British Journal of Healthcare and Medical Research https://journals.scholarpublishing.org/index.php/JBEMi <p>British Journal of Healthcare &amp; Medical Research (<strong>BJHMR</strong>) is an international, peer-reviewed, open access journal that provides an easy access to high quality manuscripts in all related aspects of diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. The journal also focuses upon the challenges and opportunities and how healthcare can benefit from it in terms of reduced costs and improved diagnosis, therapy, and care. Access to health care manuscripts provides an insight that varies across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place.</p> <p>The journal brings professionals in medicine, psychology, physiotherapy, nursing, dentistry, midwifery (obstetrics) and allied health, plus many other disciplines such as public health practitioners, community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services in health care under single roof.</p> Services for Science and Education, United Kingdom en-US British Journal of Healthcare and Medical Research 2753-7919 Evaluation the Impact of Folic Acid Deficiency During Pregnancy and Preterm Birth https://journals.scholarpublishing.org/index.php/JBEMi/article/view/15908 <p><u>Backgrounds</u>: folate restriction and excessive supplementing leave epigenetic traces, suggesting the possibility of it generating unanticipated changes in the methyloma and hence in the phenotype of the mother and children in the short or long term. There is considerable evidence that insufficient or deficient folic acid status may be linked to pregnancy complications. <u>Purposes</u>: The purpose of this study to assess the impact of folic acid deficiency during pregnancy on incidence of preterm labor. <u>Methods</u>: The study utilised cross sectional study design with 245 pregnant women who selected conveniently from primary health centres in Hail region. The study assessed folic acid and its potential impact on preterm birth. <u>Results</u>: The result of the current study indicates that 245 pregnant women attended the study. The prevalence of folic acid deficiency is 44.8% (110/245). Looking at specific classification. The prevalence of folic acid deficiency is more prevalent among pregnant women in first trimester, it was noticed among 110 women from 190 which accounts 57.8%. The results of Chi square that look at the association between the folic acid use and preterm labour showed that there is statistical association between folic acid use during first trimester and gestational birth to be completed at aged 32 -36 week (χ2 = 4.56; p=0.024). In addition, females who did not consume folic acid causes pre term labor at gestational age 24 -27 weeks ((χ2 = 3.57; p=0.018). similarly, the result of odd ratio shows that pregnant women who did consume folic acid reduce risk of preterm labor 3-5 times compared with pregnant women who did not use folic acid. <u>Conclusions</u>: The study concluded that lower intake of folate levels and folic acid supplementation are significantly associated with a higher overall risk of overall PTB</p> Aisha Alanazi Copyright (c) 2024 Aisha Alanazi http://creativecommons.org/licenses/by/4.0 2024-01-07 2024-01-07 11 1 1 10 10.14738/bjhmr.111.15908 Association Between Nutrient Intake and Anthropometric Indices of Female and Male Respondents in North West Region, Cameroon https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16117 <p>This study examined the association between nutrient intake and anthropometric indices of female and respondents in rural and urban North West Region of Cameroon. Multi-stage random sampling was used to select 480 households. Ethical approval/informed consent were obtained. Structured questionnaires, dietary assessments and focus group discussions provided information on household food consumption pattern and food security. Descriptive of simple percentages mean and standard deviation and inferential statistics of Pearson product moment correlation coefficient &nbsp;were used to analyze collected data and significance at p&lt;0.05 accepted. Data obtained and analyzed showed that, energy correlates with height and weight in IYC 6-54 months while protein correlates with weight in females 24-59 months of age in rural households. Also energy correlates with height and weight while protein correlates with weight in females 6-9 years of age in rural households. In females 10-19 years, energy and protein correlates with height and weight in rural households while energy and protein correlates with height and weight in males 6-9 years of age in rural households while energy correlates with weight and height in males 10-19years in rural and urban households. No correlation was observed in adults 20 years and above as observed.