Music and Medicine 

You might have heard of the term music therapy but do you know what it is? Do you know how it works and who it treats?

History of Music Therapy

Music therapy is as old as the old writings of Aristotle and Plato. It is a therapeutic technique used to provide support and care to people who have been injured or ill, as well as assist them with their emotional and communication needs. The first mention of music therapy appeared in an unsigned piece in 1789 in a Columbian magazine with an article entitled “Music Physically Considered”. More than 60 years after that, the Nordoff-Robbins approach to music therapy came to prominence. It was officially introduced in the 1950s and 1960s by Paul Nordoff and Clive Robbins. This approach stated that everyone is sensitive to music and has the ability to use it for personal growth. 


Music therapy can be used to help people of all ages communicate. Some illnesses that can be addressed through music therapy include post-traumatic stress disorder (PTSD), learning impairments, autism spectrum disorders, and neurological disabilities. Music establishes people’s relationship with the world through engagement with a music therapist. Music lets patients express themselves by allowing them to develop their own musical language.

Patients normally have one-on-one music therapy sessions, but can also request group sessions if they’d like. These sessions begin with a discussion of the patient’s life goals, as well as their expectations for the course’s result. Then songs from various genres will be performed; some will be instrumental only, while others will include lyrics. They can even range from being uplifting to depressing. Some patients are even instructed to write their own songs, with the goal of allowing them to express themselves via music. For example, if their song has dissonances or has loud and quick beats, it may indicate that the patient is angry. This allows patients who are unable to talk to express their feelings rather than suppressing them and suffering alone. The music therapist will then play songs that are the opposite of how the patient is feeling, in this case, soft beats and pleasant sounds. The patients may be instructed to sway, sing, or dance to the music. Although there are no set locations for therapy, it is crucial to ensure that the environment is welcoming and private, as, in more public areas, the patient may be embarrassed and hesitant to speak up. 

There are various types of music therapy. As stated in the introduction, some patients use the Nordoff-Robbins technique, a technique where it is thought that everyone is sensitive to music. Analytical music therapy is another type of music therapy. It allows patients to improvise and express themselves by singing or playing an instrument to convey their deepest thoughts, which are then analysed by a therapist. Benenzon music therapy seeks to match the patient’s sentiments to the closest melodic song, while vocal psychotherapy aims to connect the patient with themselves through singing. The Bonny Method of Guided Imaging and Music (GIM) is an intriguing sort of music therapy which allows patients to listen to classical music while being guided to imagination. This helps patients express their emotions, recall prior memories, and predict future scenarios based on what they expect to experience and how they feel at the time. In addition, cognitive behavioural music therapy (CBMT) combines music with cognitive behavioural therapy (CBT). The goal of cognitive behavioural therapy is to improve depression and anxiety symptoms by improving some behaviours and changing others. These are not the only types of music therapy that can aid patients. There are many more that can help them before, during, and after their recovery.


Some people believe that music therapy is exclusively beneficial to patients with mental illnesses; however, this is not the case. Alzheimer’s disease, traumatic brain injury (TBI), and schizophrenia are just a few of the conditions that music therapy may help with. It can also aid in the recovery from an accident, as well as issues associated with childbirth. Music therapy can assist youngsters in establishing their individuality and ambitions and help them improve their communication skills with others.

With the help of the British Association for Music Therapy (BAMT), which was founded in 2011, music therapy is starting to gain popularity in the United Kingdom. The organization’s goal is to get more individuals involved in music therapy by providing courses and events for professionals. Furthermore, a music therapist is considered a healthcare practitioner and someone who can collaborate with other healthcare experts as part of a multidisciplinary team (MDT). Music can always be viewed as a form of therapy, and some doctors may send you to a music therapist following treatment in order to help you avoid post-traumatic stress disorder (PTSD). Apart from that, Levitin noted in his book, This Is Your Brain on Music that “We’ve found compelling evidence that musical interventions can play a health-care role in settings ranging from operating rooms to family clinics”. This demonstrates how music can have an impact on everyone, including healthcare workers, by reducing stress. Furthermore, it is important to listen to music, especially in certain situations, such as the  Covid-19 outbreak. Listening to music eliminates stress and allows for a cheerful attitude. Second, it is proven that immunoglobulin, a natural killer cell that strengthens the immune system, can be produced more effectively by playing and listening to music.

Music therapy is commonly employed in religious studies all over the world. Sacred music therapy, for example, is used in North India. Indians consider diseases to be spiritual rather than microbiological. As a result, ailments are linked to demons, and they are treated by village healers who specialise in anything related to spirits. These village healers attempted to employ “sound cures” on human minds and physiology.

