Experiences of ZHAO Yonghou in Differentiation and Staged Treatment of Schizophrenia Using the Theory of Ti （Character， 体） and Yong （Function， 用） in Mental Illness / 中医杂志

Based on the theory of ti （character， 体） and yong （function， 用） in mental illness， ZHAO Yonghou's clinical experience in staged differentiation and treatment of schizophrenia is summarized. According to the theory， the core disease location of schizophrenia is in the brain， which is closely related to the organs， qi， and blood. It is proposed to interpret the pathogenesis of schizophrenia from the perspective of “zang-fu organs-qi and blood-brain and spirit”， that is， dysfunction of the zang-fu organs， disharmony of qi and blood， and malnourishment of the brain ti lead to dysfunction of the spirit ti and yong. In clinical practice， treatment of schizophrenia can be divided into four stages， for which the method of treating ti and yong simultaneously is suggested. In the prodromal stage， Liuwei Dihuang Decoction combined with Sini San （六味地黄汤合四逆散） with modifications is used to nourish the kidney and boost marrow， soothe the liver and rectify the spleen. For acute exacerbation with binding of phlegm and heat syndrome， Zhaoshi Yikuang Decoction （赵氏抑狂汤） with modifications is used to clear heat and dispel phlegm， awaken the brain and calm the mind. For phlegm-heat damaging yin pattern， Mengshi Guntan Pill combined with Zengye Decoction （礞石滚痰丸合增液汤） with modifications is used to clear heat and dispel phlegm， enrich yin and calm the mind. For the chronic treatment stage， Yudian Decoction （愈癫汤） with modifications is used to disperse phlegm and dissolve stasis， move qi and awaken the mind. For the rehabilitation and regulation stage， Shenan Pill （神安丸） with modifications is used to boost qi and nourish yin， and tranquilize the mind.

CHEN Tongyun's Experience of Treating Postinflammatory Dyspigmentation by Unblocking and Nourishing Qi and Blood / 中医杂志

This paper summarized the clinical experience of CHEN Tongyun in the treatment of postinflammatory dyspigmentation with the method of unblocking and nourishing qi and blood. It is believed that the core pathogenesis of this disease is poor qi movement and skin blood stasis， for which the method of unblocking and nourishing qi and blood should be used. Postinflammatory pigmentation on the face is mainly caused by qi stagnation and blood stasis， and it is suggested to regulate liver and spleen， move qi and invigorate blood usually with modified Tonghua Decoction （通化汤）. Postinflammatory hypopigmentation is mainly due to qi and blood depletion， for which the treatment should be fortifying the spleen and strengthening kidney， replenishing qi and generating blood， and modified Yangfu Decoction （养复汤） is commonly used. Simultaneously， medicinals of ascending and descending functions， moving qi and blood， warming yang and nourishing yin should be combined， and the results from modern pharmacological research should be considered.

PENG Qinghua's Clinical Experience in Treating Dry Eye by the Therapeutic Method of “Maintaining with the Sweet and Restoring the Body Fluids” / 中医杂志

This paper summarized PENG Qinghua's clinical experience in treating dry eye by applying therapeutic method of maintaining with sweet medicinals and restoring the body fluids. It is believed that the spleen earth insufficiency and fluids damage transforming into dryness are the main pathogenesis of the disease， and the basic therapeutic principle is maintaining with the sweet and restoring the body fluids by mainly using sweet medicines. It is advocated to use mild-sweet herbs， such as Baibiandou （Lablab purpureus subsp. purpureus）， Fuling （Smilax glabra Roxb.）， and Yiyiren （Coix lacryma-jobi L.）， to transport spleen earth， so that qi is restored and body fluids are recovered； moderate-sweet herbs， such as Dangshen （Codonopsis pilosula ［Franch.］ Nannf.）， Taizishen （Pseudostellaria heterophylla ［Miq.］ Pax）， Shanyao （Dioscorea oppositifolia L.） and Zhigancao （Glycyrrhiza glabra L.） are suggested to cultivate earth and generate metal， so as to move qi and circulate fluid； sweet-cool herbs， such as Nanshashen （Adenophora triphylla ［Thunb.］ A.DC.）， Beishashen （Glehnia littoralis ［A.Gray］ F.Schmidt ex Miq.）， Yuzhu （Polygonatum odoratum ［Mill.］ Druce）， Tianhuafen （Trichosanthes kirilowii Maxim.） are suggested to nourish yin and increase body fluids， so as to promote fluid production to moisten dryness. In this way， when the source of fluid is restored and the fluid is circulated， the fluid can be produced continuously， which provides new ideas for the treatment of dry eyes with traditional Chinese medicine.