</p> Ebai Nee Besong Patricia Ange Eyenga Manga Gustave Mabiama Bouelet Ntsama Isabelle Nyangono Biyegue Fernande Copyright (c) 2024 Ebai Nee Besong Patricia Ange, Eyenga Manga, Gustave Mabiama, Winifred Fila Ogah http://creativecommons.org/licenses/by/4.0 2024-01-07 2024-01-07 11 1 11 21 10.14738/bjhmr.111.16117 Effects of an HIV Positive Diagnosis During Pregnancy on Mother Baby Bonding at Selected Health Facilities in Lusaka District Zambia https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16184 <p><u>Background</u>: Mother-baby bonding sets the stage for the growing child to enter healthy relationships with other people throughout life and to appropriately experience and express a full range of emotions.&nbsp; The stress of a diagnosis of HIV during pregnancy can lead to unsuccessful mother-baby bonding. <u>Aim</u>:&nbsp; The study aimed to describe the effects of an antenatal HIV positive diagnosis on mother-baby bonding. <u>Methodology</u>: A qualitative descriptive cross-sectional study design was used. Purposive sampling was used to select 17 study participants on whom in-depth interviews were conducted to collect data. Data were analysed using thematic analysis. <u>Major findings</u>: The majority of participants reported positive mother-baby bonding. &nbsp;After thematic analysis, one main theme; mother-baby interactions with three subthemes; mother-baby relationship, hurdles to mother-baby bonding and cause of baby’s death, emerged. Most of the participants reported feelings of attachment to their babies, with babies responding positively to the care by their mothers. Majority of them breastfed, which enhanced the mother-baby bond. However, some of them reported negative bonding and constant fear of infecting their babies. Some participants reported that the stress of an antenatal HIV diagnosis led to pregnancy complications, which led to loss of their babies. <u>Conclusion</u>: Some participants reported negative bonding and some lost their babies due to pregnancy complications that were caused by stress of an antenatal HIV diagnosis. The study recommends assessing women for stress and categorising their coping strategies to assist those with high stress levels or those utilising negative coping in order to enhance mother-baby bonding.&nbsp;</p> Brenda Nambala Sianchapa Patricia Katowa-Mukwato Catherine M. Ngoma Copyright (c) 2024 Brenda Nambala Sianchapa, Patricia Katowa-Mukwato, Catherine M. Ngoma http://creativecommons.org/licenses/by/4.0 2024-01-07 2024-01-07 11 1 22 37 10.14738/bjhmr.111.16184 The Evolving Structure Hospitals in the United States and the Growth of Multi-Hospital Systems, 2011 – 2021 https://journals.scholarpublishing.org/index.php/JBEMi/article/view/15997 <p>A large segment of the United States (US) health care system relies heavily on competitive market forces to drive the performance of the system. &nbsp;This aspect of the US health care system is based on the premise that competition and market forces can improve the efficiency and quality of health care delivery. &nbsp;Researchers and policy analysts are increasingly concerned about structural and other changes that might undermine competitive market conditions and reduce the effectiveness of the US health care system, especially concerning hospital services.&nbsp; This paper provides a descriptive analysis of the development, growth, evolution, and structure of US hospitals with a focus on the growth of multi-hospital systems over an extended period and discusses some of the implications of these trends. The data presented here show a trend of increased concentration of hospital bed capacity within multi-hospital systems, raising anti-competitive concerns. A high concentration of hospital bed capacity within multi-hospital systems can reduce competitive forces, leading to higher prices for health care services. Our findings collectively suggest a complex landscape of hospital service delivery, ownership, and increased consolidation including the expanded role of multi-hospital systems in the US and underscore the importance of monitoring these trends and implementing policies and regulations to ensure efficient pricing, access, and quality of care while accommodating a changing health care landscape.&nbsp; While this paper applies largely to developments in the US health care system, there may be lessons from other countries, especially those countries that rely in part on competitive market forces to drive the performance of their systems.