स्वास्थ्य सम्बन्धी सम्पूर्ण जानकारी

جميع المعلومات المتعلقة بالصحة

Lahat ng impormasyong may kaugnayan sa kalusugan

स्वास्थ्य संबंधी सारी जानकारी

Semua maklumat berkaitan kesihatan

ကျန်းမာရေးဆိုင်ရာ အချက်အလက်အားလုံး

ຂໍ້ມູນທີ່ກ່ຽວຂ້ອງກັບສຸຂະພາບທັງໝົດ

Dhammaan macluumaadka la xiriira caafimaadka

स्वास्थ्यसम्बद्धाः सर्वाणि सूचनानि

Alle gezondheidsgerelateerde informative

Tota la informació relacionada amb la salut

ሁሉም ከጤና ጋር የተያያዙ መረጃዎች

ព័ត៌មានទាក់ទងនឹងសុខភាពទាំងអស់។

صحت سے متعلق تمام معلومات

Mọi thông tin liên quan đến sức khỏe

The Health Thread Logo

The Health Thread

Rezum Therapy: A Minimally Invasive Treatment for Benign Enlargement of Prostate

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

Introduction:

Benign Prostatic Enlargement (BPE) is a prevalent condition in men, characterized by bothersome urinary symptoms such as increased frequency, urgency, weak urine flow, and incomplete bladder emptying. While lifestyle modifications, dietary adjustments, and medication can help manage mild cases, individuals with more severe symptoms may find relief through surgical intervention. Among the traditional surgical options, transurethral resection of the prostate (TURP) is commonly employed, albeit with its associated risks, including bleeding, sexual dysfunction, and a prolonged recovery period [1].

A Less Invasive Option:

The Rezum System emerges as a promising alternative to conventional surgical methods. This innovative approach utilizes the application of thermal energy, in the form of steam, to target and treat the enlarged prostate tissue [2][3]. By delivering controlled bursts of steam directly to the prostate gland, Rezum therapy offers a minimally invasive solution that effectively alleviates urinary symptoms while mitigating the risks commonly associated with TURP, such as bleeding, ejaculatory dysfunction, and retrograde ejaculation [4]

How Rezum Works:

At the heart of the Rezum System lies a specialized device equipped with a small, flexible needle-like instrument. This instrument is inserted into the prostate tissue under direct visualization, allowing for precise delivery of thermal energy in the form of steam. The targeted application of steam induces localized tissue necrosis, leading to the gradual shrinkage of the enlarged prostate over time. Importantly, this targeted approach ensures the preservation of surrounding healthy tissue and structures, minimizing the risk of adverse effects commonly observed with conventional surgical methods [5].

What to Expect after Treatment:

 Patients undergoing Rezum therapy can anticipate a significant improvement in urinary symptoms, resulting in enhanced quality of life and restored urinary function. Clinical studies have demonstrated notable enhancements in urinary flow rates, reduction in post-void residual urine volume, and improvements in symptom scores following Rezum therapy. While some individuals may experience transient side effects such as temporary dysuria, urinary frequency, or urgency immediately post-treatment, these symptoms typically resolve within a few weeks and are generally milder compared to those observed following traditional surgical interventions [4].

Conclusion:

Rezum therapy represents a paradigm shift in the management of benign prostatic enlargement, offering a patient-centered, minimally invasive solution that effectively addresses bothersome urinary symptoms while minimizing the associated risks. By harnessing the therapeutic potential of steam, Rezum therapy exemplifies the advancements in medical technology and underscores the importance of individualized care in the field of urology [5][6].

REFERENCES

  1. Lee CL, Kuo HC. Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts. Ci Ji Yi Xue Za Zhi. 2017 Apr-Jun;29(2):79-83. doi: 10.4103/tcmj.tcmj_20_17. PMID: 28757771; PMCID: PMC5509197.
  2. McVary, K. T., Roehrborn, C. G., & Barkin, J. (2019). Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia: 4-Year Results from Randomized Controlled Study. Urology, 126, 171-179.
  3. McVary, K. T., Gange, S. N., Gittelman, M. C., Goldberg, K. A., Patel, K., Shore, N. D., … & Roehrborn, C. G. (2016). Erectile and ejaculatory function preserved with convective water vapor energy treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: randomized controlled study. Journal of Sexual Medicine, 13(6), 924-933.
  4. McVary, K. T., Rogers, T., & Roehrborn, C. G. (2016). Rezūm water vapor thermal therapy: practical guide for urologists and primary care physicians treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. Therapeutic Advances in Urology, 8(3), 172-181.
  5. Dixon, C.M., Cedano, E., & Mynderse, L. A. (2018). Rezūm water vapor thermal therapy for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: A systematic review of the literature. Current Urology Reports, 19(6), 44.
  6. Roehrborn, C.G., Gange S.N., Shore N.D., et al.(2020). Five year results of the prospective randomized controlled Rezūm system study: Convective radiofrequency thermal therapy for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia.Journal of Urology ,203(5),1042-1050.

Rare Kidney Diseases: A Global Perspective on Diagnosis, Treatment, and Advocacy

The Health Thread Favicon

Written By THT Editorial Team

Dr. Nabin Bahadur Basnet

Reviewed by Dr. Nabin Bahadur Basnet, Consultant Interventional Nephrologist, MBBS, PhD, FISN

Rare kidney diseases pose significant challenges to patients worldwide, often leading to chronic debilitation, morbidity, or even death. These conditions, characterized by low prevalence and genetic or metabolic origins, demand specialized care and concerted efforts to enhance awareness, diagnosis, and treatment accessibility (Iyengar et al., 2023). This article explores the landscape of rare kidney diseases, focusing on the challenges faced by children, common elements in these conditions, and the imperative need for advocacy and research initiatives.

Rare Kidney Diseases in Children: A Call for Action

Rare kidney diseases affect a substantial number of children globally, with a prevalence of 60–80 cases per 100,000 population in Europe and the United States. These diseases include over 150 different conditions, many of which manifest in childhood (Iyengar et al., 2023). Children with rare kidney diseases often face serious morbidity and require lifelong treatment. However, inequitable access to disease-modifying therapies remains a significant challenge, particularly for children from low- and middle-income countries (LMICs) (Iyengar et al., 2023).

Notable Rare Kidney Diseases:

  1. Cystinosis: A rare genetic disease causing cystine accumulation in cells, affecting various organs including the kidneys. Treatment involves cysteamine therapy to reduce cystine levels.
  2. Primary Hyperoxaluria Type 1: A genetic disorder causing oxalate buildup in the kidneys, often necessitating combined liver and kidney transplantation.
  3. Alport Syndrome: A genetic condition affecting the kidneys, ears, and eyes due to defects in specific genes. It can lead to kidney failure and other complications.
  4. Amyloidosis: Characterized by abnormal protein accumulation in organs like the kidneys, heart, brain, liver, and intestines.
  5. Polycystic Kidney Disease (PKD): Genetic mutations leading to fluid-filled cysts in the kidneys. Treatment varies based on the type of PKD.