Finally, Music therapy, which helps improve sleep quality is beneficial to everyone regardless of whether they are sick, and should be widely encouraged.  It aids in the development of both physical and psychological states, and also lowers heart rate, blood pressure and breathing rate.

Mary Ho Yan Mak, Youth Medical Journal 2022

Health and Disease

Poxes and Vaccinations

This article discusses vaccinations through the lens of poxes, namely the small poxes that inspired Edward Jenner and the rapidly rising cases of monkey pox around the world.

What are poxes?

Poxes have a large double-strand DNA genome and an oval shape. Animals are the major carriers of the virus, and they also cause it. Poxes come in a variety of forms depending on which animal the virus originated in, and direct contact with these animals can spread the disease to humans. Close human contact can spread the infection through clothing, bed sheets, and other items. Chickenpox, smallpox, and monkeypox are some of the most prevalent poxes. Chickenpox comes from chickens, monkeypox comes from monkeys, and smallpox is caused by the variola virus (WHO). General symptomsof pox viruses are normal fever symptoms but with small red spots developed on skin, causing blisters and scabs. People with poxes normally recover themselves in a month. Smallpox hasn’t been seen since 1977, but monkeypox is a new virus that has lately spread, and both of these poxes will be explored in this study.

Development and Vaccination of Small Pox

Smallpox is an ancient virus that was first discovered in Egypt’s mummies 3000 years ago, and it was also detected in China during the Han Dynasty. After that, the virus spreads to neighbouring nations like Korea and Japan before reaching Europe. There is no evidence that smallpox can be transferred by animals or insects; it can only be spread by people. The main smallpox outbreak in the United States happens in Boston, Massachusetts, in 1721. (NCEZID, 2021). This pandemic resulted in almost 6000 cases of smallpox, with 850 people dying out of a population of 11000. This outbreak, however, resulted in significant advancement in the vaccination of poxes such as smallpox and monkey poxes (Matthew Niederhuber, 2014). Smallpox is caused by the variola virus, as seen in the diagram below.

Fig 1. Structure of Variola Virus

(Leicester University, Department of Microbiology & Immunology)

The pandemic was eventually brought under control by a free mass vaccination campaign developed by Edward Jenner, an English physician. In 1976, he found that milkmaids who worked in close proximity to cows were typically immune to the smallpox outbreak. This enables a more thorough analysis of the two, and it was discovered that the milkmaids had been exposed to cowpox and are immune to smallpox. He then brought the cowpox sample and had it injected into the armpit of his gardener’s son. The 9-year-old youngster did not develop smallpox, which was also noted. Following multiple tests, the shot was acknowledged as a smallpox vaccine by the general population. The World Health Organization (WHO) began promoting a plan to eradicate smallpox in 1959. The concept was initially underfunded and did not succeed. In 1967, however, countries had progressed in laboratory technology and were able to mass-produce smallpox vaccines. From 1967 to 1977, vaccine programmes became popular in several countries, and evidence of smallpox extinction appeared all across the world, one by one, from North America to Africa. In 1975, a Bangladesh woman was diagnosed with smallpox and was quarantined until all symptoms were gone. This demonstrates that mass vaccination can have a significant positive impact on health emergencies by bolstering a large population’s defence system.

Development and Vaccination of Monkey Pox

Monkeypox is a zoonotic illness caused by the monkeypox virus, which is transmitted from monkeys to humans. It was first discovered in the Democratic Republic of the Congo in 1958 (NHS, 2022), just as smallpox was becoming more manageable. Only Central Africa and the United States had similar monkeypox outbreaks before 2003, which were blamed on African immigrants. Since 2018, there have been fewer than three cases of monkeypox worldwide each year, but a cluster of cases was detected in different places of the world in 2022, potentially resulting in a monkeypox outbreak. The pattern of monkeypox transmission globally and data on monkey pox cases reported in Central Africa are depicted in Figures 2 and 3. This demonstrates that monkey pox was virtually unknown prior to 1980, and that cases increased dramatically after 2000.

                  Fig. 2                                                                                 Fig. 3

Distrubution of monkeypox globally                          Monkeypox cases in Central Africa trend

        (Statista, 2022)                                                    (Your Local Epidemiologist, 2022)

Monkeypox virus and variola virus are belong to the Poxiviridae family, the structure of the monkeypox virus is identical to that of the variola virus that causes small pox, as seen in figure 4 below (Medscape, 2020). The fundamental distinction in symptoms is that monkey pox causes lymph node enlargement, but the variola virus does not. They both grow red patches on the skin’s surface, which later turn into blisters.

