搜索结果：Galen medical journal

Post-modern medicine signifies a paradigm shift in healthcare by integrating the strengths of both modern biomedical science and traditional medical systems. This article explores the potential of a holistic approach that combines evidence-based practices with time-tested methodologies rooted in historical medical traditions. Emphasis is placed on prevention, diagnosis, and treatment to achieve a more comprehensive and personalized understanding of health and disease. By examining the unique contributions of each system, this integrative perspective aims to enhance patient outcomes in both human and veterinary medicine. Post-modern medicine signifies a paradigm shift in healthcare by integrating the strengths of both modern biomedical science and traditional medical systems. This article explores the potential of a holistic approach that combines evidence-based practices with time-tested methodologies rooted in historical medical traditions. Emphasis is placed on prevention, diagnosis, and treatment to achieve a more comprehensive and personalized understanding of health and disease. By examining the unique contributions of each system, this integrative perspective aims to enhance patient outcomes in both human and veterinary medicine.

Anatomical terminology is often assumed to be structurally precise and historically stable. However, the anterior thoracic region demonstrates significant semantic transformation across time. In classical Latin, pectus referred broadly to the chest without sexual specification. In modern English, the term "breast" predominantly denotes the female mammary gland. This study investigates how a structurally stable anatomical region underwent progressive linguistic gendering. A qualitative historical-anatomical analysis was conducted integrating: (1) philological examination of classical Latin and Greek texts, including the Aeneid; (2) review of medical writings attributed to Hippocrates and Galen to assess early structural differentiation between thorax and mammary gland; (3) comparative analysis of medieval to 19th-century anatomical atlases to evaluate visual and terminological separation of thoracic and mammary structures; and (4) conceptual review of contemporary clinical framing in thoracic trauma and breast reconstruction. No human subjects were involved. Classical terminology (pectus, stēthos) denoted the anterior thorax without inherent sexual coding, while mastos specified mammary tissue. Renaissance dissection reinforced structural separation between thoracic wall and glandular appendage. Despite increasing anatomical precision, vernacular English progressively narrowed "breast" toward female mammary meaning. Modern anatomical standards maintain structural neutrality, but linguistic asymmetry persists in clinical and cultural discourse. The thorax has remained anatomically stable, whereas its linguistic representation has undergone gender-specific specialization. The transition from pectus to "breast" illustrates how anatomical regions may acquire cultural coding independent of structural change.

The sub-occipital transtentorial approach for pineal and pineal region tumours is reported as realized in Lyon. The approach described by C. Lapras is still performed today with a large skin flap and a large bone flap, which is sawn flush with the superior longitudinal sinus and the transverse sinus.The large bone flap allows elevation and separation of the hemisphere, avoiding its compression against the internal edge of the parietal bone.Opening the tentorium allows broad visualization of the pineal region space and of the venous arch formed by the basilar veins and the Galen vein.Protecting the occipital lobe with a rubber blade and cottonoids prevents compression of the calcarine scissure and has helped to reduce the incidence of the homonymous lateral hemianopia, which was the main criticism of this approach. In recent years, endoscopy assistance at the end of surgery has helped increase the rate of complete tumour removal by detecting pieces of tumour that were left in place.In Lyon, it was realized in more than 300 procedures.

Availability of trustworthy information has a critical role during public health emergency events. Science communication and trust in information sources, health experts and governments significantly influence public adherence to preventive measures and vaccine uptake. To investigate these effects on vaccine confidence in Southeast Asia, a region with diverse governance structures, trust levels and health literacy, this study examines trust in science and authority across six countries. Between January and June 2023, we conducted online surveys in Singapore, Philippines, Indonesia, Thailand, Malaysia and Vietnam with a total of 6611 respondents to measure their attitudes and trust towards science, vaccines, the government's management of COVID-19 and international health institutions. Our analyses explored the relationship between population trust in science, authorities and vaccine confidence. We found generally high trust in science and authority, along with strong confidence in vaccines. Trust in science increased by 0.98 (95% CI 0.93 to 1.03) for every unit increase in trust in government. Trust in information from medical staff and scientists was highest, while information from politicians and social media was least trusted. We found a positive association between the three indices across some, but not all countries. The perception of scientific support for the vaccine rollout was positively associated with vaccine confidence in nearly all contexts, with effect sizes ranging from 0.55 (in Thailand and Indonesia) to 1.07 (in Singapore). Our findings indicate that to enhance resilience against future public health emergencies and improve adherence to directives for non-urgent health concerns, health authorities should focus on communicating scientific support behind health guidelines and build trust in science and authority in the long term.

