Journal of Medicine and Life最新文献

The relationship between excess body weight and stress significantly impacts overall health. The current study evaluated the efficacy and safety of Ashwagandha (Withania somnifera) root extract (ARE) in altering stress biomarkers and its role in weight management. In this prospective, randomized, double-blind, placebo-controlled study, 100 participants (age: 19-65 years) were randomized to receive either ARE 300 mg twice daily (n = 50) or an identical placebo (PL, n = 50) for 24 weeks. The primary efficacy endpoints were changes in body weight and body mass index (BMI). Secondary endpoints included evaluation of stress (Perceived Stress Scale, PSS), quality of life (Short Form-12 Quality of Life Scale), subjective satisfaction (Subjective Satisfaction Scale, SSS), and food cravings (Food Cravings Questionnaire-Trait, FCQ-T). Clinical safety was assessed based on treatment-emergent adverse events (TEAEs) and laboratory parameters, including complete blood count, renal function tests, liver function tests, lipid profile, thyroid function tests, and glycemic parameters (plasma glucose and glycated hemoglobin). Efficacy was analyzed in 91 patients. ARE administration resulted in a significant reduction in body weight (-8.46 ± 3.86 kg; P < 0.0001) and BMI (-3.31 ± 1.57 kg/m²; P < 0.0001) compared to the PL (-2.41 ± 2.07 kg and -0.93 ± 0.79 kg/m² for body weight and BMI, respectively). Compared with PL, ARE showed significant improvements (P < 0.05) in PSS, SF-12, SSS, and FCQ-T scores. A total of seven participants with ARE and six with PL reported mild adverse events (nausea, abdominal pain, and drowsiness), which were resolved without any intervention. Ashwagandha root extract may offer a safe and beneficial approach for stress reduction and weight management.

The swift growth of teletherapy has sparked discussions about its effectiveness in comparison to traditional in-person therapy, especially in building a robust therapeutic alliance among those with anxiety and depressive disorders. The study aimed to compare the therapeutic alliance and client satisfaction across teletherapy, in-person, and hybrid modalities in the management of depression and anxiety disorders. A cross-sectional study was conducted using snowball sampling, involving 377 participants from various cities in Saudi Arabia, with a significant proportion residing in the Makkah Region (79.6%). The sample was predominantly female (69.5%), single (60.2%), and young adults aged 18-24 (53.1%). Three validated instruments were used: the Working Alliance Inventory-Short Revised (WAI-SR) to measure therapeutic alliance, and the Client Satisfaction Questionnaire (CSQ-8) to assess satisfaction. ANOVA results indicated no statistically significant difference in WAI-SR scores among the treatment groups (face-to-face, remote, and hybrid) (F = 2.804, P = .062), suggesting a similar therapeutic alliance across the modalities. However, ANOVA revealed significant differences in client satisfaction by therapy type, though further post hoc analyses are needed to identify specific group differences. Preferences varied: 52.5% favored face-to-face therapy, 24.1% preferred teletherapy, and 23.3% had no choice. Both face-to-face and teletherapy are effective in establishing a strong therapeutic alliance. Given the notable differences in satisfaction levels, mental health services should consider individual preferences to enhance treatment engagement and outcomes.

This study compares the corrosion resistance of two cobalt-chromium (Co-Cr) dental alloys manufactured by casting (Wirobond SG) and Selective Laser Melting (Mediloy S-Co). Standardized disc specimens were analyzed morphologically (SEM), elementally (EDS), and electrochemically (OCP and Tafel plots). Tests were performed in Carter-Brugirard artificial saliva (pH 4.9 and 6.8) at 37 ± 1°C. Electrochemical parameters (E_oc, E_cor, i_cor, β_a, β_c, R_p) were used to evaluate corrosion behavior. The cast alloy showed the highest R_p (1346.29 kΩ•cm²) and lowest icor (30.96 nA/cm²) at pH 6.8, indicating better corrosion resistance. SEM showed process-related surface characteristics, including porosities in SLM samples and carbide precipitates in cast samples. These are components of the material itself that make it harder and more resistant to wear. Corrosion resistance is influenced by both manufacturing method and pH. Cast Co-Cr performed better in near-neutral saliva, while the SLM alloy showed a more electropositive open-circuit potential (E_oc = 67.9 mV) at pH 4.9, indicating higher corrosion resistance from an electrochemical point of view under acidic challenge. Both materials are suitable for dental applications.

