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Vein of Galen malformation (VoGM) is a rare congenital vascular anomaly. It represents a well-recognized extracardiac cause of high-output cardiac failure in the neonatal period. We report a case of a 3.5-month-old boy who presented for routine vaccination and was incidentally found to have macrocephaly (head circumference 44.5 cm, >99th percentile) with early sun-setting eyes. He was otherwise well-appearing with a normal neurological examination. Bedside cranial ultrasound revealed bilateral lateral and third ventricular dilation with a cystic mass compressing the aqueduct, and brain MRI confirmed a dilated cystic malformation of the vein of Galen as the cause of obstructive hydrocephalus. His past medical history was significant for severe neonatal respiratory distress complicated by pulmonary hypertension and congestive heart failure, initially attributed to neonatal pneumonia. This case highlights that VoGM should be considered in the differential diagnosis of neonatal persistent pulmonary hypertension (PPHN) and high-output heart failure, even when a concurrent respiratory illness is present, and emphasizes the value of bedside cranial Doppler ultrasound and thorough physical examination including fontanel auscultation.
Article retraction means removing a published article from the journal because of ethical issues or scientific errors in order to correct the literature. In this study, we aimed to determine the reasons for retracting biomedical articles written by authors from Iran, Saudi Arabia, Pakistan, Egypt, and Turkey. This cross-sectional study included all retracted biomedical articles with first authors affiliated with Iran, Saudi Arabia, Pakistan, Egypt, or Turkey, retracted between September 1, 2010, and September 1, 2019. Data were extracted from Retraction Watch, MEDLINE, PubMed Central (PMC), Clarivate Analytics, and Scopus. Each article's information was entered into a data collection form and analyzed using SPSS version 24. Of 436 retracted articles, Iran had the highest number (223), followed by Turkey (80), Egypt (72), Saudi Arabia (35), and Pakistan (26). Common causes of retraction included plagiarism, duplication, authorship issues, and fake peer review. In Iran, fake peer review (42.6%) and authorship issues (41.3%) were most prevalent. Significant inter- country differences were found in retraction frequency and causes. The most affected fields were biology, biochemistry, oncology, cardiovascular, surgery, and pathology. The results showed that scientific misconducts (plagiarism, duplication, authorship issues, and fake peer review) were the main reasons for retracting the articles in the five studied countries. To reduce such misconducts, regional regulatory policies, improved editorial practices, and enhanced research ethics training are urgently needed.
Fever was the main symptom of nontraumatic diseases in antiquity. Increased body temperature was detected by the physician through palpation of the skin and the pulse. Hippocrates of Cos described fever in several books and numerous case studies. The great physician paid more attention to the duration and temporal distribution of the fever than to its intensity. Among the accompanying symptoms, somnolence, coma and delirium were particularly feared. More than half a millennium later, Galen of Pergamum extensively documented the fever theory of antiquity once again. The choice of conservative treatment was influenced by the patient's general condition and the frequency of fever recurrence. If it failed, phlebotomy was available as a last resort. Retrospective diagnostics have identified malaria as the principal cause of fever epidemics in antiquity. The ancient physicians often described the threat to humans from wind and water but did not recognize or at least consider the causal connection between the swarms of mosquitoes rising from the swamps and the widespread fever. Fieber war das Leitsymptom der nichttraumatischen Erkrankungen in der Antike. Die Erhöhung der Körpertemperatur wurde von den Ärzten durch Palpation der Haut und des Pulses nachgewiesen. Hippokrates von Kos hat das Fieber in mehreren Büchern und zahlreichen Kasuistiken beschrieben. Der große Arzt des Altertums hat der Dauer und zeitlichen Verteilung des Fiebers mehr Beachtung geschenkt als der Intensität. Unter den Begleitsymptomen waren Somnolenz, Koma und Delir am meisten gefürchtet. Mehr als ein halbes Jahrtausend später hat Galen von Pergamon die Fiebertheorie der Antike erneut umfangreich dokumentiert. Die Art der konservativen Behandlung war vom Allgemeinzustand der Patienten und der Rezidivhäufigkeit des Fiebers geprägt. Wenn sie versagte, stand als letztes Mittel die Phlebotomie zur Verfügung. Die retrospektive Diagnostik hat Malaria als Hauptursache der Fieberepidemien des Altertums identifiziert. Die antiken Ärzte haben die Bedrohung der Menschen durch Wind und Wasser vielfach beschrieben, den kausalen Zusammenhang zwischen den aus den Sümpfen aufsteigenden Mückenschwärmen und dem seuchenhaften Fieber aber nicht erkannt oder auch nur erwogen.
