Search results for: asylum medicine

Authors: Yifang Gong

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Pulse diagnosis is one of the most important diagnosis methods in traditional Chinese medicine. It is also the trickiest method to learn. It is known as that it can only to be sensed not explained. This becomes a serious threat to the survival of this diagnostic method. However, there are a large amount of experiences accumulated during the several thousand years of practice of Chinese doctors. A pulse pattern called 'Slippery pulse' is one of the indications of pregnancy. A simple fluid dynamic model is proposed to simulate the effects of the existence of a placenta. The placenta is modeled as an extra plenum in an extremely simplified fluid network model. It is found that because of the existence of the extra plenum, indeed the pulse pattern shows a secondary peak in one pulse period. As for the author’s knowledge, this work is the first time to show the link between Pulse diagnoses and basic physical principle. Key parameters which might affect the pattern are also investigated.

Keywords: Chinese medicine, flow network, pregnancy, pulse

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Nasrin Takzaree, Gholamreza Hassanzadeh, Abbas Hadjiakhoondi, Mohammadreza Rouini

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Introduction: Today herbal medicine are extensively used for various therapeutic reasons. Whereas Achillea millefolium L. comprises different chemical compounds it is used in classic and modern medicine for different purposes. Concerning the family planning as a principle matter, the idea of using specific herbal medicine is of great importance. Purpose: To investigate the effects of Achillea millefolium L. extract on fertility power and spermatogenesis process in male mature Wistar rats and the anti-fertility effects of this extract in male genital system. Material and methods: In this study 32 male mature Wistar rats were randomly divided in to 4 experimental groups. 1st experimental group included 8 rats receiving Achillea millefolium extract at the dose of 200 mg/kg intraperitoneally. Second and third groups received the extract the same at the doses of 400 and 800 mg/kg respectively. 4th group was considered as control group in which the parenteral distilled water was administered. after 20 days, rats were sacrificed and the spermatogenesis process was histologically examined. Results: In experimental groups receiving high doses of extract comparing with control group, thickness in seminiferous tubules basal membrane, decrease in germinal epithelium cells, congestion in testicular tissue, disarrangement in germinal epithelium cells as well as decrease in cellular condense were observed (p<0.001). Conclusion: Findings suggest that alcoholic extract of Achillea millefolium at high concentrations lead to the structural alterations and changes in spermatogenesis in testicular tissue.

Keywords: spermatogenesis, alcoholic extract of Achillea millefolium L., testis, Wistar rat

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Authors: Arunporn Itharat, Srisopa Ruangnoo, Pakakrong Thongdeeying

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The rhizomes of Dioscorea membranacea (DM) has long been used in Thai Traditional medicine to treat cancer and inflammatory conditions such as rheumatism. The objective of this study was to investigate anti-inflammatory activity by determining the inhibitory effect on LPS-induced TNF-α from RAW264.7 cells of crude extracts and pure isolated compounds from DM. Three known dihydrophenantrene compounds were isolated by a bioassay guided isolation method from DM ethanolic extract [2,4 dimethoxy-5,6-dihydroxy-9,10-dihydrophenanthrene (1) and 5-hydroxy-2,4,6-trimethoxy-9,10-dihydrophenanthrene(2) and 5,6,2 -trihydroxy 3,4-methoxy, 9,10- dihydrophenanthrene (3)]. 1 showed the highest inhibitory effect on PGE2, followed by 3 and 1 (IC50 = 2.26, 4.97 and >20 μg/ml or 8.31,17.25 and > 20 µM respectively). These findings suggest that this plant showed anti-inflamatory effects by displaying an inhibitory effect on TNF-α release, hence, this result supports the usage of Thai traditional medicine to treat inflammation related diseases.

Keywords: Dioscorea membranacea, anti-inflammatory activity, TNF-Alpha , dihidrophenantrene compound

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Authors: Chukwunonso Igboamalu, Daprim Ogaji

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Background: With the limited number of trained health care providers in Nigeria, patent and proprietary medicine vendors (PPMVs) are inevitable and highly needed especially in the rural areas for the supply of drugs in treating minor illnesses. These vendors serve as a crucial link between the healthcare system and the community, aiding in the distribution of medications and healthcare information, particularly in areas with limited hospital infrastructure. Objectives: The study set to measure the participants’ knowledge, attitude and patient referral practice and any association of their characteristics with patient referral. Methodology: This cross-sectional descriptive survey was conducted among PPMVs in Obio-Akpor LGA of Rivers State. Data was collected using a self-administered structured questionnaire and analysed using SPSS version 25. Results: The study showed that 18.3% had adequate knowledge, 62.4% had moderate knowledge and 19.2% had poor knowledge. Attitude was moderate among 73.4% of the study participants with only 13% showing adequate attitude. In reporting their referral practice, 34% showed poor referral practice, 58% reported moderate practice and only 8% showed adequate practice. Conclusion: Various facilitators as well as barriers to patient referral were highlighted by the respondents. This study indicated that while attitude and practice were moderate among respondents, the percentage of PPMVs with the adequate knowledge of patient referral was high. To enhance the effectiveness of patient referrals, addressing barriers to referral and promoting education and training for PPMVs are critical steps forward.