Diagnosis of Rare Kidney Diseases:

Children suspected of having rare kidney diseases are given a thorough clinical assessment by pediatric nephrologists. Symptoms such as swelling, changes in urine output, blood in urine, fatigue, and growth issues are evaluated to determine the need for further testing (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.).

Genetic testing plays a crucial role in diagnosing rare kidney diseases with a genetic basis. Tests like the Genetic Renal Panel screen complement genes to identify genetic mutations associated with conditions like Alport syndrome, cystinosis, or polycystic kidney disease (University of Iowa Hospitals & Clinics, n.d.).

Imaging techniques such as ultrasound are used to visualize the kidneys and detect abnormalities like cysts or structural defects that may indicate specific rare kidney diseases like autosomal recessive polycystic kidney disease (ARPKD) (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.).

Laboratory tests are conducted to assess kidney function, protein levels in urine (proteinuria), blood in urine (hematuria), electrolyte imbalances, and other markers that can provide insights into the underlying condition causing the kidney disease (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.).

Specialized clinics like the Rare Renal Disease Clinic and Renal Genetics Clinic offer comprehensive evaluation and management for children with rare kidney diseases. These clinics provide state-of-the-art genetic testing and access to clinical trials for new therapies (University of Iowa Hospitals & Clinics, n.d.).

By combining these diagnostic approaches under the care of experienced specialists like pediatric nephrologists and geneticists, children with rare kidney diseases can receive accurate diagnoses leading to tailored treatment plans and improved outcomes.

Common Elements in Rare Kidney Diseases

Rare kidney diseases share common challenges such as small patient populations, unidentified disease causes, lack of biomarkers for disease monitoring, and complex care requirements (Aymé et al., 2017). Diagnostic hurdles often delay accurate identification of these conditions, necessitating advanced techniques like genetic testing for precise diagnosis (Aymé et al., 2017).

Advocacy Efforts and Research Initiatives

Enhancing access to diagnostic testing through low-cost genetic testing initiatives and training clinicians in interpreting genetic analyses are crucial steps towards improving outcomes for individuals with rare kidney diseases (Iyengar et al., 2023). Collaborative efforts involving patient support organizations, healthcare providers, researchers, governments, and pharmaceutical industries are essential to drive advancements in diagnosis, treatment accessibility, and research innovation.

In Conclusion

Uniting stakeholders globally and prioritizing the needs of individuals with rare kidney diseases will lead to better outcomes and quality of life. Addressing the challenges posed by rare kidney diseases requires a multifaceted approach encompassing advocacy for equitable access to care, research into innovative treatments, and enhanced awareness initiatives (Rare Kidney Disease Foundation, n.d.).

REFERENCES

  1. Iyengar, A., Lanewala, A. A., Shirol, P. B., & Pais, P. (2023). Rare Kidney Diseases: Children Being Left Out in the Cold. Clinical Journal of the American Society of Nephrology. https://doi.org/10.2215/CJN.0000000000000374
  2. Aymé, S., Bockenhauer, D., Day, S., et al. (2017). Common Elements in Rare Kidney Diseases: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International, 92(4), 796-808. https://doi.org/10.1016/j.kint.2017.06.018
  1. Wong, K., Pitcher, D., Braddon, F., Downward, L., Steenkamp, R., Annear, N., et al. (2024). Effects of rare kidney diseases on kidney failure: a longitudinal analysis of the UK National Registry of Rare Kidney Diseases (RaDaR) cohort. Retrieved March 26, 2024, from https://doi.org/10.1016/S0140-6736(23)02843-X.
  2. Deeley, M. (2024, February 29). Rare Disease Day: Rare kidney diseases you may not know about. American Kidney Fund. Retrieved March 26, 2024, from https://www.kidneyfund.org/article/rare-disease-day-rare-kidney-diseases-you-may-not-know-about.
  3. Rare Kidney Disease Foundation Website https://www.rarekidney.org
  4. National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Kidney Disease in Children. Retrieved March 26, 2024, from https://www.niddk.nih.gov/health-information/kidney-disease/children#diagnose.
  5. University of Iowa Hospitals & Clinics. (n.d.). Rare Kidney Diseases. Retrieved March 26, 2024, from https://uihc.org/services/rare-kidney-diseases.
  6. National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Autosomal Recessive Polycystic Kidney Disease. Retrieved March 26, 2024, from https://www.niddk.nih.gov/health-information/kidney-disease/polycystic-kidney-disease/autosomal-recessive-pkd.

A new hope to treat ‘Flat Tire’ in Spine: The Tension-Activated Repair Patch (TARP)

The Health Thread Favicon

Written By THT Editorial Team

Dr Aayush Shrestha

Reviewed by Dr. Aayush Shrestha, Orthopaedic & Spine Surgeon, MS Ortho, FSS, 

The human spine, an architectural wonder of biology, is prone to a variety of injuries. Disc herniation is notably one of the most incapacitating conditions [1]. This condition, often compared to a ‘flat tire’ in the spine, happens when the soft, cushion-like discs between the vertebrae burst, causing the inner gel to bulge out and press against the nerves. This can result in intense pain, numbness, and even disability.

Traditional treatments have been palliative at best, focusing on alleviating pain rather than repairing the underlying damage. However, a ground-breaking study published in Science Translational Medicine heralds a new era in spinal repair with the development of the tension-activated repair patch (TARP) [1].

The TARP represents a significant advancement in the treatment of disc herniation [2]. Developed by researchers at the University of Pennsylvania and the CMC VA Medical Center, this biologic patch is designed to mimic the natural healing process of the body. The patch, which is inserted directly onto the herniated disc, is composed of nanofibers that deliver an anti-inflammatory drug, anakinra, directly to the damaged disc [1]. Anakinra, a recombinant interleukin-1 receptor antagonist, has been shown to reduce inflammation and promote tissue repair [1].

What sets TARP apart is its activation mechanism [2]. The patch is designed to respond to the natural biomechanical movements of the body, which in turn triggers the release of anakinra from microcapsules embedded within the patch. This ensures a sustained and controlled release of the medication, enhancing the disc’s ability to regain tension and integrity over time [1].

The implications of this technology are profound [2]. By providing a means to not only plug the ‘hole’ caused by herniation but also to restore the disc’s natural tension, TARP offers a potential cure for a condition that has long been considered irreversible. The researchers’ preclinical trials in large animal models have shown promising results, with discs regaining the necessary tension to reverse herniation and prevent further degeneration [2]. Moreover, the TARP could revolutionize the way we approach spinal injuries [1]. With its ability to integrate with the native tissue and reinforce the structure at the injury site, it prevents the aberrant remodeling that often follows disc detensioning. This could significantly reduce the incidence of recurrent herniations and persistent dysfunction, which are common with conventional treatments [1].

As we look to the future, the TARP presents a beacon of hope for millions suffering from spinal conditions [2]. The prospect of a treatment that not only alleviates pain but also restores spinal function is a monumental leap forward. While further research and human clinical trials are necessary, the TARP stands as a testament to the ingenuity of medical science and its relentless pursuit of solutions that restore quality of life to those afflicted by debilitating conditions.

