Editorial: Highlights from the Issue

The present issue of Future Health Journal, the official journal of AIIMS Bhopal, comprises of 15 articles, including original articles, review articles, brief communication, case reports, and letters to editor. Here, we present a brief overview of the issue.

A research article by Gayathri et al. explored the serum sodium and potassium levels as a predictive marker of severity for COVID-19 patients.¹ For this, a cross-sectional record-based descriptive study on 227 COVID-19 subjects was conducted at a tertiary care center in Kerala. Serum sodium and potassium levels at the time of admission, treatment received, patient outcomes, including an intensive care unit (ICU) admission, mechanical ventilation, and mortality, were analyzed. Authors reported hyponatremia and hypokalemia in 78.9% and 46.7% of cases, respectively, with a significant association between hyponatremia and mortality. Taken together, hyponatremia emerged as a key marker of severity in COVID-19 cases. However, previous studies have reported the association of dysnatremia with the severity of COVID-19 and mortality. In several studies, hypernatremia has been associated with mortality and acute kidney injury.²

Another original article in the current issue by Nagarajan et al. evaluated the prescription pattern of analgesics for the treatment of cancer pain.³ For this, the authors conducted a prospective observational study and recruited subjects aged 18 or older, receiving radiotherapy, chemotherapy, or palliative care and visiting the pain clinic at the Anaesthesia and Radiotherapy Outpatient Department. Of the participants, 30% were prescribed opioid analgesics, 30% nonopioids, and 40% combination therapy. It was further reported that morphine was the most common opioid, whereas tramadol was the most prescribed in combination therapy. The study highlights the importance of effective cancer pain management and careful opioid monitoring to prevent misuse, drug dependence, and adverse drug reactions.

Yet another study by Sravan et al. compared the effectiveness of blood sample collection using supraclavicular and infraclavicular approaches for both the left and right subclavian veins for postmortem microbiology (PMM).⁴ The study was conducted on blood samples from 30 cadavers, wherein the authors found that the left supraclavicular approach was superior to the infraclavicular method and can improve the chances of getting a non-contaminated, adequate sample for PMM.

Telemedicine has emerged as a promising approach to tackle healthcare challenges, particularly in resource-limited settings. Tele counseling offers benefits like improved access to care, flexibility, and cost-effectiveness while enhancing patient-doctor communication. However, it has certain limitations. In a letter to the editor, Kumar et al. discussed the accessibility, feasibility, and challenges of telemedicine for physicians during the COVID-19 pandemic.⁵ In another study, authors aimed to understand patient perspectives on telemedicine adoption, a promising tool for addressing healthcare challenges, in a limited resource setting such as Bangladesh.⁶ More specifically, the authors conducted a cross-sectional survey of 120 patients based on face-to-face structured surveys to test the awareness, acceptance, and barriers to telemedicine. The authors found that most patients showed awareness to telemedicine tools through friends or online sources and demonstrated positivity to telemedicine, especially for follow-up and mental health services. However, there were concerns regarding the effectiveness of telemedicine in emergency conditions. Poor internet connectivity, trust/security issues, and cultural resistance contributed to hurdles to the adoption of telemedicine, and therefore must be addressed for better adoption and improved access to quality healthcare in Bangladesh. Addressing these challenges is crucial for enhancing the adoption of telemedicine. Future research should involve healthcare providers and policymakers for deeper insights.

The issue also presents four review articles. The first article focuses on the future road of entrepreneurship in Ayurveda and is driven largely by the increasing consumer demand for natural, holistic health solutions.⁷ Ayurveda is creating entrepreneurial opportunities by blending traditional knowledge with modern business strategies, driven by the rising consumer demand for natural health solutions, especially post-COVID-19. Two review articles focus on the relevance of Ayurveda in healthcare systems. An article by Sabharwal and Singh emphasizes that the innovations in technology and regulatory support from the Indian government are essential for building consumer trust and promoting global acceptance of Ayurveda. In addition, technological innovations in digital health platforms and artificial intelligence (AI) have transformed the person-centric healing approach of Ayurveda to global practice. To add to this, the Ministry of AYUSH, Government of India, has provided regulatory support as well as standardization, quality, and safety. In conclusion, while challenges, including regulatory hurdles and market competition, exist, the Ayurveda entrepreneurship demonstrates potential in holistic wellness and global health.

Furthermore, a systematic review by Sabharwal and Jidani focuses on the classical components of Rachana Sharir; Rachana Sharir Vigyan elucidates the anatomical aspects of the human body.⁸ The study corelates classical aspects of Rachana Sharir to scientific knowledge. The authors carried out a systematic analysis of the classical ayurvedic text, Samhitas, for understanding origin, anatomical, and numerical positions as well as human body classification. The review focused on the contributions of Acharya Sushruta in the Sharir Sthana, especially regarding cadaveric studies that are highlighted. Taken together, Ayurveda is a combination of science and philosophy with the potential of exploration and validation for benefiting humanity.

Another review by Chenchula et al. focuses on the application of in vivo murine models for potential evaluation of antiarthritic agents.⁹ The review provides a comprehensive overview of genetically modified and induced arthritis animal models to understand disease progression and immune response as well as a tool for evaluating various drugs. The review further illustrates the challenges in the translation of findings from rodent models to human treatment. Computed tomography dose index (CTDI) and dose–length product (DLP) are two critical parameters for the optimization and monitoring of radiation dosage. Arafat et al. reviewed the literature on the importance of CTDI and DLP in the optimization of radiation dosage and patient safety in CT imaging.¹⁰

Antimicrobial stewardship program (ASP) is a step toward reduction in the spread of resistant pathogens. The authors have reviewed the role of nurses in ASPs such as allergy assessment, blood and urine culture sampling, antibiotic de-escalation, and patient monitoring, demonstrating the role of a nurse in combating antimicrobial resistance (AMR) worldwide.¹¹ Furthermore, a brief communication by Nath et al. delves into the dynamics of transmission of the Nipah virus and highlights the need for its early detection, improved therapeutics, and robust response mechanisms to manage outbreaks effectively in view of recent outbreaks in Kerala.¹²

This issue of the Future Health Journal has also included two case reports. Lipomas present at unusual locations, such as the hand, can cause pressure symptoms due to neurological compression. Kaul et al. report a case of a 55-year-old lady with carpal tunnel syndrome due to a giant palmar lipoma.¹³ Verma and Sahoo report an extremely rare case of squamous cell carcinoma of the left lower alveolus with partial thrombosis of the right internal jugular vein in a 54-year old female.¹⁴ In a letter to the editor, Kashyap and Bhat presented a rare case of isolated optic neuritis due to systemic lupus erythematosus (SLE), and suggested considering vasculitis as a potential differential diagnosis for bilateral painless vision loss in addition to demyelinating causes.¹⁵

Generative AI is emerging in healthcare, enhancing applications from patient data management to diagnostics. It leverages large language models (LLMs) to derive information from extensive datasets, aiding tasks such as listing diagnostic methods. Last, in a letter to the editor, Pandey et al. emphasize that while AI simplifies processes and aids nonnative English speakers, generative AI also faces limitations, such as ‘AI hallucinations,’ which can produce misinformation.¹⁶