International Archives of Integrated Medicine
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Item Phytochemistry and pharmacology of Cichorium intybus(Educational Society for Excellence, 2024-02) Riaz, Tahreem; Akram, Muhammad; Laila, Umme; Khalil, Muhammad Talha; Zainab, Rida; Iftikhar, Momina; Ozdemir, Fethi Ahmet; So?owski, Gawe?; Alinia-Ahandani, Ebrahim; Altable, Marcos; Egbuna, Chukwuebuka; Sfera, Adonis; Adnan, Muhammad; Parmar, PragneshCichoriumintybus L., often known as chicory, is a Mediterranean plant species that is a member of the Asteraceae family. It has been known to have therapeutic benefits for a very long time. C. intybus is unique among the six species of Cichorium that are grown in Europe and Asia because of its wide range of uses in conventional medicine. The plant has been used in many traditional medical systems, especially in India, where it has been used to treat a wide range of illnesses, from diabetes to wounds. Chicory contains a wide range of phytoconstituents, including cellulose, proteins, sugar, flavonoids, polyphenols, carotenoids, anthocyanins, tannins, coumarins, sesquiterpene lactones, fatty acids, cholins, benzo-isochromenes, alkaloids, vitamins, and minerals. The diverse ranges of therapeutic benefits associated with C. intybus are partly ascribed to this phytochemical composition. The pharmacological actions of chicory, which have been demonstrated to range from hepatoprotective to anti-inflammatory, demonstrate the plant's versatility and its potential to treat a variety of illnesses. This article offers a thorough investigation of C. intybus L.'s phytochemistry and pharmacological applications. This review attempts to be a useful resource for researchers, medical professionals, and practitioners interested in using Cichoriumintybus's medicinal properties for improving human health by compiling the body of knowledge on the botanical and chemical aspects of chicory as well as its therapeutic applications.Item Case report: Hidden Adenocarcinoma of the lung in an obese non-smoker presented with pulmonary embolism(Educational Society for Excellence, 2024-02) Abeysundara, Anura; Jayakody, SDB; Udupihille, JJKH; Rathnayake, JeewanthaBackground: Lung carcinomas are responsible for the highest number of deaths among cancers in the world. The annual new incidences exceed 2.1 million, only secondarily to breast cancer. 70% of cases occur in smokers. The majority is presented with insidious onset features of chronic cough, shortness of breaths, recurrent pneumonias, weight loss and lethargy. Majority of incidentally found patients, who are asymptomatic are in the early stages, hence have a chance for surgical resection with a better prognosis. Case report: This 44-year-old obese, non- smoking male patient presented with a short duration of pneumoniaand venous thromboembolism (VTE) and a sudden onset of pulmonary embolism (PE). A secondary deposit found in the liver suggested an adenocarcinoma of the lung by immunohistochemistry. At the time of presentation, it was classified as stage 4. The patient had to be ventilated due to the respiratory difficulty accompanied with obesity, PE and pneumonia. Unfortunately, patient died seven days following admission to intensive care unit (ICU), not allowing for chemotherapy, which was the option of treatment.Conclusion: Hidden carcinoma of the lung can easily be missed in a non-smoker who is at a lower risk for lung cancer. Presence of VTE and PE in an obese non-smoker may mask the diagnosis further. Extreme vigilance, complete and through investigations are needed to diagnose a hidden carcinoma of the lung.Item Antibiotic Sensitivity Pattern of Burkholderia cepacia complex in blood stream infections in a tertiary care hospital(Educational Society for Excellence, 2024-02) Patel, Dhwani; Mavani, Monika; Parmar, Kajal; Javadekar, Tanuja; Lakhani, SuchetaIntroduction: Burkholderia cepacia complex (BCC) is ubiquitous in nature, present in water, soil, and plants. BCC is comprised of Gram-negative non-lactose-fermenting bacteria. Gram negative, non lactose fermenting Burkholderia cepacia complex has emerged as an opportunistic nosocomial pathogen causing significant morbidity and mortality in hospitalized patients owing to its high antibiotic resistance. This study was aimed to determine prevalence of Burkholderia cepacia complex and to evaluate sensitivity