The TARP’s innovative design is not just a theoretical concept but a tangible advancement poised to transform spinal treatment protocols. Its unique tension-activated mechanism aligns seamlessly with the body’s natural movements, promoting a more organic healing process. The use of anakinra within the TARP system exemplifies the shift towards targeted therapeutic strategies, offering a glimpse into the future of personalized medicine. This technology’s adaptability suggests it could be tailored for various orthopedic applications, potentially improving outcomes for patients with a range of degenerative conditions. As the research community continues to explore the full capabilities of TARP, it stands as a beacon of progress in the ongoing quest to address some of the most challenging medical conditions faced today.

In conclusion, the tension-activated repair patch is a pioneering solution that addresses the root cause of disc herniation. It offers a new hope for patients, potentially changing the course of spinal disease progression and opening the door to a future where ‘flat tires’ in the spine can be fully and effectively repaired. It’s important to note that the tests are still in the early stages and there are many factors to consider while treating a herniated disk, like the extent of herniation. Extruded and sequestered disc fragments need removal of disc fragments.

REFERENCES

  1. Peredo, A. et al. (2023). Tension-activated nanofiber patches delivering an anti-inflammatory drug improve repair in a goat intervertebral disc herniation model. Science Translational Medicine, 15(2), eabcm1654. https://doi.org/10.1126/scitranslmed.abcm1654
  2. University of Pennsylvania School of Medicine. (2023). ‘Patch’ Uses Natural Body Motion to Fix Disc Herniation. Penn Medicine News. Retrieved from https://www.pennmedicine.org/news/news-releases/2023/january/patch-uses-natural-body-motion-to-fix-disc-herniation

Revolutionizing Prostate Cancer Treatment: The TULSA-Pro Procedure

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

Prostate Cancer:

Prostate cancer is the leading cause of cancer death and the second most common non-cutaneous cancer in males worldwide which is a significant health concern (Abudoubari et al., 2023). Wang et al. (2022) found in their study on global prostate cancer incidence and mortality that a total of 1 414 259 new cases of prostate cancer and 375 304 related deaths were reported in 2020 globally.  There are marked variations in the rate of prostate cancer in different populations worldwide which suggests its genetic predisposition (Tzelepi et al, 2022). Apart from that, age, family history, ethnicity, and tobacco smoking are additional risk factors (Berenguer et al.2023). Most of the prostate cancers identified currently are asymptomatic. Diagnosis in these cases is based on elevated prostate-specific antigen (PSA) level, digital rectal examination (DRE), and prostate biopsy. Localized and advanced diseases can cause urinary retention, blood in the urine (hematuria), blood in semen, and pelvic discomfort, back pain, weight loss (Peters et al.2023)

Recent Advances in Prostate Cancer:

The treatment landscape for prostate cancer has seen remarkable progress in recent years. Standard treatment for localized prostate cancer includes active surveillance, radical prostatectomy, and radiation therapy with or without hormonal therapy. New therapies targeting the disease’s resistance to conventional treatments are emerging. One such advancement is a therapy that combines an experimental drug, AZD5069, with enzalutamide, a hormone therapy, showing promising results in shrinking tumors and reducing PSA levels (Guo et al.2023). Another breakthrough is the development of 177 Lu-PSMA-617, a targeted radioligand therapy that delivers radiation directly to cancer cells, demonstrating effectiveness in controlling advanced prostate cancer (Sartor et al.2021)

The TULSA-Pro Procedure:

TULSA-Pro stands for Transurethral Ultrasound Ablation. It is one of the focal ablative therapies for localized prostate cancer which is minimally invasive, providing proper oncological outcome with preserving urinary continence and erectile dysfunction due to nerve sparing.

Procedure:

TULSA procedure is performed in 1.5 Tesla MRI with the patient under general anesthesia. An ultrasound applicator is placed in the prostatic urethra to deliver the focused waves to ablate the cancerous tissue sparing the healthy tissue and a rectal cooling device is placed adjacent to the prostate. Both devices are irrigated with water for thermal protection of the rectum and urethra. MRI shows real-time visual monitoring during the procedure. (Klotz et al.2021)

Post-Procedure Recovery:

Patients can be discharged the same day or can be admitted overnight. They benefit from shorter recovery times and fewer side effects like urinary incontinence and erectile dysfunction.

Clinical Evidence and Results Recent studies highlight TULSA-Pro’s effectiveness:

PSA Reduction: Studies report 75% decrease in PSA levels post-procedure, indicating effective tumor ablation (Peters et al.2023)

Preservation of Erectile Function: TULSA-Pro has been shown to minimize damage to neurovascular bundles, reducing the incidence of erectile dysfunction. (Klotz et al.2021)

Urinary Continence: Patients experience lower urinary leakage rates than traditional surgical treatments (Peters et al.2023).

Quality of life: IPSS urinary symptom score, quality of life score, and voiding/storage sub scores recovered to baseline 3 months post-procedure. Urinary continence and sexual function also recovered to baseline earlier than other measures ( Klotz et al.2021).

Advancements and Future Directions: The TULSA-Pro procedure is evolving, with advancements enhancing its precision and outcomes.

Conclusion

TULSA is a minimally invasive procedure that uses planar ultrasound energy with real-time MRI-based treatment planning, thermal dosimetry, and closed-loop temperature feedback for effective prostate cancer ablation.  It signifies a new era in prostate cancer treatment ongoing research promises to refine this innovative approach, broadening its adoption and benefiting patients and healthcare providers globally.

REFERENCES

  • Abudoubari, S., Bu, K., Mei, Y., Maimaitiyiming, A., An, H., & Tao, N. (2023). Prostate cancer epidemiology and prognostic factors in the United States. Frontiers in Oncology, 13. https://doi.org/10.3389/fonc.2023.1142976
  • Wang, L., Lu, B., He, M., Wang, Y., Wang, Z., & Du, L. (2022). Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019. Frontiers in Public Health, 10, 811044. https://doi.org/10.3389/fpubh.2022.811044
  • Tzelepi V. Prostate Cancer: Pathophysiology, Pathology and Therapy. Cancers (Basel). 2022 Dec 31;15(1):281. doi: 10.3390/cancers15010281. PMID: 36612276; PMCID: PMC9818719.
  • Berenguer, C. V., Pereira, F., Câmara, J. S., & Pereira, J. A. M. (2023). Underlying Features of Prostate Cancer-Statistics, Risk Factors, and Emerging Methods for Its Diagnosis. Current Oncology, 30(2), 2300-2321. https://doi.org/10.3390/curroncol30020178 this is for no .2
  • Peters, I., Hensen, B., Glandorf, J., et al. (2023). “First experiences using transurethral ultrasound ablation (TULSA) as a promising focal approach to treat localized prostate cancer: a monocentric study.” BMC Urology, 23, Article number: 1421
  • Guo, C., Sharp, A., Gurel, B., et al. (2023). Targeting myeloid chemotaxis to reverse prostate cancer therapy resistance. Nature, 623, 1053–1061. https://doi.org/10.1038/s41586-023-06696-z
  • Sartor, O., de Bono, J., Chi, K. N., Fizazi, K., Herrmann, K., Rahbar, K., Tagawa, S. T., & the VISION Investigators. (2021). Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. The New England Journal of Medicine, 385(12), 1091-1103. https://doi.org/10.1056/NEJMoa2107322
  • Klotz, L., Pavlovich, C.P., Chin, J., Hatiboglu, G., Koch, M., Penson, D., Raman, S., Oto, A., Fütterer, J., Serrallach, M., Relle, J., Lotan, Y., Heidenreich, A., Bonekamp, D., Haider, M., Tirkes, T., Arora, S., Macura, K.J., Costa, D.N., Persigehl, T., Pantuck, A.J., Bomers, J., Burtnyk, M., Staruch, R., & Eggener, S. (2021). Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer. Journal of Urology, 205, 769–779. https://doi.org/10.1097/ju.0000000000001362
  • Feigl, G. C., Heckl, S., Kullmann, M., Filip, Z., Decker, K., Klein, J., Ernemann, U., Tatagiba, M., Velnar, T., & Ritz, R. (2019). Review of first clinical experiences with a 1.5 Tesla ceiling-mounted moveable intraoperative MRI system in Europe. Bosnian Journal of Basic Medical Sciences, 19(1), 24-30. https://doi.org/10.17305/bjbms.2018.3777