The revival of psychedelic medicalization is often narrated as a story of scientific legitimacy and neurotherapeutic promise, yet the unusual sensitivity of psychedelics to environmental conditions has encouraged research on music, therapy, setting, and other contextual factors. Treating setting and context as the building blocks of felt atmospheres, this article examines how regulation actively shapes atmospheres of consumption for substances that alter affective and sensory perception. Debates over drug-centric versus therapy-centered models are situated within the broader issue of how law shapes contexts and settings of psychedelic consumption. Policy developments in the United States and Australia show how emerging legal pathways have variably defined personnel, setting, access, substance, and the permitted forms of "holding space" or providing support or therapy. We introduce the concept of regulatory atmospheres to describe the diffuse and sometimes invisible ways in which policy shapes the contextual conditions of psychedelic use. Although policy rarely addresses atmospheres directly, we argue that it powerfully conditions them, which the case of psychedelic drug policy makes particularly clear. Alongside emerging legal pathways, the persistent shadow cast by prohibition over underground and traditional contexts reveals how some ontologies of risk and efficacy are privileged over others.

Heavy menstrual bleeding (HMB) is a common problem existing in nearly 30% of women worldwide. An underlying bleeding disorder has been identified as a cause of HMB in a significant proportion of women seeking gynecological care for HMB. In practice, however, there is a significant underdiagnosis of bleeding disorders in these patients, highlighting a need for improvement in awareness and detection. To present a comprehensive review of the literature on HMB and bleeding disorders and to increase awareness of their interrelation. In addition, to propose a standardized diagnostic approach to help identify which women with HMB may have an underlying bleeding disorder and require further hemostatic evaluation. A literature review was performed using PubMed to identify relevant primary research and review articles on the topic of HMB and bleeding disorders in English. This was supplemented by manual reference searches and review of relevant guidelines in English and Dutch. A significant proportion (10% to as much as 62%) of women with HMB have an underlying bleeding disorder, yet many such disorders go unrecognized. Various screening instruments, particularly the validated PBAC, Philipp tool or self-BAT, can help distinguish between HMB with or without a suspected bleeding disorder, and indicate who needs additional hemostatic evaluation. An underlying bleeding disorder is far more frequent in HMB than currently appreciated. Gynecologists should be aware of this and be familiar with screening instruments and a diagnostic workflow for bleeding disorders. Multidisciplinary collaboration between gynecology and hematology is crucial for accurately diagnosing and managing potential bleeding disorders in women with HMB.

Iron deficiency during pregnancy poses a significant risk to maternal and fetal health, especially among anemic women whose physiological demand for iron increases drastically. This study aimed to evaluate the serum iron profile of non-anemic pregnant women at the time of delivery and to identify associated demographic and clinical factors. Conducted at Baharloo Hospital between 2022 and 2023, this cross-sectional study involved pregnant women who met the primary inclusion criteria of being non-anemic in the first and second trimesters and were admitted for scheduled labor. Serum ferritin, serum iron, and total iron-binding capacity (TIBC) were quantified, alongside comprehensive analysis of hemoglobin (HB) levels and red blood cell (RBC) indices. Data on demographic characteristics, and prenatal supplement usage were collected through medical records and analyzed using SPSS software. This study of 120 pregnant women (mean age 28.85 ± 6.34 years, gestational age 39.21 ± 0.8 weeks) found that most participants regularly consumed iron (93.33%) and multivitamin supplements (81.67%), with average serum iron levels of 98.73 ± 20.7 μg/dL at 3rd trimester. Key correlations included negative associations between gestational age and maternal age (r=-0.26) and between ferritin and gestational age (r=-0.18), while hemoglobin and hematocrit levels were strongly positively correlated. Logistic regression identified lower second-trimester hemoglobin as protective against delivery-time anemia (OR=0.29), and lower second-trimester MCV significantly predicted iron-deficiency anemia (IDA) (OR=0.70), when adjusting for age, gestational age, BMI, supplements or iron usage, multiparity, and educational level. As iron and multivitamin supplementation did not significantly reduce anemia risk and it was basically related to second-trimester MCV and hemoglobin, higher thresholds of these markers should be assigned as the goal of anemia prevention programs for Iranian women.

