American Journal of Medical and Clinical Research & Reviews

A Comprehensive Literature Review Examining the Efficacy of Autologous Intra-Ovarian Platelet-Rich Plasma in Women Diagnosed with POI and DOR and its Impact on ART Outcomes

Kavitha Krishnan Vandanath — 2025-11-20

Background: This extensive literature review examines the potency of autologous intra-ovarian platelet rich plasma (PRP) in women diagnosed with primary ovarian insufficiency (POR) and reduced ovarian reserve (DOR). Recent research has investigated PRP as a possible method to help improve ovarian function and improve fertility outcomes for these groups of patients.

Methods: A systematic search of medical databases was done in PubMed, Cochrane Library, Embase, and Web of Scopus done to identify relevant studies published from 2014 up to 2024. Inclusion criteria included observation studies, cohort studies and randomized controlled trials. Data extraction focused on changes in ovarian reserve parameters and ART outcomes like pregnancy rates, live birth rates and embryo quality. The studies were assessed for quality using the Newcastle-Ottawa Scale for observational studies and cohort studies and the Cochrane Risk of Bias Tools to assess the bias risk in randomized controlled trials.

Results: By using the MeSH terms related to “platelet-rich plasma,” “intra-ovarian injection” and “Diminished Ovarian Reserve", several additional relevant keywords were identified. This led to an initial search that produced 297 articles. After applying the criteria for inclusion and exclusion to evaluate these articles for eligibility,10 studies were selected for review which included a total of 1516 women. The papers included 2 randomized controlled trails, 1 retrospective study and 7 prospective studies.

Discussion: Intraovarian PRP injections show potential in enhancing ovarian function and outcomes for women with POR and POI, with some studies reporting improvements in ovarian reserve markers and pregnancy rates. However, others indicate limited benefits, highlighting variability in methodologies and PRP preparation. Future research should standardize procedures and conduct larger trials to better understand PRP's mechanisms and its impact on long-term reproductive outcomes.

Conclusion: Intra-ovarian PRP shows promise as a therapeutic option for women with POI and DOR, demonstrating improvements in ovarian reserve parameters and ART outcomes like the rates of clinical pregnancy and live births. However, further large-scale, randomized controlled trails are required to establish its extended duration of efficacy and safety. While encouraging, current evidence suggests that PRP should be considered an experimental treatment requiring additional research before widespread clinical application.

Description of the Knowledge of Elderly People About the Prevention of Osteoporosis at the Age of 60-90 Years in the Lequitura and Aisirimou, Municipality of Aileu Timor-Leste (2025)

Carlos Boavida Tilman — 2025-11-01

Introduction: By 2050, it is estimated that more than 50% The incidence of bone fractures due to osteoporosis will appear in Asia. With the highest incidence of fractures in elderly people with osteoporosis, the mortality rate is over 20%. The most recent research from the International Osteoporosis Foundation (IOF) revealed that 1 in 4 women in Indonesia aged 50-80 are at risk of developing osteoporosis.

Research Objective: To describe the knowledge of elderly people aged 60-90 about osteoporosis prevention in the Lequitura and Aisirimou Aileu-City the Municipality of Aileu Timor-Leste.

Research Methodology: The research uses a descriptive quantitative method with a cross-sectional study approach. The techniques used to define the sample are non-probability sampling. The data collection techniques used by the researcher include primary and secondary data.

Result Discussion : Shows that the population in the Hamlet of Aissirimou, Aileu City, the Municipality of Aileu is 3389 (100%): in the Village of Hudi-Laran 1498 (44.2%), Village of Aituhu-Laran 630 (18.6%), Village of Berate 451 (13.3%), Village of Erratum 451 (13.3%), Village of Erratum 24 (7.2%) and in the Village of Besilau 565 (16.7%) and population of the Hamlet of Lequitura 947 (100%): in the Village of Lequitura 206 (21.8%), in the Village of Rai-Rema 378 (39.9%), in the Village of Riheu 184 (149) and Village of Erluli 179 (179%). (18.9).

Conclusion: Based on the research results presented in the frequency distribution, the elderly people from Hamlet Lequitura and Aissirimou, for the most part, apply the Level of Knowledge in the prevention of osteoporosis with a good category in 47.2%, an adequate category in 41.7% and a low category in 11.1% of the study (Tilman CB. et al, 2025).

