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Introduction Endoscopic retrograde cholangiopancreatography (ERCP) requires effective sedation for patient comfort and procedural success. This study compares propofol-dexmedetomidine (group DP) and propofol-ketamine (group KP) for anesthetic management during ERCP. Methods This randomized, double-blinded study enrolled 50 patients (aged 18-60 years) scheduled for ERCP at Dr. D.Y. Patil Medical College and Research Centre, Pune, Maharashtra, India. Patients were randomly allocated to group DP (n=25) or group KP (n=25). Hemodynamic parameters, propofol consumption, recovery time, post-procedural pain (visual analog scale [VAS]), sedation levels (Ramsay sedation score), and post-operative side effects were recorded and analyzed. Results Group DP showed significantly lower heart rates, systolic blood pressure, and mean arterial pressure throughout the procedure (p<0.001). Group KP had lower post-operative VAS scores only in the initial post-operative period (p<0.001 at 15 minutes) but similar Ramsay sedation scores as compared to group DP. Total propofol consumption was lower in group DP, though not statistically significant (378.9 vs 454.8 mg, p=0.08). Group DP required significantly less additional propofol bolus (7.8 vs 18 mg, p<0.001) and had shorter recovery times (7.24 vs 15.2 minutes, p<0.001). Group DP showed no incidence of post-operative nausea and vomiting (PONV) or post-operative cognitive dysfunction (POCD), while group KP had a 26.7% incidence of PONV and a 66.7% incidence of POCD. Conclusion The propofol-dexmedetomidine combination offers more stable hemodynamic control, lower propofol requirements, and quicker recovery times for ERCP anesthesia. It is recommended for patients requiring tight cardiovascular control and rapid post-procedure recovery.

Meditation retreats are structured programs that immerse participants in focused meditation, mindfulness, and self-reflection over extended periods. Unlike conventional vacations, which prioritize relaxation, meditation retreats combine intensive practice with intentional rest, cultivating emotional regulation, mindfulness, and personal growth. These retreats have grown in popularity for their ability to support mental, emotional, and physical well-being. Research shows that retreats can reduce stress, anxiety, and depression while enhancing emotional resilience. Physical benefits, including reduced inflammatory markers and improved metabolic health, further contribute to long-term well-being. Positioned within the expanding wellness tourism market, meditation retreats offer sustainable benefits that surpass those of traditional leisure activities, marking them as a promising tool in preventive healthcare. In this editorial, we examine the evidence supporting these benefits and discuss challenges, such as varied formats, limited follow-up, and accessibility issues, which limit broader application. Further research is essential to standardise protocols, evaluate cost-effectiveness, and expand access, underscoring the potential of meditation retreats as a sustainable well-being intervention in today's demanding world.

Background This project investigates a music intervention to deprescribe antipsychotics in rural Veterans with dementia.  Methods The Veterans Health Administration Home-Based Primary Care Program is care provided in the home by an interdisciplinary team with the goals of decreasing hospitalizations and falls, providing education to patients and caregivers, and improving quality of life. Eighteen Home Based Primary Care Veterans with dementia and active antipsychotic prescriptions were identified with the goal to deprescribe antipsychotics in 50% of them using a music intervention. Individualized playlists and assessments for Veteran quality of life and caregiver burden were evaluated. Phone visits tracked music utilization and captured the voice of the customer. Results Antipsychotic dose reduction occurred in five of eight Veterans, totaling eight dose reductions and one discontinuation. Veteran quality of life improved; however, caregiver burden increased initially. The caregiver burden did improve when an outlier was removed. The voice of the customer favored music intervention. Conclusions A personalized music intervention is a feasible approach for reducing antipsychotic use in rural Veterans, improving quality of life, and potentially reducing caregiver burden.

Cancer patients encounter not only the physical manifestations of their disease but also a range of psychological challenges, including anxiety, depression, and severe sleep disturbances. Research indicates that approximately 50% of cancer patients experience clinically significant levels of distress, which can adversely affect treatment outcomes and diminish their overall quality of life. Moreover, the side effects of treatments such as chemotherapy and radiotherapy frequently exacerbate mental health difficulties, creating an urgent need for effective alternative supportive interventions to ameliorate these symptoms. Yoga Nidra, or yogic sleep, may be particularly efficacious for patients with cancer undergoing intensive treatments, such as chemotherapy or radiotherapy, where physical limitations or psychological stress are more pronounced. As the medical community increasingly recognizes the value of holistic approaches to cancer care, there is a growing interest in integrating complementary therapies that address both the mental and physical aspects of health. One such therapy is Yoga Nidra, a guided meditation practice that has garnered attention for its potential to alleviate psychological distress and improve sleep quality in cancer patients. Given its non-invasive, cost-effective, and highly accessible nature, Yoga Nidra presents a promising approach for enhancing the overall well-being of individuals undergoing cancer treatment. This editorial examines the role of Yoga Nidra in cancer care, highlighting its distinct benefits and emerging evidence supporting its use as a complementary therapy.

Tryambak Mahadev Gogate (1913-1998) was instrumental in the development of practical applications of Panchakarma therapies as well as in advancing Ayurvedic education and practice, which faced significant challenges during the colonial period in India. A gifted young individual, motivated by a desire to contribute to his nation, dedicated himself to the revitalization of Ayurveda. In pursuit of this goal, he engaged in self-experimentation, often at great personal risk. He meticulously documented his findings throughout these experiments, establishing techniques for administering Panchakarma therapies, refining Ayurvedic diagnostic methods, and contributing to the evolution of Ayurveda as a scientific discipline, all while making detailed observations that paralleled advancements in modern medical science.

