OSP Journal of Health Care and Medicine

The topical delivery of bromelain as an anti-inflammatory solution for skin inflammation has attracted the attention of researchers. Due to the skin barrier issue, a new method was designed for the effective delivery of specific doses of bromelain to the desired action sites. A niosome was selected as a novel and practical transdermal vehicle for the delivery of bromelain to inflamed sites. In this regard, a lipopolysaccharide (LPS)-induced human skin fibroblast (HSF1184) cell line was assembled in-vitro as a simulated model. The levels of interleukin-6 (IL-6) and tumour necrosisfactoralpha (TNF-α), the two immune-modulatory regulators of cell responses to inflammation were measured to determine the response towards the niosome-encapsulated bromelain treatment. The results showed that the niosome-encapsulated bromelain significantly reduced the levels of IL-6 and TNF-α compared to the non-encapsulated bromelain, the vehicle (niosome) and the control.

An experimental and clinical study of improved methods for applying colonic anastomoses was conducted. An experimental study was conducted on 30 mongrel dogs. The results of treatment of 165 patients with acute sigmoid colon obstruction were analyzed. The study showed that the use of improved methods for applying colonic anastomoses significantly improved the results of treatment of acute sigmoid colon obstruction.

The experiments were carried out on 145 white rats of a mixed population with an initial weight of 150-200 g contained in vivarium on a normal laboratory diet. The aim of this work was to evaluate and change the rheological properties of blood in experimental hypoxic conditions. The results showed that in acute hypoxia there are sharp violations of the physical properties of erythrocyte membranes, the severity of which, depending on its genesis.

PFAFA (Periodic Fvever, Aftous Stomatitis, Pharyngitis, Adentitis) Syndrome Represents the Most Common Cause of Periodic Fever in Paediatric Age. The Syndrome is Characterised by Recurrent Fever With at Least One of The PFAFA-Associated Symptoms. The Diagnosis of PFAFA Is Defined According to the Modified Marshall’s Criteria Modified by Thomas Et All.

We Have Evaluated the Recurrence of PFAFA Syndrome During the Italian Lockdown (March-May 2020) in Comparison to Previous Periods, Our Study Shows a Significant Reduction of Recurrence of PFAFA Syndroem Episodes in the 2020, Probabely Determined by Closure of School and by Social Distancing Measures Causing Interruption of Any Trigger Events, Despite the PFAF a Became Seemingly Unprovoked. More Studies are Needed in Order to Explaine the Trigger of PFAFA Syndrome

The purpose of this study is to evaluate the impression of IgG and IgM antibodies in autoimmune v/s severe COVID-19 infection. The objectives were to compare the levels of IgG and IgM antibodies in autoimmune and COVID-19 infection and to study the relationship between the duration of disease and levels of IgG and IgM. It was a retrospective observational study, carried out in inpatient wards of Continental Hospitals, Hyderabad, for a period of 6 months. The laboratory parameters and pharmacotherapy details were collected in the pre-designed annexure form.  This observational retrospective study was done among 67 patients in tertiary care hospital in Hyderabad. In this study, the total study population was divided into two groups –Patients diagnosed with at least one autoimmune disease (Group I). Patients were diagnosed with Severe COVID-19 infection in our study (Group II). Infants and neonates are excluded from our study. a significant difference was seen in the mean of IgG between group I and group II patients. The IgG levels were found to be significantly higher in autoimmune diseases when compared with that of severe covid-19 infections. A significant difference was seen in the mean of IgM between group I and group II patients. IgM levels were found to be significantly higher in autoimmune diseases when compared with that of severe COVID-19. We conclude that autoimmune diseases are more prevalent in women of childbearing age. IgG and IgM levels were found to be increased with an increase in severity in both autoimmune disease and coronavirus disease. Hence, IgG and IgM antibody test may be useful as effective predictors in diagnosis and severity of autoimmune disease and severe coronavirus disease.