Experience of LIN Yi in Disease-Syndrome-Syptom Differentiation and Treatment of Breast Cancer in Consolidation Phase / 中医杂志

This article summarized the clinical experience of Professor LIN Yi in applying the idea of disease-syndrome-syptom combination to the differentiation and treatment of breast cancer in consolidation phase. It is believed that the fundamental pathogenesis of breast cancer in consolidation phase is deficiency of healthy qi， so the treatment should emphasize on reinforcing healthy qi as the main and eliminating pathogen as the supplement. Commonly， Sijunzi Decoction （四君子汤）， Shenling Baizhu Powder （参苓白术散）， and Liuwei Dihuang Decoction （六味地黄汤） are used as the basic formula to strengthen the spleen and kidney to reinforce healthy qi， and Baihua Sheshe Cao （Scleromitrion diffusum ［Willd.］ R.J.Wang）， Yiyiren （Coix lacryma-jobi L.）， and ezhu （Curcuma aromatica Salisb.） are used to eliminate cancer toxin. It is also believed that the biological characteristics of different molecular subtypes of breast cancer are of great significance to the syndrome differentiation and treatment in traditional Chinese medicine， therefore， the formulas used in clinical practice are often selected taking into considerations of molecular subtypes of breast cancer. For those with positive sex hormone receptor， the most important thing is to replenish the congenital and benefit kidney essence， with modified Baihua Qiqi Decoction （白花芪杞汤）； for those with negative sex hormone receptor， the first step is to strengthen spleen and replenish kidneys， and it is especially important to strengthen the spleen with Baihua Qiling Decoction （白花芪苓汤）. At the same time， it is suggested that the primary and the secondary symptoms of patients should be differentiated， and the diseases and symptoms， as well as the modern medical laboratory indicators should be combined to give suitable medication.

Cultivation of "Emotion" Element in Red Doctors Spirit in Medical Students’ Humanistic Quality / 中国医学伦理学

The red doctors spirit is a special cultural form formed by the Chinese Communist Party in the long-term revolutionary struggle practice, and it has important practical significance and value of the times in the new era. Medicine is a subject integrating natural science and humanities. The element of "emotion" is the embodiment of traditional Chinese medical culture. It plays a role in cultivating doctors’ spirit and solving practical problems in current medical activities. By digging the four aspects of the "emotion" element in red doctors spirit of political loyalty to the party, the moral sentiment of saving the dying and healing the wounded, the rational decision-making under the transformation of medical situation, the response and processing ability of bad public opinion, and integrating it into the humanistic education of medical students. This paper explored the effective ways and promotion models of the element of "emotion" education in the growth of medical talents, so as to promote the cultivation of medical talents’ moral cultivation and ethical decision-making ability, enhance the professionalism and humanistic cultivation of medical students, and cultivate a group of medical talents with political firmness and reasonable consideration for the country.

Prevalence and determinants of burnout among South African doctors during the COVID-19 pandemic

Background: Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout. Aim: This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic. Setting: Three public sector hospitals in Gqeberha, South Africa. Methods: A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout. Results: The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71­26.40), being in the lowest income band (AOR = 10.78, 2.55­45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12­8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92­13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98­10.18). Low support at work (AOR = 9.99, 3.66­27.23), medium job satisfaction (AOR = 5.38, 2.65­10.93) and medium support at work (AOR = 3.39, 1.71­6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10­0.80) and high levels of resilience (AOR = 0.08, 0.03­0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout. Conclusion: The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors. Contribution: Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.

Perception of doctors at Elobied teaching hospital toward antibiotics resistance as a health threat

Background: Resistance to antibiotics has increased dramatically over the past few years and has now reached a level that places future patients in real danger. Several factors contribute to this problem, some of them are health workers related and others are community related. This study aimed to assess the awareness of doctors in Elobeid hospital, North Kordofan state, Sudan about the problem, its causes, and its possible preventive measures. Methods: This descriptive, questionnaire-based study was conducted in Elobeid teaching hospital between 2020, February 27 and March 13. The study involved 50 doctors in the internal medicine department. Results: Out of the 50 doctors involved, 49 (98%) agreed that antibiotics resistance is a big progressive health threat in Sudan; 86% of the participants think that selfmedication is the leading cause of antibiotic resistance; and 98% believe that providing good quality culture and sensitivity service in hospitals and health centers is the most effective preventive measure. Regarding education about antibiotics as a part of academic activities in the unit during the last year, 36% of the participants received zero sessions, 68% received 1­5 sessions, and 12% received more than 5 sessions. The assessment of doctor's adherence to the Sudan Standard Treatment Guideline revealed that 28/50 participants (56%) did not see it or hear about it, 17/50 participants (34%) know it but don't comply, and only 5/50 participants (10%) know it and comply with it. Conclusion: Participants show a good awareness about the significance of antibiotics resistance as a health threat, a good awareness about the main causes and the possible preventive measures, a low to moderate frequency of education on antibiotics, and a very poor adherence to the Sudan Standard Treatment Guidelines.

