Search results for: patent medicine vendor

Authors: Suparpit von Bormann, Winai Sayorwan, Sirichai Channim, Sararat Rungruangkhanarak, Premchai Suksamran, Piyaporn Srisuk, Piyatida Phosri

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The best medicine will not work if the patient does not take them. There are several methods developed to help patients to be adherent to medicine. However, non-adherent rate still high: 24% in physically ill and 42% in mentally ill patients. Moreover, patients might feel less confident when carrying medicine around. Normal medicine box has no alarm; whereas the one with alarm is not handy and might be left at home. Therefore, Medication Reminder (MR) was invented. MR is a medicine pocket that has an alarm clock to remind the patient when it is the time to take medicine. It also has a small light indicating the medicine the patient has to take. This pocket is attached within a purse or wallet because most people forget medicine but do not forget to take their money. This research was conducted to develop innovation assisting patients to take their medicine on time. Samples were 24 volunteers who went out to work every day. Uncoated tablets, coated tablets, and capsules were filled in three types of containers: MR, plastic bag with ziplock, and normal plastic box. Each volunteer carried three types of containers everywhere during day time. After three days, medicines were tested for physical quality (appearance, odor, color, hardness, and weight) in laboratory. Medication adherence and satisfaction questionnaires were completed by participants. The results showed that MR showed significant improvement in participants’ adherence than plastic bag with ziplock, and normal plastic box at p < .001 (x̄(SD) = 11.16(0.75), 7.83(0.98), 8.83(1.32), respectively). Based on the quality test, MR and normal plastic box significantly better protected medicine than plastic bag with zip lock at p < .001 (x̄(SD) = 4(0.00), 4(0.00), 2.5(0.54), respectively). Most participants were satisfied with the innovation in highest level (4.50 out of 5). MR has a potential to improve adherent rates of participants and therefore to be an innovation that helps reducing the cost of treatment due to non-adherence. MR also has a potential in commercial aspect due to its effects in preserving quality of medicine. MR can be integrated with local products such as silk purse that can increase income for local people.

Keywords: medication, reminder, adherence, satisfaction

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Authors: James M. Wakiru, Liliane Pintelon, Peter Muchiri, Stanley Mburu

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Maintenance performance measurement (MPM) represents an integrated aspect that considers both operational and maintenance related aspects while evaluating the effectiveness and efficiency of maintenance to ensure assets are working as they should. Three salient issues require to be addressed for an asset-intensive organization to employ an MPM-based framework to optimize maintenance. Firstly, the organization should establish important perfomance metric(s), in this case the maintenance objective(s), which they will be focuss on. The second issue entails aligning the maintenance objective(s) with maintenance optimization. This is achieved by deriving maintenance performance indicators that subsequently form an objective function for the optimization program. Lastly, the objective function is employed in an optimization program to derive maintenance decision support. In this study, we develop a framework that initially identifies the crucial maintenance performance measures, and employs them to derive maintenance decision support. The proposed framework is demonstrated in a case study of a geothermal drilling rig, where the objective function is evaluated utilizing a simulation-based model whose parameters are derived from empirical maintenance data. Availability, reliability and maintenance inventory are depicted as essential objectives requiring further attention. A simulation model is developed mimicking a drilling rig operations and maintenance where the sub-systems are modelled undergoing imperfect maintenance, corrective (CM) and preventive (PM), with the total cost as the primary performance measurement. Moreover, three maintenance spare inventory policies are considered; classical (retaining stocks for a contractual period), vendor-managed inventory with consignment stock and periodic monitoring order-to-stock (s, S) policy. Optimization results infer that the adoption of (s, S) inventory policy, increased PM interval and reduced reliance of CM actions offers improved availability and total costs reduction.

Keywords: maintenance, vendor-managed, decision support, performance, optimization

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Authors: Ashley L. Freeman, Jessica D. Watkins

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TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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Authors: Abdulrahman Aloufi

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E-commerce has evolved to become a functional and mainstream tool of global trading, including in the Kingdom of Saudi Arabia. Consequently, online consumers need protection just as much as consumers in the offline world. In 2019, the Ministry of Commerce in Saudi Arabia established a so-called ‘e-commerce law’; however, this law does not cover the court enforcement of contracts entered into by international vendors, so it is not applicable in cross-border situations. The purpose of this paper is to identify the gaps present in this new e-commerce law in Saudi Arabia.