The Sacred Temporality of Healing: Solitude, Embodied Presence, and the Physician as Witness

Julian Ungar-Sargon — 2025-11-20

This article synthesizes depth psychological insights on solitude with mystical theology to propose a transformative framework for healing practice. Drawing on Carl Jung, James Hillman, Robert Bly, and Jordan Peterson's reflections on time's preciousness, I argue that solitude functions as therapeutic tzimtzum—a sacred contraction creating space for authentic presence. ¹³

The physician who practices solitude develops capacity to witness suffering without the defensive maneuvers of biomedical reductionism. By integrating Kabbalistic concepts of divine concealment and manifestation with archetypal psychology's understanding of the soul's imaginal depths, this work proposes an embodied theology of healing that honors the patient as sacred messenger rather than diagnostic object. ¹⁶

The essay the medicalization of time within healthcare systems and advocates for temporal practices that restore the physician's capacity for moral presence.⁵

Séroprévalence et Etude Biomoléculaire du Virus de l’Hépatite E à Brazzaville

Jile Florient Mimiesse — 2025-11-20

Objectives: To describe the serological and biomolecular profile of hepatitis E virus (HEV) in Brazzaville.

Population and methods: This was a descriptive cross-sectional study conducted from January 1 to September 30, 2024, at blood collection centers of the National Blood Transfusion Center (CNTS) and pig farms in the city of Brazzaville. Blood donors and pig farmers aged 18 years and older, regardless of sex, who agreed to participate in the study were included. Sociodemographic characteristics, risk factors for HEV transmission, IgM, IgG, and viral RNA were the variables studied. The statistical tests used were Pearson's chi-squared test and odds ratio with adjustment. The significance level was set at 0.05.

Results: 98 people were recruited for our study. Men represented 53% and women 47%. The mean age was 39.18 ± 14.15 years, with a range of 18 to 77 years. More than half of the population had contact with animals, and in 43% of cases, this contact was with pigs. The overall frequency of HEV was 19.3% (n=19/98). The frequencies of anti-HEV IgG and IgM antibodies were 84% (n=16/19) and 16% (n=3/19), respectively. The frequency of HEV was 17.6% (n=12/68) among blood donors and 23.33% (n=7/38) among pig farmers. RNA was detectable in 26.32% of cases.

Conclusion: This study constitutes the first seroprevalence and molecular biology survey of HEV in Congo-Brazzaville. The results indicate that HEV infection is present in Brazzaville, particularly among blood donors and pig farmers, with a high seroprevalence.

Role of First- and Second-Trimester Uterine Artery Doppler in Predicting Adverse Pregnancy Outcomes: A Review of Literature

Rizwana — 2025-11-20

Background: Uterine artery Doppler velocimetry (UADV) is a non-invasive tool for assessing uteroplacental blood flow and identifying pregnancies at risk for pre-eclampsia (PE), fetal growth restriction (FGR), and small for gestational age (SGA). While abnormal indices such as elevated pulsatility index (PI), resistance index (RI), and persistent bilateral notching have been consistently associated with placental insufficiency, the clinical value of UADV depends on the timing of assessment, threshold definitions, and integration with other screening modalities.

Methods: This review synthesises evidence from eight high-quality studies published between 1998 and 2023, encompassing large multicentre prospective cohorts, randomised controlled trials, and meta-analyses. The studies varied in gestational age at Doppler assessment (first trimester, mid-trimester, and serial approaches), measurement technique (transabdominal or transvaginal), and criteria for abnormality (centile-based thresholds or fixed cut-offs). Outcomes assessed included PE, FGR, SGA, and composite maternal-fetal morbidity.

Results: Mid-trimester UADV demonstrated the strongest standalone predictive value, with detection rates of up to 69–93% for severe early-onset PE and FGR and ~60% for early PE/IUGR in a large randomised trial ^1,2. First-trimester Doppler alone had modest sensitivity for overall PE and SGA but was more predictive of severe phenotypes, with Martin et al. (2001) reporting 60% detection for PE requiring delivery before 32 weeks. Incorporation into multimodal algorithms, as in the ASPRE trial, achieved 76.7% detection of preterm PE at a 10% false-positive rate and, when combined with aspirin prophylaxis, reduced preterm PE incidence by over 60% ³. Smaller cohort studies and a large meta-analysis reinforced the predictive role of UADV across gestation, with the highest effect sizes in mid-to-late pregnancy.

Conclusion: The evidence consistently supports UADV as a valuable screening tool, particularly for early-onset, severe placental disease. Mid-trimester measurement offers the best standalone performance, while first-trimester assessment gains maximum utility within integrated risk models that link detection to effective interventions. Limitations include heterogeneity in technique, population differences, and the limited impact of Doppler-only strategies on outcomes without accompanying treatment pathways. This synthesis underpins the rationale for including UADV in structured screening programmes and informs the methodological approach of the present thesis.

AUTISM/PICA and H. PYLORI: CLUES AND CURES(?)