An 50 -year-old man presented to our institution complaining of recurrent fever and a mitral regurgitation murmur. He has a past history significant for paroxysmal atrial fibrillation being treated with drug rate control as atenolol and calcium channel blocker drugs as ( isopten ) 15 days ago, hypertension, hyperlipidemia, obstructive sleep diverticulosis and diverticulitis . her lab was normal and renal function was normal . (urea. creatine . uric acid) and so no adrenal or parenchymal kidney disease with normal renal artery flow she underwent a transthoracic echocardiogram which showed normal left ventricular size and no wall motion abnormalities, LVEF of 56%, severe mitral regurgitation due to incomplete cooptation of the mitral valve leaflets, trivial tricuspid regurgitation, and no pericardial effusion. A transesophageal echocardiogram confirmed restricted mitral valve leaflets resulting in incomplete cooptation and severe mitral regurgitation). No vegetation were seen. Blood cultures ruled out endocarditis as the cause of fever, and he was later found to have. leukemia

The review contains an analysis and comparison of randomised controlled trials to determine the efficacy of treatment for patients suffering from hypercholesterolemia. Intervention in trials was subject to atorvastatin treatment (established first line medication) or inclisiran (recently approved; subject to combination therapy). Outcome measures include the efficacy of both medications in treating hypercholesterolemia.

Introduction:A case control study with a sample size 117 of patients with COVID-19 infection were investigated in order to examine the benefit of usage of anticoagulants in a retrospective manner in the state of Florida. Recently, researchers found that COVID-19 is associated with a higher incidence of thrombosis than the general population. There are various mechanisms proposed for thrombosis development, most of which are still not fully understood. The addition of anticoagulants during treatment for COVID revealed a significant mortality benefit, about 8% died in the case group including 80% of whom did not receive anticoagulant. In contrast, 37% died in the control group, 4 (80%) out of 5 patients who survived were already on anticoagulants prior to the admission. A significant P value has been seen with 0.0001, OR 41.2 and CI 95%.

Background and objective: The aim of the study is to assess the fundamental roles of anticoagulants in treatment of COVID-19 patients and an improvement of the survival rate. The goal is to provide statistical evidence that anticoagulants correlate with an improvement of the survival rate and reduce the hospitalization.

Method: Case-Control Study was conducted in COVID-19 patients and admitted to hospital. The data was obtained from two different hospitals in Florida for the year 2020-2021. Total of 117 patients were included in the study and were assigned to either the case group or the control group. In the case group; there were 65 patients versus 52 patients in the control group.

Results: In one hundred seventeen patients, 53 out of 65 patients in the case group received anticoagulants, while only 5 out of 52 in the control group were already on anticoagulants secondary to medical conditions. Additionally, 24 patients died, however only 5 out of 65 patients in the case group versus 19 out of 52 in the control group, such implementation suggests a decrease in mortality rate with the use of anticoagulants.

Conclusion: The usage of anticoagulants in COVID-19 patients provided a drastic decline in mortality rate and reduced hospitalization.

Objective: To clarify the long-term cumulative survival rate (CSR) and standardized mortality ratio (SMR) of rheumatoid arthritis (RA) and osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA).

Method: Data for 325 RA and OA patients with 460 primary TKAs from 1997 to 2007 were reviewed. We divided the patients into ≤70 years (u70) and ≥71 years (o71) groups. The follow-up duration in the RA group (n=118) was 12.8±4.8 years vs 13.0±4.1 years in the OA group (n=207).

Results: The SMR of the female RA patients was 1.97 (95%CI 0.96-3.89) after 5 years and 4.59 (95%CI 3.44-6.10) after 20 years. The SMR in female OA patients was 0.41 (95%CI 0.17-0.93) after 5 years and 1.31 (95%CI 0.996-1.73) after 20 years.