Histopathological examination is a cornerstone in dermatological diagnosis, providing critical insights into the pathogenesis and classification of cutaneous disorders. This study aims to evaluate the concordance between clinical diagnoses and histopathological findings in skin lesion biopsies. This descriptive cross-sectional retrospective study analyzed 321 skin biopsies performed in a dermatology outpatient department. Demographic data, clinical presentations, biopsy site locations, and histopathological findings were systematically recorded. Biopsies were categorized into 12 groups based on histopathological diagnosis, and clinicopathological concordance was assessed. The study included 321 cases (174 men, 147 women) aged 3 to 90 years. Inflammatory dermatitis was the most common diagnosis (39.87%), followed by vesiculobullous diseases (10.90%) and benign keratinocytic/epidermal proliferation (10.59%). The head region was the most frequent biopsy site (20.87%), and plaque formation (30.52%) was the predominant clinical presentation. Overall, clinicopathological concordance was observed in 72.6% of cases. Notably, higher concordance rates were found in melanocytic lesions (100%) and vesiculobullous diseases (85.71%). Chi-square analysis revealed a highly significant association (P < 0.001) between the presence of clinical differential diagnoses and concordance with histopathological findings. This study highlights the value of histopathological examination in confirming clinical diagnoses of dermatological conditions, particularly for complex cases. To enhance clinicopathological concordance, dermatologists should provide comprehensive clinical information and, where relevant, include differential diagnoses (D/D).

COVID-19 and influenza pose serious health risks, and vaccine hesitancy is a major global health challenge. This study examined how the COVID-19 pandemic influenced public awareness and willingness to receive the flu vaccine in Jeddah, the Kingdom of Saudi Arabia (KSA). A cross-sectional web-based survey was conducted in Jeddah from October 2023 to May 2024. The survey targeted individuals aged 18 or older residing in Jeddah. Of the 487 responses, 400 met the inclusion criteria. The survey, administered in Arabic, included 20 questions on demographics, awareness, and attitudes toward vaccines. Among the participants, 72.3% were men and 54.5% were aged 18-24 years. Furthermore, 67% reported increased vaccination awareness after post-COVID-19, and 48.25% did not experience increased hesitation. Nearly all participants (94%) had heard of the influenza vaccine; however, 51.5% were unaware of its role in reducing hospitalization. Only 64% reported they would have been more likely to receive the vaccine if they had been aware of this benefit. Trust in healthcare providers' recommendations was low. Significant associations are observed between age and awareness of the influenza vaccine, and between age and perceived adequacy of vaccine information. Healthcare workers differ significantly from non-healthcare workers in their vaccine-related beliefs. The COVID-19 pandemic increased awareness of vaccines, particularly for influenza. However, hesitancy persists, driven by concerns about vaccine content and distrust toward health recommendations. Addressing these concerns is crucial for improving vaccine uptake in KSA.

Multimodal treatment of patients with a brain tumor primarily involves microsurgical excision, ideally radical, or at least subtotal resection. Tumors in deep or inaccessible locations may require biopsy followed by adjuvant therapy with chemotherapy, radiotherapy, or radiosurgery. Beyond controlling tumor growth, preserving neurological function and promoting brain plasticity are essential goals. Persistent inflammation and intracranial hypertension can trigger secondary injury through edema, excitotoxicity, and ischemia, potentially resulting in irreversible neuronal damage. Multimodal strategies, including neuroprotective measures such as Cerebrolysin administration, may help prevent or mitigate these secondary processes, supporting recovery and functional outcomes. Clinically, patients may present with headache, nausea, vomiting, seizures, or subtle cognitive and motor deficits, progressing in severe cases to deterioration of consciousness. Incorporating cerebroprotective interventions in perioperative management represents a promising approach to enhance recovery, functional independence, and quality of life in neurosurgical oncology patients.