Keywords: consumer protection, e-commerce law, Saudi consumer, international vendor

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Authors: Ngawang Tsering

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Traditional Tibetan medicine is primarily focused on promoting health and keeping away diseases from its unique in prescribing specific diet and lifestyle. The prevalence of chronic diseases has been rising day by day and kills a number of people due to the lack of proper nutritional design in modern times. According to traditional Tibetan medicine, chronic diseases such as diabetes, cancer, cardiovascular diseases, respiratory diseases, and arthritis are heavily associated with an unwholesome diet and inappropriate lifestyles. Diet and lifestyles are the two main conditions of diseases and healthy life. The prevalence of chronic diseases is one of the challenges, with massive economic impact and expensive health issues. Though chronic diseases are challenges, it has a solution in the preventive measurements by using proper nutrition design based on traditional Tibetan medicine. Until today, it is hard to evaluate whether traditional Tibetan medicine nutrition strategy could play a major role in preventive measurement as of the lack of current research evidence. However, compared with modern nutrition, it has an exclusive valuable concept, such as a holistic way and diet or nutrition recommendation based on different aspects. Traditional Tibetan medicine is one of the oldest ancient existing medical systems known as Sowa Rigpa (Science of Healing) highlights different aspects of dietetics and nutrition, namely geographical, seasonal, age, personality, emotional, food combination, the process of individual metabolism, potency, and amount of food. This article offers a critical perspective on the preventive measurement against chronic diseases through nutrition design using traditional Tibetan medicine and also needs attention for a deeper understanding of traditional Tibetan medicine in the modern world.

Keywords: traditional Tibetan medicine, nutrition, chronic diseases, preventive measurement, holistic approach, integrative

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Authors: T. Rakhi, Thrivikram Shenoy

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Esophageal atresia is a disorder of maldevelopment of esophagus with or without a connection to the trachea. Radiological reviews are needed in consultation with the pediatric surgeon and neonatologist and we report a rare case of esophageal atresia associated with atrial septal defect-patent ductus arteriosus complex. A 2-day old female baby born at term, weighing 3.010kg, admitted to the Neonatal Intensive Care Unit with respiratory distress and excessive oral secretions. On examination, continuous murmur and cyanosis were seen. Esophageal atresia was suspected, after a failed attempt to pass a nasogastric tube. Chest radiograph showed coiling of the nasogastric tube and absent gas shadow in the abdomen. Echocardiography confirmed Patent Ductus Arteriosus with Atrial Septal Defect not in failure and was diagnosed with esophageal atresia with suspected fistula posted for surgical repair. After preliminary management with oxygenation, suctioning in prone position and antibiotics, investigations revealed Hb 17gms serum biochemistry, coagulation profile and C-Reactive Protein Test normal. The baby was premedicated with 5mcg of fentanyl and 100 mcg of midazolam and a rapid awake laryngoscopy was done to rule out difficult airway followed by induction with o2 air, sevo and atracurium 2 mg. Placement of a 3.5 tube was uneventful at first attempt and after confirming bilateral air entry positioned in the lateral position for Right thoracotomy. A pulse oximeter, Echocardiogram, Non-invasive Blood Pressure, temperature and a precordial stethoscope in left axilla were essential monitors. During thoracotomy, both the ends of the esophagus and the fistula could not be located after thorough search suggesting an on table finding of type A esophageal atresia. The baby was repositioned for gastrostomy, and cervical esophagostomy ventilated overnight and extubated uneventful. Absent gas shadow was overlooked and the purpose of this presentation is to create an awareness between the neonatologist, pediatric surgeons and anesthesiologist regarding variation of typing of Tracheoesophageal fistula pre and intraoperatively. A need for imaging modalities warranted for a definitive diagnosis in the presence of a gasless stomach.