Actividades de superación profesional de médicos generales integrales sobre el uso racional de medicamentos / Professional training activities of comprehensive general doctors on the rational use of medications i: en

Introducción: El uso irracional de medicamentos se debe, entre otros elementos, a la falta de superación profesional; situación con mayor repercusión en la atención primaria de salud, donde generalmente laboran los médicos generales integrales. Objetivo: Caracterizar las actividades de superación profesional de médicos generales integrales sobre el uso racional de medicamentos. Métodos: Se realizó un estudio descriptivo y transversal de 269 médicos generales integrales que laboraban en los consultorios del médico de la familia o en los servicios de urgencia de las 17 áreas de salud del municipio de Santiago de Cuba en el período comprendido desde enero hasta julio de 2022, quienes fueron seleccionados mediante muestreo probabilístico por conglomerado bietápico. Se consideró como variable las actividades de superación profesional relacionadas con el uso racional de medicamentos, las cuales fueron valoradas a través de 5 indicadores. Resultados: La triangulación metodológica de los resultados evidenció que el nivel alcanzado en cuanto a la frecuencia de realización de dichas actividades fue bajo (índice de 1,18), al igual que lo obtenido en los indicadores analizados, excepto en el referido a la autopreparación que mostró un nivel medio. Conclusiones: Las actividades de superación profesional de los médicos generales integrales relacionadas con el uso racional de medicamentos en el municipio de Santiago de Cuba se caracterizaron por un nivel bajo de frecuencia de realización.

Introduction: Irrational use of medications is, among other elements, due to the lack of professional training; situation with more repercussion in primary health care, where comprehensive general doctors generally work. Objective: To characterize the professional training activities of comprehensive general doctors on the rational use of medications. Methods: A descriptive and cross-sectional study of 269 comprehensive general doctors who worked in the family doctor offices or in the emergency services of the 17 health areas of Santiago de Cuba municipality was carried out from January to July, 2022, who were selected by means of a probabilistic sampling by biphase conglomerate. The activities of professional training related to the rational use of medications were considered as variable, which were valued through 5 indicators. Results: The methodological triangulation of the results evidenced that the level reached as for the frequency of realization of this activities was low (index of 1.18), as well as what was obtained in the analyzed indicators, except the one referred to the self-preparation which showed a mean level. Conclusions: Professional training activities of comprehensive general doctors related to the rational use of medications in Santiago de Cuba municipality were characterized by a low level of realization frequency.

Nivel de resiliencia y su relación con factores de riesgo cardiovascular en médicos residentes del Hospital de Clínicas / Level of resilience and its relationship with cardiovascular risk factors in medical residents of the Hospital de Clínicas

Introducción: la resiliencia es la capacidad de adaptación de los individuos frente a los retos de la vida. Objetivo: determinar el nivel de resiliencia y su relación con factores de riesgo cardiovascular en médicos residentes del Hospital de Clínicas. Metodología: estudio observacional, analítico, transversal, retrospectivo. Muestreo no probabilístico, realizado en el periodo de mayo a julio de 2022. Se utilizó la encuesta de Wagnild & Young para evaluar la resiliencia. Se midieron variables sociodemográficas, niveles de resiliencia y factores de riesgo cardiovascular. Se utilizó el software Epi info para el análisis de los datos. A las variables cualitativas se les calculó la frecuencia absoluta y relativa y a las variables cuantitativas la media y desviación estándar. Para buscar la asociación entre el nivel de la resiliencia y los factores de riesgo cardiovascular se utilizó el Chi cuadrado, se consideró estadísticamente significativo p: <0,05. Resultados: participaron en el estudio 154 residentes, 45,5 % de los residentes presentaron sobrepeso u obesidad, 87,7 % consumen alcohol, 14,9 % sedentarismo, 5,2 % Hipertensión Arterial, 10,4 % dislipidemia y el 50 % antecedentes familiares de enfermedad cardiovascular. El 48 % de los médicos presentó baja resiliencia. Se encontró relación estadísticamente significativa entre la resiliencia baja y factores de riesgo cardiovascular (p <0,05). Conclusión: la mitad de los residentes presentan baja resiliencia y existe relación entre factores de riesgo cardiovascular y la baja resiliencia en los médicos residentes del Hospital de Clínicas.