pattern of Burkholderia cepacia complex in blood stream infections in Dhiraj Hospital, Gujarat which is a tertiary care hospital and teaching institute. Materials and Methods: The present study was conducted in the Department of Microbiology for a period from January 2022 to December 2022 of Dhiraj General Hospital, SBKS MI & RC, Waghodia, Gujarat. All samples were received in central laboratory and blood cultures were processed in BD BACTEC FX40. The positive culture bottles were sub cultured on Mac Conkey agar, Blood agar and Nutrient agar and were incubated for 24 hours at 37?C.The data was collected and analyzed statistically. Results: During the study period 31 positive samples for BCC were isolated from a total of 612 culture samples, thus the prevalence rate was 5.06% in our setup. BCC was found majorly in ICUs (65%) and in wards (35%).The isolates showed maximum sensitivity to Co-Trimoxazole (83.87%), followed by Ceftazidime (58.06%), Meropenem (54.83%) and Minocycline (51.61%).Conclusion: From various studies and our study we could conclude that there were variations in the results of drug sensitivity. So, there is need to properly isolate and do antibiotic sensitivity testing for better patient management. Prompt diagnosis is essential step to reduce mortality and establish infection control practices.Item Antibiotic Resistant Pattern of threatening pathogen Acinetobacter baumannii in a tertiary care hospital(Educational Society for Excellence, 2024-02) Mavani, Monika; Parmar, Kajal; Patel, Dhwani; Javadekar, Tanuja; Date, Vidya SIntroduction: Acinetobacter species are aerobic gram-negative bacteria that are ubiquitous in nature. Being a multidrug-resistant and an invasive pathogen, Acinetobacter baumannii is one of the major causes of nosocomial infections in the current healthcare system. It has been recognized as an agent of pneumonia, septicemia, meningitis, urinary tract and wound infections, and is associated with high mortality. We aimed this study to evaluate resistance pattern of a threatening pathogen i.e., Acinetobacter baumannii. Materials and method: The present study was conducted in Microbiology Department of SBKSMIRC, Dhiraj Hospital, Waghodia, Gujarat during May 2022 to December 2022. This study included all Acinetobacter baumannii isolated from all ages and microbiological specimens which were referred to Central Microbiology Laboratory of Dhiraj Hospital. The Non-Lactose fermenting, oxidase negative organisms are kept in VITEK 2 automated system for identification and sensitivity. All isolates identified as Acinetobacter baumannii were included in the study. Results: This study included a total of 52 isolates of A.baumannii. Out of which 33% were respiratory samples (sputum, Endo-tracheal secretions), 33% were pus samples, 11% were urine samples and 23% were included in other (blood, CSF, Body fluids). The most resistant drug was ceftriaxone (88.46%). Tigecycline was found to be 100% sensitive.Conclusion: This study concludes that Tigecycline is the only drug which is most sensitive for A. baumannii and other higher drugs such as Polymixin B, Colistin etc. shows less resistance. Acinetobacter infection would remain a therapeutic challenge in our hospital and health care settings due to the increasing rate of Acinetobacter species with traits of MDR and resistance to high potent antimicrobial agents.Item A Review on Ethnobotanical, Pharmacological, and Conventional uses of Fumaria indica(Educational Society for Excellence, 2024-02) Chishti, Muhammad Amjad; Ahmad, Rafiq; Riaz, Tahreem; Akram, Muhammad; Laila, Umme; Khalil, Muhammad Talha; Zainab, Rida; Iftikhar, Momina; Ozdemir, Fethi Ahmet; So?owski, Gawe?; Alinia-Ahandani, Ebrahim; Altable, Marcos; Egbuna, Chukwuebuka; Sfera, Adonis; Adnan, Muhammad; Parmar, PragneshAn annual herb is known as "Fumitory," Fumaria indica (Hausskn.) Pugsley (Fumariaceae), is a widespread weed in Pakistan's and India's plains. The plantis frequently employed in the Unani and Ayurvedic medical systems, both as a single herb and in different polyherbal preparations. It is helpful for aches, diarrhea, fever, influenza, liver issues, dyspepsia, constipation, vomiting, diuretic, anthelmintic, leukoderma, diaphoretic, blood purification, and for jaundice when combined with black pepper. It has several different chemical components, including carbohydrates, amino acids, proteins, phenolic