Keywords: anesthetic, atrial septal defects, esophageal atresia, patent ductus arteriosus, perioperative, chest x-ray

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Authors: Metahri Leyla

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Herbal medicine is one of the oldest medicines in the world. It constitutes an interesting alternative to treat and cure without creating new diseases. Despite the progress of medicine, the increase in the number of doctors, the creation of social security, many parents have resorted to herbal medicine for their children; they are increasingly asking for "natural remedies", "without risk" for their children. Herbal tea is a very accessible way to enjoy the benefits of herbal medicine. Accordingly; the objective of our study is to obtain detailed information on the composition and mode of administration of these herbal teas and to identify the different plants used; their beneficial effects, as well as their possible toxicity. The current research work represents an ethnobotanical survey spread over one month (from January 6, 2021, to February 19, 2021) carried out by means of an electronic questionnaire concerning 753 respondents involving single or multiparous mothers. The obtained results reveal that a total of 684 mothers used herbal teas for their infants, which revealed the use of 55 herbal remedies for several indications, the most sought after are the carminative effect and relief of colic, and which 9% of users noticed undesirable effects linked to the administration of herbal teas to their infants. As a conclusion, it has been asserted that the use of herbal teas as a natural remedy by Algerian mothers is a widely accepted practice, however, the "natural" nature of the plants does not mean that they are harmless.

Keywords: herbal medicine, herbal teas, children, mothers, medicinal plants

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Authors: Thuraya Ahmed Hamood Al Shidhani

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Sports Medicine injuries are very common in primary health care. It is not necessary related to direct trauma, but it could be because of repetitive stress and overuse injuries. Knowledge of Primary Health care providers about the common sports medicine injuries and when to refer to a specialist is essential. Common sports injuries are muscle strain, joint sprain, bone bruise, Patellofemoral pain syndrome, Anterior cruciate ligament injuries, meniscal injuries, ankle ligaments injuries, concussion, Rotator cuff tendinosis/impingement syndrome, lateral and medial epicondylitis and fractures. Systematic approach is very useful in evaluation of sports injuries. RICE is important in initial management. Physiotherapy is essential for rehabilitation. Definitive Management is dependent on patient’s condition and function.

Keywords: common, sports medicine injuries, primary health care, injuries

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Authors: Dong Zhan

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China sports science is the core periodical of scientific research in the field of sports in China at present. It is the first academic periodical ranked in China. The author has studied the characteristics and trends of articles on sports medicine and physical fitness published in the journal since it founded. Now, the articles on sports medicine and physical fitness published in the Journal of Sports Science from 2013 to 2017 are reviewed. The results show that 1) The characteristics of previous sports medicine articles showed that there were more articles on the basis of sports medicine than that on the application. The research on animal experiments was far more than that on the human body. Moreover, the trend was getting worse and worse as time goes on. But in the past five years, there had been a marked improvement. The basic/application has been improved from 2.1/1 to 1.3/1. This shows that sports medicine researchers have been paid more attention to the application research in sports medicine. 2) There are few articles on sports injury, because the state put the sports injury specialty into the medical colleges, and the research scope of sports research institutes does not include sports injury. It cannot meet the need for the development of sports medicine, and it should change sooner or later. 3) In the past, researchers’ effort was on athletes' physical health, not on ordinary people. Now, there is a great change, they not only research on the sportsmen’s health but also research on the health of the ordinary people. 4) Researchers mainly studied on the young people’s physical fitness in the past; now, it has been greatly improved. Researchers study on the physical health of the elderly, especially those over the age of 60. Numbers of paper researching on the young were much more than those on the old. In the past 10 years, the ratio of number of paper researching on the young to the old people was (young/old) 16.6/1, while in the past 5 years, this ratio was 6.3/1. However, this is not enough. China has a large population and needs to focus on promoting the health of the people. Conclusion: It is important to pay more attention to the application research on sports medicine and on the physical fitness, and it is also important to make a research on physical health of the elderly.