Introduction: resilience is the ability of individuals to adapt to life's challenges. Objective: determine the level of resilience and its relationship with cardiovascular risk factors in resident doctors at the Hospital de Clínicas. Methodology: this was an observational, analytical, cross-sectional and retrospective study. We used non-probability sampling, from May to July 2022. The Wagnild & Young survey was used to evaluate resilience. Sociodemographic variables, resilience levels and cardiovascular risk factors were measured. Epi info software was used for data analysis. The absolute and relative frequency was calculated for the qualitative variables and the mean and standard deviation for the quantitative variables. To find the association between the level of resilience and cardiovascular risk factors, the Chi square was used; p: <0.05 was considered statistically significant. Results: 154 residents participated in the study, 45.5 % of the residents were overweight or obese, 87.7 % consumed alcohol, 14.9 % had a sedentary lifestyle, 5.2 % had high blood pressure, 10.4 % had dyslipidemia and 50 % had a family history of cardiovascular disease. 48 % of respondents presented low resilience. A statistically significant relationship was found between low resilience and cardiovascular risk factors (p <0.05). Conclusion: half of the residents have low resilience and there is a relationship between cardiovascular risk factors and low resilience in resident doctors at the Hospital de Clínicas.

Nivel de resiliencia y su relación con factores de riesgo cardiovascular en médicos residentes del Hospital de Clínicas

Introducción: la resiliencia es la capacidad de adaptación de los individuos frente a los retos de la vida. Objetivo: determinar el nivel de resiliencia y su relación con factores de riesgo cardiovascular en médicos residentes del Hospital de Clínicas. Metodología: estudio observacional, analítico, transversal, retrospectivo. Muestreo no probabilístico, realizado en el periodo de mayo a julio de 2022. Se utilizó la encuesta de Wagnild & Young para evaluar la resiliencia. Se midieron variables sociodemográficas, niveles de resiliencia y factores de riesgo cardiovascular. Se utilizó el software Epi info para el análisis de los datos. A las variables cualitativas se les calculó la frecuencia absoluta y relativa y a las variables cuantitativas la media y desviación estándar. Para buscar la asociación entre el nivel de la resiliencia y los factores de riesgo cardiovascular se utilizó el Chi cuadrado, se consideró estadísticamente significativo p: <0,05. Resultados: participaron en el estudio 154 residentes, 45,5 % de los residentes presentaron sobrepeso u obesidad, 87,7 % consumen alcohol, 14,9 % sedentarismo, 5,2 % Hipertensión Arterial, 10,4 % dislipidemia y el 50 % antecedentes familiares de enfermedad cardiovascular. El 48 % de los médicos presentó baja resiliencia. Se encontró relación estadísticamente significativa entre la resiliencia baja y factores de riesgo cardiovascular (p <0,05). Conclusión: la mitad de los residentes presentan baja resiliencia y existe relación entre factores de riesgo cardiovascular y la baja resiliencia en los médicos residentes del Hospital de Clínicas.

Introduction: resilience is the ability of individuals to adapt to life's challenges. Objective: determine the level of resilience and its relationship with cardiovascular risk factors in resident doctors at the Hospital de Clínicas. Methodology: this was an observational, analytical, cross-sectional and retrospective study. We used non-probability sampling, from May to July 2022. The Wagnild & Young survey was used to evaluate resilience. Sociodemographic variables, resilience levels and cardiovascular risk factors were measured. Epi info software was used for data analysis. The absolute and relative frequency was calculated for the qualitative variables and the mean and standard deviation for the quantitative variables. To find the association between the level of resilience and cardiovascular risk factors, the Chi square was used; p: <0.05 was considered statistically significant. Results: 154 residents participated in the study, 45.5 % of the residents were overweight or obese, 87.7 % consumed alcohol, 14.9 % had a sedentary lifestyle, 5.2 % had high blood pressure, 10.4 % had dyslipidemia and 50 % had a family history of cardiovascular disease. 48 % of respondents presented low resilience. A statistically significant relationship was found between low resilience and cardiovascular risk factors (p <0.05). Conclusion: half of the residents have low resilience and there is a relationship between cardiovascular risk factors and low resilience in resident doctors at the Hospital de Clínicas.

