Journal For International Medical Graduates
OUR AIM If we define our aim in one word, it’s “Service”. Our mission and aim is to serve science, scientific community, students, doctors, patients, & readers by providing correct and accurate scientific evidence-based information. Our goal is to be recognized as the journal that serves people and supports merit and publishes high quality articles with correct and accurate scientific information. We also aim to serve science by providing maximum visibility of articles published in the journal by making them available to all the readers. The JIMG also serves the authors by providing fast speed publication in 30 to 60 days while maintaining diligent peer review process. All articles are submitted online, and peer review is conducted electronically to operate a transparent peer review system for the authors to increase transparency. The reviewer's reports are provided to the authors before publishing. Another aim of JIMG is to provide economical online publication platform for IMGs where many journals charge a handsome fee of thousands of dollars, JIMG publishing fee is nominal under 250 USD to 300 USD per article. We give IMGs the opportunity to not only publish their articles but also join our team of reviewers and editorial board members. JIMG also serves the reviewers by paying reviewers for their service of reviewing articles. We are the first journal according to our knowledge that pays reviewers per article fee for reviewing the article. In a nutshell, JIMG serves all parties involved in the process of writing and publishing. SCOPE The journal targets medical students, doctors, clinicians of all fields, patients, research scientists, and readers worldwide. We equip international medical personnel with the necessary knowledge at the comfort of their homes. JIMG publishes original articles (clinical trials, and observational studies), review articles (traditional reviews, scoping reviews, mapping reviews, systematic reviews, and meta-analysis), letters to the editor, opinion articles, idea article, editorial articles, animal studies, in-vitro studies and all kinds of empirical studies on a broad range of medical topics, including endocrinology, dermatology, cardiology, gastroenterology, nephrology, hematology, hematology, rheumatology, immunology, microbiology, pathology, pediatrics, gynecology and obstetrics, anesthesiology, ophthalmology, psychiatry, general surgery, neurology, and oncology. In a nutshell, the journal is open to all fields related to medicine and healthcare. The journal is the official journal of California Institute Of Behavioral Neurosciences and Psychology and encourages CiBNP students and graduates to submit their articles to the journal. However, the journal is open for clinicians of all field across the globe. The articles whether submitted by the CiBNP students and graduates or non-CiBNP students will be processed on merit and will go through a proper peer-review process. If the reviewers consider the article unacceptable to be published by the JIMG, the article will be rejected. No personal likes and dislikes will be considered while making the decision of publication. The JIMG will follow the journal policies and operations guidelines to decide the fate of the article which is strictly merit based. For any queries and concerns please contact neurocalcibnp@gmail.com In a nutshell, JIMG serves all parties involved in the process of writing and publishing.
California Institute of Behavioral Neurosciences and Psychology
Role of PCSK9 Inhibitors in Contemporary Lipid-Lowering Era: A Systematic Review of LDL-C Reduction, Cardiovascular Outcomes, and Use in Statin-Intolerant and Very-High-Risk Patients
inhibitors have expanded lipid-lowering options for patients who do not achieve low-density lipoprotein cholesterol (LDL-C) targets with standard therapy or who are unable to tolerate statins. Their role in cardiovascular risk reduction continues to evolve as outcome data accumulate and clinical experience grows.
PCSK9 inhibitors, LDL cholesterol, hypercholesterolemia, cardiovascular disease, statin intolerance, lipid management, evolocumab, alirocumab
Copyright (c) 2026 Journal For International Medical Graduates
From Virus to Vessel: Viral Infections and Pulmonary Hypertension — A Systematic Review and Mechanistic Synthesis
Pulmonary hypertension (PH) has been increasingly reported in association with several viral infections, including human immunodeficiency virus (HIV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), herpesviruses, respiratory syncytial virus (RSV), cytomegalovirus (CMV), and hepatitis C virus (HCV). However, the mechanisms linking viral infection to pulmonary vascular disease remain incompletely understood. This study was conducted as a systematic review with mechanistic synthesis in accordance with PRISMA 2020 guidelines. A structured search of PubMed, PubMed Central (PMC), the Cochrane Library, and MDPI was performed for studies published between January 2011 and February 2024. Evidence from observational human studies, animal models, case reports, and mechanistic and narrative reviews was synthesized qualitatively. Study quality was assessed using design-specific appraisal tools. Across diverse viral pathogens, pulmonary hypertension is frequently reported as a recurrent vascular phenotype characterized by immune dysregulation, endothelial injury, thrombo-inflammation, and pulmonary vascular remodeling. However, human evidence is predominantly observational and frequently based on echocardiographic assessment, limiting causal inference. Integrating clinical and experimental findings, this review proposes a stepwise pathophysiological framework linking viral infection to pulmonary hypertension. While the strongest clinical evidence exists for HIV-associated pulmonary hypertension, evidence for other viral infections remains more limited or indirect. These findings suggest a biologically plausible association between viral infection and pulmonary vascular disease while highlighting the need for prospective studies incorporating invasive hemodynamic assessment and longitudinal follow-up. Key methodological limitations include single-reviewer screening and the predominance of observational human studies relying on echocardiographic assessment and heterogeneous diagnostic approaches.