Navigating the Challenges of Infertility: Causes, Treatments, and preventative Strategies

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

 Infertility is a significant concern affecting 1 in 6 couples globally (WHO 2023), with various causes and treatment options available to address this issue. When exploring infertility, it is crucial to understand the common causes, treatment options, and preventative measures associated with the condition.

Causes of Infertility in Men and Women

Infertility can arise from a multitude of factors in both men and women. In men, common causes include low sperm count, poor sperm motility, hormonal imbalances, genetic factors like Klinefelter syndrome, mumps infection affecting sperm production, and lifestyle factors such as smoking, drug use, exposure to chemicals, stress and obesity[2][3][4]. On the other hand, in women, causes of infertility may stem from ovulation disorders, , tubal blockages, various uterine factors like endometriosis, fibroid, cervical factor, post-surgery scarring, and age-related decline in egg quality and quantity[1][2][4].

Treatment Options for Infertility

Treatment for infertility varies depending on the underlying cause. For men, treatment options may include lifestyle changes like avoiding drugs and alcohol, hormone therapy to regulate hormone levels affecting sperm quality, surgical interventions to correct anatomical issues or blockages, and assisted reproductive technologies (ART) procedures [3][4]. In women, treatments can range from medications to induce ovulation, timed intercourse or improve egg quality to surgical procedures to address structural abnormalities [1][2][4].

Preventative Measures for Infertility

Preventing infertility involves adopting healthy lifestyle practices. Both men and women can benefit from avoiding smoking and excessive alcohol consumption, maintaining a healthy weight through diet and exercise, reducing exposure to environmental toxins or chemicals that may impact fertility, and seeking timely treatment for sexually transmitted infections (STIs)[4][5]. Additionally, regular testing for STIs and addressing any underlying health conditions promptly can help prevent infertility. Moreover, with recent advances, egg or embryo freezing is an option for career-oriented couples wanting to delay pregnancy.

The emotional and social aspect of Infertility:

The journey through infertility can be emotionally taxing and socially isolating. Couples may experience a rollercoaster of hope and disappointment with each treatment cycle. The societal pressure to have children can exacerbate feelings of failure or inadequacy. It’s essential to recognize the emotional toll and provide support through counseling services, support groups, and open communication with loved ones [6].

*Technological innovations in infertility treatments:*

The field of reproductive medicine is continually evolving, with new technologies enhancing the success rates of fertility treatments. Techniques like ovarian tissue freezing and sperm DNA fragmentation tests are on the forefront of these advancements. These innovations offer new hope for couples who have had limited success with traditional fertility treatments [7].

*Nutritional Influences on Infertility *

Recent studies suggest that nutrition plays a vital role in fertility. Diets rich in certain nutrients, such as omega-3 fatty acids, iron, vitamin D and other micronutrients have been linked to improved fertility outcomes. Conversely, diets high in processed foods and sugar may negatively affect reproductive health. Nutrition counseling can be a valuable component of infertility treatment plans [8].

Global perspective on infertility

Infertility is a global issue, with varying prevalence rates and treatment accessibility around the world. In some cultures, infertility carries a significant stigma, which can impact the willingness to seek treatment. Understanding these cultural nuances is important for providing compassionate and appropriate care to individuals facing infertility [9].

In conclusion, infertility is a complex issue that affects both men and women due to various factors ranging from genetic conditions to lifestyle choices. Understanding the common causes of infertility and the available treatment options is essential for individuals facing fertility challenges. By incorporating preventative measures such as maintaining a healthy lifestyle and seeking timely medical care i.e. failing to conceive after one year of regular sexual intercourse, individuals can take proactive steps towards preserving their fertility and addressing infertility issues effectively.

* More information on recent breakthroughs on technological innovations :

The Semen Microbiome and Its Impact on Male Fertility

Recent Advances in Male Infertility Research

*More information on nutrition :

Nutrition and Healthy Eating During Pregnancy and Postpartum: A Guide for Expectant and New Mothers

REFERENCES

[1] Planned Parenthood. (2024). what is infertility? Retrieved March 24, 2024, from https://www.plannedparenthood.org/learn/pregnancy/infertility

[2] Brazier, Y. (2023, December 22). Infertility in males and females. Medical News Today. Medically reviewed by Kallen, A., MD. Retrieved from https://www.medicalnewstoday.com/articles/165748

[3] Cleveland Clinic. (2024). Male infertility. Retrieved from https://my.clevelandclinic.org/health/diseases/17201-male-infertility

[4] Mayo Clinic. (n.d.). Infertility. Retrieved from https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317

[5] ARC Fertility. (n.d.). Prevention of infertility. Retrieved from https://www.arcfertility.com/patient-resources/infertility-tutorial/prevention/

[6] American Psychological Association. (2024). The psychological impact of infertility. Retrieved from https://www.apa.org/topics/fertility/infertility-impact

[7] Human Fertilisation & Embryology Authority. (2024). Advances in fertility treatment. Retrieved from https://www.hfea.gov.uk/treatments/explore-all-treatments/advances-in-fertility-treatment/

[8] The Nutrition Society. (2023). Nutrition and fertility. Retrieved from https://www.nutritionsociety.org/papers/nutrition-and-fertility

[9] World Health Organization. (2024). Infertility: A global public health issue. Retrieved from https://www.who.int/reproductivehealth/topics/infertility/perspective/en/

 

Enhancing Doctor-Patient Relations: Strategies for Addressing Frustrations and Improving Healthcare Experiences

The Health Thread Favicon

Written By THT Editorial Team

Dr. Kishor Adhikari

Reviewed by Prof Dr. Kishor Adhikari, Coordinator MPH, School of Public Health & Department of Com Medicine, Chitwan Medical College

Effective doctor-patient relations are fundamental to delivering high-quality healthcare. However, challenges such as miscommunication, time constraints, and differing expectations can lead to frustrations for both doctors and patients. In this essay, we will explore common frustrations experienced by both parties during medical encounters, analyze the underlying causes, and propose strategies to enhance doctor-patient relations. Additionally, we will examine policy implementations in healthcare systems worldwide and offer recommendations for fostering positive interactions between doctors and patients.