Keywords: knowledge, attitude, practice, barriers, facilitators, patent medicine vendor, referral

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Authors: Nurgul A. Abenova, Gaukhar S. Dilmagambetova, Lazzat M. Zhamaliyeva

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Professionalism is a core competency that all medical students must achieve throughout their studies. Clinical knowledge, good communication skills and an understanding of ethics form the basis of professionalism. Patients, medical societies and accrediting organizations expect future specialists to be professionals in their field, which in turn leads to the best clinical results. Currently, there are no studies devoted to the study of medical professionalism in the Republic of Kazakhstan. As a result, medical education in the Kazakhstani system has a limited perception of the concept of professionalism compared to many Western medical schools. Thus, the primary purpose of this study is to analyze the perception of medical professionalism among residents and teachers of family medicine at the West Kazakhstan Marat Ospanov Medical University. А qualitative research method was used based on the content analysis methodology. A focus group discussion was held with 60 residents and 12 family medicine teachers to gather participants' views and experiences in the field of medical professionalism. The received information was processed using the MAXQDA-2020 software package. Respondents were selected for the study based on their age, gender, and educational level. The results of the conducted survey confirmed the respondents’ acknowledgment of the basic attributes of professionalism, such as medical knowledge and skills (more than 40% of the answers), personal and moral qualities of the doctor (more than 25% of the answers), respect for the interests of the patient (15% of the answers), the relationship between the doctor and the patient and among professionals themselves (15% of responses). Another important discovery of the survey was that residents are five times more likely to define the relationship between a doctor and a patient in a model “respect for the interests of the patient” in comparison with teachers of family medicine, who primarily reported responsibility and collegiality to be the basis for the development of professionalism and traditionally view doctor-patient relationship to be formed on the basis of paternalism defined by a high degree of control over patients. This significant difference demonstrates a rift among specialists in the field of family medicine, which causes a lot of problems. For example, nowadays, professional family doctors regularly face burnout problem due to many reasons and factors that force them to abandon their jobs. In addition to that, elements of professionalism such as reflective skills, time management and feedback collection were presented to the least extent (less than 1%) by both groups, which differs from the perception of the Western medical school and is a significant issue that needs to be solved. The qualitative nature of our study provides a detailed understanding of medical professionalism in the context of the Central Asian healthcare system, revealing many aspects that are inferior to the Western medical school counterparts and provides a solution, which is to teach the attributes and skills required for medical professionalism at all stages of medical education of family doctors.

Keywords: family medicine, family doctors, medical professionalism, medical education

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Authors: Jinan Fiaidhi, Hashmath Shaik

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Breaking the barrier for practicing evidence-based medicine relies on effective methods for rapidly identifying relevant evidence from the body of biomedical literature. An important challenge confronted by medical practitioners is the long time needed to browse, filter, summarize and compile information from different medical resources. Deep learning can help in solving this based on automatic question answering (Q&A) and transformers. However, Q&A and transformer technologies are not trained to answer clinical queries that can be used for evidence-based practice, nor can they respond to structured clinical questioning protocols like PICO (Patient/Problem, Intervention, Comparison and Outcome). This article describes the use of deep learning techniques for Q&A that are based on transformer models like BERT and GPT to answer PICO clinical questions that can be used for evidence-based practice extracted from sound medical research resources like PubMed. We are reporting acceptable clinical answers that are supported by findings from PubMed. Our transformer methods are reaching an acceptable state-of-the-art performance based on two staged bootstrapping processes involving filtering relevant articles followed by identifying articles that support the requested outcome expressed by the PICO question. Moreover, we are also reporting experimentations to empower our bootstrapping techniques with patch attention to the most important keywords in the clinical case and the PICO questions. Our bootstrapped patched with attention is showing relevancy of the evidence collected based on entropy metrics.

Keywords: automatic question answering, PICO questions, evidence-based medicine, generative models, LLM transformers

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Authors: Vasanthi Muniasamy, Intisar Magboul Ejalani, M.Anandhavalli, K. Gauthaman

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Social Media (SM) are websites increasingly popular and built to allow people to express themselves and to interact socially with others. Most SMT are dominated by youth particularly college students. The proliferation of popular social media tools, which can accessed from any communication devices has become pervasive in the lives of today’s student life. Connecting traditional education to social media tools are a relatively new era and any collaborative tool could be used for learning activities. This study focuses (i) how the social media tools are useful for the learning activities of the students of faculty of medicine in King Khalid University (ii) whether the social media affects the collaborative learning with interaction among students, among course instructor, their engagement, perceived ease of use and perceived ease of usefulness (TAM) (iii) overall, the students satisfy with this collaborative learning through Social media.

