Scripta Medica

How do Predatory Medical Journals try to Seduce and Fool Potential Authors? Analysis of an 18-Months Monitoring Survey

Olaf R van Loon — 2024-12-26

Background/Aim: Predatory medical publishers have developed – and still continue to develop – ‘tricks’ that are intended to fool potential authors with the objective to attract manuscripts. They do so because authors have to pay them article processing charges and these are commonly their exclusive business model. Authors become ever more reluctant to publish in predatory journals because such journals are not considered as scientifically reliable and the articles in such journals are commonly not or hardly read (and even more rarely cited). Particularly young scientists can nevertheless be relatively easily seduced by the promises of predatory journals, which tend to approach potential authors in an aggressive way. This study aimed to analyse how often aggressive advertising is synonym for predatory.

Methods: The 322 medical journals and their 105 publishers that approached from 1 January 2023 to 1 July 2024 period with the request to contribute a manuscript were analysed. The analysis dealt with several aspects that may give insight into the trustworthiness of these journals and their publishers, ie the International Standard Serial Number (ISSN), the Editor-in-Chief, the publishing history, the publisher’s location and the journal title.

Results: Only 85 (26.3 %) of the journals under study had an Editor-in-Chief and 47 (14.6 %) of the journals had no ISSN. The great majority of the journals started after 2010; the journal titles seem aimed at raising confusion with established journals and many publishers were not housed where they pretend to be.

Conclusions: Checking the above aspects of journals is an important tool helping recognise the predatory character of a journal.

Effect of Antioxidant Capsule Supplementation on Oxidative Stress Markers in Hypertensive Patients

Ludmila N Novaes-Gaeta — 2024-12-26

Background/Aim: Hypertension is a consequence of a neuromodulatory imbalance and is directly associated with cardiovascular diseases. Oxidative stress constitutes an intermediate pathophysiological mechanism for hypertension and cardiovascular disease. Evidence suggests that there is a proportional relationship between diets high in antioxidants and a reduced risk of cardiovascular events. A high antioxidant diet could scavenge the free radicals and other toxic radicals offering better protection to the cardiovascular system. The primary study objective was to evaluate the impact of dietary supplementation with fruit extract capsules on markers of oxidative stress and antioxidant capacity in hypertensive and normotensive individuals; a secondary objective was to evaluate the impact of dietary supplementation on insulin resistance, markers of inflammation and hemodynamic variables in treated hypertensive and normotensive patients.

Methods: This clinical trial comprised 30 hypertensive patients and 29 normotensive volunteers. Study participants received placebo capsules for 4 weeks, then fruit extract capsules (blueberry, cranberry and pomegranate), one capsule of each per day for 4 weeks. Blood pressure was measured at baseline, after the use of placebo and antioxidant capsules. Catalase, thiobarbiturate acid reactive substances (TBARS), superoxide dismutase (SOD), carbonyl and ferric-reducing antioxidant powder (FRAP) were used to evaluate oxidative stress.

Results: The mean age among hypertensive participants was 49.3 ± 9.3 years. Catalase increased in both groups; reduction of TBARs, FRAP and carbonyls occurred in the hypertensive group. A significant intragroup difference in homeostatic model assessment of insulin resistance (HOMAir) was noted between normotensive and hypertensive individuals at different times. No significant difference occurred regarding inflammatory cytokines, adipocytokines and haemodynamic data after antioxidant consumption.

Conclusion: The study results suggest that supplementation with fruit capsules rich in antioxidants for 4 weeks significantly reduces oxidative stress in hypertensive patients. Studies with a larger number of patients are needed to confirm the findings.

Trace Elements in Children With Pre-Dialysis and End-Stage Renal Disease

Asmaa Abd Alsalam — 2024-12-26

Background/Aim: Chronic kidney disease (CKD) impacts 11-13 % of world wild population and can lead to end-stage renal disease (ESRD). Paediatric CKD is connected with considerable morbidity and necessity for early management. Trace elements as iron (Fe), zinc (Zn) and copper (Cu) are required for a variety of physiological activities and may influence CKD progression. The main goal of this work was to analyse the amounts of trace elements among children with CKD and ESRD and their potential as disease stage biomarkers.

Methods: The study comprised 40 pre-dialysis CKD patients, 40 dialysis-dependent ESRD patients and 40 healthy controls aged 0 to 19 years. Blood samples were obtained and tested for Fe, Zn and Cu levels utilising flame-atomic absorption spectrophotometry (FAAS). Anthropometric data, such as age, body mass index (BMI) and blood pressure, were also collected. The statistical calculations were done by the utilising of SPSS version 25.0.