Global Developmental Delay (GDD) affects cognitive, language, motor, and adaptive functions in children under five years and is often a precursor to long-term neurodevelopmental disorders including intellectual disability and autism spectrum disorder. Early intervention can improve developmental outcomes, yet evidence regarding its effectiveness, especially in low-resource and diverse clinical settings, remains fragmented. To synthesize available evidence on the effectiveness of early intervention programs for children aged 0-6 years with GDD, and to identify intervention types, outcomes, and gaps in current research. A systematic review following PRISMA 2020 guidelines was conducted. PubMed, Web of Science, Scopus, and ClinicalTrials.gov were searched up to October 14, 2025, using predefined search terms. Eligible studies included children aged 0-6 years diagnosed with GDD or nonspecific developmental delay and involved an early intervention program assessing developmental outcomes. Data extraction and quality appraisal were performed using Joanna Briggs Institute (JBI) tools. Narrative synthesis was used due to heterogeneity across studies. Six studies involving a total of 689 participants were included. Interventions varied widely, including multidisciplinary rehabilitation, parent-mediated programs, community-based approaches, and combined medical-therapeutic methods. All studies reported improvements in at least one developmental domain (motor, language, cognitive, or social), with greater gains observed when interventions were initiated early (6 months) and sustained over longer durations. Parent-mediated and community-based models were feasible and effective in low-resource settings. However, no randomized controlled trials were identified, and most studies showed moderate to high risk of bias. Certainty of evidence was rated low to very low using GRADE. Early intervention programs demonstrate consistent benefits for children with GDD across settings, particularly when initiated early and involving caregivers. However, the current evidence base is limited by methodological weaknesses and lack of standardized outcome measures. High-quality randomized trials and long-term follow-up studies are urgently needed to inform best practices and policy implementation.

Endometriosis is a prevalent medical condition that significantly affect the quality of life in a substantial proportion of women, affecting their fertility and manifesting with many symptoms like gastrointestinal symptoms. The present study aimed to evaluate the impact of laparoscopic surgery for endometriosis on general and sexual quality of life, and gastrointestinal symptoms in patients diagnosed with deep infiltrating endometriosis (DIE). This prospective cohort study was conducted on 129 women diagnosed with DIE-associated infertility and referred to Yas Infertility Center in Tehran , from 2022 to 2023. Demographic data and the presence and severity of gastrointestinal symptoms were recorded. These symptoms were reassessed one month following endometriosis surgery. Participants were also asked to complete the SF-36 Quality of Life Questionnaire and Female Sexual Function Index (FSFI) questionnaires before the surgical procedure and one month later. Data were analyzed using SPSS version 24. This study of 129 patients (mean age 34.82±5.83 years, BMI 25.64±3.77 kg/m²) revealed near-universal ovarian involvement (99.2%) and adhesions (99.2%), primarily affecting rectosigmoid (24.1%) and cervix (29.5%). Pre-intervention, 98.4% reported abdominal pain (47.3% severe), 37.9% bloating, and 24.8% constipation. Post-intervention showed dramatic improvements: pain-free cases rose to 90.7%, bloating reduced to 9.3%, and constipation to 6.2% (all P0.0001). The FSFI score increased (57.6±28.8 to 65.2±27.4, P0.0001), and SF-36 pain scores halved (6.8±1.2 to 2.7±0.9, P0.0001), though vitality and emotional well-being remained unchanged. Surgical complications included hemoglobin drop (17.8%) and intestinal injury (6.2%). The findings of this study indicate that laparoscopic treatment of DIE not only alleviates gastrointestinal symptoms but also significantly enhances the quality of life and sexual function in affected women.