Keywords: social media, Web 2.0, perceived ease of use, perceived usefulness, collaborative Learning

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Authors: Shao-Chi Chien, Ying-Ju Chen, Chiao-Yu Tseng, Wan-Ting Lee, Yi-Wen Cheng

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Dr. George Leslie Mackay arrived at Takoukang (now Port of Kaohsiung) in Taiwan on December 30, 1871. When Dr. Mackay dedicated at Taiwan for 30 years, he has been an important factor in such areas as preaching, medical and engaged in education. Many researchers have thoroughly studied Dr. Mackay's travels to understand his impact on the state of education, medicine and religion in Taiwan. In the 30-year period of hard work, Dr. Mackay's made outstanding influence on the church in Taiwan. Therefore, the present study will be the mission of the establishment of hospitals, schools, churches which preaching, education, and medicine whether there are related the number of comparisons to explore. According to The Diaries of George Leslie Mackay, our research uses the Geographic Information System (GIS) to map the location of Dr. Mackay's travel in Taiwan and compares it with today's local churches, hospitals, and schools whether there are related the number of comparisons to explore. Therefore, our research focuses on the whole of Taiwan, divided into missionary, medical and education as the main content of the three major parts. Additionally, use of point layer, the surface layer of the property table to establish, in-depth mission of Dr. Mackay's development in Taiwan and Today's comparison. The results will be based on the classification of three different colors pictures that the distance of Mackay's contribution of preaching, medicine, and education. Our research will be compared with the current churches, hospitals, schools and the past churches, hospitals, schools. The results of the present study will provide a reference for future research.

Keywords: George Leslie Mackay, geographic information system, spatial distribution, color categories analysis

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Authors: Caterina Grandi, Lukas Lochner, Marco Padovan, Mirco Rizzi, Paola Sperinde, Fabio Vittadello, Luisa Cavada

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Background: In recent years, the use of Complementary Alternative Medicine (CAM) has achieved worldwide popularity. With the increased public interest in CAMs, attention to it within Health Care Schools and Colleges has also improved. Studies generally assess the knowledge and attitudes regarding CAMs in medical and nursing students. The current study focused on the knowledge, attitudes and practice of CAM in healthcare students. Aim: To assess the knowledge and attitudes regarding complementary and alternative medicine (CAM) in healthcare students in South Tyrol, a region in Northern Italy. Methodology: This cross-sectional study was carried out among 361 students. Self-administered questionnaire was adapted and modified by the researchers from several questionnaires. The instrument consisted of three sections: 1) demographical characteristics (gender, place of residence and year of study); 2) general attitudes towards CAM, evaluated through 11 items using a Likert scale (agree, partly agree, partly disagree, disagree); 3) knowledge and use about any particular CAM practices (acupuncture, aromatherapy, creative therapies, diet/nutritional therapies, phytotherapy/herbal therapies, compresses, massage therapy, Ayurvedic therapy, Tibetan medicine, naturopathy, homeopathy, pet therapy, reflexology, therapeutic touch, chiropractic/osteopathy). Results: The sample consisted of 63 males and 297 females, 58% living in villages. 151 students (42%) were in the first year, 99 (27%) in the second and 106 (30%) in the third. Both men and women agreed with statements about the utility and benefits of CAMs. Women were significantly more likely than men to agree that the CAM practices should be included in the curriculum (p < 0.004), that the health professionals should be able to advice their patients about commonly used CAM methods (p < 0.002) and that the clinical care should integrate CAM practices (p < 0.04). Students in the second year showed the highest mean score for the statement 'CAM includes ideas and methods from which conventional medicine could benefit' (p = 0.049), highlighting a positive attitude, while students in the third year achieved the lowest mean score for the negative statement 'The results of CAM are in most cases due to a placebo effect'. Regarding this statement, participants living in villages disagreed significantly than students living in the city (p < 0.001). Females appeared to be significantly more familiar with homeopathy (p < 0.002), aromatherapy (p < 0.033), creative therapies (p < 0.001) and herbal therapies (p<0.002) than males. Moreover, women were likely to use CAM more frequently than men, particularly to solve psychological problems (p < 0.004). In addition, women perceived the benefit significantly more positive than men (p < 0.001). Students in the second year revealed to use the CAM mostly to improve the quality of life (p < 0.023), while students in the third year used CAMs particularly for chronic diseases (p < 0.001). Conclusions: Results from this study suggested that female students show more positive attitudes on CAM than male students. Moreover, the prevalence of CAM use and its perceived benefits differ between males and females, so that women are more willing to use CAM practices.

