Existence Of Side Effects Research Articles

The Goals of Medicine: Debate and Disagreements Around Contraceptive Side Effects.

Since the invention of hormonal contraceptives, there has been disagreement between users and providers about the existence of side effects and their implications for care. The lack of consideration for cisgender women, and other people who may become pregnant, has often been explained by sexist bias in the philosophy of medicine. My goal is to contribute additional elements to this discussion. I will argue that there are structurally embedded assumptions about the responsibilities and goals of medicine that open the door to this sexism in the first place. While we tend to accept that contraception is part of medicine for pragmatic reasons, we do not exhibit the same form of pragmatism when it comes to dealing with side effects. This is an unjustified double standard that fails to recognize the goals of contraception and the fact that it relies on medical expertise to achieve them.

3D hierarchically fractal structure stabilized anode for achieving long-term cycle life of aqueous Zn-ion batteries

The cycling stability of aqueous Zn-ion battery (AZIB) is a serious issue for their successful application, mainly due to the considerable growth of Zn dendrites and the existence of side effects during operation. Herein, the hierarchically three-dimensional (3D) fractal structure of the ZnO/Zn/CuxO@Cu (ZZCC) anode is prepared by a two-step process, where CuxO nanowires are prepared on Cu foam by thermal oxidation method and Zn layer and ZnO surface are formed by plating. This fractal structure increases the electrodynamic surfaces and reduces the local current density, which can regulate Zn plating and inhibit dendritic growth and side effects. Apparently, the symmetric ZZCC-based cell shows a long-term operation time of 3000 h at 1 mA cm−2 with 1 mAh cm−2, and an operation time of more than 1000 h with a discharge depth of 15.94%. Compared with the bare Zn foil anode, the AZIB assembled with the composite of Mn-doped vanadium oxide and reduced graphene oxide cathode and ZZCC anode (MnVO@rGO//ZZCC) exhibits significantly improved cyclability (i.e. with 88.5% capacity retention) and achieves a Coulomb efficiency of 99.4% at 2 A g-1. This hierarchically 3D structure strategy to design anodes with superior cyclic stability contributes to the next generation of secure energy.

The potential of plant extracts containing flavonoids as anti-hyperlipidemia: A literature review

One of the risk factors that cause cardiovascular disease is hyperlipidemia. Hyperlipidemia is a condition of increased plasma fat levels consisting of increased cholesterol, triglycerides and LDL levels and decreased HDL levels. The existence of side effects on the body from antihyperlipidemic drug treatment makes herbal medicine one of the alternatives chosen as a treatment for hyperlipidemic patients. Antihyperlipidemic activity testing was carried out on various herbal plants that contain antioxidants. There are 6 types of plant extracts with activity test results that have potential as antihyperlipidemic. The literature study used a search method on the internet related to the keyword "Plants that contain flavonoid compounds and have the potential as antihyperlipidemic" on the Google Scholar page. Primary data is obtained with sources of research results that have been published in national and international journals. The result of our literature review shows that plants that have flavonoids have the potential for antihyperlipidemic. More investigation is required to determine what kind of plants, dose and side effects can improve the herb plants as a substitute for anti-hyperlipidemia treatment

HEALTH-RELATED QUALITY OF LIFE POST-SINOVAC VACCINE IN COMMUNITIES IN TAMPAN DISTRICT AND MARPOYAN DISTRICT, PEKANBARU CITY

Giving the Sinovac vaccine for Covid 19 can cause several side effects. The existence of side effects that occur, of course, affect their lives, including a decrease in activity, productivity and quality of life. This study aims to determine the HRQoL score in the community after the Sinovac vaccine in Tampan District and Marpoyan District, Pekanbaru City. The research method is analytic observational with a cross-sectional design. The research sample was people who received the first vaccine recorded at the Puskesmas in Tampan District and Marpoyan District, Pekanbaru City, which was selected by purposive sampling technique according to inclusion and exclusion criteria and obtained a sample of 100 respondents. The instrument is a questionnaire EQ5D5L and EQ-VAS. The study results showed that there was little problem with the dimensions of pain (37%) and usual activities (14%), with a score of 0,944 (EQ5D5L) and 0,975 (EQ-VAS). In conclusion, the HRQoL scores on EQ5D5L and EQ-VAS are close to 1, which means close to perfect. This research is expected to be a reference for stakeholders in selecting preventive therapy for Covid 19 and can be used as initial data for cost-utility analysis research.