Pulmonary hypertension, viral infections, COVID-19, HIV, endothelial dysfunction, immune dysregulation,pulmonary vascular remodeling
The Role of the Gut Microbiome in Immune Regulation and Autoimmune and Allergic Diseases: Implications of Probiotics, Prebiotics, and Fecal Microbiota Transplantation
Autoimmune and allergic diseases are systemic conditions caused by immune dysregulation, affecting millions globally. Autoimmune disorders, such as rheumatoid arthritis and systemic lupus erythematosus, involve autoreactive lymphocytes attacking host tissues, while allergic diseases like asthma and atopic dermatitis stem from exaggerated immune responses to environmental antigens. Emerging evidence highlights the critical role of the gut microbiome in maintaining immune homeostasis and its dysregulation (dysbiosis) in the pathogenesis of these diseases. This systematic review, adhering to PRISMA 2020 guidelines, examined studies published in the last decade to explore microbiota-mediated immune regulation and the therapeutic potential of probiotics, prebiotics, and fecal microbiota transplantation (FMT). A total of 145 records were identified, with 16 studies meeting inclusion criteria after rigorous screening and quality assessment. Results reveal that dysbiosis, marked by reduced microbial diversity and shifts in bacterial composition, contributes to immune dysfunction and disease progression. Probiotics and prebiotics were shown to enhance regulatory T-cell activity, restore gut barrier integrity, and reduce inflammatory cytokines, while FMT demonstrated efficacy in conditions such as ulcerative colitis and type 1 diabetes, improving clinical outcomes. Despite promising short-term results, challenges including variability in methodologies, accessibility, and long-term safety remain. This review highlights the gut microbiome as a crucial therapeutic target in autoimmune and allergic diseases. Integrating microbiome-based interventions with personalized approaches could revolutionize immune regulation and disease management, paving the way for innovative, accessible, and effective treatment strategies to improve patient outcomes worldwide.
Artificial Intelligence Changing the Surgical Field, Specifically Transplantation: A Systematic Review
Artificial Intelligence (AI) has become one of the trendiest topics around the world. AI has been transforming traditional methods into innovative new approaches in medicine. The main question we want to address in this paper is to see how AI helps surgeons and what challenges AI can present in transplantation. In this study, we reviewed published articles from PubMed, Google Scholar, PMC, MEDLINE, and Cochrane Library. We assessed each paper with our inclusion/exclusion criteria, which included papers published between 2019 and 2024, available as free-text articles, and written in English. We included published papers that talked about adult kidney, liver, and heart transplantation in humans. Any papers that contained only other types of transplantation, like lungs or orthopedic, were not included. We excluded papers that included pediatric or animal studies. We used 12 articles to finalize this systematic review. We used the MeSH terminology ("Artificial Intelligence"[MeSH]) AND ("Transplantation/adverse effects"[MeSH] OR “Transplantation/methods"[MeSH]), and the keywords were “Artificial Intelligence, Machine learning, Deep learning, Transplant Surgery, Artificial Neural Networks, and Transplantation”. The systematic reviews will discuss the potential benefits of decision-making and pre-operative or post-operative management, taking into consideration that further studies are needed to finalize conclusions on the effectiveness of AI in the surgical field, as this is a relatively
Atypical First-Episode Psychosis With Prolonged Catatonia and Neuroleptic Malignant Syndrome: Diagnostic Challenges and Improvement With Clozapine: A Case Report and Literature Review
Schizophrenia is a long-term mental illness that usually shows typical positive symptoms, but some patients have unusual symptoms that make diagnosis and treatment difficult. Catatonia and neuroleptic malignant syndrome (NMS) can occur in schizophrenia, yet atypical early-onset cases are not well described. This case explores the first episode of atypical psychosis with prolonged catatonia and NMS, focusing on diagnostic challenges and response to clozapine. This case report describes a 24-year-old Hispanic male, admitted with unclear depression, suicidal thoughts, disorganized behavior, and unclear psychosis, without hallucinations or delusions. Later developed prolonged catatonia overlapped with NMS following treatment with antipsychotics. Extensive medical, neurologic, autoimmune, and infectious evaluations were negative. Multiple treatments, including benzodiazepines and several antipsychotics, resulted in minimal improvement. After failure of standard treatments for five months, clozapine was started and slowly increased, following guidelines. The patient showed marked improvement, including improved speech, behavior, affect, and participation in therapy. No significant adverse effects were reported.