Keywords: sports medicine, people's health, the young, the old

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Authors: Abubakar Ahmed, Zainab Mohammed, Hadiza D. Nuhu, Hamisu Ibrahim

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Introduction: The plant Tacazzea apiculata Oliv (Periplocaceae) is widely distributed in tropical West Africa. It is claimed to have multiple uses in traditional medicine among which are its use to treat hemorrhoids, inflammations and cancers. Methods: Ethno-botanical survey through interview and using show-and-tell method of data collection were conducted among Hausa and Fulani tribes of northern Nigeria with the view to document useful information on the numerous claims by the local people on the plant. Results: The results revealed that the plant T. apiculata has relative popularity among the herbalist (38.2 %), nomads (14.8 %) and fishermen (16.0%). The most important uses of the plant in traditional medicine are inflammation (Fedelity level: 25.7 %) and Haemorrhoids (Fedelity level: 17.1 %) Conclusion: These results suggest the relevance of T. apiculata in traditional medicine and as a good candidate for drug Development.

Keywords: ethno-botany, periplocaceae, Tacazzea apiculata, traditional medicine

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Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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Authors: Dilay Merve Temur

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How knowledge is produced and how scientific knowledge progress are questions that science philosophers have investigated for centuries. When the scientific and technological developments reached the 20th century, Kuhn proposed a completely new view among all the approaches. In this article, firstly, Kuhn's theory is represented. Secondly, the criticisms of Kuhn's theory directed to him are examined, and Galison's proposal for the trade area term of the incommensurability thesis is shared. The interaction of Humoral Theory with nutrition has been illustrated extensively, and the transition to modern medicine has been described historically by including scientific and technological developments in the field of medicine. This paper will seek to see how the concept of nutrition is positioned as a trading zone within the medicine paradigm, which has experienced a revolution within the framework of the paradigm concept introduced by Kuhn.

Keywords: food studies, incommensurability, nutrition and dietetics, trading zone

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Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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Authors: Kangrij Roeksiripat

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Street vending is one of the informal economy activities which considered significance to Thai people in the economic and the day-to-day social life. It had been believed that the street vendor is a group of the poor and uneducated people. With the increasing numbers of the street vendor occupying space on public sidewalks especially in central business districts, it becomes unclear whether street vending continues as a solution to unemployment for access labors. This research attempts to study and analyze types of street vendors in Bangkok under the informal economy framework. The debate on the heterogeneous informal economy has categorized into four schools; the dualism, the structuralism, the legalism and the voluntarism. The examination also embodies with market concept with Porter’s Five Forces of Competitive Position Model analysis and the interviews with the street vendors in three case study areas: Inner zone (Pathumwan district - the sidewalk on the opposite side of Siam Paragon mall), Middle zone (Ramkhamhaeng district - the sidewalk on the opposite side of Ramkhamhaeng University) and Outer zone (Minburi district- the sidewalk of Sriburanukit Road). The result indicates that most of street vendors in Siam square are voluntarily choose to make a living in vending on a sidewalk and tend to take it as a long-term occupation even though they can be in formal wage employment. Moreover, average income and positive attitude towards self-employed are the important factors that drive them to operate street vending businesses. Meanwhile, street vending is often a family enterprise in Ramkhamhaeng area and most vendors do not wish to transform their businesses into the formal sectors. Whereas the survey conducted in Sriburankit Road reveals that almost all of street vendors migrated from other provinces and were previously paid as the unskilled workers in formal sectors. They moved to informal trades because of the uncertainty of employment in the mainstream sectors and the inconsistent income with knowledge support of friends and relatives from the same hometown. In particular, the result reveals a common pattern that street vending is the very first occupation of some group of vendors and they will continue to engage in this activity. Thus, it is important for the government to design optimal policy which not only integrating informal workers into the formal economy but also monitoring the enforcement of regulations on the modern informal economy.

Keywords: informal economy, sidewalks, street vendors, occupation

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Authors: Heng W. Chang, Mao F. Sun

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Chronic Idiopathic Urticaria (CIU) and hypertension are rarely discussed together in modern and traditional Chinese medicine, and often belong to different medical departments. However, in traditional Chinese medicinal theory, the two diseases have some similar characters. For example, they are both relevant to 'wind'. This study conducted a literature review using the China National Knowledge Infrastructure to identify herbs yielding the same effect for the two diseases. The finding showed that the common herbs used most frequently is Rehmanniae. The conclusion is that the same TCM (Traditional Chinese Medicine) mechanism of the two diseases may be 'blood heat'. It requires further study to prove it in the future.