Una pequeña historia de la medicina del trabajo en Venezuela / A short history of occupational medicine in Venezuela

Se presenta una recopilación de hechos relacionados con la salud y seguridad en el trabajo, en forma de aproximación, sin intentar un análisis histórico, siguiendo un hilo transversal del rol de la medicina, en lo que ha significado a través del tiempo la salud física y mental del trabajador. Se discute la contradicción entre la salud y el trabajo, intentando dar una explicación de cómo los diferentes sistemas económicos han intentado mediar en esta contradicción. El artículo hace hincapié en las circunstancias, que en el caso venezolano, condujeron al desarrollo de hecho y de derecho de la atención de la salud de quien trabaja, primero de nuestros ancestros, los indios americanos, luego de los esclavos negros y con el pasar del tiempo, de los trabajadores de las minas en el siglo XIX y delos trabajadores petroleros en el siglo XX, siglo que a partir de 1950, con la graduación en Inglaterra del primer médico ocupacional venezolano, el Dr. Emigdio Cañizales Guédez, vio crecer exponencialmente los profesionales que se sumaron a este campo del ejercicio profesional, que incluyó servicios en las empresas, gremios, y finalmente, los postgrados. Se trae a la memoria a personas de todo el país, que, desde su lugar de acción, dieron su aporte para que la Medicina del Trabajo o Medicina Ocupacional ocupe hoy un lugar estratégico en lo que significa la empresa nacional, sea pública o privada(AU)

A compilation of facts related to health and safety at work is presented, in the form of an approximation, without attempting a historical analysis, following a transversal thread of the role of medicine in what physical and mental health has meant over time. Who works the contradiction between health and work is discussed, trying to explain how different economic systems have tried to mediate this contradiction. The article emphasizes the circumstances that in the Venezuelan case led to the de facto and legal development of health care, first of our ancestors, the American Indians, then of the black slaves and over time of the workers of the mines in the 19th century and of the oil workers in the 20th century, a century that from1950, with the graduation in England of the first Venezuelan occupational doctor, Dr. Emigdio Cañizales Guédez, will see the professionals who joined grow exponentially. To this field of professional practice, which will include services in companies, trade unions and finally postgraduate courses. The article brings to mind people from all over the country, who from their place of action, gave their contribution so that Occupational Medicine or Occupational Medicine now occupies a strategic place in what the national company means, whether public or private(AU)

Pharmacovigilance: How aware are the prescribers?

Background: Adverse drug reactions (ADRs) is one of the important factors contributing to morbidity and mortality among patients and is a major public health burden. Spontaneous ADR reporting plays an important role in detection of ADRs, reducing their incidence and improving patient safety. India has one of the lowest ADR reporting rates in the world. Aim and Objective: The aim of the study was to assess the knowledge, attitude and practice (KAP) of doctors towards pharmacovigilance. Materials and Methods: A KAP questionnaire validated by subject experts was given to the doctors outside the teaching profession within 50 km of Government TD Medical College, Alappuzha, who consented to be a part of the study. The questions were structured to obtain the demographic details of the doctors, their KAP toward pharmacovigilance. No identifiable information regarding the participants was collected and the participants were assured of their confidentiality. A week’s time was given to the participants to answer the questions. Results: During the period of 1 year from June 2019 to May 2020, a total of 121 doctors responded to the questionnaire. The respondents aged from 26 to 67 years with the mean age being 37.31 ± 14.15 years. 94 (77.7%) thought that anyone could report an ADR while 16 (13.2%) thought that only doctors could report ADRs. Only 76 (62.8%) were aware of the existence of National Pharmacovigilance Centre in India. Ninety-eight (81%) did not know how to submit the ADR form to the nearest pharmacovigilance center. A vast majority 99 (81.8%) thought that ADRs to drugs of any system of medicine could be reported, while 20(16.5%) felt that only ADRs to modern medicines need to be reported. Among the factors discouraging doctors from reporting ADRs, lack of training to report an ADR 99 (81.8%) and lack of time during practice 83 (68.5%) were cited as the common reasons. A vast majority 116 (95.9%) had not received any formal training on ADR reporting and 114 (94.2%) opined that they would like to receive a formal training on the same. Conclusion: Doctors were largely aware of pharmacovigilance but had lack of KAP of reporting ADRs and filling up an ADR form. It emphasizes the need for regular mandatory education and training on ADR reporting among healthcare workers, and also the need to run continuous awareness campaigns on spontaneous reporting of ADRs to enhance reporting rate.

