International aspects in healthcare and medical education: Scientometric trends and knowledge maps before the COVID-19 pandemic

BACKGROUND: Literature shows that healthcare and medical education are associated with the countries/institutes' developments, and reviewing the global patterns can shed light on various aspects of this competition. The study aims to investigate the current research aspects on the internationalization of healthcare and medical education and assess its trends worldwide. MATERIALS AND METHODS: In this descriptive study, based on documents in Web of Science (n = 609), PubMed (n = 395), and Scopus (n = 6598), scientometric methods and knowledge visualization techniques were applied to evaluate global scientific production and trends from 1900 to 2020. Results were preprocessed in BibExcel (version 2016-02-20) to create a mapping file, and word co-occurrence analysis was applied to evaluate the publications. Scientific maps, authors' networks, and countries'/institutes' contributions were depicted using VOS (Visualization of Similarity) viewer and NetDraw. For trend analysis, highly frequent words were examined at intervals before 2000, 2000–2004, 2005–2009, 2010–2014, and 2015–2019. RESULTS: Altogether, 129 countries and 14536 (co)authors with 7007 affiliations contributed to the production of 6895 documents. Of the 2378 journals, the top 20 journals published 1298 (18.83%) articles. The top 20 authors together contributed to 247 papers (3.58%). High-income countries made up the most prolific nations. Also, institutes from North America, Europe, and Oceania pioneered production and cooperation. Highly co-occurring words were international cooperation, medical education, medical school, curriculum, medical research, and medical students. CONCLUSION: The countries/institutions' efforts in internationalizing healthcare and medical education are reflected in the publications in the databases of Web of Science, PubMed, and Scopus. Thus, the findings offer evidence-based information about past and present trends and help researchers and policymakers understand their global impact

Safety and Efficacy of Anti-Fibrinolytics in Orthopedic Surgery: A Meta-Analysis of Randomized Trials.

Abstract Background: Minimizing blood transfusions following elective orthopedic procedures is desirable given the risks associated with transfusion, including cost, infection, and allergic reactions. Anti-fibrinolytic agents may reduce perioperative blood loss but are used infrequently possibly due to a lack of data supporting their efficacy and concerns about increased risks for venous thromboembolism (VTE). We performed a meta-analysis to determine whether anti-fibrinolytic agents reduce perioperative blood loss in patients undergoing total hip replacement (THR) or total knee arthroplasty (TKA). Data sources: MEDLINE (1966 to May Week 3 2006), EMBASE (1980 to 2006 Week 21), Cochrane Database of Systematic Reviews, ACP Journal Club, Database of Abstracts of Reviews of Effects, and Cochrane Central Register of Controlled Trials (the latter four databases to May 29, 2006) were searched. Additional trials were identified by manual searches. Authors and/or pharmaceutical companies were contacted if required. Study selection was based on the following criteria: prospective randomized clinical trials in which tranexamic acid, epsilon-aminocaproic acid, or aprotinin were administered. Two independent reviewers abstracted transfusion requirements, total blood loss, and venous thromboembolism. Study quality was assessed using the Jadad Quality Assessment scale. Data was pooled using the Mantel-Haenszel method and a random effects model. Results: In 25 studies involving 1332 patients, the weighted mean difference (WMD) in total blood loss in patients treated with anti-fibrinolytic agents compared to patients receiving placebo was −409.50 mL (95%CI, −548.17 to −270.82; P&amp;lt; 0.00001, I2 = 89.6%). In 1557 patients, the relative risk (RR) for transfusion was 0.52 (95%CI, 0.42 to 0.64; P&amp;lt;0.00001, I2 = 58.0%). VTE did not appear to be increased in patients who received anti-fibrinolytic agents (RR 0.972 (95%CI, 0.885 to 1.06). Conclusions: Patients undergoing TKR or THA who receive anti-fibrinolytic agents appear to have reductions in blood loss and need for transfusion. Whether these medications increase VTE risk cannot be determined due to limited data. Study characteristics were heterogeneous and the optimal timing, dose, and type of anti-fibrinolytic therapy have yet to be determined. Further studies in this area are warranted.</jats:p

Anti-Tuberculosis Drug -Induced Hepatitis -A Case Report A B S T R A C T

Introduction: This is a case report focusing on a 32 years male patient who experienced hepatotoxicity after administration of anti tubercular drugs. Isoniazid, Rifampacin, Pyrazinamide, Ethambutol are the first line agents in the treatment of Tuberculosis. The incidence rate of anti-TB induced hepatotoxicity is found to be 2% to 28%. Case: In this case, the patient was receiving anti-tubercular drugs from 3 months and developed hepatitis which is a severe adverse drug reaction. Naranjo&apos;s causality assessment algorithm was used to assess the adverse effect and it indicated anti-tubercular drugs as probable cause of hepatitis