https://www.ijtmgh.com/ International Journal of Travel Medicine and Global Health en daily 1 Wed, 01 Jul 2026 00:00:00 +0330 Wed, 01 Jul 2026 00:00:00 +0330 https://www.ijtmgh.com/article_246914.html https://www.ijtmgh.com/article_243283.html The ideal of beauty is undergoing a significant shift. It is shifting from surface-level cosmetic application to a deeper understanding of our individual genetic profile. The beauty industry has worked on a general model, but the emerging field of personalized medicine is poised to revolutionize how we improve our health. https://www.ijtmgh.com/article_243273.html In recent years, the increasing frequency and intensity of natural disasters have highlighted the urgent need for comprehensive public health strategies to protect travelers in affected areas (1). Post-disaster environments often lead to outbreaks of infectious diseases due to compromised infrastructure, contamination of water supplies, and overcrowded conditions in shelters (2). Travelers, who may lack familiarity with local healthcare systems or disease risks, are especially vulnerable in these situations (3). This letter aims to address the critical importance of tailored public health measures to safeguard the health of travelers amidst post-disaster outbreaks and propose strategies for effective management. https://www.ijtmgh.com/article_243275.html Norovirus is a leading cause of acute gastroenteritis globally, contributing to significant morbidity, mortality, and economic losses in both high- and low-income countries. Although historically associated with travelers’ diarrhea, norovirus is now being recognized as a broader global health threat, with outbreaks occurring in a wide range of settings, including hospitals, cruise ships, schools, refugee camps, and communities. Its high infectivity, low infectious dose, and environmental persistence allow for rapid transmission across geographic and socioeconomic boundaries. While migrant and marginalized populations often bear a disproportionate burden due to barriers such as limited access to culturally competent care, fear of stigmatization, and exclusion from surveillance systems. Outbreaks are frequently accompanied by xenophobic narratives, which hinder effective response by fostering mistrust and delaying case reporting. This commentary underscores the need for multilingual public health messaging, migrant-inclusive surveillance, equitable infrastructure investment, and strengthened international cooperation. Reframing norovirus as a global, borderless health concern is essential for building resilient, inclusive systems capable of mitigating future outbreaks. https://www.ijtmgh.com/article_243282.html Diabetic ketoacidosis (DKA) remains a critical emergency with 1–5% mortality and an annual U.S. healthcare burden >2 billion USD. Standard management (insulin, fluids, potassium, bicarbonate) halts ketogenesis but fails to accelerate ketone clearance, address oxidative stress, or replenish depleted cofactors imitations that prolong resolution (12–24 h) and hospital stays (3–4 days). We propose the DKA-Rescue IV infusion, a novel formulation combining Ringer’s lactate, sodium bicarbonate, potassium chloride, glycine, thiamine, and N-acetylcysteine (NAC). Glycine targets ketone burden via the mitochondrial glycine cleavage system, enhancing acetoacetate clearance by 30–40% in metabolic models. Thiamine (pyrophosphate form) activates pyruvate dehydrogenase, reducing lactate accumulation by ~25%, while NAC restores glutathione, lowering oxidative markers by up to 50%. Kinetic modeling predicts accelerated acidosis correction (pH from 6.9 to 7.3 within hours) and faster ketone elimination, potentially shortening recovery to 6–8 hours. Feasibility is supported by low production costs (8–15 USD/L) and physiologic osmolarity (280–310 mOsm/L). This framework redefines DKA as a treatable metabolic network disorder and warrants early-phase clinical trials to validate safety and efficacy. https://www.ijtmgh.com/article_243272.html Chickenpox (varicella) and shingles (herpes zoster) are caused by the varicella-zoster virus (VZV). While chickenpox is typically a childhood disease, shingles occur due to viral reactivation later in life, often causing severe pain and complications. While VZV typically presents with mild symptoms, its high morbidity rate raises important ethical questions regarding vaccination, intentional exposure, and quarantine practices. Method: This study is a narrative review to assess VZV’s ethical considerations. Although the publication date of relevant articles was not an inclusion criterion, an attempt was made to prioritize more recent articles related to the varicella virus, while excluding older, less relevant articles. We analyze these issues through the lens of the four principles of medical ethics: autonomy, beneficence, non-maleficence, and justice.Findings: While respect for parental autonomy in healthcare decisions is crucial, this article argues that it must be balanced against the medical community’s responsibility to prevent