</p> Glenn A Melnick Copyright (c) 2024 Glenn A Melnick http://creativecommons.org/licenses/by/4.0 2024-01-07 2024-01-07 11 1 38 47 10.14738/bjhmr.111.15997 The Role of Brand Recognition in Enhancing Customer Retention in the Pharmaceutical Retail Sector of Zimbabwe: A Case Study of Pharmacies in Chinhoyi, Mash West, Zimbabwe https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16202 <p>This study was based on the role of brand recognition in enhancing customer retention in the pharmaceutical retail sector of Zimbabwe because brand recognition and customer retention have become popular subjects in recent years since it is believed that customers are the life blood of any business. Accordingly, the study made use of self –administered questionnaires in collecting data from customers and employees of retail pharmacies in Chinhoyi, Mash West province in Zimbabwe and the respondents were selected through stratified random sampling. Consequently, the data was analysed qualitatively using thematic analysis supported by quantitative analysis to make sure the results were genuine. Therefore, the research findings show that brand recognition does not exist in the pharmaceutical retail sector in Zimbabwe even though the majority of respondents agreed that branding especially brand recognition plays a significant role in shaping customer loyalty as well as customer retention. Furthermore, the study also shows that the attributes of branding includes familiarity with brand, relevance of pharmacy brand, differentiation of pharmacy brand, perceived quality of a brand, reliability and esteem of a brand are positive influencers of customer loyalty by so doing enhancing customer retention.</p> Gerald Munyoro Priscilla Madzinga-Kusena Copyright (c) 2024 Gerald Munyoro, Mapfunde Priscilla Madzinga-Kusena http://creativecommons.org/licenses/by/4.0 2024-01-07 2024-01-07 11 1 48 86 10.14738/bjhmr.111.16202 Management of Obesity in Children https://journals.scholarpublishing.org/index.php/JBEMi/article/view/14431 <p>The management of childhood obesity requires a comprehensive and multidisciplinary approach that includes lifestyle modifications, behavioural interventions, parental involvement, community-based interventions, and healthcare provider support. Continued research and development of innovative therapies and interventions, such as those targeting the gut microbiome and brain stimulation, may further advance the field and improve outcomes for affected children.</p> Rajeev Gupta Copyright (c) 2024 Rajeev Gupta http://creativecommons.org/licenses/by/4.0 2024-01-11 2024-01-11 11 1 87 92 10.14738/bjhmr.111.14431 Respiratory Complex II and SCOT-Oxct1 Compete for succinyl-CoA in Ketolytic Dependent Tumours https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16217 <p>The present work recalls main features of tumour cell metabolism, explaining their ketolytic dependency and vulnerability; we explored the interface between the respiration chain complexes and the nutritional supply of succinyl-CoA to the ketolytic enzyme SCOT- Oxct1. We indicated several target points in ketolysis and fatty acid synthesis pathways that would affect tumour cells, rendered vulnerable by their ketolytic dependency.</p> Maurice Israël Eric Berg Guy Tenenbaum Copyright (c) 2024 Maurice Israël, Eric Berg, Guy Tenenbaum http://creativecommons.org/licenses/by/4.0 2024-01-11 2024-01-11 11 1 93 101 10.14738/bjhmr.111.16217 Chronic Appendicitis as a Differential Diagnosis of Chronic Abdominal Pain. Clinical Case https://journals.scholarpublishing.org/index.php/JBEMi/article/view/15607 <p>Chronic appendicitis represents a rare surgical pathological entity, which is also tricky for first-contact physicians to consider as a differential diagnosis when faced with a patient with abdominal pain. There are currently well-described diagnostic criteria for it. The case of a 24-year-old female patient with no significant medical history presented with a picture of abdominal pain over three weeks of evolution. Moreover, diagnosed by contrast-enhanced computerized axial tomography with appendicitis, an open appendectomy was performed, and the histological examination confirmed the diagnosis of chronic appendicitis associated with fecalith obstruction.