Background A cold-sensitivity constitution (CSC), termed \"Hiesho\" in Japanese, is a common condition among young women that impairs quality of life through reduced peripheral circulation and autonomic imbalance. In our previous study, we reported that cold intolerance is associated with an imbalance in autonomic nervous function, as evaluated by heart rate variability (HRV). Conversely, footbathing increases parasympathetic nervous activity (PNA) and increases both peripheral blood flow and epidermal temperature. In the present study, we aimed to compare the autonomic nervous activity and peripheral skin temperatures of young women with CSC using either warm-water or steam footbathing. Methods This study employed a quasi-experimental, cross-sectional design. The participants were 12 healthy young women diagnosed with CSC (six in the warm-water footbathing group and six in the steam footbathing group). All participants reported sensations of coldness, were identified as having CSC via the Coldness Survey Questionnaire, and exhibited contrast between central (tympanic) and peripheral (hallux) body temperature measurements of 6°C. Fifteen minutes before and at 15 and 30 minutes after a 15-minute footbathing, we measured the epidermal temperature at the hallux and dorsal hand. Heart rate variability (HRV) was also assessed. Results The parasympathetic activity index tended to increase in the warm-water footbathing group 15 minutes after footbathing, although the difference was not statistically significant (p=0.065). No statistically significant differences were observed in sympathetic nerve activity index or heart rate between the two (warm-water and steam) groups. The right dorsal hand skin temperature showed an increasing trend in the warm-water footbathing group at 15 and 30 minutes after the footbath, although the difference was not statistically significant (p=0.093 at 15 min, p=0.065 at 30 min). Notably, the right hallux skin temperature increased significantly more in the warm-water footbathing group 30 minutes after footbathing (p=0.026). Conclusion Warm-water footbathing for healthy young women with CSC increased PNA and peripheral skin temperature more effectively than steam footbathing.

The efficacy of drugs is intrinsically linked to their performance characteristics. For instance, natural plant extracts, being endogenous chemical constituents of plants, exhibit limited bioavailability and biological activity due to their poor water solubility. When utilized independently, maintaining the continuity of drug action poses a challenge, and the precise targeting of action sites is arduous. This is evident in applications such as inducing osteogenesis at orthopedic surgery sites, providing anti-inflammatory treatment for localized wounds, and enhancing healing processes. With advances in material science, numerous researchers have embarked on the exploration of drug carriers. Techniques include employing microspheres for the prolonged release of drugs, utilizing membrane carriers to fabricate drug-infused dressings that aid in wound healing, and creating solid carriers to facilitate bone defect restoration. This article systematically reviews the varieties, materials, methodologies, outcomes, and advancements in the research of drug-loaded microspheres, offering a foundation for future drug carrier studies. However, it does not offer empirical data support for the selection of clinical drug carriers.

We report a case of vertebral artery dissection (VAD) in a patient with postpartum preeclampsia and underscore the contribution of chiropractic assessment in recognizing vascular pathology, facilitating neurovascular imaging, and expediting emergency intervention. A 36-year-old woman with a history of mixed connective tissue disease presented to the emergency department five days postpartum with facial and peripheral edema, recent onset of hypertension, acute severe neck pain, headache, lightheadedness, confusion, and gait instability. Magnetic resonance angiography (MRA) and magnetic resonance venography of the head were performed. Small, unruptured bilateral internal carotid artery aneurysms were visualized. The patient was admitted and treated for postpartum preeclampsia. Upon discharge, she followed up with a neuroendovascular specialist. Although the patient improved with preeclampsia management, concerning neurologic symptoms persisted. The patient later consulted a chiropractor, who suspected VAD. Emergent neck MRA was recommended and performed, confirming VAD 12 days after the initial emergency department visit. The patient was initiated on antithrombotic therapy, with subsequent resolution of symptoms and no evidence of ischemic stroke. This case underscores the importance of maintaining a high index of suspicion for VAD in postpartum patients presenting with new-onset neurological symptoms, particularly in the context of hypertensive disorders of pregnancy and underlying connective tissue disease. It further illustrates the potential role of chiropractic evaluation in the early clinical recognition of vascular pathology, which may facilitate timely diagnosis and intervention, and reduce the risk of stroke.

Cancer remains a leading global cause of morbidity and mortality. While conventional therapies such as chemotherapy and radiation are essential, growing evidence supports the adjunctive use of nutraceuticals-bioactive compounds from natural food sources-with anticancer potential. To synthesize current evidence on the mechanisms, therapeutic roles, and clinical challenges of nutraceuticals in cancer chemotherapy. A narrative review was conducted by searching literature from 2015 to 2024 across PubMed, Scopus, and Web of Science. Studies were included based on relevance to cancer patients, nutraceutical interventions, and reported therapeutic or supportive outcomes. No formal meta-analysis was performed; findings were thematically grouped and summarized. Nutraceuticals such as curcumin, resveratrol, flavonoids, and vitamins D and E exert antioxidant, anti-inflammatory, pro-apoptotic, and immune-modulatory effects. Many demonstrate synergy with chemotherapy, enhancing efficacy and reducing toxicity. Probiotics and omega-3 fatty acids, in particular, show promise in alleviating chemotherapy-induced side effects. However, clinical utility is limited by inconsistent trial results, variable dosing, low bioavailability, and lack of regulatory oversight. Some supplements may interfere with standard therapies or pose safety concerns if used indiscriminately. Nutraceuticals offer promising adjunctive benefits in cancer care, but their integration requires cautious, evidence-based application. Standardized formulations, better clinical trial designs, and regulatory clarity are needed to ensure their safe and effective use in oncology.