Keywords: attitude, CAM, complementary and alternative medicine, healthcare students, knowledge

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Authors: Shireen Ibish

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Physical inactivity and unhealthy diets have contributed to a global burden of disease with increased relation to non-communicable diseases, increased risk of colon and breast cancer, high prevalence of depression, reduced quality of life and early death. The World Health Organisation’s facts on Obesity show a tripling in prevalence across the European Region since the 1980s. This has lead to a huge public health burden, being responsible for and 10-13% of deaths (fourth largest cause of global mortality) and 2-8% of health costs in the Region. In the UK alone, the present cost of physical inactivity has been estimated to be £8.2 billion. In 2002 a paper published in the International Journal of Epidemiology on ‘sedentary’ lifestyle, put into figures the increasingly worrying statistics across European countries. “Percentages of sedentary lifestyles across European countries ranged between 43.3% (Sweden) and 87.8% (Portugal)”. This was especially so amongst obese subjects, less- educated people, and smokers. While in the UK’s “50% of adult population in the UK is predicted to be obese by 2050.” Sports and Exercise Medicine, as a specialty, has a lot to offer in targeting this globally increasing epidemic. The worrying figures and the increasing knowledge of combating and preventing this issue have lead to increased awareness amongst the medical profession and more targeted interventions to reduce the burden of disease. “The public health element of the specialty is critical – this is not simply a specialty for the management of elite athletes’ medical conditions – it is central to the promotion of exercise as a means of disease prevention, to enhance well-being and in the management of disease.” WHO advised on creating National policies, encouraging and providing opportunities for greater physical activity, and improve the affordability, availability and accessibility of healthy foods. In the UK various different movements have been established to target this problem. The Motivate2Move, Move Eat Treat and guidelines advising specialties on targeting and encouraging exercise in the population (Sport and Exercise Medicine A Fresh Approach).

Keywords: sedentary lifestyle, obesity, public health burden, medicine

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Authors: Nahid H. Hajrah, Jamal S. M. Sabir, Neil Hall

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The jasmonic pathway is ubiquitous in plants and is crucial to plant development. It Is involved in fertility, ripening, and sex determination as well as in response to environmental stresses such as herbivory, pathogen drought or temperature shock. Essentially the jasmonic pathway acts to shut down growth in order to induce defence pathways. These pathways include the production of secondary metabolites which have evolved to defend against herbivores and pathogens but are of increasing interest due to their roll in medicine and biotechnology. Here we describe the transcriptional response of Rhazia stricta (a poisonous shrub widely used in traditional medicine) to jasmonic acid, in order to better characterize the genes involved in secondary metabolite production and its response to stress. We observe coordinated upregulation of flavonoid biosynthesis pathway leading to flavonols, flavones and anthocyanins but no similar coordination of the monoterpene indole alkaloid pathway.

Keywords: medicinal plants, Rhazia stricta, jasmonic acid, transcriptional analysis

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Authors: Syed Asif Hassan, Tabrej Khan, Ibrahim Manssor Al Najar, Mohammed Nasser

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The incredible accomplishment achieved by e-commerce in consumer durable area encouraged us to implement the online e-commerce model to tap the business benefits of electronic pharmacy in Saudi Arabia. The Kingdom of Saudi Arabia is famous for traditional herbal medicine. The rich heritage of traditional medicine has helped the mushrooming of regional pharmaceutical industries manufacturing drugs and other therapeutic against various diseases. However, the implementation of e-commerce in pharmacy has not been employed in the Kingdom of Saudi Arabia. The electronic pharmacy (E-Pharm) is an important sector that is flourishing across the globe and providing benefits of E-Pharm to the customers and suppliers all around the world. In this context, our web-based application of electronic pharmacy is the one of its kind in the Kingdom of Saudi Arabia. Surveys and personal interviews were used to identify key objectives of the proposed web-based portal. As per the findings of the surveys and personal interviews, following key objectives were identified: (a) The online platform will be used for ordering of prescription based medications for consumers. (b) The e-portal will provide space for pharmaceutical retailers who do not have an electronic platform to upload and sell their therapeutic products in an organized way. (c) The web portal will provide a tracking system to track the customer’s behavior like choice, offer, order, shipment, payment, etc. The web-based e-pharmacy portal will be developed using MySQL and PHP. The development of e-pharmacy web portal and e-prescription practices will not only improve the growth of electronic pharmacy but would also decrease the possibility of prescription alteration thus providing safety and improving the quality of service provided to the patient or consumers.