The 20-year CSR of female RA-o71 patients was lowest with 9.6 (95%CI 0-26). There was no significant difference in CSR between the RA-u70 and OA-o71 groups. The CSR in the OA-u70 group was highest with 77.8 (95%CI 0.62-0.93). Cox proportional hazards model analysis of female patients showed that steroid-use [Hazard ratio (HR) 3.22, 95%CI 1.32-13.46], age (HR 1.09, 95%CI 1.05- 1.30), and rheumatoid factor (HR 1.002, 95%CI 1.00-1.01) were risk factors in the RA-u70 group.

In the RA-o71 group, steroid use (HR 4.71, 95%CI 1.35-16.7), age (HR 1.38, 95%CI 1.12-1.71) and C-reactive protein (HR 1.20, 95%CI 1.02-1.41) were risk factors, whereas in the OA group, only age at surgery (HR 1.10, 95%CI 1.033-1.163) was a risk factor.

Conclusion: SMR of female patients was high in RA and low after 5 years in OA. RA-u70 patients had the similar cumulative sur- vival curve as OA-o71. The CSR of RA-o71 patients was poor. The preoperative factors affecting survival differed between u-70 and o-71 in RA.

Background: While the medical fee system for acute care in Japan provides incentives to ensure that patients are discharged early, it does not incentivize the direct reduction of postoperative complications. This retrospective study highlighted the importance of rewards for providing high-quality surgery to patients requiring open colectomy to reduce postoperative complications. The impact of postoperative complications on hospital stay length was investigated.

Methods: This study analysed 1,096 patients who underwent open colectomy between May 2004 and December 2008. A stepwise multiple regression analysis was performed to estimate the effect of complications on the length of hospital stay. The Kaplan–Meier survival analysis was used to estimate the cumulative probability of hospital stay.

Results: The mean length of hospital stay was 24.84 (SD=2.25) days. Approximately 0.9% of the patients experienced postoperative peritonitis, while 2.5% experienced postoperative ileus. The hospital stay length was prolonged by 69.9% and 51.6% (p<0.01) for the patients with postoperative peritonitis and postoperative ileus, respectively. The cumulative probability was higher for patients with complications than those without complications.

Conclusion: This study provides empirical evidence on the need to improve the quality of surgery, which will benefit patients and hospitals. It also highlights the importance of providing additional rewards to reduce postoperative complications.

Background: Caregivers of patients with dementia are chronically stressed, and dementia symptoms can increase a caregiver's sense of burden. In general, low psychological well-being due to chronic stress is associated with low HDL cholesterol (HDL-C).

Purpose: This study aimed to examine the relationship between HDL-C in caregivers of patients with dementia and caregiving factors and dementia symptoms of their care recipients.

Method: We conducted a cross-sectional analysis of HDL-C and caregiving factors as a reflection of the health status of caregivers of patients with dementia, and idleness and indifference as symptoms of their care recipients.

Result: Daily caregiving time and idleness and indifference symptoms of patients with dementia were independent predictors of HDL-C in caregivers (P<0.05).

Discussion: Caregivers spent more time taking care of patients with dementia, and they themselves may have become mentally depressed and less motivated due to the lack of improvement in their care recipients’ condition. This may have disrupted their life and prevented them from living actively.

Conclusion: In order to improve the HDL-C status of caregivers of patients with dementia, it will be important to reduce caregiving time by using services that provide caregiver support. This, in turn, would allow caregivers to live actively and improve their motivation and quality of life.

Most cases of hypothyroidism (low thyroid function) go undetected because laboratory tests measure only the presence of thyroid hormone in the blood but cannot tell us how much active hormone reaches the bodily tissues that require it for their metabolism. The main function of the thyroid gland is to regulate metabolism. The primary hormone secreted by the thyroid is thyroxine (T4), which is physiologically inactive. T4 has to be converted into its active form, triiodothyronine (T3), in order to exert its effects. This conversion is catalyzed by the action of deiodinase enzymes that are widely distributed throughout most tissues of the body. If insufficient T3 reaches bodily cells, the result is diminished basal metabolism and concomitant hypothyroidism. Low thyroid function is a physiological issue that often escapes detection by hormone blood tests. There is, however, a physiological basal temperature test (BTT) that is 100% reliable in detecting hypothyroidism.