Book Review: Leadership Pearls for Healthcare, Edited by Ralph Junckerstorff and Sarah Baqar (Springer)
Leadership in healthcare is a subject that needs to be addressed in detail not only because we need leaders in all aspects of healthcare but also because it is not taught in the regular medical school conventional curriculum. Leadership within healthcare has evolved into a discipline that cannot be ignored because, to be a leader, one must have empathy, emotional intelligence, authenticity, and ethical integrity. In this context, the recent book by Springer, Leadership Pearls for Healthcare, edited by Ralph Junckerstorff and Sarah Baqar, emerges as an outstanding and timely contribution to the field of healthcare, addressing what effective leadership looks like in today’s clinical practice. The book is organized into eight thematic parts, which provide diverse wisdom on leadership principles drawn from hypothetical case studies, real-life examples, and evidence-based information. The editors, both seasoned professionals in healthcare leadership, formulated an extensive list of chapters that aim to translate theory into practice and knowledge into application.
Advancements in Sickle Cell Disease Treatment: A Review of Crizanlizumab
Sickle cell disease (SCD) is a chronic, inherited blood disorder marked by the presence of abnormal hemoglobin, which causes red blood cells to assume a rigid, sickle-like shape. These distorted cells contribute to hemolysis, impaired blood flow, and recurrent vaso-occlusive crises (VOCs), the hallmark and most debilitating complication of the disease. Beyond acute pain episodes, Sickle cell disease leads to progressive organ damage and reduced life expectancy, placing a substantial burden on patients and healthcare systems worldwide. While supportive care has long been the cornerstone of management, the emergence of targeted therapies offers new hope. Crizanlizumab, a humanized monoclonal antibody directed against P-selectin, disrupts the cellular adhesion processes that drive vaso-occlusive crises. This review highlights the pathophysiology of Sickle cell disease, details the mechanism of action of crizanlizumab, and evaluates clinical trial evidence regarding its efficacy, safety, and therapeutic potential. Collectively, the findings underscore crizanlizumab’s promise as a transformative therapy that can reduce VOC frequency and improve quality of life for individuals living with SCD.
Visa-Related Barriers for International Medical Graduates How Immigration Policies Derail Medical Careers
International Medical Graduates (IMGs) make up a large portion of the physician workforce in the United States, Canada, and the United Kingdom, particularly in rural and underserved communities. Despite their critical role and essential contributions, IMGs face significant barriers to their entry and practice, including visa delays, restrictive policies, and travel bans. These barriers not only affect physicians by disrupting their professional development but also the healthcare systems that rely on them, exacerbating the physician shortages, ultimately undermining healthcare access. This article sheds light on visa-related issues and how bureaucracy disrupts professional development, separates families, and compounds the worsening healthcare crisis. To address these concerns, this article proposes solutions such as the creation of a trilateral visa encompassing the US, Canada, and the UK. This would streamline application processing, prioritize family reunification, and place residency authorization directly in the hands of the training program or hospital involved. By doing this and removing immigrationrelated barriers, qualified IMGs could begin their training alongside their peers, without delays, combating the physician shortage, and strengthening healthcare systems.
Copyright (c) 2025 Journal For International Medical Graduates
Will Artificial Intelligence Replace Medical Doctors? A Question That Will Be Answered in a Few Decades. A Commentary Article.
Artificial intelligence (AI) is increasingly integrated into healthcare with applications in diagnostic imaging, robotic surgery, and predictive analytics [1,2]. Advances in deep learning and large language models have accelerated AI’s adoption across multiple specialties and care settings. For example, these models may reduce healthcare costs by identifying patients suitable for recommended chemotherapy [3]. In chronic disease management, language models have been applied to support mood regulation, smoking cessation, diabetes management, and asthma [4]. Given these advancements, concerns have emerged among clinicians and patients that AI may replace physicians. This commentary argues that although AI has transformed many aspects of healthcare, it is unlikely to replace physicians. Instead, AI will serve as a complementary tool that enhances physician expertise. The discussion will examine the benefits of artificial intelligence in the healthcare system, its limitations, and the ethical concerns that should guide its use.
Diagnostic imaging & predictive analytics
Social Media in Dermatology: Shaping Clinical Practice, Public Awareness, and Patient Engagement.
Social media has become an integral part of modern dermatology, with platforms such as Instagram, Facebook, YouTube, and Snapchat providing dermatologists with opportunities to popularize their practice, educate the public, and promote healthy skin care practices. However, this also raises concerns about misinformation, self-diagnosis, and privacy infringement. The increasing influence of skincare influencers and non-medical, unqualified content creators has led to the rapid circulation of misleading information, impacting patient decision-making, undermining professional medical advice, and promoting unnecessary treatments. Additionally, privacy concerns arise from sharing patient images and treatment results without proper consent. To maximize the benefits while mitigating risks, healthcare professionals must emphasize ethical practices, advocate for accurate information, and adhere to medical guidelines. Individuals must verify the sources of information before following advice related to skincare and dermatological treatments. Influencers, particularly those without medical expertise, are responsible for sharing evidence-based information while disclosing sponsorships or affiliations. A collective effort is essential to ensure that social media remains a reliable and responsible platform for dermatological education and awareness.
