Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Abstract This study applies Failure Mode and Effects Analysis (FMEA) to assess and mitigate risks in key hospital departments, aiming to enhance patient safety and process reliability. Conducted in a 400-bed tertiary hospital over a six-month period, the research focused on three high-risk units: the Intensive Care Unit (ICU), Operating Room (OR), and Pharmacy. Data were collected through incident reports, structured interviews, and process observations. For each failure mode, the Risk Priority Number (RPN) was calculated based on severity, occurrence, and detectability scores. In the ICU, alarm fatigue had the highest RPN (336), signaling a critical need for smarter alarm systems. In the OR, incomplete time-out procedures posed the greatest risk (RPN: 315), highlighting communication gaps. In the Pharmacy, look-alike/sound-alike (LASA) medications were the most dangerous (RPN: 336), indicating the importance of system-based labeling and verification strategies. The study concludes that FMEA is a practical, data-driven approach for identifying latent hazards in hospital systems. Targeted interventions such as staff training, digital checklists, and barcode medication administration systems are recommended. Integrating FMEA with hospital information systems and routine quality audits can significantly improve patient safety outcomes and organizational resilience.

Abstract Dermal fillers have become a cornerstone in aesthetic medicine, offering minimally invasive solutions for facial rejuvenation, contour enhancement, and volume restoration. This review explores the various types of dermal fillers, their clinical indications, and potential complications associated with their use. Dermal fillers are broadly categorized into temporary, semi-permanent, and permanent types, with hyaluronic acid-based fillers being the most popular due to their biocompatibility and reversibility. Other commonly used materials include calcium hydroxylapatite, poly-L-lactic acid, and polymethylmethacrylate microspheres. Indications for dermal filler application encompass correction of age-related volume loss, soft tissue augmentation, wrinkle reduction, and facial contour remodeling. Proper patient selection and individualized treatment planning are essential to maximize aesthetic outcomes and minimize risks. Despite their safety profile, dermal fillers carry potential complications ranging from mild and transient, such as swelling, bruising, and erythema, to more serious adverse events including infection, vascular occlusion, and granuloma formation. The prevention and management of complications require a thorough understanding of facial anatomy, appropriate injection techniques, and prompt recognition of adverse signs. Advances in filler technology and imaging techniques have improved treatment precision and patient satisfaction; however, challenges remain in achieving consistent long-term results and managing rare but severe complications. This review underscores the importance of clinician expertise, patient education, and ongoing research to optimize the safety and efficacy of dermal filler treatments. Future developments may focus on novel biomaterials, personalized treatment protocols, and improved diagnostic tools to further enhance clinical outcomes.

Abstract The lower third of the face plays a critical role in facial harmony and aesthetic perception, often being one of the first regions to exhibit signs of aging such as volume loss, sagging skin, and reduced definition of the jawline. The "Contouring Plus" approach combines the synergistic use of Calcium Hydroxylapatite (CaHA) and Hyaluronic Acid (HA) to offer a comprehensive, minimally invasive solution for rejuvenation and contouring of this facial region. CaHA, known for its biostimulatory properties, not only provides immediate volumization but also induces neocollagenesis, leading to long-term dermal remodeling. HA fillers, on the other hand, deliver precise augmentation and hydration, particularly effective in fine contouring and surface-level corrections. This integrated technique involves strategic placement of both substances in targeted anatomical zones, enhancing mandibular angle, chin projection, and submental definition while maintaining a natural and harmonious appearance. The approach emphasizes individual assessment, customized product layering, and attention to facial dynamics, which collectively contribute to high patient satisfaction and safety. Clinical evidence demonstrates significant improvements in facial aesthetics with minimal adverse effects, making this method an ideal option for both men and women seeking facial rejuvenation without surgery. This paper reviews the anatomical rationale, product characteristics, injection techniques, and clinical outcomes associated with the Contouring Plus protocol, positioning it as an advanced standard in modern aesthetic dermatology.

Abstract The rate of muscle cell growth is also dependent on the activity of some hormones, including growth hormone (GH), insulin, insulin-like growth factor-1 (IGF-1), and steroid sex hormones, especially testosterone. Research results on the acute hormonal response to resistance training show that anabolic hormones such as growth hormone and testosterone, which are very important and vital in tissue growth and remodeling, increase during and after resistance training. These hormones play an important role in increasing protein synthesis. Therefore, the improvement of some physical fitness factors in adolescents is attributed to the increase in the level of these hormones. In this regard, Kramer (2004) stated that if the rest interval between resistance training periods performed at 80% of 1RM in 6 periods and 10 repetitions in each period is less than 1 minute, it can cause a significant increase in the secretion of growth hormone and testosterone. Testosterone is an anabolic hormone that stimulates protein synthesis and plays a very important role in the growth and maintenance of muscle tissue. Growth hormone is one of the most important hormones in the body that, along with a group of other hormones, affects metabolism and is necessary for maintaining body weight and protein synthesis in adults. It has been proven that normal growth is directly related to the plasma concentration of Somatomedin-C or insulin-like growth factor IGF-1.