compounds, alkaloids, flavonoids, terpenoids, glycosides, phytosterols, fixed oils, saponins, steroids, tannins, and more. According to research investigations, this plant has a wide range of pharmacological properties, including antioxidant, analgesic, anticancer, antidiabetic, antibacterial, aphrodisiac, and therapeutic effects on biliary disorders and irritable bowel syndrome. This review focused on the chemical components and pharmacological properties of this plant, which may be useful in future molecular and phytochemical research for the development of medication formulations for the treatment of various ailments.Item Evaluation of vessel diameters in processed medical retinal images(Educational Society for Excellence, 2024-12) Obreja, Cristian-Drago?This study focuses on evaluating image processing techniques for measuring retinal vessel diameters, a critical aspect of medical image analysis for diagnosing vascular abnormalities such as diabetic retinopathy. Four algorithms, Canny Edge Detection, Marr-Hildreth Filter, Watershed Segmentation, and Chan-Vese Algorithm, were assessed for their segmentation performance and measurement accuracy. A dataset of 70 retinal images from the DRIVE database, comprising both healthy and diabetic retinopathy cases, was used. Each algorithm was implemented in MATLAB and tailored to address challenges like noise, intensity variations, and weak boundaries. Vessel diameters were calculated using a custom MATLAB algorithm based on the full width at half maximum (FWHM) of intensity profiles, with linear interpolation refining the measurements. This work highlights the potential and limitations of these algorithms in achieving accurate and reliable vessel segmentation for medical imaging applications.Item "Effect of Variable Storage Media” on the Assessment of Shear Bond Strength of Orthodontic Brackets – An In vitro Study(Educational Society for Excellence, 2024-02) Kaur, Nameeta; Mushtaq, MohammadIntroduction: Various storage media have been used in orthodontic shear bond strength studies, however, the effect of the storage media on human enamel has not been studied. Aim: The purpose of this in vitro study was to determine the effect of four commonly used storage media on the shear bond strength values of orthodontic brackets bonded on extracted human teeth. Materials and methods: A total of 60 freshly extracted non-carious premolars teeth were randomly divided into four groups. Group 1 was stored in distilled water, samples of group 2 were stored in 10% formalin, group 3 were preserved in 70% ethanol and samples of group 4 were stored in isotonic saline solution. After a storage period of 30 days, the teeth were rinsed and brackets bonded with TransbondXT and the specimens were evacuated for shear bond strength. Results: The 10% formalin sample had statistically significant greater bond strength than the other test groups. The 70% ethanol group had statistically lower bond strength compared to the other groups. The distilled water and isotonic saline solution group showed bond strength which was comparable. Conclusion: Storage media have an effect on the bond strength results. Distilled water and isotonic saline storage produced comparable bond strength. Formalin and ethanol storage produced extreme variation in SBS.Item Assessment of Root and Canal Morphology of Mandibular Second Molar Teeth in a Group of Kashmiri Patients: A Cone Beam Computed Tomography Study(Educational Society for Excellence, 2024-12) Masoodi, Ajaz Amin; Zargar, Ab Wahid; Ahangar, Fayaz Ahmed; Shafia; Purra, Aamir RashidMandibular second molars exhibit considerable anatomical variability, posing challenges during endodontic procedures. This study aimed to analyze the root and canal morphology of 100 mandibular second molars from 62 Kashmiri patients using cone beam computed tomography (CBCT). The study emphasized Vertucci’s and Fan’s classifications for canal configurations and C-shaped canals. Two- rooted molars predominated (86%), with Type IV (48%) and Type I (84%) configurations being most common in mesial and distal roots, respectively. C-shaped canals were present in 12% of cases, emphasizing the need for advanced diagnostic tools like CBCT to enhance clinical outcomes. These findings contribute to understanding the anatomical diversity in the Indo-Aryan Kashmiri population.Item The study of clinical and