Bariatric surgery (BS) is currently one of the major breakthroughs in the management of patients with morbid obesity, showing outstanding long-term results. While an abdominopelvic computed tomography (CT) aims to analyze fat distribution and anatomical integrity during a preoperative evaluation, incidentalomas are unexpected tumors or abnormalities discovered by chance on imaging. The purpose of this study was to present our institution's experience with incidental findings detected during preoperative CT evaluations in patients who are candidates for BS. In our retrospective, observational study, we analyzed preoperative CT images from 131 patients eligible for BS and selected only those diagnosed with incidentalomas. Among the 29 obese patients (89.7% female; mean age, 39.0 ± 11.6 years; mean BMI, 38.5 ± 4.6 kg/m²) who were candidates for BS and had incidentalomas detected on a preoperative CT, a total of 64 lesions were identified, with a mean of 2.2 ± 1.3 per patient. A significant positive correlation was observed between age and the number of incidentalomas found (r = 0.52, P = 0.004), with hepatic involvement being the most common type (31.2%). In summary, our study highlights that incidentalomas are not mere chance occurrences but rather a valuable and common finding in this patient population. Their discovery can have a significant impact on surgical planning, potentially requiring a modified approach, further investigation, or even contraindicating the planned BS. The findings emphasize the importance of thorough preoperative CT evaluations for BS candidates.

Impulsivity-acting without forethought, often under emotional pressure-is a prominent adolescent trait, linked to an imbalance in brain maturation. The limbic system, responsible for emotions, matures earlier than the prefrontal cortex, which shapes self-regulation. Educational contexts emphasizing different cognitive demands (emotionally expressive - drama versus analytically focused - computer science disciplines) may influence how impulsivity is expressed. This study examined differences in impulsivity levels among adolescents enrolled in drama and computer science programs. It was hypothesized that drama students would show higher impulsivity due to the spontaneous and emotionally driven nature of their training. Participants included 180 Romanian high school students (ages 14-17) from Dinu Lipatti National College of Arts (drama) and Grigore Moisil National College of Informatics (computer science). Impulsivity was measured using the Barratt Impulsiveness Scale (BIS-11), assessing attentional, motor, and non-planning components. Non-parametric tests were applied due to non-normal data distribution. Drama students showed significantly higher overall impulsivity (Mdn = 75.00) than computer science students (Mdn = 68.75), U = 642.000, P < .001, r = -.729). They also displayed greater attentional instability, more motor impulsivity, and lower planning. A moderate to strong inverse relationship between study time and impulsivity was found in the drama group (χ²(48) = 83.868, P = .003, Cramér's V = .557), but not in the computer science group. Educational context cognitive demands influence adolescent impulsivity. Emotionally expressive environments like drama may amplify impulsivity, while analytical settings foster greater self-regulation. Findings may guide targeted interventions to support adolescent self-control based on cognitive profiles.

Providing quality nursing care in intensive care units is a crucial component of hospital services. Conversely, the stress and workload in these environments put nurses at risk of job burnout. This study aimed to examine the relationship between missed nursing care and job burnout among nurses in intensive care units. This cross-sectional study used census sampling to recruit 200 nurses working in the intensive care units of teaching hospitals at Kurdistan University of Medical Sciences in Iran. The data were collected using demographic information forms, the Kalisch Missed Nursing Care Questionnaire, and the Persian version of the Maslach Burnout Inventory (MBI). Descriptive and analytical analyses were performed using SPSS software version 24. In this study, the mean score of missed nursing care was 35.29 ± 9.43. Additionally, a moderate level of job burnout among nurses was found, with a mean score of 42.54 ± 17.22. The results indicated a significant relationship between missed nursing care and nurses' gender and economic status (P < 0.05). Furthermore, missed nursing care was significantly related to job burnout (positive correlation) and its dimensions, including depersonalization and personal accomplishment (P < 0.05). Based on these findings, to enhance the quality of healthcare services in intensive care units, measures should be taken to reduce missed nursing care and job burnout among nurses.

The Constrained Disorder Principle (CDP) defines systems by their inherent disorder, which is bounded by dynamic borders. This principle determines a system's functionality and efficiency based on its continuously changing boundaries. In this paper, we present the formulation of the principle using the equation B = F, where B represents the dynamic borders, and F denotes the system's function. This equation suggests that the dynamic borders shape a system's existence, functionality, and efficiency. However, these borders impose a limit beyond which the system cannot further enhance its performance. When disorder surpasses established limits, the system's efficiency begins to decline. Conversely, insufficient disorder may also be harmful in certain situations. The paper examines the causal relationship between disorder and function, illustrating how the equation reflects the system's adaptability, efficiency, learning capabilities, memory, energy consumption, aging, and eventual termination. We also discuss how this formula can be applied to correct malfunctions and enhance system functions. Furthermore, we introduce a second-generation artificial intelligence system based on the CDP formula that incorporates noise. In summary, the B = F equation provides a valuable framework for understanding complex systems and lays the groundwork for models designed to enhance system performance.