</p> Olga Nidia Montero-Sánchez María Gabriela Pesqueira-Valerio Octavio Javier Trujillo-Cedillo Yadira Irasema Lugo-Guevara Luis Arturo Falcón-Cancino Guillermo Padrón-Arredondo Copyright (c) 2024 Olga Nidia Montero-Sánchez , María Gabriela Pesqueira-Valerio , Octavio Javier Trujillo-Cedillo, Yadira Irasema Lugo-Guevara, Luis Arturo Falcón-Cancino, Guillermo Padrón-Arredondo http://creativecommons.org/licenses/by/4.0 2024-01-18 2024-01-18 11 1 102 107 10.14738/bjhmr.111.15607 Biofield Energy: Emotional Side Effects of Long-term Prescription Drug Use https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16264 <p>Mood-altering drugs directly affect the emotional centres of the brain, and though they are meant to stabilise and improve mood, they are also known to induce a range of negative emotional side effects, including depression, anxiety, mania, panic disorder, violence, and suicidality<sup>[1]</sup>. Somewhat less considered and researched are the emotional side effects of non-mood-altering drugs, particularly those prescribed for chronic illnesses and typically used on a long-term basis. Such emotional side effects may stem from associating the medication with having an “incurable” illness as well as the physiologic effects of the drugs themselves, the latter of which can often be overlooked by both patients and physicians. Some patients who fail to manage their treatment are often faced with a learning curve they must work through to understand their condition and its complexities and treatments. In some cases, the emotional stresses of dealing with chronic illness can manifest in personality changes. Thus, teasing apart chronic illness's complex web of emotions requires a circumspect and nuanced approach. </p> Seema Bhattessa Copyright (c) 2024 Seema Bhattessa http://creativecommons.org/licenses/by/4.0 2024-01-18 2024-01-18 11 1 108 110 10.14738/bjhmr.111.16264 Differentiation of Mesenchymal Stem Cells Derived from Embryonic Umbilical Cord Blood (UCB-MSCs) Into Fibroblastic Lineage for Use as Skin Grafts in Trinidad and Tobago https://journals.scholarpublishing.org/index.php/JBEMi/article/view/15949 <p>The application of stem cells to medical therapies for example regenerative medicine and tissue engineering offers the prospect of revolutionizing human medicine. Burn and wound healing treatment options are very limited in Trinidad and Tobago resulting in a high morbidity/mortality rate of patients. Skin grafts produced from mesenchymal stem cells (MSCs) provide an exciting alternative as an option. This project describes isolation of embryonic MSCs from human umbilical cord blood (UCB-MSCs) and MSCs from bone marrow. We also for the first time in Trinidad and Tobago were able to differentiate UCB-MSCs into fibroblastic lineage cells culture and differentiation into epidermal tissue. Comparison in MSCs obtained will be made between age, ethnicity, and length of gestation to determine correlations. This would provide the basis for using these as a source for skin grafts comparable to allogenic grafts. The results of this project show that human umbilical cord blood is an excellent source of mesenchymal stem cells and that UCB- derived MSCs can be stimulated to differentiate into cells of the epidermal lineage and grown on scaffolding. This preliminary research will be used as a basis for developing skin grafts artificially by differentiation of MSCs into epidermal tissue for application as skin grafts for the treatment of burn victims and for wound healing and/or skin disorders in Trinidad and Tobago.</p> Nicole Ramlachan Jerome Foster Copyright (c) 2024 Nicole Ramlachan, Jerome Foster http://creativecommons.org/licenses/by/4.0 2024-01-18 2024-01-18 11 1 111 120 10.14738/bjhmr.111.15949 Attitude of Medical Students Towards Hospital Acquired Infections (HAIs) Prevention in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16191 <p><u>Background</u>: The attitude of medical students and health care workers towards Hospital Acquired Infections (HAIs) is a fundamental step towards implementation of the infection control protocols. These infections are acquired illnesses that are usually not present or incubating when a patient is admitted. This study seeks to assess the attitude of medical students towards Hospital Acquired Infections (HAIs) prevention in a Tertiary Hospital in Jos&nbsp; North Local Government Area, Plateau State, Nigeria. <u>Method</u><u>s</u>: This was a descriptive cross-sectional study done between June and November 2019 among medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 28 (Statistical Package for the Social Sciences).&nbsp; <u>Results</u>: The majority (98.2%) of the medical students agree that it is important to remove blood spillages quickly, and change of linens and clothes when soiled.