Keywords: urticaria, herbs, hypertension, Rehmanniae

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Authors: Zarini Ismail, Nurul Azmawati Mohamed, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, Khairani Omar

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Choosing a career is one of the most important decisions that people have to make in life. While choosing a suitable career, a person cannot ignore their intrinsic traits such as the type of personality, interests, values, and aptitude. The objective of this study is to ascertain the personality of the pre-clinical medical students and their reasons or intentions for choosing medicine as a career. This study is a cross-sectional study involving Year 3 pre-clinical medical students at Universiti Sains Islam Malaysia. Participants were given a set of validated questionnaires on demographic data and open-ended questions for reasons of choosing medicine. Thematic analysis were used to analyse the open-ended question. The Participants were also required to answer a Career Interest Questionnaire (based on Holland’s Theory). A total of 81 Year 3 medical students were involved in this study. About two third (69%) of them were female and their age ranged from 20 to 21 years old. The majority of them were from middle-income families. From the thematic analysis, there were several reasons given for choosing medicine by the students. The majority of the students stated that it was their passion and interest in the medical field (45.7%). Approximately 24.7% decided to take the medical course because of parents/family influenced and 19.8% mentioned that they wanted to help the society. Other themes emerged were jobs opportunity in future (1.2%) and influenced by friends (3.7%). Based on Holland’s theory, ideally to become a good medical doctor one should score high in investigative and social personality trait. However, 26.3% of the students had low scores in these personality traits. We then looked into the reasons given by these students for choosing medicine. Approximately 28% were due to parents/family decision while 52% admitted that it was due to their interest. When compared with the group of students with high personality scores (investigative and social), there was not much difference in the reasons given for choosing medicine. The main reasons given by the students for choosing medicine were own interest, family’s influence and to help others. However, a proportion of them had low scores in the personality traits which are relevant for medicine. Although some of these students admitted that they choose medicine based on their interest, their strength might not be suitable for their chosen carrier.

Keywords: career, medical students, medicine, personality

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Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: Amir Ashraf

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Homoeopathy is an alternative system of medicine discovered by German physician Samuel Hahnemann in 1796. It has been used by several people for various health conditions globally for more than last 200 years. In India, homoeopathy is considered as a major system of alternative medicine. Homoeopathy is found effective in various medical conditions including Pyuria. Pyuria is the condition in which pus cells are found in urine. Homoeopathy is very useful for reducing pus cells, and homeopathically potentized Conium Mac (Hemlock) is an important remedy commonly used for reducing pyuria. Aim: To reduce the amount pus cells found in urine using Conium Mac 200C. Methods: Design. Small N Design. Samples: Purposive Sampling with 5 cases diagnosed as pyuria. Tools: Personal Data Schedule and ICD-10 Criteria for Pyuria. Techniques: Potentized homoeopathic medicine, Conium Mac 200th potency is used. Statistical Analysis: The statistical analyses were done using non-parametric tests. Results: There is significant pre/post difference has been identified. Conclusion: Homoeopathic potency, Conium Mac 200 C is effective in reducing the increased level of pus cells found in urine samples.

Keywords: homoeopathy, alternative medicine, Pyuria, Conim Mac, small N design, non-parametric tests, homeopathic physician, Ashirvad Hospital, Kannur

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Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Gehan Hussein, Hams Ahmad, Baher Matta, Yasmeen Mansi, Mohamad Fawzi

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Background: Congenital heart disease (CHD) is a common problem worldwide with variable incidence in different countries. The exact etiology is unknown, suggested to be multifactorial. We aimed to study the incidence of various CHD in a neonatal intensive care unit (NICU) in a tertiary care hospital in Egypt and the possible associations with variable risk factors. Methods: Prospective study was conducted over a period of one year (2013 /2014) at NICU KasrAlAini School of Medicine, Cairo University. Questionnaire about possible maternal and/or paternal risk factors for CHD, clinical examination, bedside echocardiography were done. Cases were classified into groups: group 1 without CHD and group 2 with CHD. Results: from 723 neonates admitted to NICU, 180 cases were proved to have CHD, 58 % of them were males. patent ductus arteriosus(PDA) was the most common CHD (70%), followed by an atrial septal defect (ASD8%), while Fallot tetralogy and single ventricle were the least common (0.45 %) for each. CHD was found in 30 % of consanguineous parents Maternal age ≥ 35 years at the time of conception was associated with increased incidence of PDA (p= 0.45 %). Maternal diabetes and insulin intake were significantly associated with cases of CHD (p=0.02 &0.001 respectively), maternal hypertension and hypothyroidism were both associated with VSD, but the difference did not reach statistical significance (P=0.36 &0.44respectively). Maternal passive smoking was significantly associated with PDA (p=0.03). Conclusion: The most frequent CHD in the studied population was PDA, followed by ASD. Maternal conditions as diabetes was associated with VSD occurrence.