Keywords: e-commerce, E-Pharm, MySQL, PHP

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Authors: Veronika Lesáková, Silvia Slezáková, František Štěpánek

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Additive manufacturing technologies producing drug dosage forms aimed at personalized medicine applications are promising strategies with several advantages over the conventional production methods. One of the emerging technologies is 3D printing which reduces manufacturing steps and thus allows a significant drop in expenses. A decrease in material consumption is also a highly impactful benefit as the tested drugs are frequently expensive substances. In addition, 3D printed dosage forms enable increased patient compliance and prevent misdosing as the dosage forms are carefully designed according to the patient’s needs. The incorporation of multiple drugs into a single dosage form further increases the degree of personalization. Our research focuses on the development of 3D printed tablets incorporating multiple drugs (candesartan, losartan) and thermoplastic polymers (e.g., KlucelTM HPC EF). The filaments, an essential feed material for 3D printing,wereproduced via hot-melt extrusion. Subsequently, the extruded filaments of various formulations were 3D printed into tablets using an FDM 3D printer. Then, we have assessed the influence of the internal structure of 3D printed tablets and formulation on dissolution behaviour by obtaining the dissolution profiles of drugs present in the 3D printed tablets. In conclusion, we have developed tablets containing multiple drugs providing modified release profiles. The 3D printing experiments demonstrate the high tunability of 3D printing as each tablet compartment is constructed with a different formulation. Overall, the results suggest that the 3D printing technology is a promising manufacturing approach to dual tablet preparation for personalized medicine.

Keywords: 3D printing, drug delivery, hot-melt extrusion, dissolution kinetics

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Authors: Ramiro Quintanilla-Licea, Isvar K. Angeles-Hernandez, Javier Vargas-Villarreal

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Amebiasis caused by Entamoeba histolytica, associated with high morbidity and mortality, is currently a significant public health problem worldwide, especially in developing countries. In the world, around 50 million people develop this illness, and up to 100,000 deaths occur annually. Due to the side-effects and the resistance that pathogenic protozoa show against common antiparasitic drugs (e.g., metronidazole), growing attention has been paid to plants used in traditional medicine around the world to find new antiprotozoal agents. In this study is reported about the isolation and structure elucidation of antiamoebic compounds occurring in Lippia graveolens Kunth (Mexican oregano). The work-up of the methanol extract of L. graveolens afforded the known flavonoids pinocembrin (1), sakuranetin (2), cirsimaritin (3) and naringenin (4) by bioguided isolation using several chromatographic techniques. Structural elucidation of the isolated compounds was based on spectroscopic/spectrometric analyses (IR; 1H- and 13C-NMR; MS) and comparison with literature data. These compounds showed significant antiprotozoal activity against Entamoeba histolytica trophozoites using in vitro tests (positive control metronidazole IC50 0.205 µg/mL). The antiprotozoal activity of pinocembrin and naringenin (IC50 of 29.51 µg/mL and 28.85 µg/mL, respectively) was higher compared with sakuranetin (44.47 µg/mL) and with cirsimaritin (150.00 µg/mL), revealing that a 5,7-dihydroxylated A ring is essential for antiprotozoal activity. These research funds may validate the use of this plant in the traditional Mexican medicine for the treatment of some digestive disorders and can help to integrate the use of extracts of L. graveolens in the conventional and complementary medicine for the treatment of parasitic diseases.

Keywords: amoebiasis, antiprotozoal agents, bioguided isolation, infectious diseases

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Authors: Schulz Peter, Kee Kalya, Lwin May, Goh Wilson, Chia Kendrikck, Chueng Max, Lam Thomas, Sung Joseph

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As Artificial Intelligence (AI) is progressively making inroads into clinical practice, questions have arisen as to whether acceptance of AI is skewed toward certain medical practitioner segments, even within particular specializations. This study examines distinct AI acceptance among gastroenterologists with contrasting levels of seniority/experience when interacting with AI typologies. Data from 319 gastroenterologists show the presence of four distinct clusters of clinicians based on experience levels and perceived risk typologies. Analysis of cluster-based responses further revealed that acceptance of AI was not uniform. Our findings showed that clinician experience and risk perspective have an interactive role in influencing AI acceptance. Senior clinicians with low-risk perceptions were highly accepting of AI, but those with high-risk perceptions of AI were substantially less accepting. In contrast, junior clinicians were more inclined to embrace AI when they perceived high risk, yet they hesitated to adopt AI when the perceived risk was minimal.