Results: Trace element levels varied significantly between groups. Cu levels were higher, while Fe and Zn concentrations were lower in CKD and patients on dialysis compared to controls, with Zn exhibiting the greatest drop. Zn had the highest accuracy as a biomarker for CKD and ESRD, with an AUC of 0.999, sensitivity of 100 % and specificity of 98 %.

Conclusion: Zn is a promising biomarker for detecting CKD development and distinguishing between CKD stages and ESRD. Regular trace element monitoring is critical for controlling paediatric chronic kidney disease and improving patients’ consequences. Further research is needed to determine the therapeutic potential of trace element management in CKD.

What a Women Desire: Application of Conjoint Analysis for Analysing the Choice of Menstrual Hygiene Products and Factors Influencing Their Consummatory Behaviour

Abhay Kumar Tiwari — 2024-12-26

Background/Aim: Middle-aged adolescent girls and women experience menstruation, a normal and physiologic occurrence. Using the myths and beliefs that were already prevalent, they created their own approach of dealing with the menstrual cycle. Aim of this study was to examine women's readiness to purchase any sanitary product by examining their preferences for the characteristics of sanitary goods used during menstruation.

Methods: The utility values and relative weights assigned to various aspects, such as comfort, efficacy, hygiene, etc, have been determined through analysis. Two hundred and ten women who lived on the campus of the Banaras Hindu University were questioned. The demographic features of the respondents, the attributes with their corresponding levels and the relationship between these qualities and the type of approach employed over time are explained using descriptive and Chi-square techniques. Conjoint analysis was employed to ascertain utility value and elicit preferences.

Result: Following investigation, findings indicate that synthetic sanitary napkins are used by women more frequently than any other menstrual hygiene products and that inaccessibility and cost are the main barriers to sanitary product use. Demographic factors and the type of sanitary product used, as well as knowledge of innovative methods of menstrual hygiene, were found to be strongly correlated. The results also show that women place the least value on hygiene and the most value on the type of sanitary product. Additionally, women prefer to choose any synthetic sanitary product that is more efficient, safe, pleasant and economical and does not require replacement in less than four hours.

Harnessing Genomic and Bioinformatic Data to Broaden Understanding of Leukaemia Across Continents

Gugun Gumelar — 2024-12-26

Background/Aim: Leukaemia is a malignant disease of blood cells found in the bone marrow, which can be divided into acute lymphocytic leukaemia and myelocytic leukaemia. Current management of acute leukaemia still uses chemo therapy as the main therapy but has many side effects, therefore a new approach is needed to identify genetic factors involved in leukaemia. The aim of this study was to investigate gene variations that have potential pathogenic properties in leukaemia.

Methods: This study used genome-wide association study (GWAS) data obtained from the National Human Genome Research Institute (NHGRI) to search for genomic variants associated with leukaemia. The data was then screened using SNPnexus to detect potentially protein-damaging variants. Furthermore, the gene expression of these variants was analysed using the GTEx portal.

Results: Of the 2115 genomic variants found, four were deleterious, namely rs12140153, rs140386498, rs757110 and rs2066827, representing four different genes, namely PATJ, MINDY1, ABCC8 and CDKN1B. The allele frequency distribution of the variants showed variation between continents, with rs757110 and rs2066827 having different and higher expression than rs12140153 and rs140386498. Gene expression of the variants also varied between tissues, with rs757110 and rs2066827 having higher expression than rs12140153 and rs140386498.

Conclusion: This study successfully identified four genomic variants associated with leukaemia and showed differences in gene distribution and expression between populations and tissues. These findings may provide new insights into the molecular mechanisms and risk factors of leukaemia.

Influence of Advanced Maternal Age and Gestational Age on the Morphology of Human Placenta

Sanja Jovičić — 2024-12-26

Background/Aim: The placenta is an extraembryonic organ necessary for foetal development. Due to its availability and high content of stem cells and growth factors, placenta tissue has found its application in regenerative medicine. The aim of this paper was to determine whether the age of the pregnant woman or the gestational age affects the morphology of the term placenta and whether placentas of advanced maternal age are suitable for application in regenerative medicine.