Dean Alexander — 2025-11-20

Affected Role Knowledge: The Use of Captropil in the Treatment of Hipertension Disease in Age 30-60 Years at the Maubara Health Center, in the Municipality of Liquica Timor-Leste [2025]

Carlos Boavida Tilman — 2025-11-01

Introduction: Hypertension is a health problem in all parts of the world and as one of the main risk factors for cardiovascular diseases. Hypertension is also called as a non-communicable disease because hypertension is transmitted from people to people’s lives in everyday that clear.

Research Objective: To know the level of knowledge of patients the use of drug captopril in the treatment of hypertension diseases in age 30 -60 years in Maubara Health Center Village of the Municipality of Liquica Timor- Leste.

Research Methodology: We use quantitative descriptive method, through the technical approach of sectoral study and technique analyzes data is univariate.

Result and Discussion: The results of this research were about the level of knowledge of patients about the use of captopril drugs for patients with hypertension at the Maubara Health Center. The results of this research are divided into (2) parts as general and specific data. It shows that the level of knowledge knowing, the highest percentage is the level of knowledge of the category sufficient with a percentage of 37 (79%), is the level of knowledge and the lowest category less with a percentage of 6 (8%). Based on the results, the level of knowledge that they understand about the use of captopril drugs for the patient with the highest percentage of higher is the level of knowledge of the category sufficient with a percentage of 34 (47%). The lowest percentage is the level of knowledge in the category less than 9 (13%).

Conclusion: patients' level of knowledge the use of captopril drug in the treatment of hypertension diseases at age 30 -60 years in Maubara Health Center are sufficient according to research [Tilman CB., et al, 2025].

Investigating the accuracy of blood glucose testing by glucometer in patients referred to the emergency department

Mohammad Reza Farnia — 2025-11-20

Objectives: Hypoglycemia is a medical emergency, and timely diagnosis and treatment are critical due to its potential long-term complications. Given that glucometers are widely used in the emergency department for patient triage and diagnosis of hyper and hypoglycemia, this study was conducted to investigate its accuracy in comparison with serum blood glucose testing.

Method: This study was a retrospective cross-sectional study conducted in 2023 using hospital data of patients referred to the emergency department of an academic hospital. Demographic and clinical data were collected and recorded using information contained in the patients' records. The collected data were analyzed using SPSS27 software.

Result: Of 240 patients included,192 were non-diabetic and 48 were diabetic. The mean and standard deviation of the age of the subjects was 54.40 ± 19.30 years. In this study, 132 cases were female (about 55%) and 108 cases were male (about 45%). The Spearman correlation coefficient between the standard laboratory test and the glucometer test was 0.896.

Conclusions: Good correlation was observed between the glucometer and the standard enzymatic method of blood glucose measurement, which supports the use of glucometers in home settings.

Persistent Chylomicronemia

Ana Paula Marte Chacra — 2025-11-20

Persistent chylomicronemia is a rare but serious metabolic disorder characterized by extremely high triglyceride levels - often surpassing 1,000 mg/dL - and the abnormal presence of fasting chylomicrons. This results from severely impaired clearance of chylomicrons, leading to their continuous accumulation and posing a major risk for recurrent, potentially fatal acute pancreatitis. Its etiology includes monogenic and polygenic forms. The monogenic form, known as familial chylomicronemia syndrome, is extremely rare and caused by biallelic mutations in genes essential for lipoprotein lipase function, such as lipoprotein lipase, APOC2, APOA5, GPIHBP1, and LMF1. In contrast, the polygenic/multifactorial form is far more common and results from the combined effect of multiple genetic variants together with secondary factors such as uncontrolled diabetes, obesity, hypothyroidism, alcohol intake, nephrotic syndrome, and certain medications. Clinically, the most severe consequence is acute pancreatitis, triggered by capillary obstruction and toxic free fatty acid release within the pancreas. Other manifestations include eruptive xanthomas, lipemia retinalis, hepatosplenomegaly, and neurological symptoms linked to hyperviscosity. Diagnosis involves identifying markedly elevated triglycerides (typically >885 mg/dL) and fasting chylomicrons, sometimes evident as lactescent plasma. Genetic testing is useful when familial chylomicronemia syndrome is suspected. Management requires lifelong intervention, with strict dietary fat restriction (10-15% of daily calories), avoidance of simple sugars and alcohol, and lifestyle measures such as weight loss and smoking cessation. Traditional triglyceride-lowering drugs - fibrates, omega-3 fatty acids, and niacin—are often ineffective in familial chylomicronemia syndrome due to absent lipoprotein lipase activity. Emerging therapies focus on lipoprotein lipase - independent pathways. APOC-III inhibitors, including volanesorsen, olezarsen, and plozasiran, produce substantial triglyceride reductions across various forms of chylomicronemia. Patients with residual lipoprotein lipase activity may also benefit from ANGPTL3 inhibitors. Improved recognition, education, and personalized treatment based on clinical phenotype - not solely genetics - are essential to reduce complications and mortality.