harm and promote public health. The ethical implications of intentional exposure to VZV, particularly in the context of existing vaccination, are critically examined. In addition, the challenges of ensuring equitable access to immunization and the affordability of universal vaccination programs within healthcare equity are discussed. Access to herd immunity can also be considered a subset of justice, and this immunity can be achieved through universal vaccination.Results: The article concludes by emphasizing the essential need for a balanced approach that integrates ethical responsibilities with effective public health initiatives to manage VZV and other preventable diseases. https://www.ijtmgh.com/article_243277.html Introduction: One of the main causes of death in the world is cancer. This disease is caused by genetic and epigenetic changes that lead to the unlimited proliferation of cells and eventually lead to tumor formation. The potential anticancer effects of synbiotics, combinations of probiotics and prebiotics, have garnered increasing attention in recent years, transitioning from theoretical frameworks to practical applications in cancer research. Methods: This review explores the mechanisms through which synbiotics may exert protective effects against various types of cancer, focusing on their ability to modulate gut microbiota, enhance immune function, and reduce inflammation. We examine the existing preclinical and clinical studies that support the hypothesis of synbiotics as effective adjunctive therapies in cancer prevention and treatment. Key findings indicate that synbiotics can influence tumor microenvironments, inhibit cancer cell proliferation, and promote apoptosis, thereby offering a multifaceted approach to cancer management. Additionally, we discuss the challenges and limitations in current research, including variability in synbiotic formulations, dosage considerations, and the need for standardized clinical protocols. Results: By synthesizing current evidence and identifying gaps in knowledge, this review aims to provide a comprehensive overview of synbiotics' anticancer potential, highlighting their role in bridging the gap between hypothesis and reality. Conclusion: Future research directions are proposed to further validate the therapeutic applications of synbiotics in oncology, paving the way for innovative dietary interventions in cancer care. https://www.ijtmgh.com/article_243286.html Preterm infants are exposed to multiple risks due to their early arrival in the world, which can have profound effects on their health and development, as well as on the mental health of their families. The NIDCAP program is designed as an observational approach and attention to the specific needs of premature infants, to facilitate the care and maintenance of these infants. This study examines the effects of NIDCAP in reducing stress and anxiety in families of premature infants. This narrative review shows that NIDCAP provides parents with a greater sense of control and comfort by creating a supportive and calm environment for infants and families. Also, the personalized care practices in this program help improve sleep quality and reduce stress in infants. Based on the review of available data, this article concludes that NIDCAP not only helps improve the clinical condition of premature infants, but also reduces the cognitive and emotional burden on families. Overall, NIDCAP can be considered an effective tool in the care of premature infants and increases psychological support for families. This study seeks to emphasize the importance of identifying and implementing such programs in health canters to help improve the quality of life of infants and their families. https://www.ijtmgh.com/article_243276.html Introduction:Nurses are the largest working group in hospitals, and due to numerous responsibilities and24-hour communication with patients, attention to their issues, including happiness and the study of its related factors, and providing practical solutions, is of particular importance.Therefore, the present study aimed to determine the effective components of happiness in nurses.Methods: The current qualitative study used Silva's systematic review approach and phenomenology. The studied population consisted of nurses from Ardabil province.In the phenomenology section, 10 nurses were selected by target sampling based on criteria such as at least 3years of experience, direct experience of working challenges related to happiness and burnout, and a tendency to participate in research.10participants were adequately identified based on the principle of data saturation in qualitative research. Because after this number,no new information was obtained, and the main themes were repeated.Each interview lasted between40 and 90 minutes. Silva and Colaizzi's methods were used to analyze interviews and examine the experience of participants. Results:In the first part of the study,three main themes (theoretical concepts of happiness and job burnout,factors affecting nurses' happiness,and