A New Approach to Symptom Relief in Atopic Dermatitis: The Role of Upadacitinib
Atopic dermatitis (AD) is a common, chronic inflammatory disease that affects millions of individuals worldwide. It is characterized by intense itching, recurrent eczematous lesions, and a relapsing-remitting course, all of which significantly impair quality of life. Conventional treatments, including topical corticosteroids, calcineurin inhibitors, and systemic immunosuppressants, often provide only partial relief or carry risks of adverse effects with prolonged use. The limited efficacy and safety concerns associated with existing therapies have driven interest in targeted approaches that address the underlying immune dysregulation. One such strategy involves inhibition of the Janus kinase (JAK)–signal transducer and activator of transcription (STAT) pathway, which plays a key role in transmitting inflammatory cytokine signals involved in AD pathogenesis. Upadacitinib, a selective JAK1 inhibitor initially approved for immune-mediated conditions such as rheumatoid arthritis and inflammatory bowel disease, has recently gained approval for moderate-to-severe AD, representing a promising addition to the list of current treatment options.
Hereditary Hemochromatosis and Exacerbation of Psychiatric Manifestations Following Therapeutic Phlebotomy Sessions: A Case Report
Background: Hereditary hemochromatosis, characterized by iron overload, is well known for its systemic effects; however, psychiatric clinical manifestations are underreported. Previous research articles discussed the link between excessive iron accumulation and mood disorders that were resolved following therapeutic phlebotomy treatment. In this case study, we presented a unique case that revealed the emergence of mood disorders following phlebotomy sessions. Our aim is to explore the relationship between them. This case report describes a 24-year-old Caucasian male who was admitted to the hospital with severe depression and suicidal ideations along with poor insight and tangential thought process following a financial trauma. He was diagnosed with a Major Depressive Disorder based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V). The patient reported a diagnosis of hereditary hemochromatosis in 2023 and has received two phlebotomy treatments since then. After the second phlebotomy session, he experienced worsening depressive symptoms (passive suicidal ideations); his blood tests revealed normal iron and ferritin levels on the 5th day of admission. He had been taking Escitalopram and Lamotrigine over the past six months. Methods: We developed and searched keywords in multiple databases (PubMed, Google Scholar, etc.) after obtaining informed written consent from the patient. We then reviewed the literature thoroughly to identify cases of psychiatric exacerbation associated with hemochromatosis and phlebotomy. Results: Our case report highlights a possible linkage between phlebotomy sessions for hemochromatosis and worsening depressive symptoms despite iron normalization. Conclusion: This study stresses the need for routine mental health screening and iron profile checking following phlebotomy sessions and a multidisciplinary approach. Background: In hemochromatosis, iron accumulates excessively in many organs, such as the liver, pancreas, heart, and joints, and rarely in the brain, leading to neuropsychiatric manifestations such as anxiety, depression, mood swings, autism, and movement disorders [1, 2, 3, 4, 5, 6, 7]. Iron dysregulation can result in mood disorders, psychosis, anxiety, and neurodevelopmental problems [8]. A study showed an increased risk of psychiatric manifestations in patients with hemochromatosis, with a prevalence of 79% and 65% for depression and anxiety, respectively [9]. Although patients with hemochromatosis show a higher incidence of mental illness, specific psychiatric disorders that significantly impact quality of life are rarely reported [3, 7, 10]. Over one billion people globally are living with a mental disorder, causing increased disability and premature mortality [11]. Previous existing studies have reviewed iron dysregulation on brain function; however, the correlation between hemochromatosis with or without therapeutic phlebotomy and manifestations of psychiatric disorders still requires further research to understand better [7, 8, 12]. In this case report, we aim to explore the link between hemochromatosis and increased psychiatric manifestations following successive therapeutic phlebotomies.
Efficacy of Negative Pressure Wound Therapy on Management of Surgical Site Infections: A Systematic Review of Randomized Clinical Trials
Surgical site infections (SSIs) are common postoperative complications that typically develop within 30 days of surgery. Negative Pressure Wound Therapy (NPWT) has gained prominence because of its potential to reduce dressing changes and enhance wound care outcomes. This systematic review evaluated the efficacy of NPWT in managing SSIs based on evidence from randomised controlled trials (RCTs). A systematic review was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were sourced from Google Scholar, PubMed, and PMC using specific search terms related to NPWT and SSIs. Articles were evaluated for quality using the Cochrane appraisal to ensure a comprehensive and bias-free review. Our literature review provided us with 18,199 articles, and upon removing duplicates and irrelevant articles, 409 papers remained, which were then screened based on title, abstract, and full-length texts. Finally, 16 articles were considered; two were unavailable, four failed the critical appraisal, and two needed to meet the criteria for further evaluation. Consequently, eight studies, all of which were randomised controlled trials with a total of 1,196 patients, remained. This study involved adult males and females who underwent negative pressure wound therapy for various arthroplasties and diabetic foot ulcers. NPWT was compared to traditional dressings, and the outcomes measured were infections, epithelialisation time, hospital stay, blisters, seromas, wound complications, and amputations, with significance set at p < 0.05. NPWT showed significant benefits over traditional dressings, including reduced SSIs and fewer dressing changes. This offers a promising approach to enhancing wound management. However, given the limited research available, further research is needed to provide conclusive evidence across all surgical types and patient populations.