Spondylotic myelopathy, also known as Cervical myelopathy disorder, is characterized by spinal cord dysfunction due to compressed forces.

It is considered a common spinal disorder but is still underdiagnosed or late diagnosed. Its epidemiological data on incidence and prevalence is limited, affecting up to 5% of the population older than 40 years, driving high morbidity in care settings.

This context led us to present a case of a 37-year-old female patient living with cervical myelopathy.

Background: The cost estimation of radiology and radiotherapy procedures has been inadequately studied; therefore, the present study aimed to investigate real life cost estimation in patients with breast or prostate cancer undergoing imaging investigations and radical radiotherapy.

Methods: Data were extracted from the archives of the Radiotherapy Department of the University Hospital of Patras and included patients who underwent radical radiotherapy in the years 2017-2018. The cost for radiology tests performed three months before and after radiotherapy and the cost of radiotherapy, were calculated according to the reimbursement provided by the National Health Insurance Costing system.

Results: We included in the study 115 patients, 79 patients with breast and 36 with prostate cancer. Radiology mean cost was €191.5 and €311.1 for patients with prostate and breast cancer, respectively. We found a negative correlation between patient age, place of residence and radiotherapy cost in women treated for breast cancer. Patients older than 65 years or patients living in rural areas showed a lower radiotherapy cost (Spearman’s rho, -0.421, p<0.001, Mann–Whitney U test U=105.5, p=0.03).

Conclusion: Our findings contribute to the accumulation of pan-European financial data for radiology tests and radiotherapy, presently lacking and could help guide appropriate resource allocation toward the management of these patients in an equitable manner. We linked the histology of the tumor with treatment cost in Greece and showed that it may be influenced by other factors as well.

This study’s object was to reveal the attitudes toward the preimplantation genetic testing (PGT) for Hereditary Breast and Ovarian Cancer (HBOC) in the reproductive age lay public and the genetic professionals. The subjects of this survey were the individuals with/without history of breast and/or ovarian cancer and the clinical genetic professionals. A web-based anonymous questionnaire survey was conducted. 425 laypeople and 149 genetic professionals answered. Of the genetic professionals, 36% had been asked about reproductive options for HBOC from their clients. More than half of the laypeople (55.1-61.9%) considered PGT to be acceptable. But about half of the clinical genetic professionals (50.1%) considered it to be unacceptable and about thirty percent of the clinical geneticists considered PGT for HBOC to be acceptable for the reason of client’s Autonomy. After the European Society of Human Reproduction and Embryology (ESHRE) ethics taskforce approved PGT for adult onset and multifactorial diseases in 2003, PGT for adult-onset HBOC has become a general reproductive option. However, in Japan, the academic societies don’t allow PGT for hereditary cancer. It may be necessary to discuss whether PGT for HBOC would be allowed and support systems to aid reproductive decision making for younger couples should be urgently discussed in Japan.

Abstract: Fibroblast growth factor receptors (FGFRs) are aberrantly activated in less than 10 percent of solid tumors, through different mechanisms such as single nucleotide variants, gene fusions and copy number alterations. In some types of cancer, such as urothelial or cholangiocarcinomas this frequency increases to 10–30%.  Also, we see increased copy number alterations in breast cancer specifically after using cytotoxic therapies. There have been significant efforts to develop anti FGFR drugs. The landscape of anti-FGFR therapies does not include pan FGFR inhibitors as such there are only few drugs being assessed in early phase and randomized controlled clinical trials, such as erdafitinib and pemigatinib, and are approved by the Food and Drug Administration for the treatment of FGFR3-mutated urothelial carcinoma and FGFR2-fusion cholangiocarcinoma, respectively. Also, despite initial sensitivity to FGFR inhibition, acquired drug resistance leading to cancer progression develops in most patients.