Methods: In this research 30 placentas of healthy pregnant women, age from 18 to 42 and up to 36 to 41 weeks of gestational age were used for analyses. Tissue samples were stained with standard haematoxylin and eosin staining and immunohistochemical staining with anti-CD34 antibody. The parameters of volume density of chorionic villi, intervillous spaces and fibrinoids, as well as the thickness of the placental barrier were determined.

Results: The volume densities of chorionic villi and fibrinoids were higher in placentas of advanced maternal age, as well as in placentas of gestational age from 38 to 41 weeks of gestation, while the volume of intervillous spaces was lower in these groups. With increased maternal and gestation age, the placental membrane thickens.

Conclusion: When sampling placentas for regenerative medicine purposes, only the placentas from pregnant women younger than 35 years of age and whose gestational age are not exceeding 38 weeks should be selected.

Risk Factors of Functional Dyspepsia, Gastrointestinal Reflux Disease and Non-Erosive Reflux Disease

Ayesha Malik — 2024-12-26

Background/Aim: Functional dyspepsia, erosive and non-erosive gastroesophageal reflux disease (GERD) present a major health burden, adversely effecting quality of life. A range of factors are hypothesised to have a positive and negative influence on these diseases. This study aimed to explore the risk factors of functional dyspepsia, gastrointestinal reflux disease and non-erosive reflux disease and its subgroups.

Methods: A cross-sectional study was conducted at Combined Military Hospital (CMH), Lahore, Pakistan, from January to June 2024. Two hundred and twenty-two patients were included and interviewed to fill a tri-section questionnaire comprising a self-designed comprehensive health survey, food frequency questionnaire, gastroesophageal reflux disease questionnaire (GERD-Q), Rome IV criteria, and hospital anxiety and depression scale (HADS).

Results: Participants consisted of 70 controls, 38 GERD, 24 non-erosive reflux disease, 56 functional dyspepsia and 24 overlap reflux-dyspepsia syndrome patients. Subgroups included symptomatic and asymptomatic erosive oesophagitis, epigastric pain syndrome, postprandial distress syndrome and overlap syndrome. Older age, higher BMIs, male gender, low vegetable and yogurt intake, smoking, frequent red meat, high tea/caffeine intake, no postprandial exercise and a short dinner sleep interval were risk factors for GERD and symptomatic erosive esophagitis. Low BMI, female gender and anxiety were strongly associated with functional dyspepsia and non-erosive reflux disease.

Conclusion: Age, BMI, gender, tobacco, anxiety, depression, dietary habits and food frequencies are significant risk factors of dyspepsia and reflux disease.

Cyclophosphamide and Mycophenolate Mofetil as Induction Therapy in Lupus Nephritis

Ljubinka Božić Majstorović — 2024-12-26

Background/Aim: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystemic involvement. Almost 50 % of patients who suffer from systemic lupus erythematosus have lupus nephritis (LN) as well. Mycophenolate mofetil (MMF) or intravenous cyclophosphamide (CYC) are recommended as preferred therapy. The aim of this study was to see how MMF and CYC, when compared, are efficient in dealing with LN.

Methods: Study included 53 SLE patients with biopsy-proven class III and class IV LN. Twenty-two patients (42 %) were treated with MMF (dosage 2-3 g/day) and 31 patients (58 %) were treated with CYC (0.5 to 1.0 g/m² in monthly pulses) in a 24-week induction study. Outcome of interest was the improvement in serum creatinine, proteinuria and creatinine clearance. Primary end point included complete renal remission defined as serum creatinine within 25 % of baseline before flare and proteinuria < 0.5 g/24 h. Secondary end point included complete renal remission in follow-up period.

Results: The results revealed that response between two groups was not notably different (χ² = 0.151, p = 0.697). Four out of 22 patients (18.2 %) in MMF group and 7 out of 31 patients (22.6 %) in CYC group had complete renal remission. Most patients from both groups showed improvement from the clinical point of view. Secondary end point was also similar between treatment groups.

Conclusion: The study showed same efficiency between these treatment groups, MMF and CYC as induction for LN. No crucial differences were identified between MMF and CYC groups in terms of renal remission.

Factors Affecting Patient Satisfaction During Endoscopic Procedures

Ghazala Maryam — 2024-12-26

Background/Aim: Gastrointestinal endoscopic procedures (GEPs) are widely regarded as the premier method for assessing and treating various digestive diseases. With the rising global prevalence of endoscopic procedures, patients are becoming more discerning in selecting their endoscopists. This study aimed to identify the factors influencing patient satisfaction with endoscopic procedures.