Keywords: risk perception, acceptance, trust, medicine

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Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

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Authors: Rosa M. Gambier, Jennifer L. Carlson

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In order to revitalize the science curriculum for botany courses for non-science majors, we have introduced the use of the medicinal plants into a first-year botany course. We have connected the use of scientific method, scientific inquiry and active learning in the classroom with the study of Western Traditional Medical Botany. The students have researched models of Botanical medicine and have designed a sustainable medicinal plants garden using native medicinal plants from the northeast. Through the semester, the students have researched their chosen species, planted seeds in the college greenhouse, collected germination ratios, growth ratios and have successfully produced a beginners medicinal plant garden. Phase II of the project will be to tie in SCCCs community outreach goals by involving the public in the expanded development of the garden as a way of sharing learning about medicinal plants and traditional medicine outside the classroom.

Keywords: medicinal plant garden, botany curriculum, active learning, community outreach

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Authors: Rhaetian Bern D. Azaula

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The Philippines' indigenous population, estimated to be 10%-20%, is protected by the Indigenous Peoples Rights Act (IPRA), passed in 1997. However, due to their isolation and limited access to basic services such as health education or needs for health assistance, the law's implementation remains a challenge. As traditional medicine continues to play a significant role in society as the prevention and treatment of some illnesses, it is still customary and widely used to use plants in both traditional and modern ways; however, commercially prepared drugs are progressively advanced as time goes by. Therefore, the purpose of this quantitative study is to investigate the indigenous community at Barangay Magsikap General Nakar, Quezon, and analyze the factors that affect the respondent’s preferences in an indigenous community and reasons for patronizing traditional and commercially prepared medicines and proposes updated health education strategies and instructional materials. Slovin's formula was utilized to reduce the total population representation, followed by stratified sampling for proportional allocation of respondents. The study selects respondents (1) from an Indigenous Community in Barangay Magsikap, General Nakar, Quezon, (2) aged 60 and above, and (3) who are willing to participate. The researcher utilized a checklist-based questionnaire with a Tagalog version, and a Likert Scale was utilized to assess the respondent's choices on selected items. The researcher obtained informed consent from the indigenous community's regional and local office, the chieftain of the tribe, and the respondents, ensuring confidentiality in the collection and retrieval of data. The study revealed that respondents aged 60-69, males with no formal education, are unemployed and have no income source. They prefer traditional medicines due to their affordability, availability, and cultural practices but lack safe preparation, dosages, and contraindications of used medicines. Commercially prepared medications are acknowledged, but respondents are not fully aware of proper administration instructions and dosage labels. Recommendations include disseminating approved herbal medicines and ensuring proper preparation, indications, and contraindications.

Keywords: traditional medicine, commercially prepared medicine, indigenous community, elderly adult

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Authors: Agung A. Ginanjar, Lilitasari, Indra Prasetya, Rizal R. Hanif, Yusrina Rismandini, Atina Hussaana, Nurita P. Sari

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Hyperlipidemia is an increase of lipids and cholesterol in the blood that causes the formation of atherosklerosis. The recent pharmacological therapy nowadays is statin. Many Indonesian people use of medicinal plants. There are several medical plants that people always use to cure hyperlipidemia such as bulbs onion sabrang, areca nuts, and seed of fenugreek. Most people often use a combination therapy of conventional medicine and herbs to achieve the desired therapeutic effect of combination therapy. The use of combination therapy might cause the interaction of pharmacodynamic from those medicines so that it influences the pharmacological effect of one of medicine. The aim of this study is to know the interaction of simvastatin and a cholesterol-lowering herb seen in rats pharmacodynamic simvastatin phase. This research used post-test only controlled group design. Analysis of statistical data normality and homogenity were tested by Kolmogorov Smirnov. The ANOVA test is used when the data is obtained homogeneous but if it is found that the data are not homogeneous then kruskal-wallis test is used. Normal (63.196 mg/dl), negative (70.604 mg/dl), positive (62.512 mg/dl), areca nuts (56.564 mg/dl), fenugreek seed (47.538 ,g/dl), onion sabrang (62.312 mg/dl). The results prove that the combination of herbs and simvastatin did not have a significant difference (P>0,05). The conclusion of this study is that the combination of simvastatin and a cholesterol-lowering herb can cause some pharmacodynamic interactions such as a synergistic effect, antagonist, and a powerful additive, so that combination therapy is not more effective than single simvastatin therapy. The use of the combination therapy is not given in the same time. It would be better if there are some period of time when the combination therapy is applied.