To investigate the effects of stress related to the pandemic on the medical faculty's well-being. This study investigated the impact of pandemic-related stress on the well-being of medical faculty at King Abdulaziz University. Using a mixed-methods approach, 82 faculty members completed online surveys, including the GAD-7 and PHQ-9 scales to measure anxiety and depression, and participated in focus group discussions. The analysis explored the relationship between these psychological stress factors and self-reported academic performance across different demographics. A high prevalence of psychological distress was found: 89.6% of faculty reported at least mild anxiety, and 84.4% reported at least mild depressive symptoms. Most participants self-rated their academic performance as good (54.5%) or excellent (36.4%), and 80.5% reported missing no crucial deadlines. Regression analyses revealed a significant positive association between depression severity and higher self-reported academic performance (β = 1.48, p = 0.025). Male gender (OR = 0.20, p = 0.022) and longer weekly working hours (OR = 0.53, p = 0.019) were associated with significantly lower odds of missing deadlines. Anxiety, depression, and other covariates were not significant predictors of overall quality of life. While the pandemic was associated with a high burden of anxiety and depression among faculty, this distress did not translate into widespread self-perceived declines in academic output. The counterintuitive link between higher depression scores and self-reported performance, alongside the protective effect of male gender and increased work hours against missed deadlines, suggests complex coping mechanisms and potential resilience or presenteeism.
The high turnover rate among newly graduated nurses (NGNs) is a significant concern globally, particularly in medical-surgical units (MSUs). Identifying the key facilitators and barriers to their professional role adaptation is crucial for improving retention and facilitating a smoother transition into clinical practice. This study explored facilitators and barriers to professional role adaptation among NGNs in MSUs. A qualitative study was conducted using inductive content analysis. Twenty-one NGNs with less than one year of clinical experience were purposively selected from teaching hospitals affiliated with Tehran University of Medical Sciences. Data were gathered through semi-structured in-depth interviews and analyzed using Graneheim and Lundman's five-step approach with MAXQDA software. The findings revealed that multiple interacting factors shape role adaptation at three levels: individual, interpersonal, and organizational. Facilitating factors included personal motivation, clinical preparedness, supportive colleagues, and structured organizational support. In contrast, barriers such as stress, lack of structured orientation programs, negative work culture, and excessive workload hindered adaptation. This study revealed that the adaptation of NGNs to professional roles in MSUs is shaped by individual, interpersonal, and organizational factors. Enhancing structured support at all three levels - through targeted educational programs, professional communication, and organizational infrastructure - can improve transition outcomes, reduce early turnover, and promote workforce retention in healthcare settings.
Vein of Galen malformations (VOGMs) are congenital arteriovenous shunts that typically present in neonates and infants. Symptomatic neonates have a poor prognosis and face high mortality without dedicated neonatal intensive care and pediatric neurointervention in specialized centers. The authors present the case of a 47-year-old Puerto Rican female with a history of chronically compensated heart failure, progressive cognitive decline, and new-onset seizures. On presentation, the patient had a Glasgow Coma Scale score of 6, and CT imaging revealed intraventricular hemorrhage, extensive parenchymal calcifications, and hydrocephalus. An external ventricular drain was urgently placed, and further workup at the authors' institution, including CT angiography and digital subtraction angiography, led to the diagnosis of a choroidal VOGM. The patient's family opted for withdrawal of care without pursuing further neurosurgical intervention. The presentation of a choroidal VOGM at this advanced age is exceptionally rare. This case highlights the importance of understanding the presentations and consequences of this life-threatening condition, as well as considering endovascular or microsurgical intervention. Specifically, workup for cerebrovascular abnormalities should be strongly considered in patients with neurodegenerative presentations at atypical ages without a clear cause, as early diagnosis and management can significantly impact patient outcomes. https://thejns.org/doi/10.3171/CASE25684.
Psoriasis is a dermatological disorder whose clinical manifestations have attracted the interest of physicians since ancient times. Hippocrates of Kos in the 5th century B.C. and later Galen in the 1st century A.D. were the first to refer to skin lesions characterized by scales and itching. In the 19th century, dermatology progressed, gaining scientific autonomy and leading to improvements both in the clinical study of psoriasis and in the search for new treatment methodologies. The dermatological schools established in this century, located in London, Paris, and Vienna, dedicated themselves to studying skin diseases, adopting unique methodological approaches, and creating dermatological nomenclature. The English school focused on the objective description of lesions, while the French school was the first to approach the study of evolutionary processes, formulating theories not always based on experimental methods. Finally, the Austrian school based its research entirely on the study of diseases through the use of instruments and laboratory tests. Representatives of all three schools played a crucial role in the scientific progress of dermatology, leading to the subsequent evolution and improvement of therapies, which gradually replaced the use of ancient remedies and archaic administration methods. The treatments promoted by the different 19th-century European dermatologists reflected both their scientific thinking and the medical beliefs of the time. For this reason, the following historical-medical reconstruction of the evolution of psoriasis therapies in the 19th century can contribute to enriching the studies of dermatology.