Perception and Preparedness of Medical Students Towards the Health Care Needs Of LGBTQIA+ Community: A Cross-Sectional Study in Vadodara, Western India

Introduction: The legalization of LGBTQIA+ community will bring a new stream of patients and their specific issues to healthcare community. Despite getting their place in society, they face discrimination and stigma from healthcare professionals, which will roadblock them from accessing healthcare. This study aims to doc-ument the perception of upcoming healthcare providers towards the LGBTQIA+ community and their prepar-edness to address their healthcare needs. Methodology: A cross-sectional survey conducted among 299 final MBBS students and Interns during “Pride month” June, 2022. An investigator-designed, validated, pre-tested, semi-structured questionnaire using Google forms, documented sexual-orientation of participants and their existing knowledge, attitude and prac-tice towards the healthcare needs of LGBTQIA+ community. Results: Total 299 participants were enrolled, having a Response Rate of 94.9% (315 total participants). Pro-portion of female and male was 44.8% and 54.8% as sex (biological) respectively and 54.5% of participants identified themselves as man and 44.8% as woman as gender. Awareness about LGBTQIA+ community was among 98.33% of the participants. Mean Knowledge, Attitude and Practice Scores were 18.4 +2.7, 80.5 +12.4 and 31.4 +5.9, respectively and were positively correlated to each other. Female participants scored signifi-cantly higher, statistically than male participants in knowledge, attitude and practice domains. Conclusion: Despite of good knowledge and positive attitude toward LGBTQIA+ people, pockets of ignorance and discomfort reside among medical undergraduates and interns.

Diseño e implementación del Programa de Bienestar Profesional del Colegio Médico del Uruguay

Son múltiples los estudios que informan de una alta prevalencia de problemas de salud mental en médicos y médicas. Aunque los médicos presentan resistencias a la hora de solicitar ayuda profesional cuando están aquejados de trastornos mentales, los servicios especializados desarrollados específicamente para tratar sus problemas de salud mental han reportado resultados prometedores. El propósito de este artículo es describir el diseno y la implementación del Programa de Bienestar Profesional del Colegio Médico del Uruguay. El contexto, los insumos, las actividades y algunos de los productos se describen de acuerdo con el diseno de un estudio de caso. También se sefñalan los principales hitos en la puesta en marcha del programa, así como los elementos facilitadores, los obstáculos y los principales logros. Se enfatizará la importancia de la colaboración internacional para compartir experiencias y modelos, cómo articular el proceso asistencial para fomentar el acceso de los médicos a la atención psiquiátrica y psicológica, la necesidad de que sean flexibles y dinámicos para adaptarse a circunstancias novedosas y cambiantes como la pandemia por COVID-19 y la necesidad de que vayan en paralelo con las exigencias de los organismos reguladores de la práctica médica. Se espera que la experiencia descrita en este trabajo pueda ser de utilidad a otros colectivos latinoamericanos interesados en desarrollar programas de salud mental para los médicos.

Multiple studies have reported a high prevalence of mental health problems among male and female physicians. Although doctors are reluctant to seek professional help when suffering from a mental disorder, specialized services developed specifically to treat their mental health problems have reported promising results. The purpose of this article is to describe the design and implementation of the Professional Wellbeing Programme (Programa de Bienestar Profesional) of the Uruguayan Medical Association (Colegio Médico del Uruguay). The context, inputs, activities and some of the outputs are described according to a case study design. The main milestones in the implementation of the programme are also outlined, as well as the enabling elements, obstacles and main achievements. Emphasis will be placed on the importance of international collaboration to share experiences and models, how to design the care process to promote doctors' access to psychiatric and psychological care, the need for them to be flexible and dynamic in adapting to new and changing circumstances, such as the COVID-19 pandemic, and to work in parallel with the medical regulatory bodies. It is hoped that the experience described in this work may be of use to other Latin American institutions interested in developing mental health programmes for doctors.

Los presidentes médicos de la Sociedad Científica Argentina en sus 150 años / The medical presidents of the Argentine Scientific Society in its 150 years

Los autores describen los hechos que dieron lugar al nacimiento, en 1872, de la SCA, que cumplió 150 años de existencia. Se señalan sus fundadores, sus objetivos y los principales hitos a lo largo de ese tiempo. El análisis hace hincapié en que durante la primera mitad de ese período solo un presidente fue médico: los demás fueron ingenieros, físicos, químicos, militares, abogados e investigadores naturalistas. En cambio, durante la segunda mitad 8 médicos, de distintas especialidades, ocuparon la presidencia, todos con una destacada actuación profesional, tanto nacional como internacional, y que aportaron una característica especial a la institución, propia de esta profesión. (AU)