Trauma, an external assault's corporeal aftermath, manifests as wounds or injuries, breaching or not breaching the skin, wrought by environmental forces upon the human, and is considered One of the world's foremost public health challenges intertwines complex societal, environmental, and medical issues. In order to evaluate the severity of trauma, it seems necessary to have a quantitative scale that can be measured. Therefore, the aim of this study is to look into the predictive power of two scoring indices, The Injury Severity Score (ISS) and MGAP, in patients with multiple traumas. This research is a cross-sectional type and was conducted on trauma patients, aged 18 and over, with at least two traumas, hospitalized for over 24 hours in Taleghani Hospital in Mashhad in the period of one year from October 2020 to October 2021. For ISS, the Abbreviated Injury Scale (AIS) scores for affected organs in six body areas were determined, and the three highest AIS scores were calculated. For the MGAP score, data on injury mechanism, age, Glasgow Coma Scale (GCS), and systolic blood pressure were extracted. A chi-square test was conducted to ascertain the correlations between categorical variables and the status of survival. Additionally, Positive Triage Accuracy was measured and compared for ISS and MGAP. In this research, 699 cases were investigated. Among the patients, 567 (81%) were male and 132 (19%) were female. Also (92%) 641 patients were discharged alive and (8%) 58 patients died. Among the 114 patients admitted to the ICU, 45 (39%) died. Cases mislabeled as medium or low risk that experienced death happened in 7 cases (of 598 available records; 1.17%) based on the ISS risk stratification system with 98.18% Positive Triage Accuracy and 44 cases (of 698 available records; 6.30%), based on the MGAP risk stratification system with 32.75% positive triage accuracy. The findings show the robust predictive power of ISS, with a low mislabeling rate and high triage accuracy. Conversely, the MGAP system demonstrated a higher mislabeling rate, suggesting that its application may yield incorrect results in certain situations and settings. This shows the need for cautious consideration when applying the MGAP risk stratification system, as its performance may not be universally applicable across all scenarios.

Background: Gallstone disease (GSD) is a prevalent gastrointestinal condition influenced by genetic, environmental, and dietary factors. The ATP-binding cassette subfamily B member 11 (ABCB11) gene, encoding the bile salt export pump (BSEP), plays a critical role in bile acid transport. Polymorphisms in ABCB11 have been implicated in gallstone pathogenesis, yet evidence from Middle Eastern populations, particularly Iran, remains limited. Our study seeks to address these knowledge gaps by evaluating the association between rs2287622 and hepatic function markers in a distinct population. Materials and Methods: This investigation, conducted in a medical facility with matched participants, involved 100 individuals diagnosed with GSD and 100 comparable healthy volunteers matched by age and gender. We used a targeted PCR method (ARMS-PCR) for variant detection. Laboratory tests evaluated blood fats and hepatic indicators. We applied logistic regression modeling to explore the connection between rs2287622 and GSD, controlling for influencing variables. Results: The mean age of cases was significantly higher than controls (56.74 ± 16.25 vs. 43.07 ± 14.68 years, P0.001). Cases exhibited elevated serum levels of SGOT (P=0.021), SGPT (P=0.016), ALP (P=0.001), and direct bilirubin (P0.001). No significant differences were observed in allele frequencies (P=0.78) or genotype distributions (P=0.24) of ABCB11 polymorphisms between groups. TT was the most prevalent genotype, with no significant associations found between genotype and clinical parameters or GSD risk. Conclusion: This study found no significant association between ABCB11 polymorphisms and GSD among Iranian adults. Future research with larger samples and functional analyses is recommended to clarify the genetic determinants of GSD in this population.

Cardiovascular patients frequently suffer from xerostomia and several modalities has been tried to alleviate the symptom. Improving Oral Health Related Quality of Life (OHRQoL) is a subjective index and considered as the final achievement in oral treatments. The aim of the present study was to evaluate OHRQoL in these patients, as well as its relation to xerostomia and some other factors. In this cross-sectional study, 244 patients participated. OHRQoL was assessed by Oral Health Impact Profile 14 (OHIP-14). Xerostomia severity was quantified by the Xerostomia Inventory (XI). Consumed anti-hypertensive drugs, age and gender were also recorded. Data were analyzed using SPSS 22 (IBM version 22.0, Chicago, USA) and statistical significance level was considered P0.05. The mean age of participants was score of OHIP-14 was 58.90 ± 5.66 years, of whom 53% were male and 47% female. The mean total OHIP-14 score was 13.33 ± 11.11. Patients with xerostomia consisted 78% of the sample, with a mean XI score of 23.9 ± 5.1. Total and all domain scores of OHIP-14 were directly and significantly correlated with XI score (P0.001). Also, age had a direct and significant correlation with both OHIP-14 (P0.001) and XI (P=0.001) scores. Use of cardiovascular drugs was not significantly related to xerostomia presence or severity (P0.05). The majority of cardiovascular patients suffer from moderate xerostomia, regardless to the type of medication they consume. Xerostomia affects OHRQoL in these patients and should be treated properly to improve their life quality, especially among the elderly.