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.
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract, typically classified as either ulcerative colitis (UC) or Crohn's disease (CD). The treatment approaches for both UC and CD have changed substantially over the last 10 years, going from step-up to top-down approaches and culminating in treat-to-target algorithms. In addition to the evolution of treatment strategies for IBD, disease endpoints have also changed from symptom-based outcomes to more objective measures, including endoscopy, with histology and transmural healing currently under investigation. In this narrative review, we describe recent advances in the treatment of patients with IBD, with a focus on vedolizumab, the first and only anti-lymphocyte trafficking agent approved as a gut-selective biologic for induction and maintenance therapy in IBD. Furthermore, with the approval of more biologic agents, there remains a need to determine the sequence in which biologics should be used, both individually and in combination. Substantial progress has been made in the last decade, and even though biomarkers and algorithmic trials have been largely disappointing, other avenues, such as clinical decision support tools, prognostic tools, and new approaches incorporating computational biology, have the potential to more effectively curate a tailored approach to IBD therapy in the coming years. A decade of progress: how vedolizumab has changed research and medical care for people with inflammatory bowel disease Inflammatory bowel disease, also known as IBD, is a life-long illness caused by inflammation of the gut. This means that the gut becomes swollen and irritated. For reasons we don’t understand, the immune system makes gut inflammation worse over time. In 2014, a medication called vedolizumab was approved for IBD. Vedolizumab works by preventing certain immune cells from reaching the gut, which can help reduce inflammation. This review describes improvements in IBD treatment over the last 10 years, with a focus on vedolizumab. Studies have shown that a person’s symptoms don’t always tell doctors if their IBD is getting better or worse. Instead, experts say that treatments should aim to heal the gut, not just reduce symptoms of IBD. Many studies using vedolizumab have looked at gut healing in people with IBD. Also, many new medications for IBD have become available in the last decade. However, doctors need better guidance on when to use each medication, in what order, and whether they can be used together. Research has looked at how well these medications, including vedolizumab, work and how safe they are. This information can help doctors create better step-by-step treatment plans for people with IBD. Looking to the future, doctors hope to choose medications based on what will work best for each person. This is called precision medicine. To support this, researchers have created a tool that can help doctors predict how well someone will respond to vedolizumab by using details about their medical history. Overall, our understanding of IBD and how to treat it has changed a lot in the last 10 years. Vedolizumab will continue to play an important role in IBD research and patient care.
Quadrigeminal cavernomas are rare midbrain cavernous malformations with potential for recurrent hemorrhage, aqueductal compression, hydrocephalus, brainstem dysfunction, and death. Surgical management is complicated when a developmental venous anomaly (DVA) is associated with the lesion, as injury to this venous drainage can result in brainstem infarction. Therefore, treatment must balance definitive lesion control with meticulous preservation of the DVA. A 26-year-old man presented with an episode of acute headache and was found on magnetic resonance imaging to have a right dorsolateral quadrigeminal cavernoma (9.4 × 9.5 mm), with associated hemorrhage, triventricular hydrocephalus, and a DVA draining into the vein of Galen complex. Endoscopic third ventriculostomy was initially performed to temporize hydrocephalus, and he was discharged without deficit. Five months later, he re-presented with recurrent headache. Repeat imaging demonstrated interval lesion enlargement, rehemorrhage, and recurrent hydrocephalus. An external ventricular drain was placed. Given the patient's young age, recurrent hemorrhage, lesion growth, and ongoing obstructive hydrocephalus, definitive microsurgical resection under neuromonitoring was recommended. A subtemporal approach through the supratrochlear corridor using the lateral mesencephalic safe entry zone was selected to optimize access while preserving the vein of Labbe. Gross-total resection was achieved without neurological deficit, with preservation of the DVA and restoration of aqueductal patency. Quadrigeminal cavernomas with associated DVA require individualized operative planning because the DVA commonly drains into the deep venous system or the vein of Galen complex. In selected patients, the subtemporal supratrochlear route provides effective access for safe resection and minimizes neurological morbidity.
