Surgical navigation is a rapidly evolving multidisciplinary system that plays a crucial role in precision medicine. Surgical‐navigation systems have substantially enhanced modern surgery by improving the precision of resection, reducing invasiveness, and enhancing patient outcomes. However, clinicians, engineers, and professionals in other fields often view this field from their own perspectives, which usually results in a one‐sided viewpoint. This article aims to provide a thorough overview of the recent advancements in surgical‐navigation systems and categorizes them on the basis of their unique characteristics and applications. Established techniques (e.g., radiography, intraoperative computed tomography [CT], magnetic resonance imaging [MRI], and ultrasound) and emerging technologies (e.g., photoacoustic imaging and near‐infrared [NIR]‐II imaging) are systematically analyzed, highlighting their underlying mechanisms, methods of use, and respective advantages and disadvantages. Despite substantial progress, the existing navigation systems face challenges, including limited accuracy, high costs, and extensive training requirements for surgeons. Addressing these limitations is crucial for widespread adoption of these technologies. The review emphasizes the need for developing more intelligent, minimally invasive, precise, personalized, and radiation‐free navigation solutions. By integrating advanced imaging modalities, machine learning algorithms, and real‐time feedback mechanisms, next‐generation surgical‐navigation systems can further enhance surgical precision and patient safety. By bridging the knowledge gap between clinical practice and engineering innovation, this review not only provides valuable insights for surgeons seeking optimal navigation strategies, but also offers engineers a deeper understanding of clinical application scenarios.
Abnormal uterine bleeding in perimenopausal women is mostly due to disturbance in the Hypothalamic–pituitary–ovarian axis, which leads to an anovulatory cycle. There is an unopposed action of estrogen on the endometrium without progesterone. Ayurveda explains the condition as Asrigdara (~menorrhagia or metrorrhagia). The Doshika (~regulatory functional factors of the body) predominance in the perimenopausal period is Pitta pradhana, Vata madhya, and Kapha heena (~Pitta dominant with moderate Vata and low Kapha), and any deviation from this leads to Dosha vaishamya (~derangement of Dosha), eventually responsible for various menstrual-related disorders in females. During the perimenopausal period, menstrual irregularities commonly result from the vitiation of Apana Vayu (~one of the five subtypes of Vata, situated in the pelvic region), caused by its obstruction due to aggravated Pitta and described as Pitta-avrita apana vayu. Here, a case of Asrigdara, which was successfully managed with Ayurveda intervention for 95 days, is being presented. After the completion of treatment, the menstrual cycle became regular with normal duration and interval, and endometrial thickness reduced from 12 mm to 6 mm. Furthermore, the haemoglobin level increased from 9.8 to 11.4 g/dl, Pictorial Blood Loss Assessment Chart score decreased from 382 to 83, and Menstrual Bleeding-related Quality of Life score improved from 52 to 12. The case report demonstrates the efficacy of Ayurveda treatment in menstrual disorders, further inferring the role of Ayurveda treatment modalities in improving the overall well-being of the patient, without any adverse effects.
Ethnopharmacological relevance: Over the past decade two non-communicable diseases, hypertension (HTN) and diabetes (DM), have become two of the biggest healthcare issues in Africa, rivalling communicable diseases. This study focuses on the patient-initiated use of traditional medicinal plants (TMPs) in conjunction with doctor-prescribed conventional medicines (CMs) for the management of HTN and DM in Nigeria, highly prevalent in this Africa's most populous country. Aim of the study: The aim is to delineate the extent and demographic particulars of the usage of (TMPs) for the treatment and management of diabetes and hypertension in South Eastern Nigeria. Materials and Methods: An interview-based survey among 600 HTN and DM patients in two South Eastern Nigeria's Teaching Hospitals, together with a structured/semi-structured questionnaire, was administered on the patients. Results: Approximately, 75 % of the participants use TMPs, concurrently with their prescription medicines, demonstrating high prevalence in the use of TMPs for the management of HTN and DM. An interesting observation was that according to patient interview, most doctors did not know – and were not told - about TMP use by their patients. Potentially, the use may predispose patients to severe hypotension or hypoglycaemia and other adverse effects e.g. drug interactions and direct toxicities. Also, poor quality and scanty or anecdotal directions of TMPs raises safety concerns. Quantitative statistical cross-analysis of the data indicated some associations between the use of TMPs by patients, their conditions and demographics. Age and marital status have statistically significant association with TMP usage while no association existed between participants’ gender, level of education or religion and their usage of TMPs (P = 0.636; P = 0.533; P = 0.419 respectively). The older age group, over 40 years, use TMP more than the younger group. Married participants are more interested in traditional medicine compared with the unmarried group. Conclusion: This study forms the basis of a future survey to be conducted on Nigerian doctors, to ascertain their views on traditional/alternative medicine and its possible integration into the national healthcare system. The empirical knowledge of this study encourages more research in the search of the pharmacologically effective medicinal plants for the better health management of the Nigerian people.