Common Frustrations Experienced by Doctors:

Time Constraints: Doctors often face tight schedules, with limited time allocated for each patient encounter. The pressure to address multiple concerns within a short timeframe can lead to rushed appointments and feelings of frustration (Macharia et al., 2020).

Administrative Burden: Administrative tasks, such as documentation, billing, and electronic health record management, consume significant time and energy for healthcare providers. These tasks detract from direct patient care and contribute to physician burnout (Arndt et al., 2017).

Lack of Appreciation: Healthcare providers may feel undervalued or unappreciated for their efforts, particularly in environments where their contributions are not acknowledged or recognized (Shanafelt et al., 2017).

Legal and Regulatory Pressures: Doctors must adhere to complex legal and regulatory requirements, which can create additional stress and anxiety. Fear of malpractice lawsuits or disciplinary action may impact clinical decision-making and communication with patients (Soklaridis et al., 2016).

Emotional Toll: Dealing with patient suffering, difficult diagnoses, and end-of-life care can take an emotional toll on healthcare providers. Coping with these challenges while maintaining professionalism and empathy can be challenging (Woolhandler et al., 2016).

Strategies to Address Doctor Frustrations:

Time Management Training: Providing doctors with time management and organizational skills training can help them optimize their schedules and prioritize patient care tasks effectively. Implementing strategies such as time blocking and delegation can enhance efficiency (Körner et al., 2015).

Streamlining Administrative Processes: Healthcare organizations should invest in technology and infrastructure to streamline administrative tasks and reduce paperwork burden on doctors. Electronic health record systems, automated billing systems, and administrative support staff can alleviate administrative pressures (Shanafelt et al., 2016).

Recognition and Support: Healthcare institutions should foster a culture of appreciation and support for healthcare providers. Recognizing their contributions through awards, incentives, and peer recognition programs can boost morale and job satisfaction (Panagioti et al., 2017).

Legal Reform and Malpractice Insurance: Policymakers should explore legal reforms to reduce the burden of malpractice litigation on healthcare providers. Implementing alternative dispute resolution mechanisms, such as mediation or arbitration, can mitigate the adversarial nature of malpractice claims (Baker et al., 2017).

Mental Health Support: Healthcare organizations should prioritize mental health support services for doctors, including access to counseling, peer support groups, and wellness programs. Proactive measures to address stress, burnout, and psychological distress can promote physician well-being and resilience (West et al., 2018).

Common Frustrations Experienced by Patients:

Communication Barriers: Patients may struggle to communicate their symptoms, concerns, and treatment preferences effectively to their healthcare providers. Language barriers, medical jargon, and lack of health literacy can hinder effective communication (Street et al., 2013).

Long Wait Times: Patients often experience long wait times for appointments, tests, and procedures, leading to frustration and dissatisfaction with healthcare services. Delays in accessing care can exacerbate health problems and undermine patient-provider relationships (Barr et al., 2015).

Lack of Empathy: Some patients perceive their healthcare providers as lacking empathy or compassion, particularly when discussing sensitive or distressing topics. Providers who appear rushed or disinterested may inadvertently convey a lack of empathy, affecting patient trust and satisfaction (Hojat et al., 2011).

Information Overload: Patients may feel overwhelmed by the volume of medical information provided during appointments, leading to confusion and uncertainty about their diagnosis, treatment options, and prognosis. Simplifying complex medical information and using plain language can enhance patient understanding (Schillinger et al., 2003).

Perceived Disrespect: Patients expect to be treated with dignity, respect, and courtesy by their healthcare providers. Instances of perceived disrespect, such as dismissive attitudes, rude behavior, or discriminatory practices, can erode patient trust and confidence in the healthcare system (Dovidio et al., 2008).

Strategies to Address Patient Frustrations:

Effective Communication Skills Training: Healthcare providers should undergo communication skills training to improve their ability to listen actively, convey empathy, and communicate clearly with patients. Training programs should focus on building rapport, fostering trust, and addressing patient concerns (Bylund et al., 2010).

Appointment Scheduling Optimization: Healthcare organizations should implement strategies to reduce wait times and minimize appointment delays. This may include optimizing scheduling systems, increasing appointment availability, and improving workflow efficiencies in clinics and hospitals (Murray et al., 2009).

Empathy and Cultural Competency Training: Healthcare providers should receive training in empathy and cultural competency to better understand and respond to the diverse needs and preferences of patients. Training programs should emphasize cultural humility, sensitivity to cultural differences, and awareness of unconscious biases (Betancourt et al., 2003).

Patient Education and Shared Decision-Making: Healthcare providers should engage patients as active participants in their care, involving them in shared decision-making and treatment planning. Providing patients with information, resources, and support empowers them to make informed decisions about their health (Elwyn et al., 2012).

Respectful and Patient-Centered Care: Healthcare organizations should prioritize patient-centered care principles, ensuring that all interactions with patients are respectful, compassionate, and culturally sensitive. Creating a welcoming and inclusive environment promotes patient trust, satisfaction, and engagement in their healthcare (Epstein et al., 2005).

Policy Implementations in Healthcare Systems:

Several countries have implemented policies and initiatives aimed at improving doctor-patient relations and enhancing the patient experience. These include:

Comprehensive Training Programs: Implementing comprehensive training programs for healthcare providers to enhance communication, empathy, and cultural competence skills (Haskard Zolnierek & DiMatteo, 2009).

Appointment Scheduling Optimization: Streamlining appointment scheduling processes to reduce wait times and improve access to timely care (Zachariah et al., 2017).

Patient Education and Shared Decision-Making: Promoting patient education and shared decision-making to empower patients to take an active role in their healthcare decisions (Charles et al., 1997).

Legal Protections and Patient Rights: Strengthening legal protections for patients and healthcare providers and enforcing strict penalties for acts of violence or harassment in healthcare settings (World Health Organization, 2021).

Quality Improvement Initiatives: Implementing quality improvement initiatives to enhance patient-centered care, improve patient satisfaction, and address systemic issues affecting doctor-patient relations (Beattie et al., 2015).

Recommendations for Fostering Positive Doctor-Patient Relations:

Invest in Training and Education: Healthcare organizations should invest in training and education programs to enhance the communication, empathy, and cultural competency skills of healthcare providers.

Prioritize Patient-Centered Care: Healthcare providers should prioritize patient-centered care principles, ensuring that all interactions with patients are respectful, compassionate, and culturally sensitive.

Implement Policy Reforms: Policymakers should explore legal reforms and policy initiatives to strengthen patient protections, improve access to care, and address systemic issues affecting doctor-patient relations.

Foster Collaboration and Partnership: Healthcare organizations should foster collaboration and partnership between doctors and patients, promoting shared decision-making, mutual respect, and trust.

Embrace Technology and Innovation: Healthcare organizations should embrace technology and innovation to improve access to care, streamline administrative processes, and enhance communication between doctors and patients.

