Beyond Traditional Pain Relief: A Review of Alternative Analgesics in Myocardial Infarction Patient Management.

While morphine is the recommended first-line treatment for pain management in patients with acute coronary syndrome, recent studies have raised concerns about its association with adverse outcomes. Morphine has been found to cause delayed antiplatelet effects, decreased ticagrelor absorption, increased platelet reactivity, and compromised efficacy of dual antiplatelet therapy (DAPT). Alternative analgesics, such as lidocaine, fentanyl, and acetaminophen, have begun to emerge as viable alternatives, each with unique mechanisms and potential benefits. Lidocaine is demonstrated to have superior effects in reducing microvascular obstruction and fewer adverse events compared to fentanyl, despite being less effective in pain reduction. Fentanyl, which shows rapid onset and powerful analgesic properties, may interfere with ticagrelor absorption, potentially affecting platelet inhibition. Acetaminophen, a centrally acting analgesic, emerges as a safer alternative with comparable pain relief efficacy and minimal side effects. The results of multiple clinical trials emphasize the significance of customizing pain management approaches to match individual patient profiles and achieving the optimal balance between pain relief and potential adverse outcomes.

Rising quantitative productivity and shifting readership in academic publishing: Bibliometric insights from monkeypox literature.

The sudden spread of the monkeypox virus has been accompanied by an increase in the scientific interest in the virus. More than 1,400 PubMed-indexed documents have been authored by about 5,800 unique authors, averaging around 120 publications per month. This sheer rise in the number led us to explore the content published in the literature. We discovered more than 30% of the documents are Quantitative Productivity (QP) i.e., papers that illustrate the emerging trends of parachute concerns, modified salami tactics, cyclic recycling, and excellence in redundancy. In addition, we found few common hyper-prolific authors previously identified in the COVID-19 literature. Further, we share our experience in publishing monkeypox literature and highlight the growing readership and citation interest in editorials, commentaries, and correspondences that were thought to be uncitable in the medical literature. As long as the scientific community and public demand, the supply of such papers will continue, with no responsibility on the authors, journals, or the reader. Since overhauling the current system is an arduous task, we propose the optimization of existing retrieval services that would selectively filter documents based on article type (requires standardization of definitions) to dilute the crowding out effects of quantitative productivity.

War Psychiatry: Identifying and Managing the Neuropsychiatric Consequences of Armed Conflicts.

War refugees and veterans have been known to frequently develop neuropsychiatric conditions including depression, post-traumatic stress disorder (PTSD), and anxiety disorders that tend to leave a long-lasting scar and impact their emotional response system. The shear stress, trauma, and mental breakdown from overnight displacement, family separation, and killing of friends and families cannot be described enough. Victims often require years of mental health support as they struggle with sleep difficulties, recurring memories, anxiety, grief, and anger. Everyone develops their coping mechanism which can involve dependence and long-term addiction to alcohol, drugs, violence, or gambling. The high prevalence of mental health disorders during and after the war indicates an undeniable necessity for screening those in need of treatment. For medical health professionals, it is crucial to identify such vulnerable groups who are prone to developing neuropsychiatric morbidities and associated risk factors. It is pivotal to develop and deploy effective and affordable multi-sectoral collaborative care models and therapy, which primarily depends upon family and primary care physicians in the conflict zones. Herein, we provide a brief overview regarding the identification and management of vulnerable populations, alongside discussing the challenges and possible solutions to the same.