Abstract Facial aesthetic treatment with injectable hyaluronic acid (HA) fillers has become a pivotal technique in modern non-surgical facial rejuvenation. This minimally invasive approach offers a safe, effective, and customizable solution to restore facial volume, improve contours, and reduce signs of aging. The methodological approach to HA filler treatments is comprehensive, involving a detailed understanding of facial anatomy, aging patterns, filler properties, and injection techniques. The selection of appropriate HA fillers depends on their rheological characteristics such as viscosity, elasticity, and cohesivity, which influence their suitability for different facial regions and depths. Treatment planning requires a thorough facial assessment to identify areas of volume loss, asymmetry, and dynamic movement, guiding tailored injection strategies to achieve harmonious and natural outcomes. Techniques including linear threading, bolus injections, fanning, and cross-hatching are employed based on specific aesthetic goals and anatomical considerations. Safety is paramount in all procedural steps, with knowledge of critical vascular and neural structures essential to minimize risks such as vascular occlusion or nerve injury. Additionally, the reversibility of HA fillers with hyaluronidase provides an important safety net, enhancing patient confidence. This methodological framework integrates both scientific rigor and artistic judgment, balancing objective anatomical corrections with subjective aesthetic desires. Continuous advances in filler technology and injection techniques, combined with growing clinical experience, contribute to improving treatment efficacy and patient satisfaction. Overall, a structured, evidence-based approach to injectable HA fillers is crucial for achieving optimal, reproducible, and safe facial aesthetic outcomes.

Abstract Introduction: Evaluating the comparative effects of ketamine and dexmedetomidine on adverse events following traumatic nasal surgeries is clinically significant. Clarifying their roles in reducing postoperative nausea, vomiting, shivering, hypotension, and bradycardia supports evidence-based anesthetic selection. This research enhances perioperative care by informing tailored anesthetic strategies, ultimately promoting patient safety, improving postoperative recovery, and optimizing outcomes in trauma patients undergoing nasal surgery.

Material and methods: This prospective, randomized, double-blind clinical trial will compare ketamine and dexmedetomidine regarding adverse event incidence in adults undergoing traumatic nasal surgery. Consecutive eligible patients will be randomized and both participants and clinical staff will be blinded. Data on postoperative complications will be systematically collected and statistically analyzed. The study is ethically approved and complies with the Declaration of Helsinki, ensuring rigorous methodology, patient safety, and reliable, generalizable results for evidence-based anesthetic management.

Results: The comparative analysis of ketamine and dexmedetomidine in patients undergoing traumatic nasal surgery revealed no significant differences in the incidence of postoperative adverse events, including nausea, vomiting, shivering, hypotension, and bradycardia requiring treatment. Both anesthetic agents demonstrated similar safety profiles, with low rates of hemodynamic complications and comparable risks for common postoperative events, supporting their use as equally viable options in this clinical context.

Conclusion: This study demonstrates that ketamine and dexmedetomidine provide comparable safety profiles for patients undergoing traumatic nasal surgery, with no significant difference in the incidence of nausea, vomiting, shivering, hypotension, or bradycardia requiring intervention.

Abstract Introduction: Understanding the role of gut microbiota in the pathogenesis of ankylosing spondylitis (AS) is of paramount clinical importance, as it offers novel insights into the systemic nature of this inflammatory disease beyond the axial skeleton. Elucidating the gut-joint axis may uncover microbial biomarkers and therapeutic targets, enabling earlier diagnosis, personalized treatment strategies, and potentially disease-modifying interventions that address underlying immune dysregulation rather than merely suppressing symptoms.

Material and methods: This systematic review rigorously synthesized current evidence on gut microbiota’s role in ankylosing spondylitis by screening multiple databases, applying strict inclusion criteria, and following PRISMA guidelines. Data extraction and risk of bias assessments were performed independently to ensure reliability. Clinical and methodological heterogeneity across studies was carefully evaluated, with statistical analyses and subgroup assessments employed to interpret variability, ultimately providing a comprehensive, high-quality appraisal of the gut-joint axis in AS pathogenesis.

Results: The results of this systematic review, synthesized from nine eligible studies, reveal consistent alterations in gut microbiota composition among patients with ankylosing spondylitis. Notable findings include increased abundance of Prevotella and Lactobacillus species and reduced levels of Faecalibacterium and Ruminococcus. These microbial changes were associated with elevated pro-inflammatory cytokines (IL-17, IL-23), increased zonulin levels, and reduced butyrate, suggesting a link between dysbiosis, impaired gut barrier function, and systemic inflammation in AS.

Conclusion: Based on the synthesized evidence, ankylosing spondylitis is associated with gut microbiota dysbiosis characterized by increased Prevotella and reduced Faecalibacterium, alongside elevated pro-inflammatory, intestinal permeability markers. These findings suggest a gut–immune axis contributing to disease pathogenesis.