histopathological characteristics of oral malignant and premalignant lesion(Educational Society for Excellence, 2024-02) Awasthi, Akanksha; Bajpai, AnanyaIntroduction: Oral malignancy is one of the common malignancies in the world. The annual estimated incidence is around 275,000 with two-third of these cases occurring in developing countries. The most common type among these is squamous cell carcinoma constituting about 90%. The present study aimed to evaluate and compare the clinical and histology characteristics of malignant and premalignant lesions from oral cavity. In addition to that we also wanted to determine the clinical features of oral cavity lesions and to assess the correlation of oral cavity lesions among smokers, tobacco chewers, betel nut and alcohol user. Material and methods: The present study was carried out in the Department of Pathology from January 2018 to April 2022 at R.D. Gardi Medical College, Ujjain. Total 118 cases of oral malignant and premalignant lesions were selected for the study who were subjected to histopathology examination, after institutional and research committee approval and with due consent of the patient. All the oral cavity lesions were included which are adequate, representative of the lesion, properly resected surgical specimens such as punch biopsies, incisional biopsy, wedge biopsies, surgical excision, and hemimandibulectomy received in the surgical histopathology laboratory. Results: Among 118 cases, majority (n=84, 71.2%) of the cases presented with ulcer in oral cavity, 51 (43.2%) cases were presented with pain in oral cavity and 24 (20.3%) cases were presented with swelling in oral cavity. We found statistical significant association (p=0.049) between involved anatomical site and age groups in studied cases. No significant association (p=>0.05) between patients’ habit and squamous cell carcinoma differentiation was observed.Conclusion: Our study concluded that there was no significant association (p>0.05) between habits and site of the lesion of oral cavity. Among tobacco chewer and smokers, most common site was buccal mucosa and among alcohol user, tongue was the most common site of the lesion. On histopathology, majority of lesions were malignant, among malignant lesions the most common lesion was squamous cell carcinoma, while the most common premalignant lesion was leukoplakia.Item Stability of Prothrombin time (PT) and activated partial thromboplastin time in frozen citrated plasma for 7 days(Educational Society for Excellence, 2024-09) Warade, Jayesh PrabhakarBackground: Tests for hemostasis include prothrombin time (PT) and activated thromboplastin time (aPTT). Prothrombin time (PT) and activated partial thromboplastin time (APTT) are tests of hemostasis employed in the evaluation of coagulopathies and monitoring of anticoagulant drug therapy. These tests are supposed to be influences by many preanalytical factors. Objective: In this study, we have evaluated the stability of aliquoted plasma of blood sample collected in sodium citrate tubes for prothrombin time and activated partial thromboplastin time stored at - 20 0C for a period of 7 days. Material and Methods: 67 Patients samples collected for PT and APTT were stored for 7 days at – 20 0C in different aliquots. One aliquot is taken out daily and tested for PT and aPTT. Results were compared with initial tests results. Results: It was found that there was no significant difference between initial test results and test results of the samples are stored at – 200C. Conclusion: Samples which are collected for coagulation studies in sodium citrate preservative, if are centrifuged immediately and plasma is stored at – 200C, result generated for PT and aPTT do not show any statistically significant difference compared to samples which are immediately processed.Item Optimizing retinal vessel visualization using multi-exposure fusion and adaptive contrast enhancement for improved diagnostic imaging(Educational Society for Excellence, 2024-11) Obreja, Cristian-Drago?This study presents a multi-exposed fusion algorithm aimed at enhancing the quality of retinal images captured under variable illumination conditions. Retinal imaging devices frequently struggle with inconsistent lighting, which can lead to low-contrast images where critical vascular details may be lost. The proposed algorithm combines multiple exposures, preserving