Here we for the first time report a case series of patients with advanced cancer treated with multi targeted epigenetic therapy and we track their response on mutate allele frequencies of circulating DNA reflecting a positive and significant response in FGFR alterations. More importantly none of the cases reported developed resistance to anti FGFR approach. We conclude that such approach could change the standard practice of oncology specifically in the area of precision oncology and should be considered when FGFR alterations are considered drivers of tumor growth confirmed by liquid biopsy.

Introduction: Plantar fasciitis (PF) accounts for about 80% of cases of heel pain.  Foot orthoses (shoe insole/arch support), are one of the conservative management for plantar fasciitis. To our knowledge, we could not find any study that assesses the authentic benefits of using foot insoles with their different types on reducing PF pain among healthcare providers in the kingdom of Saudi Arabia (KSA). The aim of this was to evaluate the short and long-term effectiveness of foot orthosis in the recovery of plantar fasciitis and assess its influence on pain and quality of life among healthcare providers.

Methods: 93 subjects agreed to participate in the study male (n=30) 32.3%, and Female (n=63) 6.78%. All participants were asked to sign a consent form before participating in filling out the survey questions.

Study Design: Experienced Musculoskeletal researchers/Clinicians developed the study online questionnaire.

Results: 93 participants (n=30) 32.3% were male and (n=63) 64.5 % were Female. The results showed that 42 (45.2%) of the participants used the foot-orthosis and 51(45.8) did not use it. Out of the 42 participants who used the foot orthosis 33 (35.5%) benefited from the foot orthosis. A significant decrease in pain level score was reported after using the foot orthosis (3.00)  compared to before using the orthosis (6.79), p= 0.000.

Conclusion: The study confirms that Planter Fasciitis is one of the common problems among healthcare providers in the KSA, and foot orthosis is one of the best conservative management for decreasing PF symptoms. the study did not find a direct effect of Age, gender, BMI, and the received PT treatments on the benefits of using foot orthosis.

Hazard of any form has been known to be undesirable condition all over the world. The natural radiation contaminants which exist in rock formation could mix with borehole water drilled for human consumption. Therefore, the aim of this study was to determine the health risks associated with borehole water supply in some communities in Ogbia local government area, Nigeria. The method used was computational on activity concentrations of radionucleides of radium, thorium and potassium found in the water samples.  Dose coefficient of the isotopes and volume of water intake for certain age brackets involving infant, children and adult were applied in the computation. The results obtained showed that the annual effective dose (AED) for the infants drinking the water ranged from 4.2x10^-5 to 0.03018 < 0.26 µSvy^-1. The AED for teens ranged from 1.5x10^-5 to 0.01838 µSvy^-1< 0.20 while it ranged from 1.5 x10^-5 to 0.00308 < 0.1µSvy^-1 for adult human beings. Fatality Cancer Risk to adult ranged from 9.2x10^-7 < 2.59x10^-5 to 0.00019 ≥2.59x10^-5. Lifetime Fatality Cancer Risk ranged from 0.00022 to 0.01321 < 18.18. The severity hereditary effect in adult ranged from 3.34924x10^-8 <9.44x10^-7 to 6.8606 x10^-6 ≥ 9.44x10^-7 whereas the estimated lifetime hereditary effect ranged from 2.3x10^-6 to 4.8 x10^-6 < 6.61x10^-5. In conclusion, the implication of these results is that the borehole water samples from the twenty communities are radiologically safe for human consumption.

Unrelenting pollution is the primary cause of climate change, has been proven by this author to be complicit to all world coronavirus deaths, and via the proliferation of endocrine disruption chemicals (EDCs) worldwide over past four generations, is proving to affect the evolution of the sexual persuasions of humanity with increasing intensity with each successive generation. A 2021 US Gallop study determined that the acknowledged LGBTQ population has increased from 0.8% for those born before 1946 to 2.6% for those born from 1946-1964 to 4.2% for those born from 1965-1980 to 10.5% for those born from 1985-1996 to 20.8% for those born from 1997-2003. This is exponential growth and scientists should be attempting to provide scientific explanation(s) for this.

