als

In order to integrate and enhance the health of people, animals, and the environment, a multidisciplinary “One Health” concept has been coined. However, developing countries have frequently lagged in embracing this innovative vision. Pakistan’s ecology, human health, and animal health have all been severely jeopardized due to a lack of resources. Human health is significantly impacted by the spread and comeback of zoonotic illnesses, especially for people who live in rural regions and frequently interact with domestic or wild animals. More than 75% of zoonotic diseases were transmitted contiguously from animals to humans or indirectly through interactions among agents or vectors (including both humans and other animals). This review article gives critical insights into the most common zoonotic diseases found in Pakistan in addition to underlining the importance of the “One Health” philosophy in the management of these illnesses. Interdisciplinary research efforts are required given the current circumstances in order to politicize sustainable solutions for decreasing the disease burden in human and animal populations simultaneously.

Background: Miscarriage is a common gynecological problem and early pregnancy loss occurs in the first trimester. Early pregnancy miscarriage is managed expectantly, surgically, and medically. Medical management is a new treatment option, also surgical evacuation is the standard treatment for some types and presentations of miscarriage. Medical management might be more suitable instead of surgical evacuation, it may be less costly than surgical treatment and consequently, due to its lower complications, most patients prefer it.Purpose: This study aimed to determine women's perception of medical treatment versus surgical intervention, complications associated with surgical procedures, and medical treatment.Methodology: It was a comparative, hospital-based study conducted in Bashair Teaching Hospital, on 336 patients diagnosed with miscarriage in the first trimester, 168(group A) were treated medically while 168(group B) were treated surgically. All participating patients in the study fulfilled the selection criteria, that is, the provision of an informed consent and agreement to participate in the study. Results: The total number of women during the period of study was 336. The study found that 239(71%) of women prefer medical management compared to 97 (29%) preferring surgery. The complications associated with the medical treatment were (4.2%) infection, (0.6%) bleeding, and (95.2%) without obvious complications. The complications associated with surgical procedures were (7.7%) developmental infection, (16.1%) bleeding, (10.7%) incomplete evacuation, (1.8%) uterine perforation, and (63.7%) without obvious complications.Conclusion: The study found that over two-thirds of patients Favor medical treatment over surgical procedures. It has also revealed that medical treatment is very effective in terminating pregnancies within the first trimester.

Background: The recruitment of experienced clinical nurses into vacant faculty positions is a global strategy for preparing, employing, and retaining competent nurse educators. As clinical nurses transition to academia, many struggle with unique challenges that affect their adaptation to the academic setting. Thus, understanding novice nurse educators’ transitional challenges is critical to addressing this threat. Aim: This study aimed to explore the challenges of novice nurse educators’ transition from clinical practice to academia in Ghana. Methods: A descriptive qualitative study design was employed for this study. A purposive sampling technique was used to recruit 12 novice nurse educators from three health training institutions in the Upper East Region of Ghana. A semi-structured interview guide was used to collect data through in-depth individual interviews. The interviews were audio-recorded, transcribed verbatim, and thematically analyzed.Results: Four themes emerged: poor administrative support, poor preparation, increased workload and stress, and role ambiguity. Novice nurse educators lacked formal orientation, formal mentorship, formal education in teaching, and post-graduate education. Novices were also challenged by increased workload and role ambiguity. Conclusion: Supporting novice nurse educators' transition from clinical practice would be better served by college administrators’ creation and implementation of formal orientation and mentorship programs.

Graft Versus Host Disease (GVHD) is a major limitation to the success of allogeneic Hematopoietic Stem Cell Transplantation (HSCT) as Steroid-Refractory (SR) acute GVHD carries poor prognosis due to the absence of an efficacious second-line therapy. Mesenchymal Stem Cells (MSCs) which have immunosuppressive, immunomodulatory, and regenerative properties may become a highly effective therapeutic modality for SR-GVHD in the near future. MSCs have already been approved to treat childhood SR-GVHD in Japan, and they have been conditionally licensed in New Zealand and Canada. It is expected that MSCs will be approved for the treatment of SR-GVHD in adults in Europe, North America, and other parts of the world within a few years. Utilization of the recently introduced techniques including the use of MSC products such as exosomes and Extracellular Vesicles (ECVs) instead of the parent MSCs, robotic manufacturing technology, and genetic engineering of MSCs will ultimately overcome the remaining obstacles facing the widespread utilization of MSCs and their products as therapeutics not only in HSCT but also in other medical fields. The aim of this review is to provide an update on the remarkable progress achieved in the use of MSCs and their products in the field of HSCT.