Fig. 4 Structure of Monkeypox Virus 

(Vitrosens Biotechnology, 2022)

Monkeypox is difficult to pass between humans, however it can be carried through close contact via bedding and clothing like transmission of variola virus, as well as sexual contact. According to the WHO, 780 instances of monkeypox have been reported in countries where the virus is not common (BBC, 2022). Some people who have monkey pox have not recently travelled to affected areas, indicating that the disease is already spreading through direct contact between people. The United Kingdom has the highest number of instances of monkey pox. ‘Although the number of verified cases is not alarming, an outbreak might occur if the disease continues to spread internationally,’ according to the WHO. The majority of those infected with monkey pox in the UK (111 out of 183 confirmed cases) are young men in London, particularly gay men who have had sexual contact with other men. However, gay men are not the only ones who are at risk.

Monkeypox is not a life-threatening disease, and most people recover within a month. Vaccinations against monkey pox are available, however, to prevent the virus from spreading. People who have had small pox or had a small pox vaccination are immune to monkey pox since they both belong to the Poxiviridae virus family. Since small pox vaccines are no longer accessible, new vaccines to protect against monkey pox has been available since 2019.

Vaccination in General

Many aspects must be examined when determining whether vaccination is mandatory and enforced in a country, including the patient’s health, religion, and vaccine availability in the country. As a medical professional, offer should be made for patients to respect autonomy and the freedom to select whatever they want for their bodies, but it is also the responsibility to tell patients about the benefits and limitations of vaccinations, which must be accomplished through mass education and government backing. As a result, several countries’ immunisation programmes and inventions have failed. When it comes to COVID-19 immunisation, one of the main reasons for the virus’s global spread is that the virus is brand new, and it takes a long time for vaccines to be developed and for the public to trust science. This demonstrates the need of medical professionals collaborating with the government to avoid the spread of outbreaks, such as the rising cases of monkey pox virus, before things get out of hand. In general, poxes, particularly monkey poxes, are not particularly contagious if personal hygiene and public knowledge on the virus are improved, and it may disappear like small pox if the public is properly informed about the virus and willing to obtain immunizations against it.

1 zoonotic disease: disease that spreads from animals to humans


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Biomedical Research Health and Disease

Medicinal Cannabis


Cannabis, also known as weed, is a type of marijuana. Cannabis sativa, Cannabis indica, and Cannabis ruderalis are three plants in this category that exhibit mood-altering and hallucinogenic properties (Kayser, 2017). People use cannabis for relaxing purposes; yet, several countries have enacted legislation making cannabis illegal since it is deemed a narcotic. In the United States, however, marijuana is legalised for medical and economic reasons, such as treating chronic diseases and increasing work prospects. The significance of cannabis to current health care will be discussed in this article, as well as whether or not cannabis should be legalised globally


There are many misconceptions about CBD and THC. They both impact mood, but THC’s effects are more severe than CBD’s since THC gets you high. They share the same chemical formula, as indicated in the image below, therefore they are isomers, but the atom configurations differ. THC is prohibited in many places throughout the world because it generates a high, whereas CBD is utilised by healthcare professionals to treat anxiety, depression, and other conditions.

Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two main psychotropic substances found in cannabis products, as illustrated below:

(Atakan, 2012)

These drugs have a negative impact on the neurological system. As these molecules have a structure that is quite similar to another brain chemical, some receptors in the nervous system may mistake them for other regular brain chemicals. They bind to cannabinoid receptors on neurons, which are part of the endocannabinoid system (“How does marijuana work,” 2020), which employs cannabinoid neurotransmitters to send and receive messages. Overall, they have an effect on the hippocampus of the brain, affecting the person’s ability to build new memories and control their emotions, as well as their ability to learn and accomplish activities. It also affects the cerebellum and basal ganglia, which are parts of the brain that control gesture, balance, and posture (“How does marijuana,” 2020). As a result, cannabis users will appear to have a slower response.


Shen Nung, the inventor of Chinese medicine, first recorded cannabis in his pharmacopoeia in around 500 BC. Cannabis was first cultivated in Central Asia or the west of China. Cannabis has also been documented in Indian, Assyrian, Greek, and Roman literature. Cannabis was described in this literature as having the ability to treat depression, asthma, and pain. 