FORMULATION AND EVALUATION OF ANTI-INFLAMMATORY EMULGEL OF Brucea javanica (L.) Merr SEED EXTRACTS

Anti-inflammatory drugs are needed to overcome excessive inflammatory reactions that can interfere with activities. The existence of side effects in the use of synthetic anti-inflammatory drugs causes the search for natural drugs with high therapeutic effects and low side effects to continue. Seeds of Makassar (Brucea javanica (L.) Merr) plant are known to have anti-inflammatory activity. Topical anti-inflammatory administration is currently being developed because it can minimize side effects compared to oral. This study aimed to formulate 96% ethanol extract of Makasar fruit seeds in the form of an emulgel and to determine the physical properties and anti-inflammatory activity of the emulgel in vitro. Makasar fruit seeds were extracted by sonication method using 96% ethanol solvent (3 x 35 minutes). The extract was then formulated into an emulgel preparation with an extract concentration of 1%. Emulgel was then tested for its physical properties and anti-inflammatory activity in vitro using protein denaturation inhibition method. The results showed that the physical properties of emulgel base (F0), extract emulgel (F1), and Na-diclofenac emulgel (F2) met the requirements for homogeneity, pH, adhesion, spreadability, and viscosity tests. F0, F1, and F2 had inhibition percentages of 3.74±1.58%,; 23.07±0.72%; and 33.49±0.29, respectively. According to one-way ANOVA statistical test, the three tested groups had significant differences.

Anti-tumor necrosis factor alpha therapy (adalimumab) in Rasmussen's encephalitis: An open pilot study.

Rasmussen's encephalitis (RE) is a severe chronic inflammatory brain disease affecting one cerebral hemisphere and leading to drug-resistant epilepsy, progressive neurologic deficit, and unilateral brain atrophy. Hemispherotomy remains the gold standard treatment but causes permanent functional impairment. No standardized medical treatment protocol currently exists for patients prior to indication of hemispherotomy, although some immunotherapies have shown partial efficacy with functional preservation but poor antiseizure effect. Some studies suggest a role for tumor necrosis factor alpha (TNF-α) in RE pathophysiology. We report an open-label study evaluating the efficacy and the safety of anti-TNF-α therapy (adalimumab) in 11 patients with RE. The primary outcome criterion was the decrease of seizure frequency. The secondary outcome criteria were neurologic and cognitive outcomes and existence of side effects. Adalimumab was introduced with a median delay of 31 months after seizure onset (range 1 month to 16 years), and follow-up was for a median period of 18 months (range 9-54 months). There was a significant seizure frequency decrease after adalimumab administration (from a median of 360 to a median of 32 seizures per quarter, p ≤ 0.01). Statistical analysis showed that adalimumab had a significant intrinsic effect (p < 0.005) independent from disease fluctuations. Five patients (45%) were found to have sustained improvement over consecutive quarters in seizure frequency (decrease of 50%) on adalimumab. Three of these five patients also had no further neurocognitive deterioration. Adalimumab was well tolerated. Our study reports efficacy of adalimumab in terms of seizure frequency control. In addition, stabilization of functional decline occurred in three patients. This efficacy might be particularly relevant for atypical slowly progressive forms of RE, in which hemispherotomy is not clearly indicated. Due to our study limitations, further studies are mandatory to confirm these preliminary results.