Mesenchymal Stem Cells (MSCs) have antimicrobial, anti-inflammatory, immunomodulatory, and regenerative potentials. Additionally, utilization of MSCs in the clinical arena has been shown to be safe and well tolerated. Hence, this form of cellular therapy has gained particular attention in the treatment of several infectious disorders and their complications. MSCs have been successfully used in the treatment of the following infections and their complications: bacterial infections including complicated sepsis; viral infections including Human Immunodeficiency Virus (HIV), hepatitis B and C viruses, and Coronavirus disease (COVID-19) complicated by acute respiratory distress syndrome; parasitic infections including schistosomiasis, malaria, and Chagas disease; and mycobacterial infections including tuberculosis. The use of MSCs derived from certain sources and Extracellular Vesicles (ECVs) derived from MSCs has improved their efficacy and reduced their side effects. However, the clinical application of MSCs in the treatment of several infectious diseases still faces real challenges that need to be resolved. The current status of MSCs and the controversies related to their utilization in various infections will be thoroughly discussed in this review. 

Patients with heart failure may live longer if they receive chronic treatment with beta-adrenergic blocking medications. Unresolved are the mechanisms underlying the beneficial effects and if they may be applied to ischemic heart failure. Rats (n = 28) underwent echocardiographic-Doppler exams one and six weeks following a simulated operation or myocardial infarction (MI). After the first echocardiography, rats were randomized to either no therapy or 500 mg/l of propranolol in their drinking water. The noninfected left ventricular (LV) papillary muscles were used to record isometric contractions and intracellular Ca transients simultaneously.Untreated MI rats had a restrictive LV diastolic filling pattern, decreased systolic function (13% ± 2%), and significant LV dilatation (10.6 ± 0.4 mm vs. 8.9 ± 0.3 mm, MI vs. control). The LV chamber diameters of the propranolol-treated MI rats were 10.6 ± 0.5 mm, and systolic performance (13% ± 2%). Higher LV end-diastolic pressures (27 ± 2 mmHg vs. 20 ± 3 mmHg) and a more constrained LV diastolic filling pattern (increased ratio of early to late filling velocities and faster E wave deceleration rate) were seen in the propranolol-treated animals. Papillary muscle contractility in untreated MI rats was lower (1.6 ± 0.3 g mm²). Furthermore, the inotropic response to isoproterenol was attenuated, and Ca transients were extended. During isoproterenol stimulation, beta-adrenergic blocking administration had no effect on force development (1.6 ± 0.3 g mm²) or the length of Ca transients.Rats with postinfarction heart failure receiving chronic propranolol treatment did not have improvements in systolic function or LV remodeling. Propranolol exacerbated LV diastolic pressures and filling patterns. Additionally, there was no discernible improvement in intracellular contractility following treatment, Calcium control, or beta-adrenergic sensitivity in the myocardium that is not infarcted).

Aim: Kidney stone disease, which can affect people of all ages and whose incidence increases day by day, is becoming a public health problem due to treatment costs. This study aims to determine how factors related to kidney stones affect the diagnosis of the disease when taken together, rather than determining their relationship with the disease one by one.Materials and methods: An open-access dataset containing kidney stone status and associated factors was used in the study. Mann Whitney U test and independent sample t-test were used in data analysis. Logistic regression was performed with the backward variable selection method to determine the factors associated with kidney stones. ROC analysis was used to determine the power of the variables that were significant as a result of logistic regression analysis, individually and together, in discriminating kidney stones.Results: According to the results of logistic regression analysis, gravity, cond, and urea calc variables were found to be associated with kidney stones. With ROC analysis, it can be said that urea, calc, and gravity variables with AUC values above 0.60 can distinguish kidney stones. When the combinations of these variables are examined, the AUC values of the binary combinations are between 0.734 and 0.759, while the AUC value obtained for the triple combination is 0.831.Conclusion: According to the results obtained from the article, it can be said that while the factors associated with the disease and used in the diagnosis have little effect on the diagnosis of the disease alone based on the AUC values obtained from the ROC analysis, it can be said that considering them together increases the accuracy in diagnosis. Therefore, considering the factors thought to be associated with the disease together may be more appropriate in diagnosis and may give more accurate results.