Aims. For a study on the timeline of gout from the Corpus Hippocraticum to the Renaissance, encompassing some 26 authors, we have focussed on a Latin manuscript - "De podagra" - of the Middle Ages (posthumous edition dated to the 7th-8th century AD) of Rufus of Ephesus (98-117 AD), during the reign of Trajan. A multipurpose study has been devised to 1) translate into English and Italian the Medieval Latin treatise of the 7th-8th century AD of Rufus of Ephesus on "De podagra"; 2) define the role of Rufus in the historical timeline of gout from the Corpus Hippocraticum to the Renaissance ; 3) analyze causes, clinical presentations and therapy of acute attacks and chronic gout; and 4) identify the plant-based remedies described therein. Neither an English nor an Italian translation of "De podagra", nor the identification of the plants described therein, has been attempted before. Methods. Plants were identified taking into account methods used for studies on Dioscorides and Galen. Results. The findings highlight the originality of Rufus of Ephesus's clinical approach to therapy and the vast knowledge of diseases treated by plants. Conclusion. Rufus of Ephesus, the third most famous figure in medicine after Hippocrates and Galen, celebrated for his studies in obstetrics, gynecology, pediatrics, and neurology, a gouty physician, left a personal mark in the history of gout by making full use of his clinical skills that had been maximized by the severe apprenticeship in anatomy and in the Corpus Hippocraticum.
This study aimed to determine the association between the incidence of neonatal jaundice and the weight loss of newborns in postnatal days. In this cross-sectional study, 200 infants with jaundice were examined. The required information was obtained from the medical records. In this study, newborns were divided into two groups based on hyperbilirubinemia. Bilirubin level was compared in two groups on the fourth day of referral. Effect of weight loss was determined on hyperbilirubinemia by logistic regression. The study compared 137 healthy neonates with 53 hyperbilirubinemic neonates, finding significantly greater weight loss (0.25±0.18 kg vs. 0.09±0.11 kg, P0.001) and higher bilirubin levels (17.13±1.05 vs. 12.60±1.89 mg/dL, P0.001) in the latter group. Hyperbilirubinemic neonates had younger mothers (27.23±3.26 vs. 28.63±3.21 years, P=0.007), lower nulliparity (60.4% vs. 75.9%, P=0.033), and higher breastfeeding rates (96.2% vs. 18.6%, P0.001). Logistic regression confirmed weight loss as a strong predictor (aOR=2.14×106, P0.001), with ROC analysis showing high diagnostic accuracy (AUC=0.86-0.88). Optimal cutoffs were 0.175 kg (89% sensitivity) and 4.95% weight loss (91% sensitivity). Maternal and neonatal blood groups also influenced risk. Neonates at risk need to be more closely monitored for jaundice and weighting, thus, early detection and timely treatment can be done.
Structural neurovascular lesions (SNVLs)-arteriovenous malformations, cavernous malformations, and vein of Galen aneurysmal malformations, among others-have historically been treated using neurosurgical, radiotherapeutic, and endovascular approaches. However, lesion size, location, and presence of high-risk angioarchitectural features preclude many patients from receiving these treatments. Advances in human genetics and cerebrovascular biology have redefined SNVLs as dynamic, genetically driven lesions where sporadic cases are caused by somatic variants. Intriguingly, many SNVL-causing variants are also oncogenic and active drug targets. These data provide the rationale for a genetically driven taxonomy to guide targeted therapeutic selection. In this commentary, we synthesize efforts toward pharmacologic treatments of SNVLs and highlight how variant-specific or pathway-modulating therapies may be investigated, incorporating key considerations in molecular diagnosis, cerebrovascular biology, and molecular and phenotypic outcome measures, in forthcoming clinical trials. Together, these advances support the investigation of pharmacologic treatment strategies in carefully selected patients with SNVLs.
Artificial intelligence (AI) has emerged as a promising adjunct in surgical pathology, particularly in the diagnosis of prostate cancer, where variability in interpretation or missed cancer foci can significantly affect patient management. This review provides a concise, practice-oriented overview of the two Food and Drug Administration (FDA)-cleared AI tools for prostate biopsy interpretation: Paige Prostate Detect and Ibex Prostate Detect (formerly Galen Second Read). We examine their regulatory indications, diagnostic performance and integration requirements within digital pathology workflows. Emphasis is placed on real-world implementation considerations, including variation in technical inputs and the level at which data are analysed. We highlight less obvious risks, such as domain shift and the potential for inequitable performance in under-represented patient populations. Trade-offs between sensitivity and specificity, particularly in the context of AI-assisted pathologist assessments, are discussed using data from clinical validation studies. We also consider the variable impact of AI tools depending on the user's expertise, noting enhanced diagnostic consistency for general pathologists. By highlighting both the opportunities and limitations of integrating AI into routine practice, we aim to provide pathologists with a pragmatic understanding of how these systems may influence diagnostic workflows and to emphasise that FDA clearance must be complemented by local validation as well as ongoing performance monitoring to ensure safe and equitable deployment.