The COVID-19 pandemic has prompted significant lifestyle changes worldwide. Despite extensive research on negative impacts, there's a gap in understanding positive transitions; thus, this study explores adaptive behaviors and coping strategies during the pandemic in Saudi Arabia. A cross-sectional study recruited Saudi residents aged 18-70 via social media. Data collected through an electronic survey tool was analyzed using SPSS, focusing on demographic, health-related, and research-specific responses. Coping behaviors were interpreted using Lazarus and Folkman's model and Carver's Brief COPE framework. Among 3,508 participants, 38.0% engaged in language learning and 55.6% read books or listened to audiobooks at a frequency of 1-3 times per month. Home cooking was reported by 79.2%, and 34.8% engaged in daily remote social interactions. Gender and nationality significantly influenced coping behaviors: reading books or audiobooks was more common among females (P0.001) and non-Saudis (P0.001), while exercising 2-4 days per week was also more prevalent among females (P=0.013). Programming interest was significantly higher among males and Saudi participants (P=0.035). Study Findings show that participants adopted a variety of adaptive coping strategies, such as book reading, exercise, social interaction, and engagement with online content. Framing these behaviors through established psychological coping models enhances understanding of their role in mental well-being. These findings can inform public health strategies to promote positive coping mechanisms and support mental well-being in Saudi Arabia and similar contexts.

Polyhydramnios, defined as excessive amniotic fluid accumulation, increases the risk of maternal and fetal complications. In idiopathic cases, management options are limited. This prospective interventional study aimed to evaluate the effect of a low-glucose diet on the amniotic fluid index (AFI) in normoglycemic pregnant women with idiopathic polyhydramnios. A prospective interventional study was conducted involving 51 pregnant women between 24 to 35 weeks of gestation with idiopathic polyhydramnios at Al-Zahra Women's Tertiary Referral University Hospital from 2024 to 2025. A low glucose dietary pattern was implemented by a nutrition specialist. AFI was measured at baseline, and two- and four-week's post-intervention. To assess differences and changes in AFI across three visits paired T-tests and Repeated measures ANOVA were used. The mean AFI levels at the initial visit, and at two and four weeks later, were 27.19, 22.41, and 19.5 cm, respectively. We noted a significant reduction in AFI at both the two- and four-week marks compared to the baseline (P= 0.001). The rate of decrease in AFI after two weeks (mean= 22.4, P= 0.001) was greater than that observed four weeks later (mean= 19.5; P= 0.004). The study demonstrated that reducing excessive oral sugar intake and modifying dietary habits resulted in a reduction of the amniotic fluid index (AFI) in pregnant women with idiopathic polyhydramnios.

Interstitial Lung Disease (ILD) is the most common pulmonary manifestation in patients with primary Sjögren's syndrome. Therefore, this study aimed to investigate the prevalence of ILD in patients with primary Sjögren's syndrome (pSS) using a systematic review and meta-analysis method. This study searched databases ProQuest, PubMed, Web of Science, Cochrane, Embase, and the search engine Google Scholar until February 8, 2025. Studies were combined using the sample size and variance of each study. The heterogeneity of the studies was examined using the Q Cochrane test and the I2 index. The significance level of the tests was considered P0.05. 34 observational studies, with a total of 9535 individuals, showed that the prevalence of ILD in all patients with pSS was 23.5% (95%CI: 18.6%, 28.4%), in women 31.2% (95%CI: 18.4%, 44.1%), and in men 45.5% (95%CI: 23.6%, 67.4%). Moreover, the prevalence of ILD in patients with pSS in the age group of 30 to 39 years was 22.2% (95%CI: 18.9%, 26%), 40 to 49 years 10.8% (95%CI: 8.7%, 12.9%), 50 to 59 years 27.6% (95%CI: 17.9%, 37.4%), and 60 to 69 years 23.3% (95%CI: 17.9%, 28.7%). Also, the prevalence of ILD in patients with pSS in case-control studies was 15.6% (95%CI: 7.1%, 24.1%), in cohort studies 25.7% (95%CI: 19%, 32.4%), and in cross-sectional studies 21.4% (95%CI: 11.9%, 31%). However, the prevalence of non-specific interstitial pneumonia (NSIP) was 48.8% (95%CI: 41.4%, 56.2%), usual interstitial pneumonia (UIP) 15% (95%CI: 10.5%, 19.5%), LIP 10.8% (95%CI: 6.6%, 15%), and organizing pneumonia (OP) 9.4% (95%CI: 5.4%, 13.4%). One out of every four patients with pSS has ILD, and the prevalence of ILD was higher in men than in women. Moreover, the most common type of ILD was NSIP, followed by UIP, OP, and LIP, and the highest prevalence of ILD was in the age group of 50 to 59 years. Evaluating further studies regarding the impact of various factors on ILD can help in better diagnosing it in patients.