Apurba Saha, Mona Alice Marbaniang, Monikornika Kakoty
et al.
Introduction: Suicide is a major public health issue. The WHO included the lesbian, gay, bisexual, and transgender (LGBT) populations among the vulnerable groups of highest risk of suicide. This study, therefore, seeks to bring out the risk factors and preventive measures of suicide among the lesbian and gay youth. Methods: The study used descriptive study design with a quantitative method. The inclusion criteria include lesbian and gay youth between the age group of 22 and 25 years and pursuing Master’s degree. Through purposive sampling technique, 40 participants were selected. A structured interview schedule was constructed for this study. It was administered to understand the perceptions of participants on the risk factors and preventive measures. Results: The analysis revealed that majority of the participants agreed that lack of support, societal stigma, etc, are risks factors that may lead to suicide amongst the lesbian and gay youth, and majority participants also agree that certain preventive measures can be adopted to reduce the risk of suicide. Conclusions: Findings of the analysis highlighted differences in the characteristics of suicide among the lesbian and gay youth. Suicide prevention efforts and actions must be taken sensitively and culturally for the sexual minority populations.
COVID-19 pandemic-related pressures on primary care may have driven the inappropriate continuation of antibiotic prescriptions. Yet, prescribing modality (repeat/non-repeat) has not previously been investigated in a pandemic context. With the approval of NHS England, we conducted a retrospective cohort study of >19 million English primary care patient records using the OpenSAFELY-TPP analytics platform. We analysed repeat/non-repeat prescribing frequency in monthly patient cohorts between January 2020 and 2022. In-depth analysis was conducted on January 2020 (“pre-pandemic”) and January 2021 (“pandemic”) cohorts (with a particular focus on repeat prescribing). Per-patient prescribing and clinical conditions were determined by searching primary care records using clinical codelists. Prescriptions in a 6-month lookback period were used to delineate repeat prescribing (≥3 prescriptions) and non-repeat prescribing (1–2 prescriptions). Associations between demographics (e.g., age, sex, ethnicity) and prescribing were explored using unadjusted risk ratios. The frequency of clinical conditions among prescribed patients was examined. Antibiotic prescribing declined from May 2020; non-repeat prescribing declined more strongly than repeat prescribing (maximum declines −26% vs. −11%, respectively). Older patients were at a higher risk of prescribing (especially repeat prescribing). Comorbidities were more common among repeat- vs. non-repeat-prescribed patients. In the pandemic cohort, the most common clinical conditions linked to repeat prescribing were COPD comorbidity and urinary tract infection. Our findings inform the ongoing development of stewardship interventions in England, targeting patient groups wherein there is a high prevalence of repeat prescribing.
Therapeutics. Pharmacology, Other systems of medicine
Prakash Monika, M. N. Chandraprabha, K. N. Chidambara Murthy
Abstract Background Although chronic wounds are devastating and can cause burden at multiple levels, chronic wound research is still far behind. Chronic wound treatment is often less efficient due to delay in diagnosis and treatment, non-specific treatment mainly due to lack of knowledge of wound healing or healing resistance genes. It’s known that chronic wounds do not progress towards healing, because it gets stalled in inflammatory phase of wound healing. Objective We aimed to use phytoextracts possessing excellent anti-inflammatory properties to regulate the unbalanced levels of cytokines responsible for increased inflammation. Methods Evaluation of anti-inflammatory activity of selected phytoextracts namely, Camellia sinensis (L.) Kuntze, Acacia catechu (L.f) Willd., Curcuma longa (L.), Allium sativum (L.), Punica granatum (L.) and Azadirachta indica A. hereafter, called as catechin, epicatechin, curcumin, garlic, pomegranate and neem extracts, respectively in Acute wound fibroblasts (AWFs) and Chronic wound fibroblasts (CWFs) using flow cytometry. Results The phytoextracts exhibited no cytotoxicity below 100 μg/ml on normal Human Dermal fibroblasts (HDFs), while garlic extract showed highest cell viability followed by catechin, epicatechin, curcumin, pomegranate peel and neem based on IC50 value. Garlic, catechin and epicatechin extracts showed highest anti-inflammatory activities for both TGF-β and TNF-α in both AWFs and CWFs treated cells. After treatment of AWFs with catechin, epicatechin and garlic extracts, TGF-β and TNF-α expression was significantly reduced compared to untreated AWFs and reached to almost normal HDFs level. Also, after treatment of CWFs with catechin, epicatechin and garlic extracts, TGF-β and TNF-α expression was significantly reduced compared to untreated CWFs and was lesser than untreated AWFs. Conclusion The present findings reveal the potential of catechin, epicatechin and garlic extracts for the treatment of acute and chronic wounds with excellent anti-inflammatory properties.