Naturalistic enclosures have become a popular exhibition technique for zoos, and reptiles and amphibians are regularly housed in these exhibits. While a considerable sum of research indicates that visitors prefer naturalistic exhibits, there are fewer studies documenting the behaviour and welfare of animals housed under these conditions. This study investigated the impact of a naturalistic enclosure on the behaviour of the turquoise dwarf gecko (Lygodactylus williamsi), and the welfare perceptions of visitors. When kept under naturalistic enclosures, dwarf geckos were seen to bask (p = 0.022), and engage in inactive behaviours (p = 0.001) significantly less frequently. A non-significant decrease was also seen in locomotion | (p = 0.074). While time spent hidden remains a confounding factor for behavioural analysis, the study indicates that when provided with hiding opportunities, L. williamsi may spend a considerable amount of time hidden from the public. Questionnaire analysis revealed that 84.6% of individuals believed that naturalistic enclosures demonstrated better welfare. Additionally, individuals who had previously owned a reptile were more likely to identify that areas to hide, enrich, and mimic the natural environment were important aspects of enclosure design. While the actual benefits of naturalistic enclosure design cannot be fully addressed by this study, this work suggests that visitors tend to inherently believe that naturalistic enclosures facilitate better welfare, even if they are not aware of the natural environment of the species being housed. This requires keepers to consider both aspects of functionality and enclosure relevance when designing exhibits for herptiles.

Introduction: Adolescents and young adults often engage in oral sex. However, the factors affecting the development of agreeing with oral sex are not clear enough.Objective: We aimed to assess the degree of agreement with oral sex among high school students and to search for background factors affecting this.Material and method: We conducted a quantitative cross-sectional study among 157 females and 38 male high school students over the age of eighteen by using an anonymous, paper-based, multiple-choice, self-administered questionnaire. For statistical analysis, we used descriptive statistics, two-sample t-tests, and Spearman rank correlation. Results: Of the respondents 67.9% were sexually active and 31.6% of them had more than one sexual partner. Of males 97.1% and of females 84.9% agreed with accepting oral sex. Degree of agreement with oral sex was higher in those who had had partnered sexual experience, and in those females who more frequently met close friends outside of school. Most participants were not in a current relationship with a partner, and for those who were, its duration did not affect the degree of accepting oral sex. The degree of agreement with the proficiency in male sexuality, and the degree of agreement with those dimensions of sexuality that most expressed the sexual drive and the desire to gratify it with the partner showed the strongest positive correlation with the degree of agreement with oral sex. In addition, the degree of agreement with the items of expressing sexual openness showed correlations with the degree of accepting oral sex. Conclusion: The degree of agreement with oral sex is high among high school students. Among the factors influencing this, the intensity of meeting friends seems to be important. We therefore recommend that the schools improve sex education in groups, highlighting the risks of oral sex, to reach the target individuals and their friends as well as their potential partners.

Background: Faba bean (Vicia faba L.) is one of the most important grain legume crops in Egypt and many other countries of the world because the seeds offer a low-cost source of protein, lysine, carbohydrates, minerals, and vitamins. Chocolate spot disease is a stress-related fungal disease produced by Botrytis fabae that causes plant damage, limits photosynthetic activity, and reduces yield. Results: Trichoderma atroviride greatly reduced mycelial growth by 90.00% in vitro, followed by T. harzianum (86.67%) and T. album (83.89%) on average. In vivo, all studied antagonists dramatically reduced Botrytis fabae disease incidence and severity in both seasons 2021/22 and 2022/23. T. atroviride showed the highest efficacy bioagent (73.55 and 85.15%), followed by T. harzianum (72.55 and 81.22%), in controlling B. fabae of faba bean plants in both seasons. In addition, the results also showed that all tested biological treatments had an impact on yield components and increased levels of chlorophyll, protein%, phenols, flavonoids, Peroxidase (PO), polyphenol Oxidase (PPO), chitinase, and -1, 3-glucanase activities compared to control treatment in both seasons. In this regard, spraying T. atroviride showed the highest efficacy as a bioagent, followed by T. harzianum. Contrary, T. hamatum showed the lowest efficacy compared to other treatments in both seasons. Conclusion: This investigation was carried out to determine the effectiveness of several different antagonists, i.e., T. album, T. atrovirde, T. hamatum, and T. harzianum (30 x 106 spore/ml), Blight Stop, and Bio Zeid, for controlling Botrytis fabae on bean plants and evaluating their effect on yield parameters, components, and quality.