Antidepressants: use, adherence and awareness among medical students

This study assessed the degree of adherence and drug-related awareness and opinions regarding the importance of guidance with respect to treatment among medical students who use antidepressants. It is a cross-sectional descriptive study, carried out in a public Medical School in the state of Sao Paulo, Brazil. Of the 289 students interviewed, 33 (11.4%) use or had already used antidepressants, with fluoxetine being the most prescribed. The nurse was not cited as being responsible for guidance on the antidepressant. Although most students had received guidance on antidepressants, they did not heed guidance and still had doubts regarding their use. There was a statistically significant association regarding the consumption of other drugs in addition to antidepressants and the existence of side effects, as well as regarding an increase of the dosage without medical consultation and the existence of such side effects. Actions are necessary to acknowledge the importance of the teaching of psychopharmacology in the training of the medical professional and for greater harmony between theory and practice.

Determinants of adherence to antiretroviral therapy (ART) among patients attending public and private health facilities in Nairobi, Kenya

For maximum suppression of the multiplication of the human immunodeficiency virus (HIV) virus and subsequent increase in the CD4 cell count, a level of adherence of 95% and above is required among the patients on Antiretroviral drugs (ARVs). Most patients on antiretroviral therapy (ART) in Nairobi are not achieving the optimum adherence level required to maintain treatment efficacy, hence the risk of drug resistance and increased burden in the public health care system. The aim of this study was to identify the factors that influence adherence to ART among HIV patients attending public and private health facilities in Nairobi, Kenya. A non-interventional cross sectional study using both qualitative and quantitative data collection methods was used. The study was carried out in the Public and Private Health facilities offering ART in Nairobi, Kenya. Four hundred and fifty People living with HIV and acquired immune deficiency syndrome (AIDS) (PLWHA) receiving ARVs in selected public and private health facilities in Nairobi, between June, 2007 to June, 2008 were selected for the study. The composite adherence ART level among patients in Nairobi was found to be 85%. The major factors that were found to constrain adherence were costs, lack of social support, side effects, time to reach the health facility, and adequate knowledge of ARVs. This study found out that majority of the patients on ART in Nairobi are not achieving optimum adherence. The major factors that lead to the sub-optimal adherence are lack of social support, lack of disclosure that one is taking ARVs, poor knowledge of ARVs, associated costs such as transport and extra food requirements and the existence of side effects. Key words: Optimal adherence, high risk sexual behavior, adherence to ART, knowledge about HIV and ART, side-effects, disclosure, treatment costs, discrimination, access to art, service providers.

ОБРАЗОВАНИЕ КАК СЛОЖНАЯ И СОЦИАЛЬНО ЗНАЧИМА СИСТЕМА

Any analogy explains a little, but a lot of things well illustrates. One of the main feature of the development of a complex system is existence of side effects and negative consequences. The development of such a complex and socially relevant system as the education system is, demands special attention. New approaches are necessary in a post-soviet education system. It is obvious that the education system should change, but a well known medical principle “don't do much harm” should be realized during decision-making process on each of levels of the education system. Key words: complex system, education system, management.

Effects of Food and Drug Administration‐approved medications for Alzheimer's disease on clinical progression

AbstractBackgroundObservational studies suggest that cholinesterase inhibitors and/or memantine may delay clinical progression of Alzheimer's disease (AD) in 40% of individuals taking the medications. Given this response and existence of side effects, we sought to quantify medication use and benefits in a population‐based study of incident AD cases.MethodsThe Cache County Dementia Progression Study enrolled and followed a cohort of 327 incident AD cases for a maximum of 9 years. Drug exposure was expressed using a persistency index (PI), calculated as total years of drug use divided by total years of observation. Linear mixed‐effects models examined PI, and interactions with sex and apolipoprotein E (APOE) as predictors of clinical progression on the Mini‐Mental State Examination and Clinical Dementia Rating‐Sum of Boxes.ResultsA total of 69 participants (21.1%) reported having ever used cholinesterase inhibitors or memantine. There was a strong three‐way interaction between PI, sex, and time. Among women, a higher PI (i.e., greater duration of use) of cholinesterase inhibitors was associated with slower progression on the Mini‐Mental State Examination and Clinical Dementia Rating‐Sum of Boxes, particularly among those with an APOE ε4 allele. In contrast, higher PI was associated with faster progression in males.ConclusionA low percentage of individuals with AD in the community are taking cholinesterase inhibitors or memantine. This study suggests that women, particularly those with an APOE ε4 allele, may benefit the most from these medications. With the newly approved increased dose of donepezil, it will be imperative to determine whether a higher dose is needed in men or whether other factors warrant consideration.