Non-variceal upper gastrointestinal bleeding is a common problem worldwide, which is associated with a significant mortality rate. The purpose of this study was to investigate the relationship between the mortality rate of patients referred to the emergency room with non-variceal upper gastrointestinal bleeding and the time of therapeutic-diagnostic endoscopy. This study was a retrospective cohort observational study at Imam Reza Hospital in Mashhad, which was conducted in patients presenting with obvious symptoms of non-variceal acute gastrointestinal bleeding between April 2017 and March 2018. Underlying variables, endoscopic history, hemoglobin level, Glasgow - Blatchford score, blood pressure and the endoscopic result were extracted from patients' records. The time of death was followed up by telephone within 30 days after hospitalization. Data were compared based on the time of endoscopy since arrival. Patients with gastrointestinal bleeding were initially evaluated in the emergency room, unstable patients were transferred to the emergency room for stabilization and initial measures, and other patients were transferred to the emergency room, and the unstable patients were excluded from the plan. In this study, 189 patients (with an average age of 60.11 ± 17.59 years) were examined. 23 cases (12.16%) of death were recorded within 30 days. 26 people (13.75%) underwent emergency endoscopy within 0 to 6 hours of referral. Forty-four people (23.28%) underwent endoscopy within 6 to 12 hours and the rest (119 people, 62.96%) within 12 to 24 hours. There was no significant difference between deceased and recovered subjects in terms of various study variables, including Blatchford score, number of days hospitalized in the ward and intensive care unit, and the number of units of compressed red blood cells injected (P0.05). Diabetes was significantly more prevalent in patients undergoing endoscopy 12 h compared to the 12 h (3.36% vs. 32.86%; P=0.001). adjusting for diabetes, the timing of endoscopy (within 12 hours vs. after 12 hours) was not significantly associated with mortality, with both crude (OR 1.25, 95% CI 0.63-2.49, P=0.523) and adjusted (OR 1.30, 95% CI 0.65-2.60, P=0.456) odds ratios. Our study showed no association between endoscopy time and mortality in patients with upper gastrointestinal bleeding; however, this finding should be confirmed in future studies in more controlled populations as a clinical trial.

Amyotrophic Lateral Sclerosis (ALS) is the most common and rapidly devastating neurodegenerative disease, which causes impairment of motor neurons in the upper and lower limbs, as well as in the bulbar muscles among adults. This leads to progressive weakness of voluntary muscles. The median survival after the emergence of initial symptoms is typically three years. During this period, due to the worsening of general well-being and independence, patients and their caregivers experience significant emotional stress. Furthermore, there is currently no definitive treatment for ALS. Consequently, patients face various challenges associated with motor impairment, including mobility disturbances, respiratory dysfunction, speech difficulties, and limitations in activities of daily living. Therefore, rehabilitation plays a vital role as a component of multidisciplinary care for managing these issues and reducing the impact of the disease on patients and their families. It is considered the optimal choice for alleviating the discomfort of ALS patients until a curative treatment is discovered.This narrative review aims to provide an overview of different aspects of rehabilitation, including physical therapy, occupational therapy, speech therapy, and respiratory strategies focused on enhancing independence, functional abilities, and overall quality of life while minimizing disabilities and complications in patients coping with this debilitating condition. Amyotrophic Lateral Sclerosis (ALS) is the most common and rapidly devastating neurodegenerative disease, which causes impairment of motor neurons in the upper and lower limbs, as well as in the bulbar muscles among adults. This leads to progressive weakness of voluntary muscles. The median survival after the emergence of initial symptoms is typically three years. During this period, due to the worsening of general well-being and independence, patients and their caregivers experience significant emotional stress. Furthermore, there is currently no definitive treatment for ALS. Consequently, patients face various challenges associated with motor impairment, including mobility disturbances, respiratory dysfunction, speech difficulties, and limitations in activities of daily living. Therefore, rehabilitation plays a vital role as a component of multidisciplinary care for managing these issues and reducing the impact of the disease on patients and their families. It is considered the optimal choice for alleviating the discomfort of ALS patients until a curative treatment is discovered.This narrative review aims to provide an overview of different aspects of rehabilitation, including physical therapy, occupational therapy, speech therapy, and respiratory strategies focused on enhancing independence, functional abilities, and overall quality of life while minimizing disabilities and complications in patients coping with this debilitating condition.