Copyright (c) 2024 Journal For International Medical Graduates
Addressing the Challenges Faced by International Medical Graduates in the UK: A Call for Action
I am writing to highlight the significant challenges faced by International Medical Graduates (IMGs) in the UK, as evidenced by recent studies, and to propose actionable solutions to support their integration into the National Health Service (NHS). IMGs constitute approximately 25% of the UK medical workforce, yet they face numerous barriers that hinder their professional and personal well-being. These challenges, if unaddressed, risk exacerbating the ongoing workforce crisis in the NHS.
Differentiating Allergic and Irritant Contact Dermatitis Based on Histopathology: Overview
Differentiating Allergic Contact Dermatitis(ACD) from Irritant Contact Dermatitis (ICD) has posed a significant challenge for dermatologists, allergists, and histopathologists. Over the years, many studies have been conducted to determine whether ACD can be differentiated from ICD based on histopathology findings. A clear-cut distinction based on histopathology will facilitate the diagnosis and appropriate management of both conditions. Abbreviations: CD, Contact Dermatitis; ACD, allergic contact dermatitis; ICD, irritant contact dermatitis Objective: This review summarizes the existing literature on whether and how ACD can be differentiated from ICD based on histopathology findings. Methods: Pubmed, Embase, Web of Science, Scopus, Cochrane Library, and Google Scholar were searched from inception to August 23, 2024, for primary literature reporting on histopathology findings in ACD and ICD. We used the search words: contact dermatitis, allergic contact dermatitis, irritant contact dermatitis, histopathology, histology, biopsy, light microscopy, diagnosis. Conclusions: Although the difference between ACD and ICD has been extensively studied over the past years, the research still needs to be more conclusive in categorically differentiating the two. Further research on the comparative histopathology of ACD vs ICD will enhance our understanding and ability to accurately distinguish. In addition, many chemicals possess both irritant and allergic properties, which might be the reason for the overlap. Moreover, the studies conducted up till now have only tested patients with one dosage of chemicals. Using a range of low, medium, and high doses might aid in eliciting better and more conclusive findings.
Beyond Clinical Skills: Why Personal Development Is Essential for Modern Physicians
People normally put a high value on education almost all over the world.We go to school all through out our childhood,then for physicians it means complete undergraduate and medical degrees as well as residency to be able to do what you want.However, some people stop actively seeking to learn ,develop,and grow different areas of their growth or lives and interests when they graduate and move into workforce this is not uncommon to see.Personal development is not limited to the coaching industry or business professionals; it is a crucial discipline for all individuals across every field, including medicine. While medical doctors acquire extensive knowledge in medicine during their university education, personal development remains largely overlooked in academic curricula worldwide. However, through consistent, daily improvements, doctors can significantly enhance both their personal lives and professional careers within just a few years. This article highlights key areas of personal development that young doctors should prioritize to foster growth and success. Our aim is to raise awareness among medical professionals about the importance of integrating personal and professional growth strategies into their lives. We advocate for medical schools to make personal development a mandatory part of curriculums, ensuring that future doctors are equipped with the skills necessary for holistic success.
Aspirin Versus Enoxaparin for Deep Vein Thrombosis Prevention After Orthopedic Surgery: A Review of Efficacy and Safety
Deep vein thrombosis (DVT) is a significant complication following orthopedic surgery. This review evaluates the comparative efficacy and safety of aspirin and enoxaparin for DVT prophylaxis in this patient population. A comprehensive literature search identified relevant randomized controlled trials (RCTs), retrospective studies, and systematic reviews with meta-analyses comparing these two medications. The findings regarding aspirin's efficacy compared to enoxaparin are mixed. While some studies suggest comparable effectiveness in preventing DVT, others indicate a potential advantage for enoxaparin. However, aspirin offers advantages in terms of ease of administration (oral medication), potentially lower bleeding risk, and potentially improved patient satisfaction and adherence. Drawing definitive conclusions is limited by heterogeneity among the included studies. Variations in patient populations, surgical procedures, and follow-up durations hinder a more conclusive comparison. Additionally, the potential for bias in some studies necessitates a cautious interpretation of the results. This review also has limitations, as it does not explicitly appraise the methodological quality of each included study. Despite these limitations, aspirin emerges as a potentially viable alternative, and perhaps even an excellent option, for DVT prophylaxis after orthopedic surgery in specific scenarios. However, limitations within the current evidence necessitate further research with standardized protocols and rigorous methodological evaluation. Individualized approaches that consider patient-specific risk factors and surgical procedures are crucial. If future research confirms aspirin's efficacy and safety profile, its ease of use and potential benefits could lead to it becoming a preferred option for DVT prophylaxis.