Eficacia y tolerancia de la oxcarbacepina en dolor neuropático crónico: estudio de 40 casos

Introduction. Neuropathic pain (NP) often fails to respond to the commonly established analgesic treatment. This fact, together with the existence of side effects, has led to the need to evaluate the analgesic effectiveness of antieptlepttc drugs, which, as in the case of oxcarbawpine (OXC), are a valid alternative. Aims. The aim of this study was to evaluate the effectiveness and safety of OXC in patients suffering from chronic NP Patients and methods. We conducted a prospective, open study involving a series of 40 patients diagnosed with a long history of NP, which was previously resistant to different kinds of treatment with anticonvulsants, non-steroidal anti-inflammatory (NSAI) drugs, opiates and adjuncts. Patients were treated with OXC and they were evaluated in both the basal (prior to treatment) and final visits (after treatment) by means of the visual analogue scale (VAS), SF-McGill questionnaire and the Lattinen test. The patient's general impression of the result was also obtained. The statistical analysis was performed by calculating the 'effect size', by computing Cohen 's d. Results. Treatment with OXC diminishes different symptomatic variations of this pain. but especially so in the case of lancinating discharges (d = 0.87, important effects and burning pain (d = 0.60, moderate-important effect), although the allodynia (d = 0.48, moderate effect) also improved with treatment. In the opinion of the patients themselves, response to treatment was good or very good in 50% of cases. The chief side effects observed were dizziness, drowsiness and abdominal upsets. Conclusions. OXC can be seen as a therapeutic alternative to be taken very much into account in patients with NP having different aetiologies; it has a good benefit-risk ratio and is a form of treatment that is well accepted by patients.

The direct costs to the NHS of discontinuing and switching prescriptions for hypertension.

There is much evidence to suggest that the treatment of hypertension reduces the risk of cardiovascular diseases and that it is cost-effective in most patients. However, the effectiveness of treatment relies on compliance and maintenance of treatment. Each pharmacological agent differs in terms of side effects. The existence of side effects can result in poor compliance and switching between treatments. A number of studies have reported high discontinuation rates for anti-hypertensive therapies. This potentially imposes costs on the health service. The aim of this study is to use the MEDIPLUS data set to consider the cost arising from switching and discontinuation of therapy. The analysis will assess the resource costs in terms of extra GP visits and hospitalisations arising from individuals switching and discontinuing treatments. The total costs of hypertension were estimated to be around 76.5 m pound sterling per annum, of which 26.9 m pound sterling can be attributed to patients who switch or discontinue therapy.

Experiences With Gossypol as a Male Pill

In 1981 to 1983 we performed a clinical study with gossypol involving 152 participants, and in 1983 to 1985 we conducted another study of 120 participants. The first study was aimed at confirming gossypol's antifertility efficacy and determining the existence of side effects. The objective of the latter study was to find out whether the addition of a potassium salt supplement or a potassium-sparing agent could alleviate the side effect of hypokalemia. In both studies, the participants took a gossypol pill, 20 mg/day for 60 to 75 days for loading, and 50 mg/wk for maintenance. All participants were followed up for a year. The antifertility efficacy was found to be more than 90%, and the chief side effect was lowered serum potassium. In our 1983 to 1985 study, we concluded that since neither potassium supplementation nor triamterene solved the problem, it is very likely that gossypol is a nephrotoxic agent. With 1 year of gossypol treatment, serum testosterone and serum luteinizing hormone showed no change, whereas serum follicle-stimulating hormone showed some elevation after 6 months. The Shanghai researchers found that in their gossypol users, plasma and urinary R2 microglobulin levels were elevated to a certain extent. However, 25 subjects in our 1983 to 1985 study showed no appreciable change. Our volunteers had stopped taking gossypol for more than 1 year. In 1986 we started a third study, which was aimed at finding the lowest antifertility dose to minimize possible renal toxicity.