&nbsp; Concerning periodic cleaning of walls and floors with disinfectants, 98.2% consider this to be important, while 0.5% do not and 1.4% do not know. As regards the quick disposal of used syringes and needles, 98.6% see this as important, while 1.4% do not. Regarding the importance of instrument sterilization for infection control, 97.7% said it is important, 95.5% considered the habit of hand washing between patients by health workers as important, 3.2% don’t know and 0.5 said it is not important. A high proportion (84.5%)&nbsp; of students were willing to adopt the HAI prevention methods, 11.4% were undecided and 4.1% were unwilling. One in twenty (19.6%) were not decided about championing the promotion of HAI in the hospital, 3.7% were unwilling to be HAI ambassadors, 76.7% agreed to help promote the need for HAI prevention. <u>Conclusion</u>: Generally, majority of students had a positive attitude (91.8%) toward HAI prevention while 8.2% had negative attitude.&nbsp; This is a foundation for championing the spread of the message and monitoring compliance with the standard precautions and existing protocol for HAI prevention.&nbsp;</p> Prosper I. Okonkwo Kingsley Chinedu Okafor Bolarinwa Boluwatito Joel Haruna Garba Bitrus Salome Kwaghal Copyright (c) 2024 Prosper Ifeanacho Okonkwo, Okafor, Kingsley C. , Bolarinwa Boluwatito , Joel Haruna Garba, Bitrus Salome Kwaghal http://creativecommons.org/licenses/by/4.0 2024-01-22 2024-01-22 11 1 121 130 10.14738/bjhmr.111.16191 Towards the Biomarker-Driven Development and their Global Impact in the Evidence-Based Clinical Practice of Personalized and Precision Healthcare Services https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16340 <p>Drug development continues to move in the direction of the development of clinical practice as applicable to <em>Personalized and Precision Medicine (PPM)</em>, - where ideally the most effective therapy or treatment is determined by the genetic makeup of the patient.</p> Sergey Suchkov Daniel Scherman Aleksey Glinushkin Alan Wu Tatiana Grishina Shawn Murphy Vladimir Zemskov Veronika Polyakova David Smith Sofya Blokh R. Holland Cheng Philip D. Cotter Vassiliy Tsytsarev Valentina Demidova Mihail Kovalev Copyright (c) 2024 Sergey Suchkov, Daniel Scherman, Aleksey Glinushkin, Alan Wu, Tatiana Grishina, Shawn Murphy, Vladimir Zemskov, Veronika Polyakova, David Smith, Sofya Blokh, R. Holland Cheng, Philip D. Cotter, Vassiliy Tsytsarev, Valentina Demidova, Mihail Kovalev http://creativecommons.org/licenses/by/4.0 2024-02-10 2024-02-10 11 1 131 157 10.14738/bjhmr.111.16340 Efficacy and Safety of Low Flow Oxygen During Procedural Sedation in the Office; An Analysis of SAO2 (pulse oximetry) and End Tidal Expired Oxygen(FeO2). https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16338 <p><u>Purpose</u>: measurement of FeO2 confirms the safety of low flow oxygen. <u>Patients and methods</u>: In a series of 235 patients undergoing office plastic and dental surgery under conscious sedation with midazolam/fentanyl or promazine/meperidine during the Covid pandemia we evaluated the safety of low flow (0.5-1 lt/min) oxygen adding the continuous measurement of FeO2 to the standard non invasive monitoring. <u>Results</u>: FeO2 demonstrated no relationship with pulse oxymetry and a negative relationship with etCO2.Low flow oxygen corrected both FeO2 and SaO2.Vital signs were stable and all patients were discharged home within 2 hr after surgery. <u>Conclusion</u> :FeO2 measurement could constitute an early warning signal of impendind danger and serve the purpose of oxygen sparin</p> Claudio Melloni Copyright (c) 2024 Claudio Melloni http://creativecommons.org/licenses/by/4.0 2024-02-10 2024-02-10 11 1 158 170 10.14738/bjhmr.111.16338 It is Necessary to Increase the Training and Motivation of Primary Care Health Professionals in the Face Of Rare Diseases in Spain https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16353 <p><u>Background</u>: Rare diseases (RDs) are defined as low prevalence diseases with great heterogeneity. Globally, they constitute an important public health problem. Most of them are incurable, chronic and have a great family impact. The objective of this study was to investigate the knowledge about RDs among primary care health professionals (137 doctors and 113 nurses) in our health area (Vigo, Spain). <u>Methods</u>: A total of 250 primary care health professionals, randomly chosen, completed an anonymous survey to evaluate their level of knowledge about aspects related to RDs. The survey contained a questionnaire (seven questions) related to basic aspects of rare diseases. <u>Results</u>: Primary care health professionals showed very poor knowledge about the impact of RDs on public health. There were no statistically significant differences when comparing the responses of doctors versus nurses in any of the responses obtained (p &gt; 0.05). <u>Conclusions</u>: Among the main challenges facing RDs is shortening the diagnostic delay and providing comprehensive care. Primary care health professionals should play a key role, since they are the gateway to the health system. Unfortunately, the results of our survey reveal very poor knowledge about basic aspects of RDs. It is necessary to increase training and motivation if we want to improve the health care provided from primary care to patients with RDs.