Effectiveness of a Ketogenic Diet in Children With Refractory Epilepsy: A Systemic Review
A notable proportion (10%-20%) of children with epilepsy remain unresponsive to pharmacological treatment. Current strategies for the management of refractory epilepsy encompass surgical treatments (vagus nerve stimulation) as well as the adoption of a Ketogenic Diet. By adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review to identify all relevant studies in English language that investigated the effectiveness of a Ketogenic diet in children with refractory epilepsy. A total of 125 studies were identified and eight, involving a total of 1330 patients, met the criteria. Of the identified eight studies, one was randomized controlled trial, one was systematic review/meta-analysis, and the rest were observational studies. More than half (54%) of the participants reported seizure resolution, while 17% became seizure-free after one month of initiating the ketogenic diet. Ketogenic diet have been shown to be efficacious for the treatment of epilepsy in infants.
American Psychological Association (APA) Ethics Code and California Laws and Licensing Requirements to Be a Psychologist
In this short article, I will cover the summary of the American Psychological Association (APA) ethics code and the licensing requirements to become a psychologist in the state of California for international medical graduates (IMGs) planning to be licensed in California. Each state can have different requirements, so IMGs should refer to their respective state psychology boards for specific licensing requirements.
Abraham Maslow’s Legacy: A Personal Exploration of Hierarchy
Whenever the history of psychology is written and the names of the most influential psychologists are discussed, Abraham Maslow will always be on the list. He is known as one of the pioneers of humanistic psychology, and his theory of motivation is renowned worldwide. The hierarchy of needs proposed by Maslow outlines human needs, suggesting that to fulfill higher needs such as self-esteem and self-actualization, the basic needs (called deficiency needs) must first be met. Maslow had a troubled childhood, and he may have used the emotional pain he experienced as a child to achieve great things in his life. It is possible that his own life experiences led to the formulation of his remarkable theory of motivation, which has not only helped me personally in achieving career success but has also benefited numerous people over the years and continues to do so. In this article, I will discuss Maslow’s life and his theory of motivation, and I will also address how this theory has influenced my life and career.
Comparison of Endotracheal Tube (ETT) and Laryngeal Mask Airway (LMA) in Pediatric Anesthesia: A Systematic Review
The present systematic review compares the effects of the laryngeal mask airway (LMA) and the endotracheal tube (ETT) on hemodynamic response and airway difficulties in pediatric anesthesia patients. The terms "children," "postoperative," "pediatrics," "laryngeal mask airway," "endotracheal tube," and "subglottic" were utilized. The scope of the literature review was limited to randomized controlled trials (RCTs), and PubMed, Google Scholar, and the Cochrane Library were among the databases searched. Two reviewers used the Cochrane Risk of Bias Tool to assess quality. Eight RCTs in total were included. When compared to the ETT, results showed that the number of attempts for endotracheal intubation was fewer than for the placement of the LMA. Additionally, there was an increase in blood pressure, heart rate, and mean arterial pressure with the use of the ETT. The incidence of postoperative respiratory complications, including laryngospasm, bronchospasm, and sore throat, was higher with the use of the ETT. We conclude that the use of the LMA can be a safe alternative to the ETT in pediatric patients, producing fewer hemodynamic changes and postoperative complications.
Can Targeted Interventions Aimed at Improving Mental Health and Reducing Symptoms of Depression in Hypertensive Patients, Lead to Increased Medication Compliance and Improved Longevity? A Systematic Review
Background: Hypertension is identified as a chronic disease leading to complications and untimely deaths if left untreated or undiagnosed. There are several factors that contribute to the worsening of hypertension either directly or indirectly. Medication noncompliance is one of the direct factors. Depression plays a significant role as an indirect factor which convolutes management goals in hypertension. Correlation of mental health and adherence to medication requires further exploration. Method: Medical databases such as PubMed, Cochrane library, Science direct were searched for relevant literature ranging between May 2013 and May 2023. The literature found was screened, checked for eligibility and 10 papers were reviewed. This was done using the Preferred Reporting Items for Systemic Review and Meta-analysis (PRISMA) guidelines. The finalized papers investigated the relationship between mental health/ depression and antihypertensive compliance. Improvement in mental health led to reduced blood pressure which was associated with better medication compliance. Result: The analysis encompassed 10 research papers involving a total of 12,121 patients, excluding 542 individuals who had concurrent chronic conditions. One of the studies had other chronic diseases in addition to hypertension in it. Among these papers, one included patient with additional morbidity alongside hypertension. The studies hailed from diverse locations including Nigeria, Palestine, China, and the USA, with a notable proportion of patients being of Chinese origin. This predominance of Chinese patients reflects the abundance of relevant studies conducted in China on the subject matter. Conclusion: The studies showed a significant improvement in blood pressure control with depression management. In the studies, other contributing factors to medication compliance were found and incorporated into this systematic review. Different methods were used to measure depression and medication compliance across the studies. All this warrant further research into the topic and how solutions can be implemented globally.
