Disability Issues, Aging, and Preventive Measures

As we know, aging is an ongoing biological process from which no human being can escape. Although everyone is familiar with ageing, defining it is not so easy. There is no United Nations standard numerical criterion of old age, but, it is agreed cut off is 60 plus years. Currently, due to the availability and accessibility of effective medication and treatment at specialty hospitals that increase life expectancy of old age people, over the past century, the population, although aged with disabilities, has aged around the world. Recent advances in the field of medicine, public health, technology, and rehabilitation in different streams have reduced the discrepancy in life expectancy for persons with disabilities.

Distnct Schistosoma mansoni-Specific Immunoglobulin Subclasses Are Induced by Different Schistosoma mansoni Stages—A Tool to Decipher Schistosoma mansoni Infection Stages

Despite the existence of an effective medication against schistosomiasis, the disease remains a major health problem in affected areas, especially for those lacking appropriate sanitary facilities. Moreover, treatment cannot prevent re-infection since it is only effective on adult schistosome worms. Previous retrospective studies in the Sudan have discovered unique immuno-epidemiological profiles in uninfected individuals and those positive for Schistosoma mansoni via polymerase chain reaction (PCR) but egg-negative and those with eggs in their stool. Expanding on these data, serum samples from these individuals were further investigated for the presence of cercarial (SmCTF)-specific antibodies, which would indicate immune responses at the early stages of infection. Indeed, SmCTF IgG1, 2, 3 and 4 levels were significantly elevated in SmPCR+ individuals when compared to egg+ patients. Following multivariable regression analysis, including SmCTF-specific Igs, Schistosoma egg antigen (SEA)-specific and Schistosoma worm antigen (SWA)-specific immunoglobulins revealed a specific immunoglobulin (Ig) profile of individuals presenting different states of infection, which may be a useful future tool in order to identify egg− individuals and thereby prevent unnecessary treatments.

Detect Drug Interactions with Metronidazole

Introduction: Metronidazole has been prescribed to treat infections for over a century and continues to be helpful in the therapy of amoebiasis, trichomoniasis, and giardiasis. Metronidazole is a cost-effective medication because of its low price, few adverse effects, and favorable pharmacokinetic and pharmacodynamic properties; nevertheless, it interacts with a wide variety of other medications. Some interactions with other medicines diminish its effectiveness, while others increase it. Aims: The study aims to detect and evaluate metronidazole interactions with other medicines at King Abdulaziz Specialist Hospital. Methodology: This retrospective study encompasses the review of 360 computerized prescriptions inside the outpatient clinic at King Abdulaziz Specialist Hospital in Saudi Arabia between March and September 2020 to detect and evaluate interactions among metronidazole and different medications. Results: Metronidazole interactions are mostly major or moderate. Metronidazole had the most common interactions with domperidone (15.83 %), famotidine (13.89 %), and ciprofloxacin (11.67 %). Metronidazole contains a nitroimidazole ring, which suppresses the metabolism in the liver of numerous medications, including those that may be metabolized by the CYP3A4 and/or CYP450 2C9 isoenzymes. The combination of metronidazole with phenytoin or phenobarbital can cause metronidazole elimination to be accelerated and phenytoin clearance to be reduced. Metronidazole may improve warfarin's anticoagulant effects, leading to a longer prothrombin time and a higher risk of bleeding. Concurrent use of metronidazole with alfuzosin, escitalopram, and ondansetron may raise the risks of QT-interval prolongation and arrhythmias. Conclusion: Most metronidazole drug interactions can be avoided by following excellent clinical care and clinical pharmacology concepts, such as avoiding complex treatment regimens, educating patients. and identifying patient risk factors. Furthermore, before prescribing and dispensing medicines, physicians and pharmacists should utilize drug-drug interactions checkers such as Micromedex and Lexicomp or a book such as Stockley's Drug Interactions.

Use of upadacitinib in the treatment of psoriatic arthritis

Upadacitinib, a selective JAK 1 inhibitor, has been evaluated for efficacy and safety in the treatment of psoriatic arthritis (PsA). Relevant literature using the terms ‘upadacitinib’ and ‘PsA’ were identified via PubMed and Google Scholar. Efficacy of upadacitinib in the treatment of PsA versus placebo was demonstrated in the SELECT-PsA I and II trials. SELECT-PsA1 also showed upadacitinib was noninferior to adalimumab in the treatment of PsA. The most common adverse events in patients treated with upadacitinib were infections, malignancies and thromboembolic events. Upadacitinib is an effective medication that can be used in the treatment of active PsA. Despite its proven efficacy and safety, upadacitinib does not yet have long-term safety data.

Nonfreezing Cold Injury (Trench Foot)

Nonfreezing cold injury (NFCI) is a modern term for trench foot or immersion foot. Moisture is required to produce a NFCI. NFCI seldom, if ever, results in loss of tissue unless there is also pressure necrosis or infection. Much of the published material regarding management of NFCIs has been erroneously borrowed from the literature on warm water immersion injuries. NFCI is a clinical diagnosis. Most patients with NFCI have a history of losing feeling for at least 30 min and having pain or abnormal sensation on rewarming. Limbs with NFCI usually pass through four ‘stages.’ cold exposure, post-exposure (prehyperaemic), hyperaemic, and posthyperaemic. Limbs with NFCI should be cooled gradually and kept cool. Amitriptyline is likely the most effective medication for pain relief. If prolonged exposure to wet, cold conditions cannot be avoided, the most effective measures to prevent NFCI are to stay active, wear adequate clothing, stay well-nourished, and change into dry socks at least daily.