Background: Changes in lung structures persist in stable Chronic Obstructive Pulmonary Disease (COPD), but their correlation with the clinical picture remains unclear. The purpose of this study was to assess the stable COPD picture via the relationship between exhaled breath condensate (EBC) particle concentration and the Saint George Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and six-minute walking test (6 MWT). Methods: 12 stable COPD and 12 healthy subjects participated in the study. The EBC was collected with Rtube and analyzed using the Accusizer FxNano. Particle concentration was measured and correlated with the findings of the tools used to assess the health status and functional profile of COPD. The results’ analysis was performed with the Spearman’s test and the Mann-Whitney U - test.Results: The COPD group presented a worse picture of health status and functional profile compared to the healthy group. Correlations were observed between components of the SGRQ and CAT. The two groups presented similar levels of EBC particle concentrations, but the number of small particles was higher in COPD subjects. A correlation of the EBC particle concentration with the activity and total score of the SGRQ was only observed in the healthy group. Conclusion: The total particle number was similar in the COPD and healthy groups. A few correlations between the EBC particles and tools used were also observed. The use of EBC particle concentration to monitor COPD status cannot be claimed with confidence because of the small sample size. Further research is necessary, particularly in large-scale groups.

In this review, latex from the Hevea Brasiliensis tree is presented as a material originating from nature, used to produce natural rubber, raw material for countless products for industry, as well as the manufacture of preservatives, and gloves, among others. Nowadays, its potential is expanding into various technological areas, one of which is biomedical, as described in this article. Latex has the possibility of being preserved using ammonium, which is a chemical of high health risk, but nowadays it is being substituted by acid systems excluding traditional chemicals. With these new preservation processes, the prospective use of latex for the design of biosensor scaffolds for drug release, and as membranes that can replace synthetic latex in patches for bioremediation in soft and bone tissues, synthetic muscles, membranes for biological micro laboratories, among others, is being studied to optimize its possibilities.

According to statistical data in Poland, sexual acts of minors account for about 3% of all criminal acts committed by minors and nearly 20% of all acts from the catalogue of crimes against sexual freedom and morality. The main objective of the study was to attempt to develop and present characteristics of minors who commit rape with particular cruelty. Taking into account the way the perpetrators act, the motivational background, and the circumstances of the crime. In particular, attention was paid to specific individual and family characteristics. Because it is not clear whether juvenile sex offenders are different from non-sex offenders. The aim of this article is an attempt to capture individual, family, and environmental differences. The study was also intended to provide information about who the victims are. The study was conducted on the basis of empirical material from court cases in which the basis of liability was Article 197§4 of the Penal Code, and the perpetrators or accomplices of the acts were minors who at the time of the act were over 15 years of age but under 17 years of age. The research material consisted of court case files that had been finally completed, including forensic psychological opinions prepared by court experts. Cases from 2015-2020 were analysed. The obtained results allowed us to capture some specific features of families in which minors were brought up and the characteristics of juvenile sex offenders themselves. This article raises the difficult issue of juvenile responsibility for sexual crimes and indicates areas in which it is necessary to regulate interactions and areas of possible preventive impacts.

Intraovarian injection of autologous Platelet Lysate (PL) can be considered a potential therapeutic strategy for ovarian function rejuvenation. Especially, in women diagnosed with Poor Ovarian Response (POR) or Primary Ovarian Insufficiency (POI), the exogenous administration of the autologous platelet-derived growth factors, influence positively the regulation of the serum Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), and Anti-Mullerian Hormone (AMH) and Estradiol (E2). Therefore, the evaluation of the serum levels of the aforementioned hormones was performed on 10 participants with a mean age of 43 ± 4 years diagnosed with POR or POI, who received intraovarian PL injection monotherapy. The monitoring of the serum hormone levels was performed for 3 months. The results of this study clearly showed that all participants were characterized by elevated levels of FSH and LH and reduced levels of E2 and AMH, prior to the PL injection. However, the levels of all hormones started to change after the 1st month of follow-up monitoring. Moreover, 40% of the participants conceived successfully either by natural way or after in vitro Fertilization (IVF). Considering these, the intraovarian injection of autologous PL exhibited promising evidence regarding the altering of hormone levels at physiological values. Moreover, the contained PL growth factors were implicated in angiogenesis promotion and also in toleration of the inflammatory microenvironment, regulating positively ovarian function. In conclusion, the intraovarian autologous PL injection is considered a safe, effective, and tolerable therapeutic strategy in women with POR or POI. Moreover, the results of this study were very encouraging, especially for the women with infertility issues, who want their genetic offspring.