The authors describe the events that led to the birth, in 1872, of the SCA, which celebrated 150 years of existence. Its founders, its objectives and the main milestones throughout that time are indicated. The analysis emphasizes that during the first half of that period only one president was a doctor: the others were engineers, physicists, chemists, soldiers, lawyers, and naturalistic researchers. On the other hand, during the second half, 8 doctors, from different specialties, held the presidency, all with an outstanding professional performance, both nationally and internationally, and who contributed a special characteristic to the institution, typical of this profession. (AU)

Prevalence of Health Problems, Professional and Financial Satisfaction among Doctors Working Across Vadodara City: A Cross-sectional Study

Background: The present study was conducted to know the distribution of various health problems among doctors and to assess professional and financial satisfaction levels among doctors. Methods: A Google Form questionnaire-based cross-sectional study was conducted among 122 doctors in Vadodara selected purposively after taking consent. Google form was circulated by email and WhatsApp groups. The form consisted of questions related to demographic details, health problems, financial and job satisfaction. All the responses were recorded and analyzed in MS Excel 2019. Results: Among the 122 doctors, 89 (72.95%) were male and 33 (27.04%) were female and 101 (82.78%) doctors were taking treatment for some ailment. Around 86.9% of doctors regularly opt for a health check-up. Among the health problems reported by doctors, the most common were musculoskeletal ailments (72.13%) followed by hypertension (28.9%), diabetes (17.2), cardiac (12.3%), endocrinal (10.65%), eye (9.01), mental (6.55) problems. Approximately 37.70% of doctors answered that health problems temporarily affect their work; 5.73% of doctors felt the need to modify their work pattern. About 91.80% of doctors were satisfied by their profession, while 108 (88.52%) doctors were financially satisfied with their work. Conclusion: More than half of the professionals complained of musculoskeletal problems. The majority of health care professionals were professionally and financially satisfied.

Are Patients Satisfied with Government Health Care? A Study on Patient’s Level of Satisfaction and Their Perception of Violence Against Doctors at A Government Hospital in North Karnataka, India

Background: The level of patient satisfaction must be evaluated periodically to assess the quality of health care provided by the government and to improve health care delivery in developing nations. The purpose of the study is to determine the level of patient satisfaction and their perception of violence against doctors among in-patients attending government teaching hospital. Methodology: It was a cross-sectional study among in-patients of government teaching hospital in North Karnataka. A predesigned structured Patient Satisfaction Questionnaire –18 (PSQ–18), along with self-framed violence questionnaire was used as study tools. Descriptive Statistics, ANOVA & Kruskal - Wallis tests were done using SPSS version 16. Results: The mean score for overall satisfaction was 3.72± 0.387. The mean patient satisfaction was highest for interpersonal manner (4.00 ±0.72) & the least was accessibility and convenience (3.52±0.58). Among the study subjects47.5% had heard about the violence against the doctors, 33.5% said violence against doctors is on rise. Violence against doctors was unethical according to 57.5% and 60% said it must summon punish-ment. Conclusions: The overall patient satisfaction was good; accessibility and convenience need to be improved. The study helps in understanding patient’s needs in various dimensions of health care.

Research on Syndrome and Treatment Rules of Famous Doctors in Treating Ulcerative Colitis Based on Data Mining / 中医杂志

ObjectiveTo systematically review the clinical experience of four sessions of Masters of Traditional Chinese Medicine and two sessions of National Famous Chinese Medicine Practitioners in treating ulcerative colitis （UC）. Data mining and analysis were conducted to clarify the diagnosis and treatment ideas and characteristics of prescription used by these famous doctors in treating UC. MethodsRelevant literature on the treatment of UC by renowned doctors was retrieved from the establishment of the database until March 31， 2023. The literature was collected from databases such as China National Knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform， Chinese Science and Technology Periodicals Database， and China Biomedical Literature Database. The data mining techniques including frequency analysis， association rules， and cluster analysis were conducted using the Ancient and Modern Medical Case Cloud Platform V2.3.5. ResultsA total of 157 literatures were included in this study， including 115 clinical case data. The study found that UC can be categorized into 14 types of syndrome patterns for treatment， including large intestine dampness-heat syndrome （75，65.22%）， syndrome of dampness stagnancy due to spleen deficiency （23， 20.00%）， spleen-kidney yang deficiency syndrome （21， 18.26%）. The main affected organs were the spleen （85， 73.91%） and large intestine （75， 65.22%）， and they were closely related to liver （24， 20.87%） and the kidney （21， 18.26%）. The predominant pathogenic factors were dampness （83， 72.17%） ， heat （80， 69.57%） and qi deficiency （65， 56.52%）. The treatment involved 30 kinds of treatment methods， including heat-clearing and dampness-draining method （75， 65.22%）， pleen-tonifying and qi-boosting method （25，21.74%） and spleen-invigorating and dampness-transforming method （23， 20.00%）. The medication involved 187 ingredients， with the most commonly used being heat-clearing herbs （37， 19.79%） and tonifying herbs （27， 14.44%）. The tastes of the herbs were mostly sweet （85， 45.45%） ， bitter （80， 42.78%） ， and pungent （71， 37.97%）. The association rules revealed 16 high-frequency combinations mainly composed of Huanglian （黄连）， Baishao （白芍） and Gancao （甘草） along with Baizhu （白术）， Fuling （茯苓）， Muxiang （木香） and Danggui （当归）. ConclusionFamous doctors are skilled in diagnosing and treating UC based on the differentiation of the zang-fu organs and qi-blood. The key pathological mechanism is “spleen deficiency as the root， and large intestine damp-heat as the manifestation”. The core treatment approach is “heat-clearing， spleen-tonifying， and dampness-draining”， with the inclusion of “regulating qi and blood， and balancing cold and heat”.