Shokoofe Noori, Mitra Nourbakhsh, Hossein Imani
et al.
Abstract Background Use of natural products has been proposed as an efficient method in modulation of immune system and treatment of cancers. The aim of this study was to investigate the potential of cryptotanshinone (CPT), naringenin, and their combination in modulating the immune response towards Th1 cells and the involvement of JAK2/STAT3 signaling pathway in these effects. Methods Mouse models of delayed type hypersensitivity (DTH) were produced and treated with naringenin and CPT. The proliferation of spleen cells were assessed by Bromodeoxyuridine (BrdU) assay. Flowcytometry and enzyme-linked immunosorbent assay (ELISA) tests were employed to evaluate subpopulation of T-lymphocytes and the levels of cytokines, respectively. The JAK/STAT signaling pathway was analyzed by Western blotting. Results We showed higher DTH, increased lymphocyte proliferation, decreased tumor growth and reduced JAK2/STAT3 phosphorylation in mice treated with naringenin and CPT. Moreover, a significant decline in the production of IL-4 and an upsurge in the production of IFN-γ by splenocytes were observed. Additionally, the population of intra-tumor CD4+CD25+Foxp3+ T cells was significantly lower in naringenin + CPT treated animals than that in controls. Conclusion Naringenin-CPT combination could exert immunomodulatory effects, suggesting this combination as a novel complementary therapeutic regimen for breast cancer.
This paper is the first known documentation of a covid patient in ARDS and MODS who recovered from home through Ayurveda telemedicine and when not completely dependent on oxygen. The covid patient suffered from fever, body ache, breathlessness, fatigue, and was admitted to the hospital when his SpO2 was at 56, his CT scores at 18/25, Corads 6 and his NL ratio was at 9. The patient was shifted to another hospital as he refused treatment in the first hospital; in the second hospital also he refused treatment and got himself discharged against medical advice when his SpO2 was at 65, RR 40. The patient sought Ayurvedic treatment through phone voluntarily when in MODS. He showed clinical improvement within a day and the SpO2 steadily raised to reach 94 in 27 days. He may have required invasive mechanical ventilation for COVID-19 ARDS reflected by his raised covid biomarkers (Malik et al., 2021) [1]. But this was not necessitated; also other risk factors for poor outcomes were his old age, comorbidities as diabetes, kidney injury and liver injury. This paper records that oral and ophthalmic administration of Ayurveda medicines can immediately increase SpO2 levels. This case study also opens up possibilities of emergency care in Ayurveda with respect to hypoxia.
Introduction Workload in oncology during a pandemic is expected to increase as manpower is shunted to other areas of need in combating the pandemic. This increased workload, coupled with the high care needs of cancer patients, can have negative effects on both healthcare providers and their patients. Methods This study aims to quantify the workload of medical oncologists compared to internal medicine physicians and general surgeons during the current COVID-19 pandemic, as well as the previous H1N1 pandemic in 2009. Results Our data showed decrease in inpatient and outpatient workload across all three specialties, but the decrease was least in medical oncology (medical oncology −18.5% inpatient and −3.8% outpatient, internal medicine −5.7% inpatient and −24.4% outpatient, general surgery −17.6% inpatient, and −39.1% outpatient). The decrease in general surgery workload was statistically significant. The proportion of emergency department admissions to medical oncology increased during the COVID-19 pandemic. Furthermore, the study compared the workload during COVID-19 with the prior H1N1 pandemic in 2009 and showed a more drastic decrease in patient numbers across all three specialties during COVID-19. Discussion We conclude that inpatient and outpatient workload in medical oncology remains high despite an ongoing COVID-19 pandemic. The inpatient medical oncology workload is largely contributed by the stable number of emergency department admissions, as patients who require urgent care will present to a healthcare facility, pandemic or not. Healthcare systems should maintain manpower in medical oncology to manage this vulnerable group of patients in light of the prolonged COVID-19 pandemic.