strategies for enhancing happiness and reducing burnout) and15axial codes were extracted as components of happiness. In the second part of the study, one main theme and three axial codes were identified, in which barriers and challenges were extracted.Conclusion:The results showed that various factors,including individual,family,educational, occupational,and financial elements,affect the happiness of nurses.Additionally,by identifying the challenges and obstacles in the nursing profession,we can provide solutions to improve conditions and increase the happiness of nurses. https://www.ijtmgh.com/article_243280.html Objectives: This study was conducted to ensure traveler health and food safety by investigating the effects of key sachet-filling machine parameters on the quality and safety of single-serve instant beverage packaging.Methods: Three main variables were examined under controlled experiments: metallized film thickness (55, 75, and 95 μm), sealing temperature (125, 135, and 145 °C), and filling speed (slow, medium, and fast). Evaluations focused on three critical indicators package distortion, adhesion to the cutter, and seal integrity—to establish optimal conditions that ensure product safety and maintain packaging quality for single-serve use.Results: Increasing metallized film thickness from 55 to 95 μm reduced adhesion to the cutter but led to higher package distortion. Higher sealing temperatures (145 °C) improved adhesion, yet, when combined with higher filling speeds, seal integrity deteriorated. Optimal conditions were identified at 75 μm thickness, 135 °C sealing temperature, and medium filling speed, which minimized distortion and adhesion while ensuring high-quality sealing and safe single-serve packaging.Discussion: These findings emphasize the importance of simultaneous optimization of machine parameters to enhance packaging quality and safety in single-serve instant beverage production. The results provide a reliable basis for designing industrial processes that prioritize product safety, minimize health risks for travelers, and ensure consistent packaging performance https://www.ijtmgh.com/article_243278.html Introduction: Points of Entry (PoEs), such as seaports, are critical for managing the movement of people and goods. Nevertheless, they are also significant vectors for the international spread of infectious diseases. As such, the International Health Regulations (IHR) established by the World Health Organisation are a cornerstone of global public health security, requiring countries to strengthen their preparedness and response capacities at PoEs. However, like many developing countries, Nigeria faces significant disparities in preparedness, leaving it vulnerable to emerging health threats, particularly in the post-COVID-19 era. Therefore, this study assessed the core capacities related to preparedness and response at three key Nigerian maritime PoEs: Lagos Apapa, Rivers, and Delta Port. Method: We employed a descriptive cross-sectional survey using the State Party Annual Reporting (SPAR) questionnaire to evaluate core capacity parameters, including allocated funds, training, equipment availability, inter-agency collaboration, and emergency contingency plans. Results: Findings indicate significant regional disparities, with Lagos Apapa showing relatively better preparedness than Rivers and Delta Ports, which faced considerable challenges in funding, training, and equipment availability. Specifically, Lagos Apapa port reported 75% (functional capacity in funding, while Rivers and Delta ports face minimal functional capacity, particularly in training (15.9% and 9.1%) and equipment availability (19.1% and 16.0%). Conclusion: These findings demonstrate critical gaps in Nigeria's public health infrastructure at PoEs and emphasise the need for targeted interventions to improve core capacities, contributing to ongoing efforts to strengthen public health systems at PoEs in developing nations, in alignment with the IHR. https://www.ijtmgh.com/article_243902.html Irritable bowel syndrome is influenced by several psychological factors that influence individuals' vulnerability. Emotional schemas, which are a set of beliefs about emotions, are considered to be one of these important factors.The aim of this study is to investigate the role of self-compassion as a mediating mechanism in explaining the causal relationships between emotional schemas and the Symptom Severity in patients with irritable bowel syndrome.Materials and MethodsThe method of this study was descriptive-correlational. The statistical population included patients with irritable bowel syndrome who referred to the gastroenterology clinic of Imam Reza Hospital in Mashhad during 2020. A convenience sample of 323 patients was selected. Research tools include Leahy Emotional Schema Scale, Francis et al. IBS Symptom Severity Questionnaire, and Neff Self-Compassion Scale. The data were analyzed by structural equation modeling.Findings: The total path coefficient for maladaptive schemas towards increasing the severity of irritable