ZHUANG Lixing's Experience in Differentiating and Treating Levodopa-Induced Dyskinesia in Parkinson's Disease / 中医杂志

This paper summarized Professor ZHUANG Lixing's clinical experience in differentiating and treating levodopa-induced dyskinesia （LID） in Parkinson's disease. It is believed that the fundamental pathogenesis of LID lies in the disharmony or malnourishment of tendons and vessels. Based on the clinical manifestations， peak-dose LID is differentiated into two syndromes： syndrome of hyperactive liver yang causing wind and syndrome of deficiency of both liver and kidney. For the syndrome of hyperactive liver yang causing wind， the treatment focuses on calming the liver to stop the wind， and relaxing the tendons to stop tremors. The main prescription used is Zhengan Xifeng Decoction （镇肝熄风汤） with the addition of Shijueming （石决明） and Zhenzhumu （珍珠母）. For the syndrome of deficiency of both liver and kidney， the treatment focuses on nourishing the liver and kidneys， and replenishing yin to stop the wind. The main prescription used is Dabuyin Pills （大补阴丸） with modification. LID in the acoustic phase is differentiated into syndrome of phlegm-damp blocking middle jiao and syndrome of deficiency of both qi and yin. For the syndrome of phlegm-damp blocking middle jiao， the treatment focuses on dissipating phlegm and eliminating dampness， and nurturing tendons and vessels. Wendan Decoction （温胆汤） or Erchen Decoction （二陈汤） with modification is used. For the syndrome of deficiency of both qi and yin， the treatment focuses on replenishing qi and nourishing blood， and nurturing tendons and vessels. The main prescriptions used are Buzhong Yiqi Decoction （补中益气汤） or Bazhen Decoction （八珍汤） or Shenling Baizhu Powder （参苓白术散） with modification. Biphasic LID is differentiated as the Shaoyang pivot disadvantageousness， and the treatment focuses on harmonizing Shaoyang and regulating the pivot. The main prescription used is Xiaochaihu Decoction （小柴胡汤） with modification.

ZHANG Yunling's Experience in the Treatment of Amyotrophic Lateral Sclerosis from Emphasis on both Spleen and Kidney / 中医杂志

This paper summarized Professor ZHANG Yunling's experience in the treatment of amyotrophic lateral sclerosis （ALS） from emphasis on both spleen and kidney. It is considered that the characteristic of ALS manifested as overlap of atrophy-flaccidity disease and convulsive disease， and the core pathogenesis are the deficiency of spleen and kidney and the inner pathogenic qi. ZHANG advocated that ALS should be treated from tonifying both the spleen and kidney， as strong spleen and kidney led the latent pathogen at peace. Usually applied Huangqi （Astragalus mongholicus）， Baizhu （Atractylodes macrocephala） combined with Taizishen （Pseudostellaria heterophylla）， fried Yiyiren （Coix lacryma-jobi）， Doukou （Myristica fragrans） and Sharen （Wurfbainia villosa） to tonify the middle and replenish qi， ascend lucidity and descend turbidity to invigorate the spleen； Roucongrong （Cistanche deserticola）， Tusizi （Cuscuta chinensis） combined with Shanyao （Dioscorea oppositifolia）， Shanzhuyu （Cornus officinalis） and prepared Dihuang （Rehmannia glutinosa） are used to support the fire and nourish the water， so as to replenish the spleen. The empirical formula regarded invigorateing the spleen and replenishing the kidney as the core therapeutic principle throughout the treatment of the whole process， which aimed at extinguishing inner wind and pacifying latent pathogen when treating the root.