Keywords: onion bulb sabrang, areca nuts, seed of fenugreek, interaction medicine, hyperlipidemia

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Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

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Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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Authors: Inna Vinokurova, N. Savvina

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The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

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Authors: Mufizur Rahman

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This thesis argues that by the citizenship policies of the Myanmar government, the rights of Rohingya have been taken away and the identity of Rohingya has been marginalized. An emphasis is made on the history, ancestors, homeland, and ideal when an individual seeks recognition for ethnic identity. Ethnic groups hold on to their unique culture, cultural heritage, language, homeland, and historical past not only to act in solidarity but also to reinforce the consciousness of national identity. Rohingya ethnic group in Rakhine state (formerly Arakan state) is in seek for identity and citizenship rights in the country. Even though Rohingya people have been living in Arakan for centuries, they are being marginalized and have been deprived of their rights by the 1982 citizenship law, which was created by the authoritarian leader after the military coup in 1962. This study elaborated marginalized and persecuted life of Rohingyas for decades by the Government of Myanmar (GOM) in their homeland and after the enactment of the 1982 Citizenship Law and citizenship policies enforced by the government. Thereby, every right was deprived systematically from the Rohingya by the GOM. By this circumstance of the country, many Rohingyas have fled from the country and sought asylum in other countries. This study primarily used the qualitative research data of in-depth personal interviews by conducting 18 Rohingya participants from the diaspora community, including male and female participants. The study examined the narrative of the Rohingya identity and citizenship policies of their homeland from the personal experience of the diaspora community.

Keywords: Rohingya, identity, citizenship policies, Diaspora community, homeland, Myanmar

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Authors: A. N. Sharma

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A traditional medicine comprises a knowledge system, practices related to the cure of various ailments that developed over generations by indigenous people or populations. The indigenous populations developed a unique understanding with wild plants, herbs, etc., and earned specialized knowledge of disease pattern and curative therapy-though hard experiences, common sense, trial, and error methods. Here, an attempt has been made to study the possible aspects of traditional medicines for the enhancement of male sexual performance among the indigenous populations of Madhya Pradesh, India. Madhya Pradesh state is situated more or less in the central part of India. The data have been collected from the 305 Bharias of Patalkot, traditional health service providers of Sagar district, and other indigenous populations of Madhya Pradesh. It may be concluded that sizable traditional medicines exist in Madhya Pradesh, India, for the enhancement of male sexual performance, which still awaits for scientific exploration and intensive pharmaceutical investigations.

Keywords: Bharias, indigenous, Madhya Pradesh, sexual performance, traditional medicine

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Authors: Srie Rezeki Nur Endah, Richa Mardianingrum

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Cancer is one of the most feared diseases and is considered the leading cause of death worldwide. Generally, cancer drugs are synthetic drugs with relatively more expensive prices and have harmful side effects, so many people turn to traditional medicine, for example by utilizing herbal medicine. Erythrina poeppigiana is one of the plants that can be used as a medicinal plant containing 10,11-dihidroerisodin compounds that are useful anticancer etnofarmakologi. The purpose of this study was to identify the target of 10,11 dihydroerisodin receptor compound as in silico anticancer candidate. The pure isolate was tested physicochemically by MS (Mass Spectrometry), UV-Vis (Ultraviolet – Visible), IR (Infra Red), 13C-NMR (Carbon-13 Nuclear Magnetic Resonance), 1H-NMR (Hydrogen-1 Nuclear Magnetic Resonance), to obtain the structure of 10,11-dihydroerisodin alkaloid compound then identified to target receptors in silico. From the results of the study, it was found that 10,11-dihydroerisodin compound can work on the Serine / threonine-protein kinase Chk1 receptor that serves as an anti-cancer candidate.

Keywords: anti-cancer, Erythrina poeppigiana, target receptor, 10, 11- dihidroerisodin

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Authors: A. Bouzabata, A. Boukhari

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Curcuma longa L. (Zingiberaceae), commonly known as turmeric, has a long history of traditional uses for culinary purposes as a spice and a food colorant. The present study aimed to document the ethnobotanical knowledge about Curcuma longa and to assess the variation in the herbalists’ experience in Northeastern Algeria. Data were collected by semi-structured questionnaires and direct interviews with 30 herbalists. Ethnobotanical indices, including the fidelity level (FL%), the relative frequency citation (RFC) and use value (UV) were determined by quantitative methods. Diversity in the knowledge was analyzed using univariate, non-parametric and multivariate statistical methods. Three main categories of uses were recorded for C. longa: for food, for medicine and for cosmetic purposes. As a medicine, turmeric was used for the treatment of gastrointestinal, dermatological and hepatic diseases. Medicinal and food uses were correlated with both forms of use (rhizome and powder). The age group did not influence the use. Multivariate analyses showed a significant variation in traditional knowledge, associated with the use value, origin, quality and efficacy of the drug. These findings suggested that the geographical origin of C. longa affected the use in Algeria.