bowel syndrome symptoms was positive and significant. In contrast, adaptive schemas were related to decreasing the severity of irritable bowel syndrome symptoms. Self-compassion also showed a significant and negative relationship directly with the reduction in the severity of irritable bowel syndrome symptoms. Indirect effects through self-compassion were also significant: maladaptive schemas were negatively related to self-compassion and adaptive schemas were positively related to self-compassion, and finally this mediation was related to the severity of symptoms.ConclusionThe results show that emotional schemas, both directly and indirectly through the mechanism of self-compassion, play an important role in explaining the severity of irritable bowel syndrome symptoms. https://www.ijtmgh.com/article_245342.html Background: Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome (ACS), predominantly affecting young women without traditional cardiovascular risk factors. The postpartum period represents a particularly high-risk phase, during which pregnancy-associated SCAD often manifests with severe clinical features such as left main coronary involvement, ventricular dysfunction, or sudden cardiac arrest.Case Presentation: Twelve days after cesarean delivery, a 39-year-old lady developed acute chest discomfort, loss of consciousness, and cardiac arrest. Electrocardiography showed ST-segment elevation in leads V1–V4 with Q waves in V1–V3 after CPR. Anteroseptal hypokinesia and lowered left ventricular ejection fraction by 25–35% on transthoracic echocardiography. Coronary angiography indicated substantial ostial and proximal left anterior descending artery constriction and mild left main coronary artery involvement, confirming type 2A SCAD. The patient was conservatively treated with dual antiplatelet therapy, beta-blocker, guideline-directed heart failure medication, and vigilant monitoring. Repeat angiography showed near-complete spontaneous coronary dissection repair. The patient was clinically stable and improved left ventricular systolic function over 6 months. The patient was advised to do cardiology follow-up every 6–12 months for evaluation.Conclusion: This case underscores the potential severity of postpartum SCAD while highlighting favorable outcomes with conservative management. Early recognition of SCAD in young postpartum women presenting with ACS is crucial to avoid misdiagnosis and guide appropriate therapy. The patient’s meaningful recovery in cardiac function (EF rising from 25% to 45%) at follow-up supports conservative treatment and follow up strategies in appropriately selected cases. https://www.ijtmgh.com/article_245343.html Background: Hairy cell leukemia (HCL) is a rare indolent B-cell malignancy classically characterized by the presence of the BRAF V600E mutation, which has important diagnostic and therapeutic implications. BRAF V600E–negative HCL is uncommon, often poses diagnostic challenges, and is generally considered less responsive to standard purine nucleoside analog therapy.Case Presentation: We report the case of a 42-year-old man who was incidentally found to have pancytopenia during routine blood donation. Initial evaluations suggested chronic lymphocytic leukemia, and the patient was treated with rituximab, corticosteroids, and subsequently ibrutinib, without clinical or hematologic improvement. Progressive cytopenia and splenomegaly prompted reevaluation. Repeat bone marrow examination and immunophenotyping were consistent with hairy cell leukemia. Molecular analysis for the BRAF V600E mutation was negative. Despite the reported lower sensitivity of BRAF-negative HCL to purine analogs, the patient was treated with cladribine in a 21-day regimen along with appropriate antimicrobial prophylaxis. Following therapy, the patient demonstrated gradual and sustained recovery of blood counts, achieving complete hematologic remission. on 5th month follow-up; the patient’s blood counts were normal and sustained remission was achieved.Conclusion: This case highlights the importance of considering hairy cell leukemia in patients with atypical or treatment-refractory chronic lymphoproliferative disorders. It also demonstrates that selected cases of BRAF V600E–negative HCL may respond favorably to cladribine. Further studies are needed to better define the optimal management strategies for this rare HCL subset. https://www.ijtmgh.com/article_247026.html Gastrointestinal cancers, including those of the esophagus, stomach, and colon, represent a significant global health challenge with high morbidity and mortality rates. Recent research has highlighted the potential role of gut prebiotics in influencing cancer development and progression. This review examines the mechanisms by which prebiotics, non-digestible fibers that promote the growth of beneficial gut bacteria, may contribute to gastrointestinal health and cancer prevention. We explore the impact of prebiotics on gut microbiota composition, immune modulation, and the production of short-chain fatty acids (SCFAs), which