Smell is one of the most highly developed senses in some insects, animals and fish. It conditions the survival of species on Earth.  It serves to locate the food source, senses danger and helps to find a partner to extend the species. With the help of smell, individuals communicate with each other. The smell of the insect, the silkworm, is excellent. The male recognises in the air single particles of an odorous substance secreted by the female from a distance of 10 km.  Fish use their sense of smell and memory in their journeys of thousands of kilometres from rivers to seas. A shark can smell blood in the water from several kilometres away. Ants leave an olfactory trail for their brethren, indicating a food source, or leave a "death scent" when they warn of danger. Man, not having such a good sense of smell, uses dogs with 10 times better sense of smell to track down drugs or criminals. The record-holder among sniffers is the male nocturnal peacock butterfly (Eudia pavonia), which can smell the pheromones of a female from a distance of 11 km, when the signal produced has only 0.0001 mg of scent per dose. The signal sent by the female into the ether is perfectly produced molecules according to her own code. The partner has a specific coded receptor and reads           the transmitted information.

Butterflies do not have a nose, the olfactory cells are located on the antennae and further information is transmitted to the central nervous system, where it is analysed.

The paper highlights the molecular basis of olfactory information transmission and reception.

Background: Malignant obstructive jaundice is associated with a poor prognosis. Patients can undergo percutaneous transhepatic biliary drainage (PTBD), but the impact it has on quality of life is not well understood. 

Objective: To assess the potential impact of PTBD on quality of life in patients with obstructive jaundice from advanced malignancy using surrogate markers including complications, hospital length of stay, readmission, reintervention, and mortality.

Methods: A retrospective analysis of a single-centre cohort of all patients with advanced solid organ malignancy undergoing PTBD between April 2020 and February 2022. Data was collected from electronic medical records.

Results: Among the sixteen patients, abdominal pain and cholangitis were observed in 62.5% and 37.5% patients, respectively. Peritonitis, biliary leak, perihepatic abscess, and haemobilia occurred in individual cases. The median hospital length of stay post PTBD was nine days. The 30-day readmission rate for PTBD-related complications was 31.3% with a median of three total readmissions per patient. The 30-day reintervention rate was 62.5%. The 30-day all-cause mortality was 25% (95% CI:8.9-53.3), which included one procedure-related death.

Conclusions: Quality of life in patients with obstructive jaundice from advanced solid organ malignancy undergoing PTBD can be adversely impacted due to the high risk of complications, reintervention, hospitalisation, and mortality. Thorough patient assessments are crucial in selecting appropriate candidates for PTBD.

Fundamentals: Medical care in the scope of mental health is still facing important barriers. The aim of the present work is the critical study on specialised quality literature on this field, considering that mental health is a priority problem in public health. This work aims to provide a topical, narrative, analytical and exhaustive reflection on the obstacles that stigma, language and nosology entail.

Methods: Secondary research consisting of critical examination of other related works which are mainly theoretical and clinical but rarely empirical studies.

Results: A new use of language is being postulated; however, this may not entail traditional operational syndromic criteria being downgraded. On the other hand, the media’s approach to mental health is currently being highly questioned since there are countless erroneous ideas, frivolities and myths that are constantly repeated. Likewise, certain sensationalist speeches reinforce stigma. Language must be understood as a linguistic behaviour that will also require a relevant philosophical and analytical approach, taking into account that the conversation on health and disease does not operate the same way in different contexts. We will critically and superficially deal with diagnosis, discrimination and prejudices surrounding mental disorders.

Conclusions: The tendency towards stigmatisation of mental disease occurs in almost all spheres and this signifies important communicative and cultural challenges. The scientific deliberations and controversies presented in this work on the use of language in diagnosis and the current and potential taxonomic systems on mental disease are highly topical.