Medicinal plants have been a main source of therapeutic agents from ancient time to cure diseases. Terminalia arjuna (Roxb.) Wight & Arn. (T. arjuna) is one of the most accepted and beneficial medicinal plants in indigenous system of medicine for the treatment of various critical diseases. This comprehensive review provides various aspects of its ethnomedical, phytochemical, pharmacognostical, pharmacological and clinical significance to different diseases particularly in cardiovascular conditions. This plant has a good safety outline when used in combination with other conventional drugs. This review highlights various medicinal properties of T. arjuna through different studies such as antioxidant, hypotensive, anti-atherogenic, anti-inflammatory, anti-carcinogenic, anti-mutagenic and gastro-productive effect.
Background: Children's motor skills are inversely related to sedentary screen time. COVID-19-lockdown during the pandemic has caused a further increasing on screening time.Aim: The current research aims at investigating the impact of Stickygym games on motor development of children.Materials and Methods: Twenty-eight eligible subjects (4-6 years old) were chosen and randomly grouped into control group (n=13) and experimental group (n=15). Using TGMD-2 test, gross motor development was measured. The experimental group performed online Stickygym games for 8 weeks. Stickygym kit includes Hook & Loop strips, with two linear polyester strips being easily but firmly attached together. Trained instructors performed online training sessions. In the end, TGMD-2 test was conducted again in person. Data analysis was done using Shapiro-Wilk, Levene and the analysis of covariance tests were with the significance level of 0.05 in SPSS 24.Results: Some locomotion skills were significantly improved by Stickygym games: bound (P=0.005), galloping (P=0.012), and running (P=0.003), as well as object control skills: overhand throw (P=0.004), underhand roll (P=0.01), and striking a stationary ball (P=0.021).Conclusion: This play kit can be utilized by pre-school educators and parents for improving object control and locomotion skills in preschool children.
Amaç: Bu çalışmanın yapılmasının temel amacı 8-11 yaş dilimindeki okul çağı çocukların Türkçedeki nazometrik norm değerlerini betimlemektir. Çalışmada ayrıca, yaş, cinsiyet ve ekonomik gelir seviyesi değişkeninin nazometrik norm değerleri üzerindeki etkisine bakmak da hedeflenmiştir. Yöntem: Çalışmaya, 8-11 yaşları arasında olan ve herhangi bir dil, konuşma ve işitme sorunu olmayan 57’si kız, 72’si erkek olmak üzere 129 çocuk dahil edilmiştir.Katılımcılar 96-107, 108-119, 120-131 ve 132+ olmak üzere 4 gruba ayrılmışlardır. Çalışmadaki veriler, oral, oronazal ve nazal pasajların katılımcılara okutulması suretiyle, Nasometer II (model 6400) kullanılarak elde edilmiştir. Bulgular:Metinlerdeki nasal seslerin oranı arttıkça nazometrik değerlerde artış görülmektedir. Cinsiyet faktörü oral pasaj üzerinde etkilidir. Yaşla birlikte nazal puanlarda artış görülmektedir.
Abstract Background Seed of mature Croton tiglium Linne, also known as Tiglium seed (TS), has been widely used as a natural product due to its several health beneficial properties including anti-tumor and antifungal activities. Despite its ethnomedicinal beneficial properties, toxicological information regarding TS extract, especially its long-term toxicity, is currently limited. Therefore, the objective of the present study was to evaluate acute and subchronic toxicity of TS extract in rats after oral administration following test guidelines of the Organization for Economic Cooperation and Development (OECD). Methods Toxicological properties of TS extract were evaluated by toxicity assays to determine its single-dose acute toxicity (125, 250, 500, 1000, or 2000 mg/kg), 14-day repeated-dose toxicity (125, 250, 500, 1000, or 2000 mg/kg) and 13-week repeated-dose toxicity (31.25, 62.5, 125, 250, and 500 mg/kg) in Sprague-Dawley rats and F344 rats. Hematological, serum biochemical, and histopathological parameters were analyzed to determine its median lethal dose (LD50) and no-observed-adverse-effect-level (NOAEL). Results Oral single dose up to 2000 mg/kg of TS extract resulted in no mortalities or abnormal clinical signs. In 13-week toxicity study, TS extract exhibited no dose-related changes (mortality, body weight, food/water consumption, hematology, clinical biochemistry, organ weight, or histopathology) at dose up to 500 mg/kg, the highest dosage level suggested based on 14-day repeat-dose oral toxicity study. Conclusion Acute oral LD50 of TS extract in rats was estimated to be greater than 2000 mg/kg. NOAEL of TS extract administered orally was determined to be 500 mg/kg/day in both male and female rats. Results from these acute and subchronic toxicity assessments of TS extract under Good Laboratory Practice regulations indicate that TS extract appears to be safe for human consumption.