Keywords: NICU, risk factors, congenital heart disease, echocardiography

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Authors: Ahlem Dhahri, Waleed Omri, Audrey Becuwe, Abdelwahed Omri

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In industrial processes, decision-making ranges across different scales, from process control to supply chain management. The purchasing decision-making process in the supply chain is presently gaining more attention as a critical contributor to the company's strategic success. Given the scarcity of thorough summaries in the prior studies, this bibliometric analysis aims to adopt a meticulous approach to achieve quantitative knowledge on the constantly evolving subject of purchasing decision-making in supply chain management. Through bibliometric analysis, we examine a sample of 358 peer-reviewed articles from the Scopus database. VOSviewer and Gephi software were employed to analyze, combine, and visualize the data. Data analytic techniques, including citation network, page-rank analysis, co-citation, and publication trends, have been used to identify influential works and outline the discipline's intellectual structure. The outcomes of this descriptive analysis highlight the most prominent articles, authors, journals, and countries based on their citations and publications. The findings from the research illustrate an increase in the number of publications, exhibiting a slightly growing trend in this field. Co-citation analysis coupled with content analysis of the most cited articles identified five research themes mentioned as follows integrating sustainability into the supplier selection process, supplier selection under disruption risks assessment and mitigation strategies, Fuzzy MCDM approaches for supplier evaluation and selection, purchasing decision in vendor problems, decision-making techniques in supplier selection and order lot sizing problems. With the help of a graphic timeline, this exhaustive map of the field illustrates a visual representation of the evolution of publications that demonstrate a gradual shift from research interest in vendor selection problems to integrating sustainability in the supplier selection process. These clusters offer insights into a wide variety of purchasing methods and conceptual frameworks that have emerged; however, they have not been validated empirically. The findings suggest that future research would emerge with a greater depth of practical and empirical analysis to enrich the theories. These outcomes provide a powerful road map for further study in this area.

Keywords: bibliometric analysis, citation analysis, co-citation, Gephi, network analysis, purchasing, SCM, VOSviewer

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Authors: Shweta Shriwas, Sumeet Dwivedi

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Knowledge of use of traditional medicine is as old as human civilization in almost every system of medicine. Traditional practitioner viz., vaidhayas, ojha, hakim have their own herbal therapy in the treatment of infertility among women’s. Infertility is very common in developed and developing countries due to busy life style of women’s. The present study was initiated with an aim to identify medicinal plants resources from traditional practitioners of Malwa region of Madhya Pradesh to treat infertility. An ethnomedicinal study of Malwa region viz., Indore, Dewas, Ratlam, Ujjain, Dhar, Mandsour and Neemuch of Madhya Pradesh, India comprising fifty-seven study site was conducted during Jan-217 to June-2017. During the course of present investigation, the traditional use of medicinal plants for infertility in women was revealed by traditional practitioner. The botanical name, family, local name, part used, habit along with mode of their administration and dose duration were enumerated.

Keywords: herbal medicine, infertility, traditional, Malwa, Madhya Pradesh

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Authors: Qin-Min Ge, Shu-Ming Pan

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Emergency clinicians usually get teaching qualification after graduating from medical universities without special faculty training in China mainland. Emergency departments are overcrowded places, with large numbers of patients suffering undifferentiated illness. In the field of emergency medicine (EM), improving the faculty competencies and developing the teaching skills are important for medical education, they could enhance learners outcomes and hence affect the patients prognosis indirectly. This article highlights the necessities of faculty training in EM, illustrates the qualities a good clinical educator should qualify, advances the skills as educators in an academic setting and discusses the ways to be good clinical teachers.

