Objective(s): To assess the influence of the USMLE Step 1 transition on research productivity during the pre-residency period of matched obstetrics and gynecology residents.

Design: Retrospective cohort study comparing research productivity between residents who matched before the Step 1 transitioned from graded to pass/fail (class of 2026) and after it (class of 2028). PubMed-indexed publications were analyzed for count, authorship, specialty…

Gitelman Syndrome (GS) is a rare autosomal recessive renal tubulopathy caused by inactivating mutations in the SLC12A3 gene, characterised by hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. Hyperthyroidism - most commonly Graves’ disease -independently produces hypokalemia through intracellular potassium shift mediated by upregulated Na+-K+-ATPase activity, a phenomenon termed Thyrotoxic Periodic Paralysis (TPP). When these two conditions coexist, the electrolyte…

Cultural learning does not always begin with instruction. For many people, it begins with observation, silence, correction, and lived consequence. This reflective paper develops that premise through my own learning pathway, where Daoism arrived early as a way of noticing how life settles when one interferes less, and Buddhism later became the closest label I could write on school forms to express a similar experiential grounding. Drawing on scholarship on Buddhist Daoist interactions in…

Hand hygiene is one of the most effective methods for preventing healthcare-associated infections and ensuring patient safety in healthcare settings. Despite its importance, many nursing students fail to consistently follow proper hand hygiene practices during clinical training. Poor compliance contributes to the spread of infections among patients, healthcare workers, and communities. Following the COVID-19 pandemic, healthcare institutions worldwide emphasized the urgent need to strengthen…

The lives and deaths of Danny Chan, Leslie Cheung, Michael Jackson, and Whitney Houston unveil a profound lesson: fame comes with a hidden cost, often unseen by fans and the public. This reflective article explores the imbalance between jiwa (Soul) and raga (Outer persona), arguing that the psychological and emotional toll of celebrity life mirrors disrupted ecological systems when the energy output exceeds inner replenishment, eruption becomes inevitable. Drawing metaphors from ecological…

Modern institutions often celebrate titles, ranks, honours, and ceremonial recognition as markers of success. While such symbols may serve administrative and cultural functions, they may also generate emotional distance, hierarchy anxiety, and misplaced attention when detached from meaningful service. This reflective commentary examines the tension between symbolic elevation and practical contribution through ecological metaphors, institutional theory, and systems thinking. Drawing from…

Travel often becomes a mirror that helps us understand ourselves. Landscapes turn into emotional archives, and small encounters with rivers, bridges, and sculptures become quiet teachers that reshape how we see the world. This reflection revisits my academic conference and family trip to Arashiyama, Kyoto in 2019. Four landscapes captured along the journey, namely one of a deep gorge with an emerald river, one of the iconic Katsura River and Togetsukyo Bridge, one of lined tanuki sculptures…

Atopic dermatitis is a chronic, relapsing inflammatory disorder traditionally regarded as a seasonal disease with exacerbations occurring predominantly during colder months. However, clinical observations and emerging evidence indicate that many patients experience disease flares throughout the year, independent of seasonal variation. This persistent disease activity is driven by ongoing skin barrier dysfunction, immune dysregulation, and continuous exposure to non seasonal triggers such as…

Background: Noonan syndrome is an autosomal dominant multisystem disorder characterized by short stature, distinctive facial features, congenital heart defects, and variable developmental delays. While pulmonary valve stenosis is the most common cardiac lesion, Tetralogy of Fallot is rarely reported in Noonan syndrome. To date, there are fewer than 60 documented cases of Noonan syndrome associated with Tetralogy of Fallot in the medical…

Partial Androgen Deficiency in Aging Men (PADAM), also known as andropause, male climate, or late-onset hypogonadism, has been recognized since the 1950s. This article reviews the history, diagnosis, and treatment of PADAM syndrome, with a focus on recent therapeutic approaches, particularly human chorionic gonadotropin (HCG) therapy.

Keywords: PADAM Syndrome; Treatment