</p> Susana Portela Pérez Lucía Cameselle-Cortizo Teresa Calheiros Cruz Vanesa Rodríguez-Fernández Jorge F Cameselle-Teijeiro Copyright (c) 2024 Susana Portela Pérez, Lucía Cameselle-Cortizo, Teresa Calheiros Cruz, Vanesa Rodríguez-Fernández, Jorge F Cameselle-Teijeiro http://creativecommons.org/licenses/by/4.0 2024-02-10 2024-02-10 11 1 171 179 10.14738/bjhmr.111.16353 Life Expectancy and Life Years Lost After HIV Diagnosis in Puerto Rico, 2000-2020 https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16347 <p><u>Background</u>: In 2019, the Global Burden of Disease estimated that HIV/AIDS was globally the second top cause for disability-adjusted life years in individuals 25–49 years of age and the ninth most common cause for young individuals between the ages of 10-24. The objective of this study was to estimate the average life expectancy and life years lost (LYL) in individuals diagnosed with HIV in Puerto Rico from 2000-2020 and to evaluate the relationship between LYL and demographic factors. <u>Methods</u>: The epidemiological design was a retrospective cohort study of 11,524 people diagnosed with HIV who received services under the Eligible Metropolitan Area (EMA) of San Juan, Puerto Rico. The population among this cohort was described using socioeconomic characteristics with frequencies and proportions by category. We estimated the LYL by matching the expected residual lifetime for someone diagnosed with the disease with the life expectancy of the general population at that specific age as the null model. <u>Results</u>: LYL is greater with earlier HIV onset and is also influenced by level of poverty, type of insurance, and documented mode of transmission of HIV. The average life expectancy (number of years alive remaining after diagnosis) across all ages of an HIV-diagnosed individual is between 12 and 14 years. We found greater LYL in HIV patients with lower income status across age groups; in those without insurance, significantly in ages of 40-49 years; as well as with perinatal transmission versus other modes of transmission, and intravenous drug use versus heterosexual contact. No distinction was found between males versus females. <u>Conclusion</u>: This study reaffirms the importance of prevention and demographic aspects such as age, poverty level, insurance type, and factors related to lifestyle (transmission modes) to develop better prevention strategies to reduce the LYL as a consequence of HIV.</p> Grisel Burgos-Barreto Daniel Reyes Raymond L Tremblay Copyright (c) 2024 Grisel Burgos-Barreto, Daniel Reyes, Raymond L Tremblay http://creativecommons.org/licenses/by/4.0 2024-02-10 2024-02-10 11 1 180 194 10.14738/bjhmr.111.16347 Postmenopausal Hormone Replacement Therapy (HRT) May Cause Dementia: Are There Alternatives? https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16388 <p>Based on recent observations and a study in which it was found that postmenopausal hormone replacement therapy (HRT) can cause an increased incidence of dementia, the question arises as to the causes of this and the purpose of this therapy. According to our experience, it can be assumed that these negative effects occur with chemical-artificial hormone replacement, since these are not identical with endogenous hormones. We contrast this with the existing possibilities of nature-identical treatments using the prohormone pregnenolone and agents of plant origin. So far we have not experienced any case of dementia with them.&nbsp;</p> Manfred Doepp Copyright (c) 2024 Doepp, Manfred http://creativecommons.org/licenses/by/4.0 2024-02-10 2024-02-10 11 1 195 198 10.14738/bjhmr.111.16388 Advanced Intermittent Auscultation (AIA)’ of Fetal Heart Rate in Labour – Launch of a Scientific, Reliable and Forward-Looking Training Module for Birth-Attendants, Combining Simplicity with Sound Bayesian Foundation and Modern Technology https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16393 <p>Intrapartum fetal heart rate (FHR) monitoring has very wide clinical application of vital importance. However, there are several different methods of Intermittent auscultation (IA) which continue to suffer from some shortcomings and even inaccuracies resulting in birth asphyxia. Clinical studies alone have not provided the epistemic perfection for IA or cardiotocography (CTG). However, integrating