This study delves into the forensic examination of textile fibers for identification through the application of the X-ray diffraction (XRD) technique. With the textile industry producing an array of materials, both natural and man-made fibers, the need to distinguish between them for forensic purposes becomes paramount. The primary objective of this research is to identify unique characteristics in fiber samples, differentiating between branded and non-branded company textiles. The focus is placed on fresh, unused cloth fibers obtained directly from shops. The study encompasses two broad categories of fibers: natural (such as cotton, silk, and wool) and man-made (including nylon, rayon, and polyester). Samples from both branded and non-branded textiles undergo analysis using XRD, a sophisticated method capable of revealing the crystallographic structure of materials. Results obtained from the XRD analysis unveil intensity peaks at various levels and degrees, providing distinctive patterns for individualization. Even within the same fiber category, such as polyester and cotton, discernible differences in intensity peaks facilitate the identification process. This research contributes to the advancement of forensic techniques by offering a reliable means of identifying textile fibers. The utilization of XRD not only allows for the differentiation between natural and man-made fibers but also enables discrimination among textiles produced by different companies. The implications of this study extend to forensic investigations, where the ability to precisely identify fibers can provide valuable evidence in criminal cases involving textiles.

A very unusual, interesting, and challenging case of a 24-year-old female who was born with three openings in the neck. The patient had chronic abdominal gaseous distention, recurrent abdominal pain, and constipation since early infancy. The patient presented in emergency with acute painful red, hot, and tender swelling in the left upper cervical area. Laboratory studies showed high inflammatory markers and a provisional diagnosis of abscess with a sinus was made. The patient underwent an emergency incision and drainage. Sinus recurred and a sinogram showed it to be a residual cyst in the left submandibular salivary gland. The total cyst excision was attempted with resultant recurrence and grade IV facial nerve palsy. Post-operatively recurrent infections caused by Methicillin-resistant Staphylococcus aureus (MRSA) required several courses of oral and intravenous broad-spectrum antibiotics with several hospital admissions with no resolution in sight. Subsequent ultrasound and magnetic resonance imaging showed a residual infected cyst, cutaneous sinus, and a fistula opening in the left ear canal. A diagnosis of branchial cyst type II of the first brachial cleft remnant with a fistula was established with bilateral branchial fistulas of the second branchial remnants and the associated colorectal hypoganglionosis based on radiological studies. The patient refused any further operative interventions. Therefore, the option of conservative treatment of hypoganglionosis with holobiotics consisting of prebiotics, probiotics and postbiotics, laxatives, dietary changes, lifestyle modifications, and dietary supplements started. All antibiotics were stopped. These therapies resulted in the resolution of residual first branchial remnants and recurrent MRSA infections with the improvement in the facial nerve palsy from grade V to grade III-IV together with an excellent cosmetic and functional result. The patient is doing well at follow-ups being infection-free for 18 months and repeat contrast-enhanced computed tomogram (CECT) has shown complete resolution of the residual cyst, sinus, and fistula with fibrosis.

Bronchiolitis is one of the most common respiratory infections in children under 2 years of age predominantly caused by Respiratory syncytial virus and other viruses like influenza, Para influenza, and Adenovirus. Rhinovirus, etc. Most children have mild symptoms however bronchiolitis has also been well linked to severe morbidities and mortalities. Even though bronchiolitis has been well recognized for many years, there are still very few therapeutic strategies available beyond supportive management. There are many controversies about therapeutic management in bronchiolitis published in standard guidelines and research in this area. Management can be divided into pharmacological and supportive therapy. Evidence suggests that the current management of bronchiolitis is purely supportive consisting of oxygen supplementation, frequent suctioning, and maintaining good hydration and nutrition. Regarding pharmacological therapy, neither bronchodilators nor corticosteroids have significant efficacy in the treatment of bronchiolitis. However, some studies suggest that adrenaline and nebulizer 3% saline showed some benefit only in terms of outcome. The current recommendation also supports the use of Palivizumab as prophylaxis in certain groups of infants and young children.