have been associated with anti-inflammatory and anticancer properties. Additionally, we discuss emerging evidence from clinical and preclinical studies that suggest a protective effect of prebiotics against gastrointestinal cancers. By synthesizing current findings, this review aims to underscore the importance of dietary interventions utilizing prebiotics as a potential strategy for reducing the risk of gastrointestinal cancers and improving patient outcomes. Future research directions are proposed to further investigate the clinical implications and optimal application of prebiotics in cancer prevention and management. https://www.ijtmgh.com/article_247027.html Introduction: Emerging zoonoses such as Ebola, Lassa fever, and COVID-19 have exposed critical vulnerabilities in Africa’s public health systems, especially at the interface of human, animal, and environmental interactions. Although the One Health approach provides a collaborative framework to tackle these complex challenges, its effectiveness in Africa requires adaptation to local contexts.Methods: This short communication synthesizes recent literature and case examples from Kenya, Uganda, Rwanda, and other African nations to examine the practical implementation of One Health strategies across the continent.Results: Findings highlight persistent barriers, including inadequate funding, fragmented cross-sectoral coordination, and limited engagement of communities. However, successful initiatives demonstrate that integrating traditional knowledge such as local beliefs, practices, and healing systems, and grassroots structures like community-based organizations and informal governance systems, can enhance the reach and relevance of One Health interventions.Conclusion: Building Africa’s resilience to future zoonotic threats requires more than the adoption of global One Health frameworks. It demands a shift toward culturally grounded, community-led strategies that leverage local expertise and social systems. Renewed investment in these context-specific approaches is crucial for sustainable public health outcomes. https://www.ijtmgh.com/article_247028.html This comprehensive review article explores the multifaceted effects of fasting on the physical performance and health capacity of travelers during long-duration journeys. As travel becomes increasingly common, understanding the physiological and psychological implications of fasting is crucial for optimizing health outcomes. The review synthesizes existing literature on the physiological adaptations that occur during fasting, including metabolic shifts, energy utilization, and hydration status. Additionally, it examines the psychological effects, such as mood alterations and cognitive performance, which can significantly impact a traveler's experience. The article further discusses adaptation mechanisms that enable individuals to maintain physical performance while fasting, highlighting strategies for effective fasting practices during extended travel. By providing insights into the interplay between fasting, physical performance, and health capacity, this review aims to inform travelers and health professionals about the potential benefits and challenges associated with fasting in the context of long journeys. https://www.ijtmgh.com/article_247029.html Background: Chronic inflammation drives pathologies such as prediabetes, type 2 diabetes, colorectal cancer (CRC), severe community-acquired pneumonia (CAP), and liver cirrhosis, yet biomarkers like high-sensitivity C-reactive protein (hsCRP) or interleukin-6 (IL-6) may lack specificity for oxidative-inflammatory depth. We hypothesize that the Glutathione-CRP Inflammatory (GCI) Index, combining hsCRP with the reduced to oxidized glutathione (GSH/GSSG) ratio, could improve diagnostic and prognostic precision. Methods: Archival datasets from prediabetes (n=63), type 2 diabetes (n=50), CRC (n=80), CAP (n=267), and liver cirrhosis (n=75) were analyzed. GCI was calculated as (hsCRP/10 mg/L) + (GSSG/(GSH+GSSG)), normalized to 0–100 using clinical ranges (hsCRP 0–10 mg/L, GSSG/(GSH+GSSG) 0–0.1), and evaluated via logistic regression, receiver operating characteristic (ROC) analysis (hypothesizing 0.05–0.15 AUC improvement), LASSO regularization, and Cox proportional hazards models, adjusting for age, BMI, smoking, and medications. Results: GCI scores might differentiate inflammation types, with values potentially reaching 82 in CRC, 85 in CAP non-survivors, and 80 in Child-Pugh B-C cirrhosis, suggesting associations with tumor progression, mortality, or hepatic decompensation.In diabetes, scores could decline from 72 to 58 post-GSH supplementation, indicating therapeutic response. GCI may outperform hsCRP (AUC 0.841 vs. 0.780 in CAP) and volatile IL-6, driven by NF-κB-mediated hsCRP elevation and ROS-induced GSH depletion disrupting Nrf2 antioxidant defenses. Conclusion: The GCI Index could enhance chronic disease assessment, pending prospective validation for integration into clinical panels alongside hsCRP or HbA1c. https://www.ijtmgh.com/article_247030.html