Conclusion:

Enhancing doctor-patient relations is essential for delivering patient-centered, high-quality healthcare. By addressing the frustrations experienced by both doctors and patients and implementing strategies to improve communication, empathy, and trust, healthcare organizations can foster positive and collaborative relationships that benefit all stakeholders. Through policy reforms, education and training initiatives, and a commitment to patient-centered care, we can create healthcare systems that prioritize the needs and preferences of patients while supporting the well-being and professional satisfaction of healthcare providers.

REFERENCES

  1. Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W.-J., Sinsky, C. A., & Gilchrist, V. J. (2017). Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. The Annals of Family Medicine, 15(5), 419–426.
  2. Baker, L. C., Bundorf, M. K., & Kessler, D. P. (2017). Vertical Integration: Hospital Ownership of Physician Practices Is Associated with Higher Prices and Spending. Health Affairs, 36(5), 756–764.
  3. Barr, P. J., Scholl, I., Bravo, P., Faber, M. J., Elwyn, G., & McAllister, M. (2015). Assessment of patient empowerment – a systematic review of measures. PLOS ONE, 10(5), e0126553.
  4. Beattie, M., Murphy, D. J., Atherton, I., & Lauder, W. (2015). Instruments to measure patient experience of healthcare quality in hospitals: a systematic review protocol. Systematic Reviews, 4(1), 84.
  5. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining Cultural Competence: A Practical Framework for Addressing Racial/Ethnic Disparities in Health and Health Care. Public Health Reports, 118(4), 293–302.
  6. Bylund, C. L., Makoul, G., & Starzyk, E. J. (2010). Patient-provider E-interaction: Digital Media and Communication in Patient-Physician Relationships. Patient Education and Counseling, 78(3), 329–334.
  7. Charles, C., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Social Science & Medicine, 44(5), 681–692.
  8. Dovidio, J. F., Penner, L. A., Albrecht, T. L., Norton, W. E., Gaertner, S. L., & Shelton, J. N. (2008). Disparities and distrust: the implications of psychological processes for understanding racial disparities in health and health care. Social Science & Medicine, 67(3), 478–486.
  9. Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., Edwards, A., & Barry, M. (2012). Shared Decision Making: A Model for Clinical Practice. Journal of General Internal Medicine, 27(10), 1361–1367.
  10. Epstein, R. M., Franks, P., & Fiscella, K. (2005). Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues. Social Science & Medicine, 61(7), 1516–1528.
  11. Haskard Zolnierek, K. B., & DiMatteo, M. R. (2009). Physician Communication and Patient Adherence to Treatment: A Meta-analysis. Medical Care, 47(8), 826–834.
  12. Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C., & Gonnella, J. S. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. Academic Medicine: Journal of the Association of American Medical Colleges, 86(3), 359–364.
  13. Körner, M., Bütof, S., Müller, C., Zimmermann, L., & Becker, S. (2015). Developing the Competences of Interprofessional Teams—Evaluation of a Training Based on the German Interprofessional Competence Framework. Journal of Interprofessional Care, 29(5), 430–436.
  14. Macharia, P. M., Ong’ayo, G., Oyugi, H., Nyamogo, G., & Kosgei, R. J. (2020). Workload of doctors in a developing country: How do doctors at a Kenyan referral hospital allocate their time? PLOS ONE, 15(9), e0239345.
  15. Murray, M., Berwick, D. M., & Advanced Access, A. G. (2009). Reducing Delays and Waiting Times Throughout the Healthcare System. The Joint Commission Journal on Quality and Patient Safety, 35(9), 505–506.
  16. Panagioti, M., Geraghty, K., Johnson, J., Zhou, A., Panagopoulou, E., Chew-Graham, C., Peters, D., Hodkinson, A., Riley, R., & Esmail, A. (2017). Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 177(7), 1002–1011.
  17. Schillinger, D., Piette, J., Grumbach, K., Wang, F., Wilson, C., Daher, C., Leong-Grotz, K., Castro, C., & Bindman, A. B. (2003). Closing the Loop: Physician Communication With Diabetic Patients Who Have Low Health Literacy. Archives of Internal Medicine, 163(1), 83.
  18. Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., West, C. P., Sloan, J., & Oreskovich, M. R. (2017). Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Archives of Internal Medicine, 172(18), 1377–1385
  19. Shanafelt, T. D., Noseworthy, J. H., & Executive Leadership Council, M. S. (2016). Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clinic Proceedings, 92(1), 129–146.
  20. Soklaridis, S., Bernard, C., Ferguson, G., & Gauthier, G. (2016). Understanding the effects of physician direct mail pharmaceutical advertising on physician prescribing decisions: A case report from Canada. Journal of Psychiatry & Neuroscience, 41(5), 353–360.
  21. Song, Z., & Baicker, K. (2019). Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes: A Randomized Clinical Trial. JAMA, 321(15), 1491–1501.

The Semen Microbiome and Its Impact on Male Fertility

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

 In 1981, Lynn Margulis published Symbiosis in the journal Cell Evolution, she proposed that life emerged not as the outcome of a competitive race but by interacting organisms joined together for a very specific order. Human body not only consist of trillions of cells but trillions of ancient species including bacteria and it may be surprising that the mitochondria that makes the energy for the body originated from an ancient bacteria and it retained its unique genome that is known as Mitochondrial DNA.

These microbiomes, occupies and live in a harmony in different part of the body and body fluids especially in  the gut, vaginal, and in the semen microbiome. These microbiomes involved in the health and well-being of humans.  Recent research has shed light on the significance of the semen microbiome and its potential influence on male fertility. This article aims to explore the latest findings on the semen microbiome and its relevance to male fertility, drawing from verifiable sources to provide a comprehensive understanding of this emerging field.

Understanding the Semen Microbiome

The semen microbiome, once thought to be microbe-free, has been revealed to host its own microbial community, akin to the microbiomes of the gut and vagina (Hill, 2021). This microbiome comprises a diverse array of microbes originating from various glands in the upper reproductive tract, as well as “drifter” bacteria from urine, the urethra, and potentially from a person’s blood or their sexual partners (Winters & Walsh, 2019). However, the impact of these individual species of bacteria on health has long been a mystery (Hill, 2021).

Recent Research Findings

A recent investigation conducted at the University of California, Los Angeles (UCLA) delved into the semen microbiome’s potential link to infertility, yielding insightful findings (Winters & Walsh, 2019). The study, published in Scientific Reports, identified a bacterial species, Lactobacillus iners (L. iners), associated with sperm motility issues in individuals experiencing infertility (Winters & Walsh, 2019). This microbe, commonly found in the vaginal microbiome, has been linked to impaired sperm motility, a key factor contributing to male infertility (Winters & Walsh, 2019).

The study involved the genetic sequencing of semen samples from 73 men, half of whom were fertile and the other half seeking fertility consultation due to issues such as lower sperm count or motility (Winters & Walsh, 2019). The researchers identified five common bacteria species in the semen microbiome, with high levels of L. iners correlating with impaired sperm motility in men experiencing infertility (Winters & Walsh, 2019). This discovery is significant as it suggests a potential link between the semen and vaginal microbiomes, indicating their influence on each other and their role in fertility (Winters & Walsh, 2019).