Sensitizing International Medical Graduates to Identify Narcissist Personaliy Disorder
Narcissistic personality disorder is a complex personality disorder that was first conceptualized by Sigmund Freud in 1914.Narcissistic personality disorder is characterized by a persistent sense of self-importance, grandiosity, and admiration of oneself.
Therapeutics Uses of Psychedelics in Patients With Psychiatric Disorders a Systematic Review
The impact of psychedelic treatment on patients suffering from psychiatric diseases like depression, anxiety, post-traumatic psychiatric disorder (PTSD), and existential distress related to cancer has become very intriguing to psychiatrists in the modern era. Serotonergic psychedelics include Lysergic acid diethylamide (LSD), psilocybin, mescaline, ayahuasca, and methylene-deoxy methamphetamine (MDMA) which act agonistically on 5-hydroxytryptamine type 2-A (5-HT2A) receptors. Psychedelics produce a wide range of effects, based on varying sites of 5-HT2a receptors, including changes in consciousness, perception, mood, and behaviour. Psychedelics can lead to both good and bad trips depending on the dose and environment in which it is taken. We used systematic approach by strictly following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines. Data is extracted from pub med using mesh strategy, and from google scholar and science direct by using keywords. 10 review articles are selected by using quality appraisal tools. The purpose of this paper is to highlight the mechanism of action and role of psychedelics in patients with mental health disorders. In this review, we discussed the effective models of neurodynamical changes produced by psychedelics, and we also show that these substances can be used as a potential treatment option for psychiatric patients. Psychedelics have shown effective improvement in psychiatric diseases in many pilot studies and randomized controlled trials. There is still a debate going on about which models best suggest their role in the field of psychiatry.
Psychedelic/ Psychotropic drugs/ Hallucinogen
Impact of Pharmacogenomics Testing on Response to Antidepressants and Antipsychotics – A Systematic Review
Introduction: With the sequencing of the human genome and the subsequent revelation of the genetic structures underlying many complex illnesses and responses to many treatments, precision medicine has emerged as a new player in the healthcare setting. We aimed to assess the Impact of pharmacogenomics testing on response to Antidepressants and Antipsychotics. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in this systematic review. This systematic review identified PubMed, PMC, and Medical Literature Analysis and Retrieval System Online (MEDLINE), Supplementation of the available articles for the review was done using Google Scholar and Research Gate. Results: Ten study articles were included after analyzing 12408 papers. These studies were gathered by searching through Mesh advanced search strategy and regular keywords with Boolean search strategy through multiple databases. The next step was screening the titles, and abstracts and only 166 papers passed through the full-text screening according to the inclusion and exclusion criteria. The quality of the included 166 studies was assessed using the Cochrane risk of bias tool for randomized trials. Finally, ten studies resulted from the qualitative synthesis and were included in this systematic review. Conclusion: combinatorial pharmacogenomics testing has the potential to be a useful tool in directing the treatment of depression in different age cohorts. In addition, it has a role in response improvement among patients with previous antidepressant failure.
predictive medicine and Antidepressant Drug
Accuracyof Ultrasound and CT Scans in the Diagnosis of Acute Appendicitis in Children: A Systematic Review
Acute appendicitis (AA) is the most common surgical emergency in childhood. Accurate and early diagnosis is important because any delay in diagnosis may lead to perforation or abscess formation. Today, abdominal ultrasonography (US) and computed tomography (CT) scans are the most common imaging methods used for diagnosis. The aim of this study was to evaluate the accuracy of US and CT scans in the diagnosis of AA in children. We started our research by using online libraries as our database. We searched PubMed, Google Scholar, the Cochrane Library, and the Web of Science for our data collection. We used both the medical subject headings (MESH) and regular keywords. Our review investigated English-language articles regarding the accuracy of US and CT scans in the diagnosis of AA in children (2013-2023) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Articles were screened by title, abstract, inclusion and exclusion criteria, and quality assessment tools. The search identified 513 studies; eight were eligible for inclusion in the analysis. A total of 3341 pediatric patients were included across the eight observational studies in our systematic reviews. The included articles revealed that low-dose CT showed the highest accuracy in the diagnosis of AA. Whereas the US showed the lowest. However, the combination of US as the primary examination followed by CT in a non-diagnostic US yielded the highest sensitivity, specificity, and accuracy. Also, some studies revealed that several factors decreased the sensitivity of CT and US in diagnosing AA in children, like different hospital settings, the radiologist's experience, age, sex, body mass index, and disease severity. According to the review articles, a CT scan is the most accurate test and has high sensitivity and specificity; however, the radiation hazards are minimized using a CT scan as a primary tool for diagnosis. US is easily accessible, cost-effective, and has high sensitivity. However, it is operator-dependent, has low specificity, and is incompatible with some young children, so it can be used as a first-choice and low-dose CT scan in complicated cases and non-diagnostic US. Ideally, more randomized clinical trials are also required.