Keywords: emergency education, competence, faculty training, teaching, emergency medicine

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Authors: Luciano Tarantino, Emanuele Balzano, Paolo Tarantino, Riccardo Aurelio Nasto, Aurelio Nasto

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Liver transplantation (OLT) is contraindicate in Portal Vein tumor Thrombosis (PVTT) from Hepatocellular Carcinoma at hepatic hilum(pH-HCC) Surgery,Thermal ablation and chemotherapy show poorer outcomes Electrochemotherapy (ECT) has been successfully used in patients with pH-HCC with PVTT. We report the results of ECT as downstaging aimed to definitive cure by OLT. F.P. 53 years HBV related Cirrhosis Child-Pugh B7 class; EGDS F2 aesophageal Varices. Diabetes. April 2016 : Enhanced Computed Tomography (CT) detected HCC(n.3 nodules in VII-VIII-VI;diameter range=25 cm) and PVTT of right portal vein. The patient was considered ineligible for OLT. May 2016: first ablation session with percutaneous Radiofrequency-ablation(RFA) of 3 HCC-nodules . August 2016: second ablation session with ECT of PVTT. CT october 2016: disappearance of PVTT and patent right portal vein. No intraparenchymal recurrence. CT march 2017: No recurrence in portal vein and in the left lobe. local recurrence in the VII-VIII segments. May 2017 : transarterial chemoembolization (TACE) of right lobe recurrences. CT October 2017: patent right portal vein. No recurrence. The patient was reconsidered for OLT. He underwent OLT in April 2018. At 36-months follow-up , no intrahepatic recurrence of HCC occurred. March 2021: enhanced CT and PET/CT detected a single small nodule (1.5 cm) uptaking tracer in the left upper pulmonary lobe, no hepatic recurrence . CT-guided FNB showed metastasis from HCC . June 2021: left lung upper lobectomy . At the current time the patient is alive and recurrence-free at 64 months follow-up. ECT Could be aneffective technique as pre-OLT dowstaging in HCC with PVTT.

Keywords: liver tumor ablation, interventional ultrasound, electrochemotherapy, liver transplantation

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Authors: Alina Hamid Bari

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Intellectual Property (IP) policies of a country have a huge impact on the pharmaceutical industry as this industry is all about patents. Developed countries have used IP protection to boost their economy; developing countries are concerned about access to medicine for poor people. U.S. company, Pfizer had a monopoly for 14 years for Lipitor and it all came to end when Pfizer decided to operate in India. This research will focus at the effects of Indian IP policies on USA by comparing Pfizer & Ranbaxy with regards to Trade Related Aspects of Intellectual Property Rights. For this research inductive approach has been used. Main source of material is Annual reports, theory based on academic books and articles along with rulings of court, policy statements and decisions, websites and newspaper articles. SWOT analysis is done for both Pfizer & Ranbaxy. The main comparison was done by doing ratio analysis and analyses of annual reports for the year 2011-2012 for Pfizer and Ranbaxy to see the impact on their profitability. This research concludes that Indian intellectual laws do affect the profitability of the U.S. pharmaceutical industry which can in turn have an impact on the US economy. These days India is only granting patents on products which it feels are deserving of it. So the U.S. companies operating in India have to defend their invention to get a patent. Thus, to operate in India and maintain monopoly in market, US firms have to come up with different strategies.

Keywords: atorvastatin, India, intellectual property, lipitor, Pfizer, pharmaceutical industry, Ranbaxy, TRIPs, U.S.