Methods: A cross-sectional study was conducted with 409 participants, out of which 212 responses were included for analysis. Exclusions were made due to contradictory answers or incomplete questionnaires. Demographic data were collected and patient satisfaction was assessed using a questionnaire. The relationship between various factors and patient satisfaction was analysed using Spearman's rank correlation.

Results: The majority of patients (50.9 %) underwent endoscopy, with 59.4 % being males and 40.6 % females. The average age of the participants was 42.34 years. The study found that the most significant factors affecting patient satisfaction were waiting time to get an appointment (15.5 %), waiting time on the day of the procedure (17.0 %) and pain or discomfort during and after the procedure (15.6 %). Additionally, the personal manner of the physician and nurses, as well as comprehensive explanations before and after the procedure, were also significant factors. The study also found that certain aspects of the endoscopic procedure impacted satisfaction differently across gender and age groups. The questionnaire demonstrated strong internal consistency with a Cronbach’s alpha value of 0.917.

Conclusion: This study underscores the importance of addressing waiting times, improving communication and managing patient discomfort to enhance satisfaction with endoscopic procedures. The findings provide valuable insights for improving the quality of care in endoscopy units.

Therapeutic Applications of Novel Drug Delivery Systems of Liquorice: An Updated Review on Recent Advancements

Sanshita — 2024-12-26

In recent times, individuals are focusing more on natural substances, primarily due to their safety and non-toxicity. Also, there is an increasing demand by industries for the phytoconstituents that might be incorporated in pharmaceuticals, cosmetics, dietary products and nutraceuticals. Liquorice is one of the widely used Chinese herb since ancient times due to its medicinal properties. It exhibits broad spectrum biological activities such as anti-inflammatory, immunomodulatory, anti-oxidant, anti-cancer, anti-diabetic, anti-microbial properties, and is used in the treatment of different diseases such as cancer, inflammation, viral infections, cardiovascular and respiratory disorders. Different novel formulations such as nanoparticles, microparticles, liposomes, nanomicells and self-emulsifying drug delivery system are developed that overcome major limitations of liquorice including its low solubility, stability and less bioavailability. In this review, we discuss about liquorice, its historical background, pharmacokinetics, therapeutic applications, its different mechanism of actions, with major emphasis on liquorice encapsulated novel formulations (nanoparticles, nanomicelles, liposomes, niosomes, microparticles, microspheres, self-nanoemulsifying system, self-micro-emulsifying system). Also included brief description of pre-clinical studies and liquorice containing marketed products. Liquorice, a prominent constituent of different dietary products, has aroused the interestof many researchers because of its anti-proliferative capacity, tumour microenvironment manipulation and autophagy activation in numerous cancer types. Nanotechnology-based techniques for enhanced solubilization, stability and targeted drug delivery have been tested by formulation scientists. Liquorice is enclosed in different novel carriers and encapsulated liquorice displayed enhanced stability, solubility, high encapsulation efficiency, controlled drug release,and extended circulation time period.

Streptomyces-Derived Nano-Doxorubicin: Clinical Status and Patents Granted

Prabhjot Kaur — 2024-12-26

Streptomyces have been presented as a great source of antibiotics and anti-cancer drugs over the past century. Especially Streptomyces living in adverse conditions produce certain metabolites with cytolytic and anti-microbial activities, which have been utilised for manufacturing antimicrobial and anticancer drugs. Doxorubicin (DOX) is a potent anti-cancer drug derived from Streptomyces, that is widely used for various cancers, including cancers of the ovary, urinary bladder, GI tract, breast, thyroid gland, lung, bone, kidney (nephroblastoma) and blood (leukaemia). This anthracycline antibiotic is limited by its adverse effect profile, with the main adverse effects being nausea, vomiting, alopecia, infertility, cardiotoxicity, myelosuppression and nephrotoxicity. Nanoparticle delivery systems present a good solution to avoid adverse effects. Some nano-based formulations have reached the clinics, while many new ones in the pipeline show promising results. This review attempts to compile the existing literature on the clinical status of DOX highlight the need for the development of nanoparticles (NPs) that may serve as drug delivery agents, imaging probes and other multifunctional particulates. The integration of nanotechnology with Streptomyces-derived compounds can help shape the anti-cancer therapy of the future.

