The Journal of Medicine, Law & Public Health

Laser-Induced Thermal Therapy in the Management of Low-Grade Gliomas: A Narrative Review

2024-12-03T08:57:01-08:00

Background:

Low-grade gliomas (LGGs) are slow-growing, World Health Organization Grade I and II tumors that can transform into more aggres-sive malignancies over time. This transformation pre- sents significant challenges in managing the burden of health care. Laser-induced thermal therapy (LITT) has emerged as a promising minimally invasive treat-ment option for LGGs, offering precise tumor ablation with minimal damage to surrounding tissues.

Method:

This narrative review synthesizes data from relevant studies on the evolution, clinical manifestations, mo-lecular characteristics, and emerging management strategies for LGGs, with a focus on the role of LITT.

Results:

LITT, a minimally invasive technique, offers targeted tumor ablation with the added benefit of disrupting the blood-brain barrier to enhance drug delivery. Studies have shown that LITT can effectively reduce tumor size and improve survival rates in patients with both primary and recurrent gliomas. However, challenges such as procedure-related complications, including motor deficits and cerebral edema, as well as the need for further research on long-term efficacy, remain.

Conclusion:

LITT represents a significant advancement in the treatment of LGGs, combining precision and minimal invasiveness. Future studies should focus on optimiz-ing protocols, integrating molecular and genetic in-sights, and assessing long-term outcomes to enhance therapeutic efficacy and patient quality of life.

Psychological Safety in Saudi Arabian Healthcare: A Scoping Review

2024-09-26T21:25:06-07:00

Background: Psychological safety arises from the knowledge that one will not be penalised for speaking one’s mind, sharing concerns, or admitting mistakes. There is a dearth of studies in the Saudi Arabian context on the subject of mindfulness-based interventions to improve psychological safety in the workplace.
Objectives: This study aims to investigate psychological safety in the Saudi Arabian healthcare sector, with the goal of promoting mindfulness-based interventions for healthcare workers. Presently, there are no formal training programs in Saudi Arabia for the healthcare workforce; essentially, the concept of mindfulness-based organisational education has yet to reach the attention of human resource managers in this sector. Our aim, therefore, is to raise awareness of the potential for novel intervention programs to improve psychological safety.
Methods: The review follows the Arksey and O'Malley (2005) method, using the Preferred Reporting Items for Systematic Reviews. The aim of a scoping review is to detect potential research gaps. Presently, mindfulness-based programs relating to psychological safety are under-researched in the Saudi Arabian context, and a scoping review is a preliminary requirement before a formal systematic review is conducted.
Results: Our findings indicate that healthcare workers do perceive barriers to psychological safety in the workplace, suggesting a need for training interventions that may help improve this situation.
Conclusion: Saudi Arabian healthcare settings require further interventions, in line with Saudi Vision 2030, to improve workplace effectiveness and increase psychological safety among healthcare workers.

Effects of Bans on Prostitution on Prevalence of Induced Abortions

2024-11-14T05:44:09-08:00

Background: Prostitutes are at high risk of unintended pregnancy, and induced abortions are widely practised among this cohort.
Aims: This study examined the effects of prostitution bans on the prevalence of induced abortions. We focused particularly on the bans on juvenile prostitution, which were introduced by 32 states of Japan between 1975 and 1998.
Methods: This was a cross-sectional study employing event-study analyses and a difference-in-difference-in-differences methodology. We compared the changes in numbers of induced abortions before and after the bans were introduced, among women under 20 years of age and among those aged 20―24 years, over states.
Results: The number of induced abortions among women under 20 years of age increased after the juvenile prostitution bans were implemented. In the fifth year of implementation, the number increased by 56.79 percentage points (p < 0.001) compared with the previous year.
Conclusion: The number of induced abortions among adolescents increased after juvenile prostitution was banned. As to its mechanism, the outcomes of our additional identification suggest that former juvenile prostitutes who retired due to the bans contributed to the increase.

Health-Harming Legal Needs Identified by People with HIV

2024-10-16T08:08:23-07:00

Introduction: People with HIV (PWH) often face health-harming legal needs that impede access to and retention in HIV care. The Organizational Partnerships for Healthy Living (OPAHL) intervention addresses these gaps by integrating legal services with health care.