them with the understanding of fetal pathophysiology, practical experience and critical thinking during adverse event investigations provides functional knowledge required for reliable and efficient IA. The “Advanced Intermittent Auscultation (AIA)” regime and training module published in 2022, pragmatically uses the current knowledge-base retaining simplicity of IA while maximising the benefits of widely available affordable modern but simple technology, thus improving efficiency, reliability and accuracy of IA. In addition, AIA opens the possibility judging the FHR baseline variability in future, unfeasible with previous regimes. Many current IA regimes, by mistakenly insisting on actually counting the fetal heart tones, have failed to make progress and remain unsafe, and hence best abandoned. This article describes in detail the foundational concepts of “Advanced Intermittent Auscultation (AIA)”. It demonstrates the superiority of handheld Doppler monitors which should be preferentially used. Importantly, ‘auscultation’ should not mandate ‘actual counting’ by single or multiple-count methods, which is laborious and less accurate. The FHR displayed on the Doppler device has the same accuracy as that on the CTG. Simply observing this display (and modest attention to the tempo of heart sounds) constitutes the most reliable technique of inferring FHR periodic variations. The FHR display should be observed from the latter part of contraction to the beginning of the next contraction (or eventually a full contraction-relaxation cycle). AIA maintains the benefits of the simplicity of IA by avoiding unwarranted, impractical and unproven addition of parameters like FHR cycling or post-deceleration overshoots. The AIA regime is comprehensive, pragmatic, practical, non-laborious (facilitating more holistic care), more accurate / reliable and thus enhances patient safety. Hence, AIA should be adopted worldwide including by the national professional bodies in UK, Europe, Americas and Australasia.</p> S. L. Sholapurkar Tanya Capper Copyright (c) 2024 Shashikant L Sholapurkar, Tanya Capper http://creativecommons.org/licenses/by/4.0 2024-02-10 2024-02-10 11 1 199 213 10.14738/bjhmr.111.16393 The Role of Social Media in Providing Support for Individuals with Spinal Cord Injury https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16450 <p><u>Introduction</u>: New media has changed the dynamics and rules of social interaction, notably doctor-patient communication, which has become transversal. Blogs, Social Networks, Forums and Online Health Communities are increasingly prevalent, allowing patients and their families to discuss issues and questions related to chronic disability conditions. <u>Aim</u>: we evaluated the opportunities offered by the New Media overcoming disability. <u>Material Method</u>: we considered <em>two</em> patients presenting spinal cord injuries (SCI) Both individuals refused the diagnosis and the therapeutic limits related to the spine damage. <u>Results</u>: New media can improve disability self-awareness. <u>Conclusion</u>: technology is a valuable asset, a significant resource; but high technology in medicine cannot replace the high touch that is human contact.</p> Gabriella Fizzotti Copyright (c) 2024 G. Fizzotti http://creativecommons.org/licenses/by/4.0 2024-02-10 2024-02-10 11 1 214 217 10.14738/bjhmr.111.16450 Parkinson’s Disease and Food Expenditure in Italy: Stochastic and Non-Stochastic Analyses https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16463 <p><u>Background</u>: The correlation between food and Parkinson's disease (PD) suggests the Mediterranean diet (MeD) could provide beneficial effects. <u>Objective</u>: Examine the association between PD and food expenditure/consumption in various regions of Italy in 2016. <u>Methods</u>: The food consumption of 19,500 families in 540 Italian municipalities, recorded both in terms of expenditure and weight (kilograms) across 56 distinct food categories, was calculated for the year 2016, along with the Parkinson's Disease prevalence expressed in terms of standardized mortality ratio (SMR). The correlations to Parkinson's disease were determined using stochastic analysis based on partial least squares regression (PLSR) and non-stochastic analysis (neural network mapping). <u>Results</u>: The following results were obtained by focusing on food categories deemed significant in both stochastic and non-stochastic <u>Analyses</u>: Yogurt, fresh vegetables, wine, processed meat, citrus fruit, and butter were identified as causative factors, while cheese, ice cream, beef, grapes and strawberries, bananas, canned fruit, and fruit