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.
We observed that some late-term fetal prenatal magnetic resonance imaging (MRI) scans revealed normal brain structures but exhibited diffuse hyperintense signals on T2-weighted imaging (T2WI) in the cerebral white matter (white matter hyperintense signal [WMHS]). Currently, the pathological basis of this phenomenon remains unclear, and few studies have systematically investigated its impact on fetal and postnatal brain development. We aimed to compare the differences in apparent diffusion coefficient (ADC) values across distinct brain regions between fetuses with WMHS and age-matched control fetuses, to explore the potential etiology of WMHS by combining these findings with morphological changes in cerebral veins, and to conduct a comprehensive evaluation combined with clinical follow-up. We retrospectively analyzed fetal imaging data from MRI examinations performed at our hospital between January 2014 and May 2024. A total of 87 late-term fetuses (gestational age [GA]: 29-40 weeks) were identified with diffuse hyperintense signals on T2WI in the cerebral parenchyma; age-matched normal fetuses with the same sample size were enrolled as the control group. We compared differences in ADC values across distinct brain regions among fetuses with WMHS and simultaneously analyzed morphological differences in the deep cerebral veins between the two groups, combined with postnatal clinical follow-up, to explore the impact of WMHS on brain development and its clinical significance in late-term fetuses. (1) ADC values in the majority of brain regions of fetuses in the WMHS group were higher than those in the control group, with the greatest difference observed in the F2 region. (2) Compared with the control group, fetuses in the WMHS group exhibited significantly increased lumen areas of the vein of Galen (VOG) and straight sinus (SS), with a p-value of < 0.05 considered statistically significant. (3) Successful follow-up was achieved in 45 control infants and 36 WMHS cases. All control fetuses showed normal neurodevelopmental outcomes, while 33 infants in the WMHS group had normal and 3 had adverse outcomes, including cerebral palsy, developmental delay, and autism. In late-term fetuses with WMHS, elevated ADC values in specific brain regions and concurrent deep cerebral venous dilation indicate underlying intracranial abnormalities. In addition, our follow-up results indicate that these combined changes may be associated with adverse neurodevelopmental outcomes in some infants.
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.
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.
Traditional medicine, rooted in ancient history, resurged due to concerns over synthetic pharmaceuticals' adverse effects. Persian medicine, emphasizing medicinal plants, aligns with global healthcare recommendations. Both Iranian and Chinese medicine have influenced medical knowledge historically. Patients worldwide value Traditional Chinese Medicine (TCM) for chronic and severe illnesses. This study goal was to conduct a bibliometric analysis of herbal medicine research in Iranian and Chinese CAM clinical trials to identify trends, patterns, and differences in research productivity and impact. This bibliometric study compared Chinese and Iranian CAM clinical trials using Web of Science data. It focused on RCTs, applying search terms for CAM and Chinese or Iranian CAM, with exclusion criteria to filter out irrelevant publications. No limitation was posed on publication time. The dataset included author information, article details, keywords, and citation history. It calculated the Annual Growth Rate (AGR) and used visual tools like the Three-Field Plot to illustrate associations. Additionally, Lotka's Law was applied to author productivity, and a co-citation collaboration network was analyzed using Bibliometrix r package. Key findings for Iranian CAM include 71 documents by 342 authors with an average document age of 3.11 years. Chinese CAM featured 255 documents by 1857 authors with an average document age of 5.75 years. Iranian CAM showed a negative annual growth rate of -18.05%, while Chinese CAM had a positive rate of 5.65%. The included studies for Chinese CAM span from 2004 to 2024, while those for Iranian CAM range from 2015 to 2024. The most cited Iranian CAM document had 66 citations, and in Chinese CAM, "TONG XL, 2012" and "LIU XL, 2019" had the highest total citations. Decentralized research practices were observed in China, while Tehran and Shiraz universities led clinical trials in Iran. Our study indicates differing research trends in Iranian and Chinese herbal medicine. Iranian CAM research showed a declining trend, with Tehran and Shiraz universities leading clinical trials, while Chinese CAM research displayed a growing landscape with a more decentralized approach and greater historical prominence among authors.
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