Implications for Male Fertility

The findings of this study have far-reaching implications for male fertility. With approximately 50% of infertility cases attributed to male individuals, understanding the role of the semen microbiome in infertility is crucial (Hill, 2021). The research paves the way for the development of targeted treatments aimed at rectifying issues with sperm parameters, potentially alleviating the burden of infertility for couples (Hill, 2021).

Furthermore, the identification of specific bacteria, such as L. iners, and their potential impact on sperm motility opens new avenues for exploring drug targets to address infertility (Hill, 2021). This could lead to the development of innovative treatments tailored to rebalance the semen microbiome, akin to current approaches used to treat bacterial vaginosis in the vaginal microbiome (Hill, 2021).

Future Directions and Implications for Clinical Practice

While the research on the semen microbiome and its connection to male infertility is still in its nascent stages, the findings have set the stage for future comprehensive investigations into the complex relationship between the semen microbiome and fertility (Winters & Walsh, 2019). These studies could potentially lead to the identification of new biomarkers for clinical laboratory testing, offering valuable insights for couples experiencing fertility issues (Winters & Walsh, 2019).

In conclusion, the emerging field of semen microbiome research has unveiled a new dimension in the understanding of male fertility. By shedding light on the role of the semen microbiome in influencing sperm parameters and male fertility, these findings have the potential to revolutionize the diagnosis and treatment of male infertility, offering hope to countless couples striving to conceive.

REFERENCES

  1. Hill, J. E. (2021). The Semen Microbiome: A New Contributor to Male Fertility? Scientific American.
  2. Winters, K., & Walsh, T. J. (2019). Microbial Communities in Semen Could Impact Fertility. University of California – Los Angeles Health Sciences.

Recent Advances in Male Infertility Research

The Health Thread Favicon

Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

Infertility is a prevalent issue with an estimated 9% of couples worldwide experiencing fertility challenges, half of which are attributed to male factors 1 Revolutionary genetic studies like exploring the Y chromosomes sequencing (2)DNA fragmentation techniques as well as recent technological advances like ICSI procedures shed light on various causes and potential treatments for male infertility, offering hope for effected couples.

Challenges & Causes of Male Infertility 1,3,4

Male infertility can stem from a range of factors, including genetic mutations, lifestyle factors, medical illnesses, environmental exposures, and medications. Genetic variations have been identified as a leading cause of male infertility, with recent studies focused on deciphering these genetic markers to develop targeted therapies 1,3 4 . Additionally, oxidative stress has been recognized as a significant contributor to sperm DNA damage and impaired function, emphasizing the potential role of antioxidant supplementation in mitigating these effects 1, 3

Dr Hagai Levine, an epidemiologist at the Hebrew University of Jerusalem, and his colleagues published an analysis in 2017 and an update in 2022 , these two papers found about a 50 percent decrease in sperm concentration since 1970s. 5, 6. 

Furthermore, the decline in sperm count is paralleled by declines in testosterone and increases in testicular cancer and male genital anomalies.

Treatment Approaches 1,3,4,7

Oxidative damage of sperm DNA is positively linked with oligoasthenoteratozoospermia (OAT), and male infertility. The antioxidants are being explored worldwide to combat OAT, sperm DNA fragmentation and reactive oxygen species. Recent prospective, double-blind, randomized, placebo-controlled multi centre trial by Patki et al was conducted in 300 sub-fertile males (25-45 years) has explored the use of antioxidants with a proprietary formula of micronutrients, essential amino acids, antioxidants, and vitamins such as coenzyme Q10, L-carnitine, L-arginine, L-glutathione, vitamins like C, E, B6, B12, B1, A, D, ginseng extract, lycopene, folic acid along with elemental zinc, iron, copper selenium, manganese. Subjects were randomised in either the antioxidant blend treatment group or placebo group, assessed changes in sperm count, motility, normal morphology, semen volume, and percent DFI before and after treatment (90 days). Study results confirmed the well-researched fact of antioxidants being effective to reduce oxidative stress and thus improve sperm DNA integrity and also improved semen parameters in males aged 40 and above.

Furthermore, advancements in reproductive technologies, including intra cytoplasmic sperm injection (ICSI), have significantly enhanced fertilization rates, especially in cases where traditional IVF methods may not be successful 1, 3

Role of Varicocelectomy and Testicular Sperm Extraction 1,3

Conventional male reproductive surgeries, such as varicocelectomy and testicular sperm extraction (TESE), have been studied to broaden their indications for addressing male factor infertility. Varicocelectomy, in particular, has shown improvements in semen parameters, including sperm concentration and motility, following repair 12

Infertility Evaluation & counselling. 3

The American Urological Association (AUA) and American Society for Reproductive Medicine (ASRM) have provided guidelines for the diagnosis and treatment of male infertility, emphasizing the importance of a thorough evaluation to identify potentially treatable causes 3. Moreover, male infertility risk factors, reproductive history, and medical interventions that may impact fertility should be carefully assessed during the evaluation process 3. ASRM/AUA guidelines recommend Clinicians should advise couples with advanced paternal age (≥40) that there is an increased risk of adverse health outcomes for their offsprings. 8

Future Directions and Considerations

Efforts to understand the molecular and genetic factors responsible for spermatogenesis and fertilization are ongoing, offering the potential for improved outcomes in male factor infertility 1,3 . Additionally, the use of assisted reproductive technologies, such as intrauterine insemination (IUI) and in vitro fertilization (IVF), remains crucial in overcoming various causes of idiopathic infertility 3, 4

In conclusion, recent advances in male infertility research have provided valuable insights into the causes and potential treatments for this prevalent condition. By focusing on genetic variations, oxidative stress, and innovative treatment approaches, researchers aim to improve fertility outcomes for affected individuals. 

REFERENCES

  1. Boivin J, et al. “International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care.” Hum Reprod. 2007.
  2. Nature ,Vol 621 14 September 2023.
  3. Smits RM, et al. “Antioxidants for male subfertility.” Cochrane Database Syst Rev. 2019.
  4. Schlegel PN, et al. “Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II.” Fertil Steril. 2021.
  5. Human Reproduction Update, Volume 23, Issue 6, November-December 2017,
  6. Human Reproduction Update, Volume 29, Issue 2, March-April 2023
  7. Transl Clin Pharmacol. 2023 Mar;31(1):28-39
  8. https://www.auanet.org/documents/Guidelines/PDF/Male-Infertility-Guideline.pdf

Herbal medicine and supplements

The Health Thread Favicon

Written By THT Editorial Team

Dr. Hari Sharan Aryal

Reviewed by Dr. Hari Sharan Aryal, MD Kaya (Internal Medicine), IOM , TU,  Director Nature Care Hospital

Herbal medicine and supplements have been used for centuries to treat various health conditions and improve overall wellbeing. These natural remedies are derived from plants and have been used as traditional medicines in many cultures worldwide. In recent years, there has been an increase in the use of herbal medicine and supplements, driven by growing interest in natural and alternative healthcare practices. In this essay, we will explore the types and kinds of herbal medicine and supplements, their uses, and research-based findings.