Diabetes presents a significant health challenge worldwide, with profound implications extending beyond glycemic control to impact various bodily systems. This review explores the intricate relationship between diabetes and musculoskeletal disorders, shedding light on their epidemiology, pathophysiology, and clinical implications. Individuals with diabetes face a heightened risk of developing musculoskeletal conditions, particularly tendon disorders such as adhesive capsulitis rozen shoulder, rotator cuff tears, muscle atrophy, osteoarthritis and diabetic hand syndrome. Mechanisms underlying these disorders include inflammation, glycation, and impaired tendon homeostasis, exacerbated by factors like insulin resistance and oxidative stress. Furthermore, diabetes poses challenges in orthopedic surgery, leading to increased rates of surgical complications and poorer outcomes. Understanding the interplay between diabetes and musculoskeletal health is crucial for developing targeted interventions aimed at optimizing patient care and outcomes in this population. Diabetes presents a significant health challenge worldwide, with profound implications extending beyond glycemic control to impact various bodily systems. This review explores the intricate relationship between diabetes and musculoskeletal disorders, shedding light on their epidemiology, pathophysiology, and clinical implications. Individuals with diabetes face a heightened risk of developing musculoskeletal conditions, particularly tendon disorders such as adhesive capsulitis rozen shoulder, rotator cuff tears, muscle atrophy, osteoarthritis and diabetic hand syndrome. Mechanisms underlying these disorders include inflammation, glycation, and impaired tendon homeostasis, exacerbated by factors like insulin resistance and oxidative stress. Furthermore, diabetes poses challenges in orthopedic surgery, leading to increased rates of surgical complications and poorer outcomes. Understanding the interplay between diabetes and musculoskeletal health is crucial for developing targeted interventions aimed at optimizing patient care and outcomes in this population.

Subarachnoid hemorrhage (SAH) is a life-threatening neurological condition that accounts for approximately 5% of all strokes. This study aimed to evaluate the demographic, clinical, and radiological factors associated with in-hospital mortality in patients with non-traumatic SAH and to assess potential differences before and after the COVID-19 pandemic. This retrospective analytical study was conducted on 177 patients with non-traumatic SAH admitted to Imam Hossein Hospital, Tehran, from November 2021 to December 2022. Diagnosis was confirmed by a neurologist using clinical presentation, imaging, and cerebrospinal fluid analysis. Patients were grouped based on discharge status (deceased vs. survived), and also classified into early- and late- pandemic subgroups based on their admission date. Comparative analyses and binary logistic regression were performed to identify predictors of in-hospital mortality. Among 177 patients (mean age: 54.75 years), 36 (20.3%) died during hospitalization. Blood pressure, blood sugar, and level of consciousness at admission were significantly associated with mortality (P 0.05), as were disease severity (Hunt and Hess grade) and angiography status (P 0.001). No significant associations were found for age, sex, hospitalization duration, creatinine, platelets, hypertension, diabetes, or aneurysm characteristics (P 0.05). Logistic regression identified lower Glasgow Coma Scale (GCS) scores (P 0.001) and higher systolic blood pressure (P = 0.004) as independent predictors of mortality. Mortality was higher in the late-pandemic group (23.9% vs. 16.0%), though not statistically significant (P = 0.18). Lower GCS scores and elevated systolic blood pressure at admission were independent predictors of in-hospital mortality in patients with non-traumatic SAH. The COVID-19 pandemic period was associated with reduced use of angiography and a trend toward increased mortality, underscoring the importance of maintaining access to timely care during public health crises.