CBD had then been introduced to the western world, offering medical benefits such as mood enhancers and the prevention of convulsions in children. In a 1936 film, it was discovered that CBD is a highly addictive chemical that causes mental disease and violence. Marijuana has recently gained widespread acceptance as a treatment for patients suffering from mental illnesses, and CBD has been approved for medical usage in most parts of the world (“History of cannabis”). While studying in India in the 1930s, an Irish doctor named Sir Willian Brooke O’Shaughnessy discovered that cannabis can help with stomach pain. Then, people started to notice the effects of THC, which is the psychoactive ingredient in cannabis, which led to a lot of debate on CBD. 

Medicinal Uses

As previously mentioned, CBD has pain-relieving and antipsychotic properties. It also has the ability to alleviate cancer symptoms, protect nerve cells, and aid the heart.

In terms of pain relief, CBD inhibits the activation of endocannabinoid receptors, blocking them from accepting endocannabinoids and so preventing the regulation of sleep, appetite, pain, and the immune system. Some of these painkillers operate best when combined with THC, the psychoactive ingredient in marijuana. CBD was studied to see if it could help with the symptoms of fibromyalgia, a disorder that causes widespread discomfort. The study looked at 2701 people with fibromyalgia and found that using CBD helped them feel better (Kubala, 2021).

CBD oil can also aid with anxiety, insomnia, and PTSD in terms of mental health. They assist the body to metabolise serotonin by targeting 5-HT1A, a serotonin receptor, so that serotonin levels rise and a person’s mood is lifted (Leasca, 2019). CBD can lessen anxiety during a test, according to a study involving 57 males who consumed CBD 90 minutes before the test (Leasca, 2019).

CBD oil has been demonstrated in certain studies to shrink cancer tumour size and improve heart failure symptoms, but current trials are not well-designed and the data is insufficient. A woman in the United Kingdom was diagnosed with a 41mm tumour, but she refused chemotherapy and radiotherapy. Regular CT scans every 3-6 months revealed that the tumour was diminishing, and she confessed that she had been taking CBD oil (“Daily usage of Cannabidiol,” 2021). In another study, nine healthy males were given 600mg of CBD oil before participating in a stress test that raised blood pressure. It was discovered that these males had a lower increase in blood pressure, implying that CBD can help to lower blood pressure (Kubala, 2021).

Criticism Around the World

Medicinal cannabis is generally accepted in many nations throughout the world, including the United Kingdom, New Zealand, Poland, and others. Canada, the United States (certain states), and South Africa are among the countries that have legalised recreational marijuana, while others, such as China, Japan, and Indonesia, still consider it illegal. 

Cannabis is regarded as less hazardous than strong amounts of alcohol, and countries that make it legal strengthen control over crime and the cannabis trade while also allowing cannabis to be more widely accessible for medicinal uses. Companies must have a licence to sell cannabis in the United States, and it is also taxed in states that have legalised it, such as Washington, which has a 37 per cent excise tax on those sales.

Cannabis is now classified as a Class C narcotic in nations that have legalised it, such as in the United Kingdom, so that maximum punishments for supply can be reduced and policy can be focused on more serious offences. Medicinal cannabis, on the other hand, has been demonstrated to provide medical benefits, such as pain relief, as previously indicated. As a result, private doctors in the United Kingdom who are registered with the General Medical Council are permitted to prescribe medical cannabis if other treatments have failed.

Some countries have legalised cannabis to make it easier for authorities to assess and control the substance; nonetheless, this could lead to issues such as widespread usage of the drug and harmful repercussions such as violence and mental illness. In general, medicinal cannabis is beneficial in the treatment of patients and the alleviation of pain. If it is carefully handled, it will be helpful to society.

Mary Ho Yan Mak, Youth Medical Journal 2022


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Biomedical Research Commentary

A Man Who Received a Heart Transplant from a Pig

Giving organs to someone who needs them is known as organ transplantation. The concept of organ transplantation was initially proposed in the 1900s, and the first cornea transplant was performed in the Czech Republic, with the patient regaining his sight. Joseph Murray performed the first kidney transplant in the United States in 1954, and the same approach is still used today, benefiting many patients. In 1963, Dr. Thomas Starzl performed the first kidney transplant in the world, but the patient died soon after. Dr. Starzl began a series of studies into drugs in order to help patients who had a transplant live a longer life. In 1965, an organ donated by a deceased individual happened in the United Kingdom. Dr. Christaian Banard of South Africa performed the world’s first heart transplant. Although the patient died as a result of the procedure, it demonstrated that transplantation is possible. The first successful kidney transplant occurred in 1967, following multiple investigations. In the 1980s, countries all over the world began to establish donor cards and organizations to administer transplants in order to ensure the safety and reliability of organs supplied by donors.