Free radical exposure is a causative factor in both cancer and coronary artery disease (atherosclerosis). Free radicals are highly reactive unstable molecular fragments that alter DNA creating mutant cells that proliferate out of control causing tumors throughout the body and bulges inside artery walls. The body produces enzymes which act as free radical scavengers that neutralize as many free radicals as possible before they can cause harm. Unfortunately, our modern lifestyle generates far more free radicals than the body has mechanisms for coping. Fortunately, there are naturally occurring antioxidants that protect against free radical damage. This study provides the therapeutic levels of five supplementary nutrients required to protect cells from the damaging effects of oxygen radicals.

To investigate the effect of hypertension on 10-year prognosis in T2DM after 10-year multi-factorial management. 246 patients with Type 2 diabetes (T2DM) were enrolled from the Zuojiazhuang community in Beijing in 2008. Based on combined hypertension or not, the patients were divided into simple T2DM (DM group) and T2DM combined with hypertension (DM + HTN group). All patients received the multi-factorial intervention for 10 years. The clinical features and occurrences of endpoint events were evaluated at the end of follow-up in 2018. During the 10-year follow-up, the incidence of cardio-cerebrovascular events in DM+HTN group (23 cases, 13.29%) was significantly higher than that of the DM group (47 cases, 2.13%). In Cox multivariate analysis, hypertension had an important effect on cardio-cerebrovascular endpoint events risk (HR：7.63，95%CI：1.04−6.22). Kaplan-Merier curve showed significant difference in survival curves between the two groups (P<0.05). In conclusion, the incidence of the cardio-cerebrovascular events in T2DM with hypertension is 7.63times higher than that of simple T2DM. Hypertension is associated with a worse 10-year prognosis in T2DM.

Coronary artery disease is caused by free radical damage to tumor suppressor genes, which mutation allows cells to proliferate out of control to create benign mini tumors between the endothelium lining and the smooth muscle walls of arteries. As these tumors grow, they cause tiny tears in the endothelium that are patched with interlacing filaments of fibrin. This rough scar tissue traps minerals (especially calcium), heavy metals, macrophages, and cellular debris. The final smooth layer of cholesterol that is applied over this arterial plaque plays no causal part in its development. Recent studies indicate that nearly 75 percent of patients hospitalized for a heart attack had cholesterol levels which indicate they were not at high risk for a cardiovascular event, according to current national cholesterol guidelines. Thus, there is no causal relation between serum cholesterol levels and coronary artery disease.

African narrative has been from the perspective of the West when it comes to medicine. However African narrative based on traditional perspective can be illuminating and enriching to Western world. This paper focuses on traditional indigenous healers and their techniques in healing their patients. The work delineates the unique roles of Babalawo…the Yoruba medicine men… the interpersonal relations with their clients and their service to community. The paper concludes for cooperation between the traditional healers and mainstream western trained practitioners because there is a correlation that exists between traditional healers and western trained medical doctors.

This research draws upon several areas of current research relating to risk factors in public health services and their effect on minority populations in the U.S. Most minorities today are affected with at least one non-communicable disease and most often, their behaviors trigger health risks, coupled with the inequity that leads to lack of access to quality health. When considering risk factors, it is suggested that modifiable behaviors such as tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol, all increase the risk of non-communicable diseases (NCDs).  The research design relied on both secondary sources and qualitative data. Secondary data included publicly available data on social, economic and health status characteristics of minorities. Documentary data includes the articulating the interpretation, then the reflecting (also reflective) of the interpretation of the empirical material, and finally, the generating of theory as a multidimensional typology. After extensive analysis of the current research, the researchers concluded that the nation needs to be prepared for another global pandemic and start working on prevention measures that would work if used early and foster success in controlling the outcome. A rapid risk prevention strategy will help those disenfranchised (the unemployed and uninsured), create predictability, economic security and wellness.