Background: Wernicke encephalopathy is an acute neurological condition defined by a clinical triad of ophthalmoplegia, ataxia, and confusion. This disease is due to thiamine deficiency.Case presentation: After persistent diarrhea and vomiting, a 15-year-old boy presented up-beating nystagmus, with binocular vertical diplopia and unstable gait. An etiological workup revealed a celiac disease. Magnetic resonance imaging showed bilateral periaqueductal region lesions. Treatment and discussion: Because of suspected Wernicke’s encephalopathy, the patient was treated with thiamine replacement and significant improvement of symptoms took place. Wernicke encephalopathy is a serious medical disorder with enormous morbidity and mortality. Evaluation should include patient history with a physical and ophthalmologic examination and laboratory workup with appropriate imaging.Conclusion: Undiagnosed celiac disease can lead to malabsorption of vitamin B1 causing acute symptoms of Wernicke encephalopathy.

Introduction: In Sudan, Grewia tenax fruits, are known commonly as Goddaim. The fruit’s pericarp is used traditionally for a long time as a juice or a porridge to treat iron deficiency anemia (IDA). Traditional Goddaim users have a very strong belief in its effectiveness. However, the pattern of hemoglobin improvement follows an initial fast increase followed by a decline upon continuing its use. Some previous studies have attributed its effect to high iron content, while the iron quantity was too small. This work attempts to find an explanation for its mechanism of action by screening the fruit extract and its respective fractions for secondary metabolites, minerals, vitamins, and fibre. Methods: Entailed three methodologies: Chemical analysis to identify quantified minerals, ascorbic acid and non-digestible fibers, Phytochemical Analysis to separate and identify secondary metabolites using high-performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS-MS technique), and estimation of radical scavenging activities of crude fruit extract and its respective chloroform and ethyl acetate fractions by inhibition of the 2,2-diphenylpicrylhydrazyl (DPPH).Results: Ascorbic acid and indigestible fibres were revealed in the aqueous extract. Secondary metabolites were flavonoids (e.g., quercetin, kaempferol), organic acids (e.g., ferulic acid, chlorogenic acid), β-carboline alkaloids (e.g., 3-hydroxy-tetrahydroharman) identified in the chloroform, and ethyl acetate fractions. The in vitro antioxidant activity of G. tenax fruit extract was confirmed spectrophotometrically. Conclusion: It can be concluded that the initial enhancement of iron absorption through ascorbic acid and fibres, followed by iron uptake inhibition, could be explained by iron chelation by the chelators in the fruits. This paradoxical effect may qualify G. tenax fruits as a safety gauge for improving haemoglobin levels without compromising iron excess once iron stores are filled by keeping the oxidative stress in check. This may present G. tenax fruits as a good and safe remedy that optimizes the treatment of IDA.

Background: Clinician managers can play a crucial role in healthcare organizations, including hospitals, by combining their clinical expertise with managerial responsibilities. They bring valuable insights and firsthand experience of patient care to managerial positions, contributing to improved patient outcomes and hospital performance. However, they face unique challenges that require careful attention and solutions. Aim: This review aims to critically discuss the role of clinicians as managers, the challenges that they face, and how they exercise their influence in hospital settings. Key findings: The role of clinicians as managers is critical for effective leadership and delivery of high-quality patient care. Described as a two-way window, clinician managers bridge the gap between medicine and management by combining clinical expertise with managerial skills in a hybrid leadership approach. Studies have shown a positive impact on hospital performance, including enhanced quality care, improved patient outcomes, and potentially better financial performance. In addition, they play a vital role in fostering interdisciplinary collaboration and boosting staff engagement. However, challenges such as identity conflicts, and limited formal training, are present, especially for first-time managers. Conclusion: Adapting to the dual role of clinician and manager demands a mindset shift and the development of new skills, necessitating strategic support. This includes leadership education, organizational support, mentoring, and collaborative models to empower clinician managers. Targeted training programs, formal mentoring, and peer support networks equip them with essential skills, while workload management, well-being initiatives, and a culture of balance foster success and growth.