Transplant occurs when a collection of cells from one person are removed and transplanted into another person or another area of the same person’s body. When people receive a transplant, the recipient’s immune system may reject it because it recognises it as foreign
tissue. Immunosuppressive medicine may be required after the transplant to prevent rejection. Transplants of hearts, lungs, and livers, to name a few, are now possible thanks to current technology, but standard tests and checkups between the donor and recipient are
required, such as blood groups, tissue kinds, infection, and general health.

Dr Richard Lower’s attempt to transfer blood from animals to humans in 1665 was initially rejected because it resulted in many deaths. However, according to BBC News, “Man gets genetically-modified pig heart in a world-first transplant.” Bartley P Griffith, a surgeon at the
University of Maryland School of Medicine, performed this 7-hour surgery to transplant a genetically modified pig heart into David Bennett, a 57-year-old patient with terminal heart disease. Bennett would die if the surgery was not performed, so this was his last resort.

David Bennett was convicted of the stabbing in 1988. Mr. Bennett was sentenced to ten years in prison for stabbing Edward Shumaker in 1988. The public has argued that Mr. Bennett is unworthy of a heart transplant because of his history and that he does not deserve attention despite being the first man in the world to receive a transplant from other animals. Doctors, on the other hand, believe that a person’s history should not be used to determine the level of care he receives because doctors must adhere to the four pillars of
medical ethics: do no harm, justice, autonomy, and non-maleficence.
On January 31, 2022, medical professionals from the University of Maryland School of Medicine (UMSOM) and the Maryland Medical Centre (UMMC) performed the surgery. Dr. Mohiuddin, the scientific director, and Dr. Griffith, the clinical director, monitored the surgery.

Dr. Mohiuddin is a *xenotransplantation expert, and he co-founded the Cardiac Xenotransplantation Program with Dr. Griffith in 2017. Dr. Mohiuddin spent over 30 years proving that pig hearts can function normally in humans through peer review, and the last 5 years modifying the surgical process used in transplantation surgery. UMSOM received $15.7 million USD in funding for the research. The pig heart has been genetically modified: there are genes in pig hearts that may cause human rejection; these genes have been removed. In addition, six genes that aid in the acceptance of a pig heart by humans were inserted into the genome. Another gene that promotes the growth of pig heart tissues was also removed.

The doctors at the medical school determined that Mr. Bennett is not a candidate for a human transplant; this decision is usually made when the patient’s health is at its worst. This is due to Mr. Bennett’s irregular heartbeat, which resulted in the mechanical heart pump being banned and him receiving a human transplant because he did not follow doctors’ orders. The solution of using a genetically modified pig heart was first approved by the United States Food and Drug Administration (FDA), as genetically modified pig hearts are
only used for medical experiment purposes. Although the FDA rejected Dr. Mohiuddin’s trial experiment a few years ago, they approved this surgery that lasted for 7 hours because it was the last option to save the patient’s life. This surgery was successful, and Mr. Bennett’s heart function is still normal. He did, however, need to be watched. First, consider the heart’s performance, such as irregular heartbeats, swelling, and so on. Second, his immunology response, such as how his immune system reacts to the new genetically modified pig heart, and whether or not rejection occurs. Mr. Bennett will also need to take anti-rejection medication.

The public, on the other hand, has criticised the surgery as unethical and dangerous. Animal rights, religion, and medical implications were some of the ethical issues raised by this performance. For starters, the People for the Ethical Treatment of Animals (PETA) ruled that
genetically modifying an animal’s organ to make it act like a human organ is unethical. Furthermore, the pig heart was removed in the morning on the surgery day, prompting some to argue that animals have the right to life as well. In terms of religion, some people in
certain regions may refuse to accept an animal’s organ being transplanted into a human body; for example, Muslims and Jews do not consume pigs, though there are exceptions if it saves someone’s life. In terms of medical implications, the four pillars of medical ethics
should be considered: beneficence, non-maleficence, autonomy, and justice. Patients should be given adequate information about the procedure, as well as the potential risks and outcomes of the surgery.

According to the Health Resources and Services Administration of the United States (HRSA), 106,671 men, women, and children are currently waiting for an organ transplant, and 17 people die each day while waiting for an organ transplant. If Mr. Bennett recovers
successfully from the surgery, it will demonstrate that transplants from animals can also work in humans, resolving one of the current medical problems of limited organs for transplantation. However, ethical issues should be addressed first by increasing public awareness and education. If the problem is resolved, it will result in a significant
improvement to current healthcare systems around the world, as well as providing a higher quality and more efficient healthcare for its people.

*Xenotransplantation: transporting animal organs to human

Mary Mak, Youth Medical Journal 2022


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