Methods: This mixed-methods study was conducted at two health centers in Philadelphia, PA, from October 20, 2022 through 2024. The trial aims to: (1) refine the OPAHL intervention prototype for PWH with detectable viral loads; and (2) test the feasibility, acceptability, and preliminary effects of OPAHL, which includes (a) comprehensive partner training; (b) screening for legal concerns; and (c) access to legal services. Key legal concerns were identified from 111 participants through quantitative and qualitative analyses of patient-reported responses and attorney case summaries.

Results: Major findings from the preliminary dataset reflect distinct categories of legal concerns reported by participants, including Personal/Advanced Care Planning (n = 50), Other Legal Concerns (n = 26), Unsafe Housing/Repairs (n = 23), and Eviction or Threat of Losing Home (n = 15).

Conclusions: Findings highlight the diverse and complex legal concerns impacting PWH, particularly in relation to personal and housing-related planning. Understanding and addressing these challenges is crucial for developing targeted interventions to strengthen the HIV care continuum.

Perioperative Management of Patient with Systemic Mastocytosis Going for Total Thyroidectomy

2024-12-18T09:48:00-08:00

Systemic mastocytosis (SM) is a rare disorder affecting 1 in 10,000 individuals, characterised by abnormal mast cell proliferation in extra-cutaneous organs, resulting in a variety of presentations ranging from mild asymptomatic disease to life-threatening tissue-destructive disease. Severe anaphylaxis caused by the release of histamine from mast cells can lead to poor postoperative outcomes, especially during general anaesthesia, as the severe manifestations of anaphylaxis, such as cardiovascular collapse and bronchospasm, may potentially be the first symptoms to present. In this case report, we describe the perioperative and intraoperative management of a 70-year-old female with SM, undergoing total thyroidectomy.

Challenges Associated with Negative Pressure Pulmonary Oedema: A Case Report and Review

2024-12-06T02:42:08-08:00

Negative pressure pulmonary oedema (NPPO) is a rare but serious complication for patients undergoing general anaesthesia. It often presents a diagnostic dilemma, thus posing significant management challenges. Despite the complexity of diagnosis, the pathophysiology and management of NPPO have been extensively studied. We present a case of NPPO in a middle-aged obese patient with high perioperative cardiac risk who underwent an emergency open appendicectomy. This case report details the anaesthetic approach to managing the patient’s complex comor-bidities, the series of events leading to the diagnosis, and subsequently the management of NPPO. We dis-cuss the challenges encountered in diagnosing and managing NPPO, and review potential preventive measures. Our conclusion underscores that diagnosis of NPPO remains challenging, and early identification of patients at risk with vigilant monitoring is crucial for timely diagnosis and effective management.

Emergency Medicine and Rapid Response Virtual Team (EM-RRVT): Insights from the Hajj 1445/2025 Experience

2024-10-20T16:14:27-07:00

Introduction: The use of telemedicine in acute care settings has not been investigated in large mass gatherings. Further exploration is needed to determine its efficacy, applicability and to explore challenges and opportunities.

Aim: This study aims to evaluate a pilot deployment of virtual emergency team during one of the largest mass gatherings in the world, the Hajj religious season.

Methods: The Emergency Medicine and Rapid Response Virtual Team (EM-RRVT) was launched from June 13 to July 6, 2024. The pilot was conducted in phases, with Phase One occurring in Mecca from June 13 to June 19. Subsequently, the team was activated on an on-demand basis. The team's role was to complement the on-ground teams as well as various emergency departments.

Results: The team encountered a total of 324 patients from 20 countries, with a variety of medical conditions. The most prevalent condition was acute coronary syndrome, followed by trauma, within the peak hours from 10:00 to 22:00 coinciding with the movement of pilgrims. Over half of the patients were treated and released back to their Hajj contingents during surge hours.

Conclusion: The use of telemedicine in an acute setting showed promising results. The establishment of the Emergency Medicine and Rapid Response Virtual Team proved to be both feasible and applicable. The scalability and flexibility of the service contributed to its efficiency.