the best features from each - improving both clarity and detail. Using the database of 40 retinal images, the method evaluates image quality through the structural similarity index measure (SSIM). Results indicate high structural similarity between fused images and input images across different illumination levels, with SSIM values above 0.9 for medium and high exposure. Furthermore, incorporating Contrast-Limited Adaptive Histogram Equalization (CLAHE) enhances contrast, facilitating clearer vessel visualization against the background. The improved contrast and detail retention achieved by the algorithm support accurate retinal vessel analysis, which is crucial in diagnosing conditions like diabetic retinopathy and glaucoma. This approach provides a robust, enhanced imaging solution for medical diagnostics, significantly improving readability and reliability in retinal assessments.Item Turkish Validity and Reliability Study of Spirituality in Palliative Care Scale(Educational Society for Excellence, 2024-09) Vicdan, Ayse Kacaroglu; Baybuga, Media Subas?; Akpinar, HavvaAim: This study aimed to assess the validity and reliability of the “Spirituality in Palliative Care Scale” among nurses in Türkiye. Methods: The study was carried out with a methodological design. The study population consisted of nurses working in internal medicine and surgical clinics at a training and research hospital located in the western part of Türkiye between November 15, 2022, and April 12, 2023. The data for the study were collected through face-to-face interviews with nurses during their weekday break times in the clinics they worked. Results: Considering the opinions of the experts, the content validity indices of the scale items ranged between 0.88 and 1.00. As a result of the factor analysis, the number of items in the scale decreased from twelve to eight. The total variance explanatory value of the acceptance and spiritual nursing behaviors subscale was 35.010%, that of the ability to be mindful subscale was 30.783%, and that of the Spirituality in Palliative Care Scale was 65.792%. The factor loadings of the scale items ranged from 0.636 to 0.852. The Cronbach?s alpha coefficient for the scale with eight items was found to be 0.851, for the ability to be mindful subscale was 0.728, and for the acceptance and spiritual nursing behaviors subscale was 0.843.Conclusion: It was determined that the Turkish version of the Spirituality in Palliative Care Scale met the validity and reliability criteria at an acceptable- level. The scale, which has an important place in the evaluation of Spirituality in Palliative Care, can be used in clinical studies.Item The Adaptation of the Disaster Nursing Readiness Evaluation Index for Nurses in Türkiye(Educational Society for Excellence, 2024-09) AKGÜN, ?enay; ÖZTA?, Duygu; ÖZPULAT, Funda; ?EN, Ye?im ÇET?NKAYABackground: Türkiye frequently faces natural disasters, especially earthquakes. That’s why this study aimed to translate and validate the Disasters Nursing Readiness Evaluation Index (DNREI) for Nurses in Türkiye was developed by Maeda, et al. in 2018 to Turkish. Methods: This was cross-sectional and methodological research. The index used in this study was 37 items and 6 sub-dimensions. There search was conducted with 362 nurses selected through snow balling sampling. Disasters Nursing Readiness Evaluation Index-TR was applied to determine the validity and reliability using the exploratory and confirmatory factor analysis. Cronbach's alpha analysis and the Split-Half Method were used to determine internal consistency. Dependent samples t- test to compare the test-retest scores for time invariance; and intra-class correlation coefficient. Results: The content validity of the Turkish version of the index is between 0.87 and 1.00. The content validity index score was found to be 0.92. The Split-Half method was applied to analyze reliability and there liability coefficients were found to be 0.83 and 0.85. As a result of theconfirmatory factor analysis of the DNERI-TR, it was found that the 6-factor structure of the scale was valid and the goodness of fit tests was appropriate. Conclusion: The “Disasters Nursing Readiness Evaluation Index-TR” was found to have a high level of reliability and validity for nurses in Türkiye to evaluate the disaster readiness of nurses and to develop a disaster education model for