Comparing Endoscopy and Surgery: A Systematic Review of Early Colorectal Cancer Treatments
Colorectal cancer is a major type of gastrointestinal cancer that significantly contributes to disease burden and mortality, particularly among younger people. Early colorectal cancer refers to the early stages of the disease that require early detection and treatment to improve the overall prognosis and survival. There are various treatment options available for early colorectal cancer, such as endoscopic resection, including methods like transanal endoscopic microsurgery (TEMS), endoscopic mucosal resection (EMR), or submucosal dissection (ESD), as well as surgical resection, including open and laparoscopic techniques. However, to make informed decisions about which approach is best, it is crucial to thoroughly understand the long-term outcomes associated with each option. We systematically reviewed the PubMed and Google Scholar databases from 2013 to August 11, 2023, to obtain such knowledge. We selected nine for in-depth analysis after carefully reviewing 2761 articles, including those written in English and focusing on human studies. The review focused on individual benefits, merits, and drawbacks, considering the extent of the disease, clinical outcomes, survival, and complication rates. Although endoscopic resection has the advantage of being less invasive and promoting faster patient recovery, it should be noted that its primary objective may not necessarily be achieving complete excision (R0). This is because there are potential obstacles, including inadequate lymph node removal and inaccurate T staging that may prevent the achievement of R0. Nevertheless, it is important to stress that both endoscopic and surgical resection ultimately share the goal of complete excision and curing the patient. Finally, this systematic review emphasizes the need for additional research to fill knowledge gaps, improve clinical decision-making, and promote the application of sophisticated technology. As the landscape of early colorectal cancer treatment evolves, a balanced integration of endoscopic and surgical resection procedures, together with emerging technologies, can improve patient outcomes and increase treatment efficacy.
Role of Proprotein Convertase Subtilisin Kexin Type 9 Inhibitor Therapy in Treatment of Patients With Polycystic Ovary Syndrome: A Systemic Review of Metabolic and Cardiovascular Outcomes
Polycystic Ovary Syndrome (PCOS) is a common endocrine condition that affects both obese and non-obese women of reproductive age group. Its clinical presentation is dysmenorrhea, hirsutism, acne, metabolic complications, infertility, and polycystic ovaries. The study is aimed to assess the efficacy of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors to lower dyslipidemia in women with PCOS to prevent long term cardio-metabolic complications. PCSK 9 Inhibitors ( Alirocumab, Evolocumab, and Inclisiran) bind to LDL receptors in liver and lower LDL-C levels, preventing long term adverse side effects. This review aims at showing that these drugs can be effective when prescribed to women with PCOS early-on to prevent some serious cardiovascular and metabolic complications in the long run. In terms of medical therapy, most physicians prescribe Metformin and Statins as first line agents to control risk factors. But much of the research supported the use of PCSK 9 Inhibitors early in the disease process or as an add-on to statins for controlling the lipid profile. When compared to Statins, the control rates of PCSK 9 Inhibitors were equal or superior and they showed additive effect when given along with other lipid lowering agents. Studies showed these drugs have only minor side effects and have good tolerability profile. They do not have severe side effects as compared to statins or fibrates.
Critical Consiousness for International Medical Graduates
Critical consciousness is an intellectual framework that is promoted in medical education. It helps to raise reflective awareness of professional power in healthcare. Moral virtues such as politeness and honesty are important to cultivate. The field of medicine plays a vital role in improving the quality of life and enhancing the physical and intellectual performance of human beings.
Emerging Trends & Techniques Related to Treatment in Patients With Intra – Conal Cavernous Hemangioma of the Orbit(OCH)/Orbital Cavernous Malformation (OCVM) and Treatment Related Complications, a Systematic Review
Orbital Cavernous venous malformation (OCVM), formerly known as cavernous hemangioma of the orbit (OCH) is a frequent benign, slow-growing, non-distensible venous malformation with ISSVA classification which classifies it into different types. This research has employed randomized controlled trials (RCTs), case reports, retrospective case studies, systematic reviews, and cohort studies to evaluate the treatment choices for OCVM and its consequences. The goal of this review is to analyze the comprehensive therapies used for OCVM. For our literature search, we looked at PubMed/MEDLINE, PubMed Central and Cochrane across six years (from 2016 to 2021). Using the Cochrane risk of bias quality assessment tool, the found studies underwent a quality check (modified Cochrane RoB 2). For the reporting of this systematic review, we adopted preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria and included a total of 10 papers. The majority of research confirmed the accuracy of OCVM detection using MRI and CT. To evaluate the effects of the intervention on OCVM more precisely, more trials with a longer follow-up time are needed. This study will explore recommendations and guide orbital surgeons, regardless. It will aid in the development of future strategies involving both invasive and noninvasive procedures to close the surgical and complication gap.
Copyright (c) 2023 Journal For International Medical Graduates