Types and Kinds of Herbal Medicine and Supplements:

Herbal medicine and supplements come in various forms, including teas, tinctures, capsules, powders, and extracts. Here are some of the most commonly used herbal remedies:

Echinacea: Echinacea is a popular herb used to boost the immune system and prevent colds and flu. Studies have shown that Echinacea can reduce the risk of catching a cold by up to 58% and reduce the duration of symptoms by 1 to 4 days (1).

Ginkgo biloba: Ginkgo biloba is a tree native to China that is used to improve memory and cognitive function. Research suggests that Ginkgo biloba can improve attention and memory in individuals with mild cognitive impairment (2).

St. John’s Wort: St. John’s Wort is a flowering plant used to treat mild to moderate depression. Several studies have shown that St. John’s Wort can be as effective as antidepressant medications in treating mild to moderate depression (3).

Turmeric: Turmeric is a spice commonly used in Indian cuisine and has antiinflammatory properties. Studies have shown that turmeric can help reduce inflammation in the body and alleviate symptoms of osteoarthritis and rheumatoid arthritis (4).

Uses and Research-Based Findings:

Herbal medicine and supplements have been used to treat various health conditions, including anxiety, depression, insomnia, digestive disorders, and chronic pain. Here are some research-based findings on the use of herbal remedies for specific health conditions:

Anxiety: Kava, an herb native to the South Pacific, has been shown to reduce symptoms of anxiety. Studies have reported that Kava can reduce anxiety symptoms by up to 50%, with no significant side effects (5).

Insomnia: Valerian root, an herb native to Europe and Asia, has been used for centuries to treat insomnia. Studies have shown that valerian root can improve sleep quality and reduce the time it takes to fall asleep (6).

Digestive Disorders: Peppermint oil has been shown to be effective in reducing symptoms of irritable bowel syndrome (IBS), including abdominal pain and bloating. Studies have shown that peppermint oil can reduce IBS symptoms by up to 40% (7).

Chronic Pain: Devil’s claw, an herb native to Africa, has been shown to be effective in reducing chronic pain, particularly in individuals with osteoarthritis. Studies have reported that devil’s claw can reduce pain by up to 25% (8).

Safety and Quality Control: Ensuring the safety and quality of herbal medicine and supplements is crucial. Regulatory authorities in many countries have implemented guidelines and quality control measures. It is essential to use products from reputable manufacturers, adhere to recommended dosages, and consult qualified healthcare professionals.

Conclusion: Herbal medicine and supplements offer a natural and alternative approach to healthcare, with many potential benefits for various health conditions. With increasing research and evidence-based practices, herbal remedies are gaining recognition as an integral part of integrative medicine. However, further research, quality control measures, and collaboration between different healthcare systems are necessary to ensure the safe and effective integration of herbal medicine and supplements into modern healthcare practices.

REFERENCES

  • Karsch-Völk, M., Barrett, B , Avins, A. L., & Linde, K. (2014). Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews, (2), CD000530.
  • Weinmann, S., Roll, S., Schwarzbach, C., Vauth, C., & Willich, S. N. (2010). Effects of Ginkgo biloba in dementia: systematic review and meta-analysis. BMC geriatrics, 10(1), 14.
  • Ng, Q. X., Venkatanarayanan, N., & Ho, C. Y. X. (2017). Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. Journal of affective disorders, 210, 211-221.
  • Henrotin, Y., Priem, F., & Mobasheri, A. (2013). Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. Springerplus, 2(1), 56.
  • Sarris, J., Stough, C., Bousman, C. A., Wahid, Z. T., Murray, G., Teschke, R., … & Savage, K. M. (2013). Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. Journal of clinical psychopharmacology, 33(5), 643-648.
  • Fernández-San-Martín, M. I., Masa-Font, R., Palacios-Soler, L., Sancho-Gómez, P., & Calbó-Caldentey, C. (2010). Effectiveness of Valerian on insomnia: a metaanalysis of randomized placebo-controlled trials. Sleep Medicine, 11(6), 505-511.
  • Ford, A. C., Talley, N. J., Spiegel, B. M., Foxx-Orenstein, A. E., Schiller, L., Quigley, E. M., & Moayyedi, P. (2008). Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and metaanalysis. BMJ, 337, a2313.
  • Chrubasik, S., Thanner, J., Künzel, O., & Conradt, C. (2001). Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin® in patients with pain in the lower back, knee or hip. Phytomedicine, 8(2), 123-130.

Breast health and breast cancer awareness

The Health Thread Favicon

Written By THT Editorial Team

Dr. Deepak Shrestha

Reviewed by Dr. Deepak Shrestha, MD , Assosiate Professor(Dept. of OBGYN, Lumbini Medical College)

Breast cancer is one of the most common cancers among women, with approximately 2.3 million new cases diagnosed worldwide in 2020. Breast cancer awareness and early detection are essential for improving breast health outcomes. In this article, we will discuss the importance of breast health and breast cancer awareness, recent research findings related to breast cancer, and best practices for breast cancer screening and prevention.

Importance of Breast Health and Breast Cancer Awareness

Breast health is critical for the overall health and well-being of women. Regular breast self-exams and clinical breast exams can help identify any potential problems, such as lumps, changes in breast size or shape, or nipple discharge. Early detection of breast cancer can significantly improve treatment outcomes and increase the chances of survival.

Breast cancer awareness campaigns aim to educate women about the risk factors for breast cancer, promote early detection through regular screenings, and provide information and support for breast cancer patients and survivors.

Recent Research Findings

Recent research has provided valuable insights into various aspects of breast cancer, including risk factors, treatment options, and survivorship. Some of the recent findings related to breast cancer include:

Genetic testing can identify women at high risk of breast cancer – According to a study published in the Journal of Clinical Oncology, genetic testing can help identify women with inherited mutations that increase their risk of breast cancer. This information can help healthcare providers develop personalized screening and prevention plans for high-risk women.

Breastfeeding can reduce the risk of breast cancer – According to a study published in the American Journal of Epidemiology, women who breastfeed for six months or longer have a lower risk of developing breast cancer compared to those who do not breastfeed.

Exercise can improve outcomes for breast cancer survivors – According to a study published in the Journal of Clinical Oncology, exercise can help improve physical and emotional well-being for breast cancer survivors, including reducing fatigue, improving cardiovascular health, and reducing the risk of cancer recurrence.

Best Practices for Breast Cancer Screening and Prevention

Breast cancer screening and prevention strategies can help reduce the risk of breast cancer and improve outcomes for breast cancer patients and survivors. Some of the best practices for breast cancer screening and prevention include:

Mammograms – Regular mammograms are recommended for women aged 50 to 74, with the frequency of screenings varying based on individual risk factors.

Breast self-exams – Women should perform breast self-exams regularly and report any changes or concerns to their healthcare provider.

Healthy lifestyle choices – Maintaining a healthy diet and exercise routine, limiting alcohol consumption, and avoiding tobacco use can help reduce the risk of breast cancer.

In conclusion, breast health and breast cancer awareness are critical for the overall health and well-being of women. Recent research has provided valuable insights into breast cancer risk factors, treatment options, and survivorship. Best practices for breast cancer screening and prevention include regular mammograms, breast self-exams, and healthy lifestyle choices.

REFERENCES