Keywords: curcuma, indices, knowledge, variation

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Authors: Rukaiya Suleiman Umar, Annah Kwadu Medugu

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Moringa oleifera is mainly used as herbal medicine in most homes in Northern Nigeria. The plant is easy to grow and thrives very well regardless the type of soil. Use of moringa leaves in food production can yield attractive varieties on menu. This paper evaluates the acceptability of dishes produced with fresh moringa leaves with a view to promoting it in popular restaurants. A three course menu consisting of cream of moringa soup as the starter, mixed meat moringa sauce with semovita as the main dish and moringa roll as sweet was produced and served to a 60-member taste panel made of three groups of 20 each. Respondents were asked to rate the organoleptic qualities of the samples on a 10-point bipolar scale ranging from 1 (Dislike extremely) – 10 (Like extremely). Data collected were treated to one sample t-test and One Way ANOVA. Results show that the panelists extremely like the moringa products. It is recommended that Moringa oleifera should be incorporated into meals which is more readily acceptable than medicine.

Keywords: Moringa oleifera, food production, menu planning, healthy living

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Authors: Gülseren Kırbaş Doğan, Emin Karakurt, Mushap Kuru, Hilmi Nuhoğlu

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Developmental anomalies can be caused by defects in bone tissue, cartilage tissue, or primitive mesenchymal tissue. Genetic-, environmental-, teratogenic-, faulty breeding selection–, or feeding-related anomalies can be observed either locally or systemically. This study aimed to evaluate in detail the various anomalies in six calves according to pathological and anatomical investigations. Six calves were delivered to the Department of Pathology at the Kafkas University Faculty of Veterinary Medicine between 2017 and 2019. These calves comprised one with anencephaly, one with the diencephalic syndrome, one with Schistosoma reflexum, two with anasarca, and one with nasal and calvarium openings. After necropsy, samples were taken from the organs, foreseen, and routine pathological examinations were performed. Following these procedures, the calves were brought to the anatomy laboratory and anatomically examined. As a result, various anomalies in 6 calves were evaluated according to pathological and anatomical investigations. These findings are believed to contribute to the literature.

Keywords: anatomy, anomaly, calf, pathology

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Authors: Jerome Osentowski

Abstract:

The objective at Central Rocky Mountain Permaculture Institute has been to put in practice a sustainable way of life while growing food, medicine, and providing education. This has been done by applying methods of farming such as agroforestry, forest farming, and perennial polycultures. These methods have been found to be regenerative to the environment through carbon sequestration, soil-building, climate change mitigation, and the provision of food security. After 30 years of implementing carbon farming methods, the results are agro-diversity, self-sustaining systems, and a consistent provision of food and medicine. These results are exhibited through polyculture plantings in an outdoor forest garden spanning roughly an acre containing about 200 varieties of fruits, nuts, nitrogen-fixing trees, and medicinal herbs, and two indoor forest garden greenhouses (one Mediterranean and one Tropical) containing about 50 varieties of tropical fruits, beans, herbaceous plants and more. While the climate zone outside the greenhouse is 6, the tropical forest garden greenhouse retains an indoor climate zone of 11 with near-net-zero energy consumption through the use of a climate battery, allowing the greenhouse to serve as a year-round food producer. The effort to source food from the forest gardens is minimal compared to annual crop production. The findings at Central Rocky Mountain Permaculture Institute conclude that agroecological methods are not only beneficial but necessary in order to revive and regenerate the environment and food security.

Keywords: agroecology, agroforestry, carbon farming, carbon sequestration, climate battery, food security, forest farming, forest garden, greenhouse, near-net-zero, perennial polycultures

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Authors: Michael Keller

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Beyond the heterodoxy expressed in his now-famous 1838 address to the Harvard Divinity School, Emerson’s timing was particularly dangerous. Ideologically, New England faced a severe crisis of identity, as traditional categories of class and religion were growing increasingly unstable. Jones Very, influenced by Emerson, crossed the perceived border between acceptable religious zeal and insane enthusiasm. Abner Kneeland, on the other hand, crossed the uncomfortable border between post-Puritan Unitarian rationalism and blasphemous Enlightenment skepticism. More importantly, Kneeland oversaw a more overtly subversive brand of resistance (in the form of freethought periodicals) that not only threatened religious orthodoxy but also threatened to destabilize the class structure of New England. Very and Kneeland provide instructive case studies of how religious ideologies could run afoul of the social contract and the law itself. By looking closely at the social and religious forces that led to Kneeland’s prosecution for blasphemy, Jones Very’s forced committal to McLean Asylum, and Emerson’s escape from these fates, we gain a greater understanding of the shifting cultural landscape of 1830s New England. This paper will examine Emerson’s resistance to the traditional forces of class and ideology in Massachusetts by situating his early work in the context of the ideological battles of his time. More specifically, I will explore how Emerson was able to resist the conservative cultural forces of his time without experiencing the extremity of their wrath.

Keywords: American literature, cultural studies, emerson, religious studies

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