juice were deemed partially causative. Added sugar, flour, lamb, and dried legumes emerged as having protective properties, while seed oil, pork, fish, canned fish, and canned tomatoes exhibited only partially protective effects. Southern Italy has a significantly lower SMR for PD compared to the North due to lower consumption of foods found to be causative for PD and higher consumption of protective foods. <u>Conclusions</u>: In 2016, the PD death rate was significantly lower in Southern Italy than in the North. The dietary habits in the Southern regions were also significantly different: a lower consumption of causative foods and higher consumption of protective ones. The data on food expenditure and quantities allow us to monitor the correlation with PD SMR on an annual basis.</p> Umberto Cornelli Enzo-Villa Grossi Martino Recchia Claudia Antonelli Luca Battaglia Giorgia Bonalume Roberto Butti Matteo Camurri Beatrice Carluccio Camilla Clementi Federico Condoleo Alessio D’Ambrosio Veronica De Lucia Rebecca Giardinetti Greta Gusperti Marco Idonia Luca Idonia Maria Daniela Iftime Sofia Malnati Kevin Mandelli Chiara Masini Beatrice Messina Stefano Nebbia Gabriele Piarulli Daniele Piccinini Francesca Pulecchi Alessandro Radici Matteo Rattaggi Mattia Testa Viviana Volpi Meerab Zahra Copyright (c) 2024 Cornelli, Umberto, Grossi, Enzo-Villa, Recchia, Martino, Antonelli, Claudia, Battaglia, Luca, Bonalume, Giorgia, Butti, Roberto, Camurri, Matteo, Carluccio, Beatrice, Clementi, Camilla, Condoleo, Federico, D’Ambrosio, Alessio, De Lucia, Veronica, Giardinetti, Rebecca, Gusperti, Greta, Idonia, Marco, Idonia, Luca, Iftime, Maria Daniela, Malnati, Sofia, Mandelli, Kevin, Masini, Chiara, Messina, Beatrice, Nebbia, Stefano, Piarulli, Gabriele, Piccinini, Daniele, Pelucchi, Francesca, Radici, Alessandro, Rattaggi, Matteo, Testa, Mattia, Volpi, Viviana, Zahra, Meerab http://creativecommons.org/licenses/by/4.0 2024-02-20 2024-02-20 11 1 218 239 10.14738/bjhmr.111.16463 Cancer of the Larynx: A Brief Overview with Case Studies https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16477 <p>Laryngeal cancer (LC) is globally a common malignancy affecting the the head and neck (HN) region. It occurs in the aero digestive tract and is the second most common tumour affecting the (HN) area. Squamous cell carcinoma (SCC) make up to 96% of LC. The surgical removal of LC remains an important modality of treatment. Therapeutically chemo-radiation therapy is incorporated in early and late stages of the disease and has been a game changer in preserving laryngeal organ function. Advances in endoscopic&nbsp; laser technology with trans-oral resection&nbsp; (TOR) of many cancers reduces morbidity and preserves laryngeal function.Treatment modalities include immunotherapy (biological) and targetting cancer cells (target therapy) to prevent cancer cell multiplication. Genetic biomarkers are unravelling newer information of the disease (LC). Risk modification factors for LC are cessation of smoking and&nbsp; discouraging the use of alcohol products.</p> Bashir Ahmed Bulbulia M R Ahmed Copyright (c) 2024 B A Bulbulia, M R Ahmed http://creativecommons.org/licenses/by/4.0 2024-02-20 2024-02-20 11 1 255 262 10.14738/bjhmr.111.16477 The Safety Properties of Sodium Alginate and its Derivatives https://journals.scholarpublishing.org/index.php/JBEMi/article/view/16126 <p>Alginate is a biomaterial with a vast use in biomedicine, food and pharmaceutical industry due to its advantageous properties such as abundance, biocompatibility and easiness of gelation. The Food and Drug Administration (FDA) has confirmed some alginates salts and related derivative to “generally regarded as safe” components for oral use. According to the vast use of alginate as a harmless agent in food and pharmaceutical industries, logically its hydrolysate and ultimately its residues including Mannuronic and Guluronic acids, as alginate hydrolysate components are safe and non-toxic ingredients. In this regard, a number of studies have been conducted to reveal the safety of these agents. Hear, we aimed to review the safety of sodium alginate and its hydrolysate in the literature. In conclusion, the outcomes of acute and chronic toxicity studies indicate that the sodium alginate and its hydrolysate have a high safety profile when administered orally to animals.</p> Laleh Sharfi Mohammad Reza Nowroozi Galina Smirnova Anna Fedotova Dmitry Babarkin Abbas Mirshafiey Copyright (c) 2024 Laleh Sharfi, Mohammad Reza Nowroozi, Galina Smirnova, Anna Fedotova, Dmitry Babarkin, Abbas Mirshafiey http://creativecommons.org/licenses/by/4.0 2024-02-20 2024-02-20 11 1 263 274 10.14738/bjhmr.111.16126