Myostatin and Follistatin—New Kids on the Block in the Diagnosis of Sarcopenia in IBD and Possible Therapeutic Implications

Sarcopenia, which is a decrease in muscle strength and quality of muscle tissue, is a common disorder among patients suffering from inflammatory bowel disease. This particular group of patients often presents with malnutrition and shows low physical activity, which increases the risk of sarcopenia. Another important factor in the development of sarcopenia is an imbalanced ratio of myostatin and follistatin, which may stem from inflammation as well as genetic factors. Currently, research in this area continues, and is aimed at identifying an effective medication for the treatment of this condition. Additionally, we still have no sarcopenia markers that can be used for diagnosis. In this paper, we address the role of myostatin and follistatin as potential markers in the diagnosis of sarcopenia in patients with Crohn’s disease and ulcerative colitis, particularly in view of the genetic and biological aspects. We also present data on new perspectives in the pharmacotherapy of sarcopenia (i.e., myostatin inhibitors and gene therapy). Nevertheless, knowledge is still scarce about the roles of follistatin and myostatin in sarcopenia development among patients suffering from inflammatory bowel disease, which warrants further study.

Biotherapic produced from serum of refractory to Trypanosoma cruzi animal increases survival in mice infected with the protozoan.

Trypanosoma cruzi infection affects approximately eight million people from the Southern United States to Southern Argentina1, with 1.5 million of them in Brazil. The lack of an effective medication for the causative treatment of this infection arouses the interest of many researchers. Considering the data obtained by our team regarding the effects of biotherapic in murine infection with T. cruzi2-7, the relationship of the effects of biotherapic with the biological material used and the species from which this material is collected, the resistance or susceptibility of this species against the pathology to be treated2-7, and the refractoriness of birds8 to T. cruzi, in this study we evaluated the effects of ultradiluted serum of Gallus gallus domesticus on the treatment of mice infected with Trypanosoma cruzi. Methodology: In a blind, controlled and randomized assay, 21 male Swiss mice, eight weeks-old, were allocated into three groups: CI: infected animals without treatment(n=7); Alcohol13cH: infected and treated with alcohol 13cH animals(n=7); Serum13cH: infected and treated with serum of Gallus gallus domesticus 13cH animals(n = 7). The Infected animals were inoculated with 1400 blood trypomastigotes of T. cruzi-Y strain. Medications were prepared from uninfected serum of Gallus gallus domesticus according Brazilian Pharmacopoeia Homeopathy9 and administered two days before infection and on days 2, 5 and 8 after infection. The medication was diluted in the drinking water at concentration of 1% and offered ad libitum overnight. The groups were evaluated regarding survival period up to 161 days (endpoint). The project was submitted to the Ethics Committee CEUA Nº 2401220716 . Results: Data are presented in Figure 1. The animals that received treatment with Gallus gallus domesticus serum 13cH(Serum 13cH) had higher survival rate(p

Medication review, polypharmacy and deprescribing: Results of a pilot scoping exercise in undergraduate and postgraduate education

Background: As part of tackling polypharmacy, effective medication review and safe deprescribing are key to World Health Organisation’s (WHO) 3rd Global Patient Safety Challenge. There is little information about whether this occurs consistently in pharmacy and medicine courses in England. Objective: To create a snapshot of medication review, polypharmacy and deprescribing educational activity in a small number of university courses for medicines, pharmacy and non-medical prescribing. Method: The authors undertook a pilot scoping exercise by emailing colleagues in schools of pharmacy and medicine across England about course inclusion of medication review and deprescribing. 11 universities, describing 17 programmes, responded (eight undergraduate pharmacy, four undergraduate medicine, four postgraduate medicine, one non-medical prescribing course). Data were categorised as: programme content, tools to support deprescribing, learning outcomes, and future intentions for deprescribing teaching. Results: The results suggested variation in what was being taught. Conclusion: In order to address both national and international agenda, the authors suggest that inclusion of training in this area and consistency of curricula are crucial to adequately equipping our future workforce to be fit for purpose.

RECOVERY COMPLICATION IN COVID - 19 SURVIVORSHIP: A NEW CHALLENGE

The growing population of COVID-19 survivors in second wave represents a clear challenge to clinicians and researchers to look beyond the search for a cure and to address the multifaceted needs of those living with and beyond diagnosis. Common complications that disrupt the psychosocial, physical aspects of life and multi systemic complication for adult. COVID-19 survivors after primary treatment include: fatigue, neurological, cardiovascular, hepatic impairment,ocular,dermatological manifestation,Oral manifestation,acute pancreatitis,musculoskeletal,renal and reproductory system complications. Psychosocial interventions,particularly group-based interventions,physical activity programs, continuous monitoring and prompt treatment have shown great promise in improving these outcomes.Future research will identify even bettertargeted, more efficacious, and more cost effective medication and vaccination policy to counter COVID-19 outcomes. Healthcare providers must realize that they serve as vital gatekeepers to services that will help optimize outcomes. Addressing these issues in the post-treatment period represents the new challenge to supportive care.