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Authors: Metahri Leyla, Helali Amal, Dali Yahia Mustapha Kamel

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Herbal medicine is one of the oldest medicines in the world. It constitutes an interesting alternative to treat and cure without creating new diseases. Despite the progress of medicine, the increase in the number of doctors, the creation of social security, many parents have resorted to herbal medicine for their children; they are increasingly asking for "natural remedies", "without risk" for their children. Herbal tea is a very accessible way to enjoy the benefits of herbal medicine. Accordingly; the objective of our study is to obtain detailed information on the composition and mode of administration of these herbal teas and to identify the different plants used; their beneficial effects, as well as their possible toxicity. The current research work represents an ethnobotanical survey spread over one month (from January 6, 2021 to February 19, 2021) carried out by means of an electronic questionnaire concerning 753 respondents, involving single or multiparous mothers. The obtained results reveal that a total of 684 mothers used herbal teas for their infants, which revealed the use of 55 herbal remedies for several indications, the most sought after are the carminative effect and relief of colic, and which 9% of users noticed undesirable effects linked to the administration of herbal teas to their infants. As a conclusion, it has been asserted that the use of herbal teas as a natural remedy by Algerian mothers is a widely accepted practice, however the "natural" nature of the plants does not mean that they are harmless.

Keywords: Keywords: Herbal medicine, Herbal teas, Children, Mothers, Medicinal plants.

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Authors: Priscilla Akua Agyapong

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Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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Authors: Jing Li Hong

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This study compared Michel Foucault’s thoughts and the Chan School’s thoughts on the idea of healing. Healing is not an unfamiliar idea in Buddhist thoughts. The paired concepts of illness and medicine are often used as a metaphor to describe the relationship between people and truth. Foucault investigated the topic of care of self in his later studies and dedicated a large portion of his final semester course at the Collège de France in 1984 to discuss the meaning of Socrates’s offering of a sacrifice to the god of medicine in Phaedo. Foucault indicated a key preposition in ancient philosophy, namely healing. His idea of healing also addressed the relationship between subject and truth. From this relationship, Foucault unraveled his novel study on truth, namely the technologies of the self, with an emphasis on the care of self. Whereas numerous philosophers ask obvious questions such as ‘what is truth’ and ‘how to learn about truth,’ Foucault proposed distinct questions such as ‘what is our relationship to truth’ and ‘how does our relationship with truth turn us into who we are now?’ Thus, healing in both Buddhist and Foucault’s thoughts is related to the relationship between being and truth. This study first reviews Buddhist and Foucault’s ideas of healing to explicate what is illness and what is medicine. Because Buddhist thoughts cover an extensive scope, this study focuses on the thoughts of the Chan School. The second part is a discussion on medicine (treatment), specifically what is used as the medicine for the illness in both thoughts, and how can this medicine treat the illness. This part includes a description and comparison of the use of concepts of negation in these two thought groups. Finally, the subjects that practice the technologies of the self in both groups are compared from the idea of care of self; in other words, the differences between the subjects formed by the different relationships between being and truth are analyzed.

Keywords: Chan, heterogeneous, living style, language of paradox, Michel Foucault, negation, parrhesia, the care of self

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Authors: Tshegofatso Rambau, Tonderai Muchenje

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Zero-day attacks (ZDA) are increasing day by day; there are many vulnerabilities in systems and software that date back decades. Companies keep discovering vulnerabilities in their systems and software and work to release patches and updates. A zero-day vulnerability is a software fault that is not widely known and is unknown to the vendor; attackers work very quickly to exploit these vulnerabilities. These are major security threats with a high success rate because businesses lack the essential safeguards to detect and prevent them. This study focuses on the factors and techniques that can help us detect zero-day attacks. There are various methods and techniques for detecting vulnerabilities. Various companies like edges can offer penetration testing and smart vulnerability management solutions. We will undertake literature studies on zero-day attacks and detection methods, as well as modeling approaches and simulations, as part of the study process.

Keywords: zero-day attacks, exploitation, vulnerabilities

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Authors: Shizra Waris, Saleem Akhtar

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Big data is a research area receiving attention from academia and IT communities. In the digital world, the amounts of data produced and stored have within a short period of time. Consequently this fast increasing rate of data has created many challenges. In this paper, we use functionalism and structuralism paradigms to analyze the genesis of big data applications and its current trends. This paper presents a complete discussion on state-of-the-art big data technologies based on group and stream data processing. Moreover, strengths and weaknesses of these technologies are analyzed. This study also covers big data analytics techniques, processing methods, some reported case studies from different vendor, several open research challenges and the chances brought about by big data. The similarities and differences of these techniques and technologies based on important limitations are also investigated. Emerging technologies are suggested as a solution for big data problems.

Keywords: computer, it community, industry, big data

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