life-long learning.Item Constructive Alignment in Forensic Learning: Enhancing Educational Outcomes(Educational Society for Excellence, 2024-10) Parmar, Pragnesh; Rathod, GunvantiConstructive alignment is an educational principle that aligns learning objectives, teaching activities, and assessment tasks to enhance student learning outcomes. In forensic learning, which integrates theoretical knowledge and practical skills, constructive alignment ensures that all components of the curriculum work cohesively to support student mastery of forensic medicine or forensic science. This article explores the concept of constructive alignment in forensic education, discussing its principles and providing examples to illustrate its application.Item Comparison of the resin luting cements for the fracture resistance of endodontically treated teeth with prefabricated glass fiber posts - An in-vitro study(Educational Society for Excellence, 2024-09) Shujaulla, SyedBackground: This is an in-vitro study done to compare the effect of ferrule on fracture resistance of endodontically treated teeth restored with the glass fiber post cemented with two different esthetic resin modified cements Aim: To compare the fracture resistance of endodontically treated teeth restored with prefabricated glass fiber posts luted with two different resin cements. Materials and methods: Forty-eight freshly extracted maxillary central incisors of similar dimensions were used. The teeth were endodontically treated and decoronated to the level of the facial CEJ. The teeth specimens were divided into two groups of twenty-four each. In both the groups the Bioloren glass fiber posts were used. In Group 1 the posts were cemented with CALIBRA® esthetic resin system. In Group 2 the posts were cemented with SMARTCEMTM2. Cores were built using composite resin material. The teeth were then embedded in auto polymerizing acrylic resin blocks. The specimens were subjected to loading in a universal testing machine. The data obtained was subjected to statistical analysis. Results: The fracture resistance was higher for group 2 teeth with a mean ±SD of 2744±452.56340. The failure load observed in Group 1 was lower with a mean ±SD of 2178±452.56344. The one way ANOVA showed that in both the groups resin modified cements (Calibra® esthetic resin cement andSmartCemTM2) highly significantly influenced the resistance of the specimen to fracture under static loading (P < 0.002 and P <0.001 respectively). Conclusion: The inherent strength of the SmartCem™2 enhanced stability and strength of the overall restoration when compared to Calibra®. Further studies should incorporate thermal cycling of the specimen and cyclic loading, stress distribution patterns, photo elastic analysis, finite element analysis and model studies to achieve better results.Item Increase in Animal Bites: A Growing Concern for Srinagar’s inhabitants(Educational Society for Excellence, 2024-07) Nabi, Shahroz; Kawoosa, Misbah Ferooz; Sabah, Iram; Ayoub, ShifanaRabies is a zoonotic disease which is spread by animals to humans. Srinagar city in Kashmir, is home to more than 1 million inhabitants. According to data obtained from the Anti-Rabies Clinic (ARC) at SMHS Hospital, between April 2023 and March 2024, the ARC documented a total of 8,652 bite cases. These included 5,386 dog bite cases, 2,844 cat bite cases, 27 monkey bite cases, 95 cow bite cases, 14 bear bite cases, 12 wild boar bite cases, and 294 other bite cases involving leopards, jackals, eagles, and more. Addressing the rise animal bite cases requires a multi-faceted approach. By addressing the root causes and implementing preventative measures, it is possible to reduce the incidence of cat bites and ensure the safety and well-being of Srinagar’s residents. Mutisectoral collaboration and coordination can drastically reduce the incidence of animal bite related rabies in Srinagar city.Item A study of ‘P’ wave axis in emphysema in elderly(Educational Society for Excellence, 2024-08) Sharma, Sadhna; A, ManishaChronic obstructive pulmonary disease (COPD) can affect the Cardiovascular system as secondary effects of the disease. The Electrocardiography is a good investigation for early recognition of any cardiac changes that occurs as a result of secondary effects of COPD. The vertical P-wave axis on ECG is a useful criterion for screening patients with COPD. The correlation