Healthy Connections: Crafting Compelling Healthcare Marketing Strategies

Riat El Khair — 2024-12-26

Due to the importance of healthcare on both an individual and public level, the efficient functionality of the healthcare system is a fundamental component of society's overall well-being. The primary purpose of this research was to assess how academic contributions to healthcare marketing investigations have evolved over time. The paper delved into various aspects from 2015 to 2024, including publishing trends, core journals, authorship patterns, institutional affiliations, nation-wise contributions, theme distributions, author collaborations and keywords. Data was collected from the Scopus database by using appropriate keywords. The collected dataset underwent meticulous analysis and visualisation using the VOSviewer software. This analytical approach facilitated the identification of significant bibliometric metrics, enabling a deeper understanding of the dynamics and peculiarities of healthcare marketing research throughout the specified period. The most fruitful affiliation or institutional source for healthcare marketing was University Sains Malaysia. Top 5 most productive authors contributing to the field of healthcare marketing were Bellio et al, Buccoliero et al, Djakeli et al, Ghinita et al and Harrison et al. The United States was the nation that produces the greatest number of scientific articles related to healthcare marketing. The most important journal for healthcare marketing was International Journal of Pharmaceutical and Healthcare Marketing. The most common subjects in healthcare marketing were business, management and accounting. With twenty-one publications, the number of international scholarly publications on healthcare marketing reached a peak in 2023. Eleven writers were closely associated with the ownership of two or more documents. There were 24 keywords with a significant human correlation.

The Importance of Emotional Intelligence in the Management of Stress at Work

Ramiza Hamulić — 2024-12-26

Emotional intelligence is the ability to recognise one's own and other people's emotions and adjust one's behaviour in accordance with them. Numerous studies have shown that emotional intelligence has a positive effect on job satisfaction, employee performance, interpersonal relationships, business communication and productivity. In today's fast-paced and competitive business world, the ability to understand and manage one's own emotions, as well as the emotions of others, becomes crucial for building professional relationships. Emotionally intelligent people cope more easily with acute and chronic stress, which directly affects mental health and work performance. Using emotional intelligence as a tool to reduce stress in the workplace, as well as to resolve conflicts that have cause-and-effect relationships, allows for a better understanding of the needs and feelings of employees. The ability to effectively manage emotions and stressful situations can significantly contribute to employee satisfaction and loyalty, that is crucial to long-term business success.

Boerhaave Syndrome in a Paediatric Patient With Diabetic Ketoacidosis: A Case Report

Yasir S Alkhalifah — 2024-12-26

Diabetic ketoacidosis is a serious and potentially life-threatening complication of type 1 diabetes mellitus (T1DM), which often results from poor glycaemic control. While diabetic ketoacidosis is well documented, rare complications such as Boerhaave syndrome can considerably increase morbidity. This case report presents a 14-year-old girl with poorly controlled T1DM and celiac disease who was admitted with diabetic ketoacidosis and developed severe vomiting and abdominal pain. Imaging studies revealed the presence of pneumomediastinum, which raised concerns about oesophageal injury and a diagnosis of Boerhaave syndrome was made. The patient was managed conservatively with correction of metabolic acidosis, intravenous antibiotics, supportive care and close monitoring. Her condition improved gradually, with resolution of ketoacidosis and stabilisation of the pneumomediastinum without invasive intervention. This case highlights the importance of early identification and the adoption of a multidisciplinary approach in managing atypical complications of diabetic ketoacidosis. Timely intervention can ensure favourable outcomes even in the presence of severe complications.

Innovation of CRAM Flap for Reconstruction of High-Voltage Electrical Burn Injuries – Case Series

Bertha Kawilarang — 2024-12-26

Electrical burns cause devastating injury with major soft tissue loss and pose a major threat to life. The damage caused by electrical injuries can extend to deeper tissues, causing exposed soft tissues such as tendon and nerve. The rectus abdominis muscle is a donor of musculocutaneous flap due to the well-known blood supply and high vascularity. The rectus abdominis pedicled flap can be either performed transversely or vertically oriented. The drawback of both of these techniques is the insufficient coverage particularly when used for wide or circular defects. Crescent-shaped rectus abdominis musculocutaneous (CRAM) flap is an innovation that is intended to be used for coverage of circumferential defects with extensive soft tissues exposed as can be seen in the defect caused by electric burn injury. In this paper, cases of high-voltage electrical injury at different anatomical regions which were successfully reconstructed with CRAM flap are presented. Overall, CRAM flap was a reliable flap resulting in well-vascularised soft tissue coverage and acceptable functionality.