Background: Military personnel are expected to maintain optimal health to carry out their duties effectively. Therefore, promoting a health-enhancing lifestyle among military personnel is crucial. This study aims to provide a protocol for designing a tailored intervention to promote a healthy lifestyle among military personnel. Methods: This study will be conducted in several stages, including a qualitative study, a scoping review, the development of a conceptual framework for a health-promoting lifestyle among military personnel, the development and validation of a questionnaire based on the conceptual framework, a cross-sectional study to assess the current status of a health-promoting lifestyle among military personnel and its influencing factors, and the development of the structure and content of a tailored intervention based on the collected data. Conclusion: This study contributes to the body of knowledge on promoting a healthy lifestyle among military personnel. The results of this study have the potential to have a significant impact on military health policies and programs. By providing comprehensive evidence on the factors influencing a health-promoting lifestyle among military personnel, decision-makers and policymakers will be equipped with the knowledge to develop tailored interventions and allocate resources effectively. https://www.ijtmgh.com/article_247031.html Background: Unlike modern, structured approaches such as cognitive-behavioral therapy, narrative therapy lacks fixed, standardized protocols. Instead of following predetermined guidelines, the therapeutic process is shaped through collaboration with the client and guided by the approach's principles, goals, and philosophy. However, for conducting efficacy studies, it is necessary to develop structured protocols that remain aligned with theoretical foundations. The present study aimed to design and describe a six-session narrative therapy protocol for children and adolescents exhibiting symptoms of anxiety and depression.Methods: This study was an intervention development article employing a qualitative developmental approach and was conducted between 2024 and 2025. The design process included a systematic review of the literature, conceptual analysis of the theoretical foundations of narrative therapy, integration of findings into structured therapeutic sessions, and expert review of the protocol content.Results: The final protocol consists of six individual one-hour sessions designed based on narrative therapy maps. The use of these maps provides structure and coherence for research while preserving the authenticity and flexibility of the approach. Moreover, activities such as drawing during the externalization, between-session assignments, and active involvement of parents and significant others contributed to therapeutic goals.Conclusion: Grounded in the principles, goals, and philosophy of narrative therapy, the proposed protocol offers a balanced response to both the scientific requirements of research and the approach's core tenets. It may serve as a theoretical and practical model for designing and implementing future research studies in the field of narrative therapy for children and adolescents. https://www.ijtmgh.com/article_247032.html Background: The Arbaeen pilgrimage is among the world’s largest mass gatherings and is associated with a high burden of respiratory and gastrointestinal infections. Practical, low-cost prophylactic measures suitable for crowded, resource-constrained settings are needed. Oral probiotics and nasal barrier agents may offer a feasible approach.Methods: We conducted a pragmatic, open-label field intervention study across 10 health centers (Mawkibs) in Najaf, along the Najaf–Karbala walking route, and in Karbala during Arbaeen 2023. Healthcare workers aged 16–70 years received carrageenan nasal spray, Streptococcus salivarius lozenges (K12/M18), the combination, or no intervention (control), according to operational feasibility at each site. Self-reported gastro-respiratory symptoms (GIRS: fever, cough, sore throat, runny nose, diarrhea, vomiting) were collected by telephone on day 25 to capture symptoms within the Arbaeen target period. Analyses used Chi-square/Fisher’s exact tests, Kruskal–Wallis, and age- and sex-adjusted logistic regression (two-sided p≤0.05).Results: A total of 222 participants were included and analyzed (control n=106; intervention n=116: lozenge n=19, spray n=60, combination n=37). Mean reported product use was 5.36 days. Compared with control, the combination arm showed lower odds of fever (OR 0.114; 95% CI 0.045–0.291), cough (OR 0.183; 95% CI 0.075–0.446), and sore throat (OR 0.174; 95% CI 0.074–0.406). Diarrhea and vomiting were not significantly different. No serious adverse events were reported.Conclusions: In this real-world setting, combined carrageenan spray and S. salivarius lozenges were associated with lower odds of flu-like symptoms among healthcare workers. Findings are exploratory and should be confirmed in larger placebo-controlled studies.