between vertical P-wave axis and Emphysema was investigated on a number of controlled series to see if P-axis verticalization as lone criterion can be effectively used to screen emphysema in general population. Correlation between degrees of P-axis verticalization and the severity of the obstructive lung disease was also studied to see if this criterion can be used for gross quantification of the Chronic obstructive pulmonary disease (COPD). Objective of the study is to study the P wave axis and its correlation with severity of COPD.Item A Comparative Analysis of the Hippocratic Oath and Charak Oath in Medical Ethics(Educational Society for Excellence, 2024-07) Parmar, Pragnesh; Rathod, GunvantiMedical ethics serves as the cornerstone of the healthcare profession, guiding practitioners in their commitment to patient welfare and ethical decision-making. Two ancient ethical codes, the Hippocratic Oath and the Charak Oath, have significantly influenced medical ethics throughout history. This article undertakes a comprehensive comparative analysis of these ethical codes, examining their origins, principles, and applicability in the contemporary healthcare landscape.Item A Comparative Study of Endothelial Dysfunction in Essential Hypertension(Educational Society for Excellence, 2024-08) Sharma, Sadhna; Ramya, SrirangamEndothelium plays a fundamental role in the cardiovascular system, forming an interface between blood and adjacent tissues by regulating the vascular tone through the synthesis of nitric oxide, prostaglandins and other relaxing factors. Endothelial dysfunction is characterized by vasoconstriction, cell proliferation and shifting toward a proinflammatory and prothrombic state. In hypertension endothelial dysfunction may be involved in the initiation and development of vascular inflammation, vascular remodeling, and atherosclerosis and is independently associated with increased cardiovascular risk. Different conditions such as impaired vascular shear stress, inflammation and oxidative stress, activation of the renin angiotensin system have been described as important pathophysiological mechanisms involved in the development of endothelial dysfunction. The release of extracellular vesicles by neighboring cells in the vascular wall has emerged as an important regulator of endothelial function and with potential antihypertensive properties and beneficial effects by counteracting the hypertension mediated organ damage. Furthermore, macrovesicles are emerging as an innovative therapeutic approach for vascular protection, allowing the delivery of bioactive molecules, such as miRNA and drugs interacting with the renin angiotensin system.Item A critical discussion of the outcome literature of cognitive behavioural therapy for social anxiety disorder(Educational Society for Excellence, 2024-01) Riaz, Tehreem; Akram, Muhammad; Iftikhar, Momina; Ozdemir, Fethi Ahmet; Solosky, Gawel; Ghauri, Aymen Owais; Sfera, Adonis; Parmar, PragneshSAD is a common mental condition with high prevalence rate and early onset resulting in the social avoidance and dysfunctioning. From the outcomes of several research studies it is highlighted that among of the numerous cognitive behavioural model, individual behavioural therapy plays most important role for social anxiety disorder. The research on CBT's effectiveness in treating SAD symptoms and a poor life quality is summarised in this article. In this review, the relative effectiveness of various CBT techniques is also discussed for both short-term and long-term follow-up periods. This review examines the strengths and limitations of the existing evidence base by critically examining empirical studies in this topic. It examines methodological concerns like as sample characteristics, outcome measurements, and treatment regimens, all of which might have an impact on the interpretation of results. Furthermore, the study identifies areas that require additional investigationand makes recommendations for future studies to improve SAD understanding and treatment. The aim of this review is to offer a thorough examination of the existing outcome literature on CBT for SAD. The study investigates the efficacy of CBT in lowering symptoms of social anxiety and enhancing functional results. It also investigates long-term therapy maintenance and discovers potential moderators and mediators of treatment outcomes.